AUTHOR=Shu Yun , Wang Zhouyu , Shang Hongjuan , Le Wei , Lei Yan , Huang Longzhang , Tao Liming , Chen Jun , Li Jing 

TITLE=Case Report: Response to crizotinib treatment in a patient with advanced non-small cell lung cancer with LDLR-ROS1 fusion

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1169876

DOI=10.3389/fonc.2023.1169876

ISSN=2234-943X

ABSTRACT=<p>C-ros oncogene 1 (<italic>ROS1</italic>) fusion is a pathogenic driver gene in non-small cell lung cancer (NSCLC). Currently, clinical guidelines from the National Comprehensive Cancer Network (NCCN) have recommended molecular pathologic tests for patients with NSCLC, including the detection of the <italic>ROS1</italic> gene. Crizotinib is a small molecule tyrosine kinase inhibitor of anaplastic lymphoma kinase (<italic>ALK</italic>), <italic>ROS1</italic>, and mesenchymal-epithelial transition (<italic>MET</italic>). In recent years, the efficacy of crizotinib in NSCLC patients with <italic>ROS1</italic> fusion has been reported. Here, a 77-year-old woman was diagnosed with stage IVA lung adenocarcinoma harboring a novel low-density lipoprotein receptor (<italic>LDLR</italic>)<italic>-ROS1</italic> fusion variant. This novel <italic>LDLR-ROS1</italic> fusion was identified by targeted DNA next-generation sequencing (NGS) panel and then verified by RNA fusion panel based on amplicon sequencing. This patient benefited from subsequent crizotinib therapy and achieved progression-free survival of 15 months without significant toxic symptoms. Our case report recommended a promising targeted therapeutic option for patients with metastatic NSCLC with <italic>LDLR-ROS1</italic> fusion and highlighted the importance of genetic testing for accurate treatment.</p>