AUTHOR=Hu Haoyue , Tan Songtao , Xie Meng , Guo Peng , Yu Qiang , Xiao Juan , Zhao Kangrui , Liao Qiong , Wang Yi 

TITLE=Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer

JOURNAL=Frontiers in Pharmacology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1167959

DOI=10.3389/fphar.2023.1167959

ISSN=1663-9812

ABSTRACT=<p>In non-small cell lung cancer (NSCLC), two key genetic alterations, epidermal growth factor receptor (<italic>EGFR</italic>) mutations and anaplastic lymphoma kinase (<italic>ALK</italic>) rearrangements, are commonly believed to be mutually exclusive. Studies have reported that concurrent <italic>EGFR/ALK</italic> co-mutation in non-small cell lung cancer patients is rare, with a prevalence ranging from 0.1% to 1.6%. However, the clinical and pathological characteristics of these patients are not well-defined, and the optimal treatment approach for such cases remains controversial. In this report, we present a case of stage IV lung adenocarcinoma with both epidermal growth factor receptor and anaplastic lymphoma kinase mutations, along with high PD-L1 expression. The patient initially received treatment with epidermal growth factor receptor tyrosine kinase inhibitors (TKIs), but the disease progressed. However, following a switch to <italic>ALK</italic>-TKI therapy and local radiotherapy, the lesion showed regression. Our report also provides a comprehensive summary of the clinical and pathological features, as well as treatment strategies, for non-small cell lung cancer patients with concurrent epidermal growth factor receptor mutation and anaplastic lymphoma kinase rearrangement.</p>