间变性淋巴瘤激酶
医学
福尔菲里
贝伐单抗
阿列克替尼
福克斯
结直肠癌
伊立替康
奥沙利铂
癌症研究
克里唑蒂尼
西妥昔单抗
碱性抑制剂
癌症
肿瘤科
化疗
内科学
肺癌
恶性胸腔积液
作者
Tingting Hu,Jinbo Zhan,Li Li,Yan He,Yun Lin,Jingru Wang,Haiming Yu,Jianping Xiong,Ziling Fang,Jun Deng,Shanshan Huang,Xiaojun Xiang
标识
DOI:10.1093/oncolo/oyae020
摘要
Abstract Anaplastic lymphoma kinase (ALK) rearrangement is a well-known driver oncogene detected in approximately 5% of non–small cell lung cancer. However, ALK rearrangement is much less frequent in other solid tumors outside the lungs, such as colorectal cancer (CRC); thus, the optimal management of CRC with ALK rearrangements has yet to be established. In this report, we describe 2 cases of ALK-positive CRC, both of which benefited from ALK tyrosine kinase inhibitor (ALK-TKI) therapy. Case 1 was a postoperative patient with poorly differentiated colon adenocarcinoma, who was diagnosed with metastatic relapse shortly after surgery. Both fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and bevacizumab combined with 5-fluorouracil, l-leucovorin, and irinotecan (FOLFIRI) proved ineffective against the disease. The patient was then treated with ensartinib, as the CAD-ALK fusion gene was detected by genomic analysis. The patient was initially treated with ensartinib monotherapy for 9 months, then with ensartinib combined with local radiotherapy and fruquintinib for another 4 months for isolated hilar hepatic lymph node metastasis. The patient experienced disease progression with an acquired ALK G1202R resistance mutation that responded well to lorlatinib. Case 2 involved a 72-year-old man with advanced colon cancer (pT4bN2aM1b, stage IV) harboring an EML4-ALK fusion. The patient underwent resection of the right colon tumor due to intestinal obstruction, but the disease continued to progress after 12 courses of FOLFIRI and bevacizumab chemotherapy. However, the patient responded remarkably well to alectinib. Our report emphasizes the importance of gene detection in the treatment of malignant tumors, and the significance of ALK mutations in CRC.
科研通智能强力驱动
Strongly Powered by AbleSci AI