AUTHOR=Yan Lingxin , Zheng Jiayu , Pan Qingyun , Liang Yuxian , Yu Pengli , Chen Quanfang 

TITLE=Novel PPFIA1-ALK, ALK-C2orf91(intergenic) double-fusion responded well to alectinib in an advanced lung adenocarcinoma patient: a case report

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1264820

DOI=10.3389/fonc.2023.1264820

ISSN=2234-943X

ABSTRACT=Anaplastic lymphoma kinase (ALK)-rearrangement non-small cell lung cancers (NSCLCs) have favorable response to ALK inhibitors. However, ALK fusion mutations harbored approximately 90 distinct fusion partners. Patients with different ALK fusions might respond distinctly to different-generation ALK inhibitors. In this case report, we identified a novel non-reciprocal ALK fusion: ALK-C2orf91(intergenic) (A19: intergenic) and PPFIA1-ALK (P2: A20) by next-generation DNA sequencing in an advanced lung adenocarcinoma patient. After 2 months of alectinib, the targeted lung lesion regressed significantly and evaluation of therapeutic efficiency indicated partial response. To date, the patient had achieved 12 months of progression-free survival from alectinib treatment. Our study extended the spectrum of ALK fusion partners in ALKpositive NSCLC, and we reported a new ALK fusion: PPFIA1-ALK and ALK-C2orf91(intergenic) and its sensitivity to alectinib firstly in lung cancer. We believe that this case report has an important clinical reference.