Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer

SMARC4 is the catalytic subunit of the SWI/SNF chromatin remodeling complex and is one of the most common altered chromatin remodeling ATPases in cancer. Studies have indicated that SMARCA4 loss is associated with highly aggressive tumors, independently predicting shorter overall and disease-specifi...

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Main Authors: Yanqing Pan, Lingxin Yan, Shaoxi Wang, Huiling Li, Quanfang Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1530142/full
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author Yanqing Pan
Lingxin Yan
Shaoxi Wang
Huiling Li
Quanfang Chen
author_facet Yanqing Pan
Lingxin Yan
Shaoxi Wang
Huiling Li
Quanfang Chen
author_sort Yanqing Pan
collection DOAJ
description SMARC4 is the catalytic subunit of the SWI/SNF chromatin remodeling complex and is one of the most common altered chromatin remodeling ATPases in cancer. Studies have indicated that SMARCA4 loss is associated with highly aggressive tumors, independently predicting shorter overall and disease-specific survival. SMARCA4-deficient non-small cell lung cancer (NSCLC) primarily affects male individuals, especially smokers, and is characterized by large, aggressive tumors. Cases of SMARCA4 deletion combined with actionable driver gene mutations (e.g., ALK) are rarely reported. In this report, we describe a male non-smoker diagnosed with SMARCA4-deficient, EML4-ALK non-small cell lung cancer who has been undergoing ensartinib targeted therapy for 3 months, resulting in a significant partial response. We also propose that, from a signaling perspective, the presence of SMARCA4 deficiency may influence the sensitivity of EML4-ALK NSCLC to targeted therapy, highlighting the need for further investigation into the underlying mechanisms and the exploration of novel therapeutic approaches.
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series Frontiers in Oncology
spelling doaj-art-8be2af2b366a497f945fec949b5138872025-08-20T03:48:57ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15301421530142Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancerYanqing Pan0Lingxin Yan1Shaoxi Wang2Huiling Li3Quanfang Chen4Department of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaSMARC4 is the catalytic subunit of the SWI/SNF chromatin remodeling complex and is one of the most common altered chromatin remodeling ATPases in cancer. Studies have indicated that SMARCA4 loss is associated with highly aggressive tumors, independently predicting shorter overall and disease-specific survival. SMARCA4-deficient non-small cell lung cancer (NSCLC) primarily affects male individuals, especially smokers, and is characterized by large, aggressive tumors. Cases of SMARCA4 deletion combined with actionable driver gene mutations (e.g., ALK) are rarely reported. In this report, we describe a male non-smoker diagnosed with SMARCA4-deficient, EML4-ALK non-small cell lung cancer who has been undergoing ensartinib targeted therapy for 3 months, resulting in a significant partial response. We also propose that, from a signaling perspective, the presence of SMARCA4 deficiency may influence the sensitivity of EML4-ALK NSCLC to targeted therapy, highlighting the need for further investigation into the underlying mechanisms and the exploration of novel therapeutic approaches.https://www.frontiersin.org/articles/10.3389/fonc.2025.1530142/fullcase reportensartinibSMARCA4-deficientEML4-ALKnon-small cell lung cancer
spellingShingle Yanqing Pan
Lingxin Yan
Shaoxi Wang
Huiling Li
Quanfang Chen
Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
Frontiers in Oncology
case report
ensartinib
SMARCA4-deficient
EML4-ALK
non-small cell lung cancer
title Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
title_full Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
title_fullStr Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
title_full_unstemmed Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
title_short Case Report: Ensartinib as a first-line treatment for SMARCA4-deficient and EML4-ALK non-small cell lung cancer
title_sort case report ensartinib as a first line treatment for smarca4 deficient and eml4 alk non small cell lung cancer
topic case report
ensartinib
SMARCA4-deficient
EML4-ALK
non-small cell lung cancer
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1530142/full
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