Lung cancer : journal of the International Association for the Study of Lung Cancer
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The immune checkpoint ligand programmed cell death 1 ligand 1 (PD-L1) is expressed in various tumors and is associated with the response to anti programmed cell death 1 (PD-1)/PD-L1 drugs. We evaluated PD-L1 expression in thymomas and thymic carcinomas to determine whether PD-L1 represents a therapeutic target in unresectable thymomas or thymic carcinomas that could be amenable to antibody-based immunotherapy. ⋯ To the best of our knowledge, this is the largest-scale study to evaluate PD-L1 expression in thymomas and thymic carcinomas. The data suggest that the anti PD-1/PD-L1 drug could be of potential use in immunotherapy for unresectable or relapsed thymomas and thymic carcinomas.
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Acquired resistance mutations to anaplastic lymphoma kinase (ALK) inhibitors such as crizotinib and alectinib have been documented in non-small cell lung cancer (NSCLC) patients harboring ALK rearrangement (ALK+). Of note I1171T/N/S mutations in the ALK kinase domain have recently been described by several groups to confer resistance to alectinib, a second-generation ALK inhibitor. Additionally one of these reports demonstrated one ALK+ NSCLC patient harboring an I1171T acquired mutation has responded to ceritinib, another second-generation ALK inhibitor. ⋯ This is the fifth patient case to date demonstrating that ALK I1171 mutation confers resistance to alectinib and the second reported case of ALK I1171 mutation being sensitivity to ceritinib. Substitutions of isoleucine at amino acid 1171 in the ALK kinase domain may distinguish which second generation ALK inhibitor will be effective after crizotinib failure. This case also provides evidence that transaminase elevations is likely a unique adverse event associated with crizotinib and unlikely a "class" effect involving all ALK inhibitors.