A Novel Intergenic Region (chr2: 30,316,870)-ALK Fusion in a Patient with Lung Adenocarcinoma Responding to Crizotinib Combined with Pemetrexed Treatment: A Case Report

Abstract

Background

Anaplastic lymphoma kinase (ALK) rearrangements have been reported as an important oncogenic driver in 5–7% non-small cell lung cancer (NSCLC) patients. Reports about the intergenic region (IGR) as an ALK fusion partner are rare. In this study, we report a novel IGR (chr2: 30,316,870)-ALK fusion in an advanced lung adenocarcinoma patient that responded effectively to crizotinib combined with pemetrexed.

Case Presentation

A 68-year-old Chinese female was diagnosed with stage IV right lung adenocarcinoma (cT3N3M1c). The targeted next-generation sequencing (NGS) of 14 cancer-related genes identified an IGR (chr2: 30,316,870)-ALK fusion. Her lung lesions have been successfully converted from a partial response to a complete response after administrating crizotinib for 1 year combined with 6 cycles of chemotherapy with pemetrexed. So far, her progression-free-survival has reached 21 months.

Conclusion

In this case, we firstly report a novel IGR (chr2: 30,316,870)-ALK fusion by using targeted NGS, and highlight the efficacy of crizotinib combined with pemetrexed to reduce unbearable gastrointestinal adverse reactions. It provides valuable clinical guidance for the treatment of similar cases in the future.

Keywords:

• NSCLC
• IGR-ALK
• NGS
• crizotinib
• pemetrexed

Date Availability

All datasets generated for this study are included in the manuscript.

Ethics Approval and Consent for Publication

The studies involving human participants were reviewed and approved by The Ethics Committee of Ningbo No.2 Hospital. Written informed consent was obtained from the patient for publication of this report.

Acknowledgment

Thanks for the technical support provided by Nanjing Geneseeq Technology Inc.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflict of interest.

Additional information

Funding

Supported by Ningbo Clinical Research Center for Respiratory Diseases (Grant No. 2022L004); Supported by Ningbo Health Branding Subject Fund (Grant No. PPXK2018-05); Supported by Medical Scientific Research Foundation of Zhejiang Province, China (Grant No.2019KY593); Supported by Ningbo Natural Science Foundation, China (Grant No.202003N4277).