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=13

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=<p>Non-small cell lung cancers (NSCLCs) with anaplastic lymphoma kinase (ALK)-rearrangement have favorable responses to ALK inhibitors. However, <italic>ALK</italic> fusion mutations harbored approximately 90 distinct fusion partners. Patients with different <italic>ALK</italic> fusions might respond distinctly to different-generation ALK inhibitors. In this case report, we identified a novel non-reciprocal <italic>ALK</italic> fusion, <italic>ALK-C2orf91</italic>(intergenic) (A19: intergenic) and <italic>PPFIA1</italic>-<italic>ALK</italic> (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 <italic>ALK</italic> fusion partners in <italic>ALK</italic>-positive NSCLC, and we reported a new <italic>ALK</italic> fusion, <italic>PPFIA1</italic>-<italic>ALK</italic> and <italic>ALK</italic>-<italic>C2orf91</italic>(intergenic), and its sensitivity to alectinib firstly in lung cancer. We believe that this case report has an important clinical reference.</p>