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CASE REPORT article

Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1474997
This article is part of the Research Topic Advances in the Management of Lung Cancer: From the Bench to the Bedside and Back View all 12 articles

Ensartinib as a neoadjuvant therapy for stage IIIA non-small cell lung cancer patients with EML4-ALK fusion: a case report and literature review

Provisionally accepted
Hao Zhang Hao Zhang Wei Xia Wei Xia Yifan Zhang Yifan Zhang Shihao Bao Shihao Bao Zeng Jingtong Zeng Jingtong Xianjie Li Xianjie Li Bo Zhang Bo Zhang Hanqing Wang Hanqing Wang Song Xu Song Xu Zuoqing Song Zuoqing Song *
  • Tianjin Medical University General Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    Anaplastic lymphoma kinase (ALK) inhibitors have shown efficacy in treating ALK-positive advanced non-small cell lung cancer (NSCLC) patients. However, the effectiveness of ensartinib neoadjuvant therapy remains ambiguous. Herein, we reported that preoperative systemic treatment with the ALK inhibitor ensartinib can be beneficial for treating initially inoperable tumors. In this study, we present a case of a 60-year-old female patient who was diagnosed with stage IIIA (cT2aN2aM0, ninth TNM stage) lower left lung adenocarcinoma harboring an EML4-ALK fusion. After three months of therapy, the neoadjuvant treatment with ensartinib provided a partial response, with significant tumor and lymph node shrinkage. Preoperative ensartinib neoadjuvant therapy for NSCLC is safe and effective. Nevertheless, clinical trials can be conducted in the future to validate our results. Moreover, we performed multiple immunofluorescence staining analyses on samples before and after neoadjuvant therapy, observed and compared the changes in the expression of relevant immune cells (CD8+ T cells, macrophages, PD-1, and PD-L1), and performed a simple analysis.

    Keywords: ensartinib, EML4-ALK fusion, Neoadjuvant, Non-small cell lung cancer, immune microenvironment

    Received: 02 Aug 2024; Accepted: 28 Jan 2025.

    Copyright: © 2025 Zhang, Xia, Zhang, Bao, Jingtong, Li, Zhang, Wang, Xu and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zuoqing Song, Tianjin Medical University General Hospital, Tianjin, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.