• Hua-Fei Chen, Wen-Xian Wang, Chun-Wei Xu, Li-Chao Huang, Xiao-Feng Li, Gang Lan, Zhan-Qiang Zhai, You-Cai Zhu, Kai-Qi Du, Lei Lei, and Mei-Yu Fang.
• Department of Thoracic Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital,The Third Affiliated Hospital of Jiaxing University, Jiaxing Zhejiang 314000, People's Republic of China.
• Lung Cancer. 2020 Apr 1; 142: 59-62.

ObjectivesTransforming anaplastic lymphoma kinase (ALK) gene rearrangements are well known as a unique subset of non-small cell lung cancer (NSCLC) with mutations other than EGFR. Currently, crizotinib is the standard first-line treatment for ALK-positive NSCLC.Materials And MethodsWith advances in detection methods, more and more uncommon ALK fusion partners have been identified. Herein we present a novel SOS1-ALK fusion and the efficacy of crizotinib in an advanced NSCLC patient harboring this type of fusion.ResultsA 52-year-old Chinese man had left upper lobe primary NSCLC and synchronous multiple lung metastases (cT2N3M1, stage IV). The ultrasound-guided fine-needle aspiration cytology of palpable left supraclavicular lymph nodes and the results of immunohistochemistry staining supported the diagnosis of metastatic lung adenocarcinoma. Using a next-generation sequencing assay (NGS), we showed that the tumor had a SOS1-ALK fusion which the breakpoints was (S2, A20) rather than other actionable mutations. Therefore, the patient received first-line crizotinib and experienced a remarkable tumor response and has tolerated crizotinib well until this writing.ConclusionConsidering this rare SOS1-ALK fusion and remarkable response to an ALK-inhibitor, it is important to be aware of the presence of SOS1-ALK fusions in patients with advanced NSCLC to better guide targeted therapy. Precision methods, such as NGS for oncogenic alteration detection, should also be encouraged in clinical practice.Copyright © 2020 Elsevier B.V. All rights reserved.

27 keywords...

hide…