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Identification of atypical ATRNL1 insertion to EML4-ALK fusion gene in NSCLC
B. Robesova, M. Bajerova, J. Hausnerova, J. Skrickova, M. Tomiskova, D. Dvorakova,
Jazyk angličtina Země Irsko
Typ dokumentu kazuistiky, časopisecké články, práce podpořená grantem
- MeSH
- fúzní onkogenní proteiny chemie genetika MeSH
- inhibitory proteinkinas terapeutické užití MeSH
- inzerční mutageneze * MeSH
- lidé středního věku MeSH
- lidé MeSH
- molekulární sekvence - údaje MeSH
- nádory plic diagnóza farmakoterapie genetika MeSH
- nemalobuněčný karcinom plic diagnóza farmakoterapie genetika MeSH
- pyrazoly terapeutické užití MeSH
- pyridiny terapeutické užití MeSH
- rentgendiagnostika hrudníku MeSH
- sekvence nukleotidů MeSH
- sekvenční analýza DNA MeSH
- staging nádorů MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
We herein present a rare case of an EML4-ALK positive patient. A 61-year-old man was diagnosed with locoregional non-small cell lung cancer (NSCLC). No EGFR mutations were detected, and therefore the ALK rearrangement was evaluated using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) and the reverse transcription PCR (RT-PCR) method for EML4-ALK. All methods showed a positive result and, therefore, the patient was treated with crizotinib with a good therapeutic response. However, a detailed RT-PCR analysis and sequencing revealed an unexpected 138 bp insertion of attractin-like 1 (ATRNL1) gene into the EML4-ALK fusion gene. In our case, the positive therapeutic response suggests that ATRNL1 insertion does not affect EML4-ALK's sensitivity to crizotinib. This case shows great EML4-ALK heterogeneity and also that basic detection methods (IHC, FISH) cannot fully specify ALK rearrangement but in many cases a full specification seems to be important for an effective TKI indication, and sequencing ALK variants might contribute to optimized patient selection.
Citace poskytuje Crossref.org
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- $a Robesova, Blanka $u Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic. Electronic address: blanka.robesova@fnbrno.cz.
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- $a Identification of atypical ATRNL1 insertion to EML4-ALK fusion gene in NSCLC / $c B. Robesova, M. Bajerova, J. Hausnerova, J. Skrickova, M. Tomiskova, D. Dvorakova,
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- $a We herein present a rare case of an EML4-ALK positive patient. A 61-year-old man was diagnosed with locoregional non-small cell lung cancer (NSCLC). No EGFR mutations were detected, and therefore the ALK rearrangement was evaluated using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) and the reverse transcription PCR (RT-PCR) method for EML4-ALK. All methods showed a positive result and, therefore, the patient was treated with crizotinib with a good therapeutic response. However, a detailed RT-PCR analysis and sequencing revealed an unexpected 138 bp insertion of attractin-like 1 (ATRNL1) gene into the EML4-ALK fusion gene. In our case, the positive therapeutic response suggests that ATRNL1 insertion does not affect EML4-ALK's sensitivity to crizotinib. This case shows great EML4-ALK heterogeneity and also that basic detection methods (IHC, FISH) cannot fully specify ALK rearrangement but in many cases a full specification seems to be important for an effective TKI indication, and sequencing ALK variants might contribute to optimized patient selection.
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- $a Bajerova, Monika $u Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic.
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