阿法替尼治疗一例ALK突变阳性肺鳞癌患者疗效分析
Analysis of the Efficacy of Afat-inib in the Treatment of ALK-Positive Squamous Cell Carcinoma
DOI: 10.12677/ACRPO.2022.111001, PDF,    国家自然科学基金支持
作者: 李 伟:山东大学附属省立医院肿瘤中心放疗科,山东 济南
关键词: 肺鳞癌ALK突变阿法替尼 Lung Squamous Cell Carcinoma ALK Mutation Afatinib
摘要: 探讨针对ALK突变阳性肺鳞癌患者的肿瘤靶向治疗,提高对其诊治水平。报道一例ALK突变阳性肺鳞癌及其靶向治疗,同时对国内外报道的相关文献进行复习。患者,男,54岁,因“干咳伴发热1月余”入院。经气管镜活检诊断为肺鳞状细胞癌,基因检测(NGS)示EML4-ALK基因融合。行阿来替尼靶向联合化疗治疗2周期,后单药阿来替尼靶向治疗6周,复查CT显示病情进展。猜测可能含有ALK重排的肺鳞癌对阿来替尼的反应较低,但肺鳞癌中ALK基因融合非常罕见,针对ALK基因突变阳性肺鳞癌患者的ALK-TKI治疗效果尚需进一步的研究证实。
Abstract: To explore the tumor targeted therapy for patients with ALK mutation positive lung squamous cell carcinoma and to improve the level of diagnosis and treatment. This paper reports a case of ALK mutation positive lung squamous cell carcinoma and its targeted therapy, and reviews the relevant literature at home and abroad. The patient, male, 54 years old, suffered from “dry cough with fever for more than 1 month” be hospitalized. Lung squamous cell carcinoma was diagnosed by tracheoscopic biopsy. Gene detection (NGS) showed EML4-ALK gene fusion. The patients were treated with targeted combination chemotherapy of afatinib for 2 cycles, followed by targeted treatment of single drug afatinib for 6 weeks, and the CT reexamination showed the progress of the disease. It is speculated that lung squamous cell carcinoma with ALK rearrangement may have a low response to afatinib. But ALK gene fusion in lung squamous cell carcinoma is very rare, the therapeutic effect of afatinib on patients with ALK gene mutation positive lung squamous cell carcinoma needs to be confirmed by further research.
文章引用:李伟. 阿法替尼治疗一例ALK突变阳性肺鳞癌患者疗效分析[J]. 亚洲肿瘤科病例研究, 2022, 11(1): 1-5. https://doi.org/10.12677/ACRPO.2022.111001

参考文献

[1] Sung, H., Ferlay, J., Siegel, R.L., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. [Google Scholar] [CrossRef] [PubMed]
[2] Soda, M., Choi, Y.L., Enomoto, M., et al. (2007) Identification of the Transforming EML4-ALK Fusion Gene in Non-Small-Cell Lung Cancer]. Nature, 448, 561-566. [Google Scholar] [CrossRef] [PubMed]
[3] Zhao, W., Choi, Y.L., Song, J.Y., et al. (2016) ALK, ROS1 and RET Rearrangements in Lung Squamous Cell Carcinoma Are Very Rare. Lung Cancer, 94, 22-27. [Google Scholar] [CrossRef] [PubMed]
[4] Kim, Y., Hammerman, P.S., Kim, J., et al. (2014) Integrative and Comparative Genomic Analysis of Lung Squamous Cell Carcinomas in East Asian Patients. Journal of Clinical On-cology, 32, 121-128. [Google Scholar] [CrossRef
[5] Morris, S.W., Kirstein, M.N., Valentine, M.B., et al. (1995) Fu-sion of a Kinase Gene, ALK, to a Nucleolar Protein Gene, NPM, in Non-Hodgkin’s Lymphoma. Science, 267, 316-317. [Google Scholar] [CrossRef
[6] Koivunen, J.P., Mermel, C., Zejnullahu, K., et al. (2008) EML4-ALK Fusion Gene and Efficacy of an ALK Kinase Inhibitor in Lung Cancer. Clinical Cancer Research, 14, 4275-4283. [Google Scholar] [CrossRef
[7] Inamura, K., Takeuchi, K., Togashi, Y., et al. (2009) EML4-ALK Lung Cancers Are Characterized by Rare Other Mutations, a TTF-1 Cell Lineage, an Acinar Histol-ogy, and Young Onset. Modern Pathology, 22, 508-515. [Google Scholar] [CrossRef] [PubMed]
[8] Martelli, M.P., Sozzi, G., Hernandez, L., et al. (2009) EML4-ALK Rearrangement in Non-Small Cell Lung Cancer and Non-Tumor Lung Tissues. The American Journal of Pathology, 174, 661-670. [Google Scholar] [CrossRef] [PubMed]
[9] Camidge, D., Bang, Y., Kwak, E., et al. (2011) Progression-Free Survival (PFS) from a Phase 1 Study of Crizotinib (PF-02341066) in Patients with ALK-Positive Non-Small Cell Lung Cancer (NSCLC). Journal of Clinical Oncology, 29, 2501. [Google Scholar] [CrossRef
[10] Mikes, R.E., Jordan, F., Hutarew, G., et al. (2015) First Line Crizotinib in Anaplastic Lymphoma Kinase (ALK) Rearranged Squamous Cell Lung Cancer. Lung Cancer, 90, 614-616. [Google Scholar] [CrossRef] [PubMed]
[11] Vergne, F., Quéré, G., Andrieu-Key, S., et al. (2016) ALK-Rearranged Squamous Cell Lung Carcinoma Responding to Crizotinib: A Missing Link in the Field of Non-Small Cell Lung Cancer? Lung Cancer, 91, 67-69. [Google Scholar] [CrossRef] [PubMed]
[12] Seto, T., Kiura, K., Nishio, M., et al. (2013) CH5424802(RO5424802) for Patients with ALK-Rearranged Advanced Non-Small-Cell Lung Cancer (AF-001JP Study): A Single-Arm, Open-Label, Phase 1-2 Study. The Lancet Oncology, 14, 590-598. [Google Scholar] [CrossRef