Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib

作者：Yinyin Xue, Wen Li, Kaili Huang, Qinghua Zhou, Qiang Wu · 发表于：Frontiers in Pharmacology · 年份：2025 · DOI：10.3389/fphar.2025.1602654 · 被引用次数：2 · 研究领域：Lung Cancer Treatments and Mutations、Lung Cancer Research Studies、Lung Cancer Diagnosis and Treatment

Background: Anaplastic lymphoma kinase (ALK) rearrangement is a crucial oncogenic driver in non-small cell lung cancer (NSCLC). ALK tyrosine kinase inhibitors (ALK-TKIs) represent the primary therapeutic option for advanced NSCLC patients with ALK rearrangements. However, the definitive determination of ALK-TKIs sensitivity towards newly identified rare ALK rearrangements remains elusive. Herein, we present a patient with lung adenocarcinoma harboring a novel ALK rearrangement who exhibited major pathological response (MPR) following neoadjuvant treatment with alectinib. Materials and methods: hybridization (FISH, The Vysis ALK Break Apart FISH Probe Kit), and next-generation sequencing (NGS) analyses (Burning Rock, Guangzhou, China) on biopsy sample obtained from the patient. Results: The patient, a 66-year-old female, was diagnosed with stage IIIB-N3 adenocarcinoma in the right upper lobe of the lung. NGS testing revealed a previously unreported MIR217HG-ALK rearrangement, which was subsequently confirmed by IHC and FISH. Following 5 months of neoadjuvant treatment with alectinib, the patient underwent the right upper lobectomy and achieved MPR, resulting in disease-free survival (DFS) exceeding 19 months. Conclusion: In this study, we present the first documented case of a patient with lung adenocarcinoma harboring a novel MIR217HG-ALK rearrangement who exhibited favorable response to neoadjuvant alectinib. Our findings suggest that alectinib holds promise as an efficaciou...