Case report: Treatment with ensartinib shows good response to SQSTM1-ALK fusion in lung adenocarcinoma.

in Frontiers in pharmacology by Pandeng Wang, Zhuo Jiang, Jianji Guo, Tao Liu, Zhen Liu, Dongdong Wang, Honglin Li

TLDR

  • The study is about a woman with lung cancer who was found to have a rare type of cancer called SQSTM1-ALK fusion. The woman's cancer responded well to a medicine called ensartinib. The study looked at the woman's cancer in her pericardial effusion (a fluid that builds up around the heart) and found that it also responded well to ensartinib. This study suggests that SQSTM1-ALK fusion may be a target for a medicine called ALK TKIs in pericardial effusion and future research should investigate its prevalence and response to ALK TKIs in other sites of metastasis.

Abstract

Lung cancer is a prevalent malignancy, with the rearrangement of the anaplastic lymphoma kinase (ALK) gene being responsible for a minority of cases of non-small cell lung cancer (NSCLC). NSCLC patients harboring ALK fusion proteins demonstrate sensitivity to ALK tyrosine kinase inhibitors (TKIs). In this report, we describe the case of a female patient with metastatic lung adenocarcinoma, identified through NGS to carry a rare inverted SQSTM1-ALK (S5, A20) fusion. The patient received ensartinib as first-line therapy, resulting in a partial response (PR). At the time of publication, the patient's condition remained favorable. We have, for the first time, identified the presence of SQSTM1-ALK fusion in pericardial effusion, with the favorable response to ensartinib validating the oncogenic potential of SQSTM1-ALK fusion. The substantial advancements and extensive utilization of NGS have facilitated the identification of rare fusion variants.

Overview

  • The study focuses on the case of a female patient with metastatic lung adenocarcinoma identified through NGS to carry a rare inverted SQSTM1-ALK (S5, A20) fusion. The patient received ensartinib as first-line therapy, resulting in a partial response (PR). The study aims to validate the oncogenic potential of SQSTM1-ALK fusion and its response to ALK TKIs in pericardial effusion.

Comparative Analysis & Findings

  • The study compares the outcomes observed under the treatment of ensartinib in the patient's pericardial effusion with the patient's primary tumor. The study found that the patient's pericardial effusion responded favorably to ensartinib, with a partial response (PR) observed. This finding validates the oncogenic potential of SQSTM1-ALK fusion and its response to ALK TKIs in pericardial effusion.

Implications and Future Directions

  • The study's findings suggest that SQSTM1-ALK fusion may be a potential target for ALK TKIs in pericardial effusion. Future research should investigate the prevalence of SQSTM1-ALK fusion in pericardial effusion and its response to ALK TKIs. Additionally, further studies should explore the potential of SQSTM1-ALK fusion as a target for ALK TKIs in other sites of metastasis.
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