Small cell transformation in crizotinib-resistant ROS1-rearranged non-small cell lung cancer with retention of ROS1 fusion: A case report.

Abstract

C-ros oncogene 1 receptor tyrosine kinase (ROS1) rearrangement has been detected in patients with advanced non-small cell lung cancer (NSCLC). Although ROS1 tyrosine kinase inhibitors (TKIs) provide a survival benefit for patients with ROS1-rearranged advanced NSCLC, subsequent therapy remains limited. Small cell transformation is an important mechanism of drug resistance in epidermal growth factor receptor-mutant NSCLC. However, its significance in mediating ROS1 resistance has not been determined yet. Here, we present the case of a 63-year-old man with ROS1-rearranged advanced NSCLC who had disease progression with small cell transformation of the mediastinal lymph node after 8 months of treatment with crizotinib. More importantly, fluorescence in situ hybridization of post-progression tumor biopsy demonstrated retention of ROS1 rearrangement. Tissue biopsy remains indispensable for patients who acquire resistance to ROS1 TKIs.

• Authors: Chi-Hao Wu, Po-Lan Su, Che-Wei Hsu, Chang-Yao Chu, Chien-Chung Lin
• Journal: Thoracic cancer (Thorac Cancer) Vol. 12 Issue 22 Pg. 3068-3071 (11 2021) ISSN: 1759-7714 [Electronic] Singapore
• PMID: 34623764 (Publication Type: Case Reports)
• Copyright: © 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Chemical References

• Protein Kinase Inhibitors
• Proto-Oncogene Proteins
• Crizotinib
• Protein-Tyrosine Kinases
• ROS1 protein, human

Topics

• Carcinoma, Non-Small-Cell Lung (drug therapy, genetics, pathology)
• Cell Transformation, Neoplastic (genetics)
• Crizotinib (therapeutic use)
• Drug Resistance, Neoplasm (genetics)
• Gene Rearrangement
• Humans
• Lung Neoplasms (drug therapy, genetics, pathology)
• Male
• Middle Aged
• Protein Kinase Inhibitors (therapeutic use)
• Protein-Tyrosine Kinases (genetics)
• Proto-Oncogene Proteins (genetics)
• Small Cell Lung Carcinoma (drug therapy, genetics, pathology)