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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0043-1776704
Case Report

Primary Resistance to ALK Inhibitors in a Patient with Nonsmall Cell Lung Cancer with ALK Rearrangement: A Case Report with Review of Literature

Authors

  • Suma Devaraj

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Soumya Surath Panda 

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Gourab Arun

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Adya Kinkar Panda

    2   Department of Radiology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Debahuti Mohapatra

    3   Department of Pathology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Lalatendu Moharana

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Spoorthy Kolluri

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Sindhu Kilaru 

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Swati Sucharita Mohanty 

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

  • Ghanashyam Biswas

    1   Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India

Funding None.
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Abstract

Anaplastic lymphoma kinase inhibitors (ALKi) are the standard of care for metastatic ALK-rearranged nonsmall cell lung cancer (NSCLC). Though most patients respond well to ALK, seldom there are instances where the disease progresses rapidly. Here, we present a case of a 41-years-old male diagnosed as NSCLC with ALK rearrangement. Despite being started on first- and second-generation ALK-targeted therapy, he had rapid disease progression ultimately succumbing to the disease within 3 months of diagnosis. We suspect that our patient has a variant of ALK, making him resistant to both first- and second-line targeted therapy. Subjecting such nonresponders to next-generation sequencing and identifying the variants might help to recognize a subset of patients among ALK+ NSCLC who will need intense monitoring and early institution of other therapies for a better outcome.

Keywords

EML4-ALK fusion protein - nonsmall cell lung cancer - resistance

Declaration of Patient Consent Form

Consent was obtained from the patient.


Ethics Approval

This study was approved by the institutional Ethics Committee, with Ref.no/DRI/IMS.SH/SOA/2021/097 dated 07.07.2021 (first approval) and Ref.no/IEC/IMS.SH/SOA/438 dated 13.10.2022 (approval renewal); and was conducted in accordance with the Declaration of Helsinki.


Declaration of Interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Authors' Contributions

All authors contributed equally to the writing, data, and figures of the final manuscript. The authors confirm that all authors have read and approved the manuscript.




Publication History

Article published online:
27 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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