Complete pathological remission after neoadjuvant ensartinib in patients with locally advanced lung adenocarcinoma and with CTLC-ALK and ALK-DHX8 rearrangements

ALK rearrangement occurs in approximately 3%–5% of non-small cell lung cancer (NSCLC) [ [1] Wu K.L. Chen H.L. Tsai Y.M. et al. First-line anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive lung cancer in asian populations: systematic review and network meta-analysis. J Clin Med. Sep 25 2021; 10https://doi.org/10.3390/jcm10194376 Crossref Scopus (2) Google Scholar ]. Ensartinib is a potent new-generation ALK inhibitor with high activity and is well-tolerated in patients with crizotinib-resistant, ALK-positive NSCLC, including those with CNS metastases [ [2] Yang Y. Zhou J. Zhou J. et al. Efficacy, safety, and biomarker analysis of ensartinib in crizotinib-resistant, ALK-positive non-small-cell lung cancer: a multicentre, phase 2 trial. Lancet Respir Med. Jan 2020; 8: 45-53https://doi.org/10.1016/s2213-2600(19)30252-8 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar ]. Ensartinib represents a new first-line option for patients with ALK-positive NSCLC. And ensartinib had an acceptable safety profile: low proportions of patients required dose modifications or discontinued the study and most treatment-related adverse events were grade 1 or 22. Evidence of the effectiveness of ensartinib as neoadjuvant therapy in locally advanced NSCLC with ALK rearrangement is limited. At present, there are no case reports of ensartinib as neoadjuvant treatment. Here, we report a case of locally advanced adenocarcinoma harbouring ALK rearrangements with a pathological complete tumour response after ensartinib treatment.