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Xuefeng Xia
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P2.14 - Targeted Therapy (ID 183)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.14-38 - ATAD2B-ALK, a Novel Fusion in Lung Adenocarcinoma Identified Using Next-Generation Sequencing (NGS) (Now Available) (ID 1844)
10:15 - 18:15 | Author(s): Xuefeng Xia
- Abstract
Background
Anaplastic lymphoma kinase (ALK) rearrangements is an important molecular subtype of non-small cell lung cancer (NSCLC), and patients with this variant are sensitive to ALK inhibitors. Since the discovery of the EML4-ALK fusion ten years ago, several fusion partners of ALK in NSCLC have been reported, including KIF5B, KLC1, HIP1, TPR and so on. According to previous reports, different fusion partner lead to various function and activity of the fusion product. Here, we identified a novel fusion partner for ALK in a lung adenocarcinoma patient.
Method
A 46-year-old smoking Chinese male was diagnosed with lung adenocarcinoma of left lower lobe. In Oct 2017, the patient accepted lobectomy and lymph node dissection, then received 4 cycles of adjuvant chemotherapy. Lymph node metastasis occurred one and a half years after his surgery. The lymph node biopsy sent for genomic testing with a NGS-based pan-cancer 1021-gene panel. Immunohistochemistry (IHC) of ALK was performed to confirm the ALK fusion.
Result
A novel ATPase family AAA domain containing 2B(ATAD2B)-ALK fusion was identified in the lymph node biopsy tissue. The fusion occurred in intron 1 of ATAD2B gene and intron 19 of ALK gene located on short arm of chromosome 2 (ATAD2B(PMT..IVS1)_ALK(IVS19..END)). ATAD2B is a phylogenetically conserved nuclear protein expressed during neuronal differentiation and it was also reported to play a role in tumorigenesis. As IHC confirmed the expression of ALK, we proposed the fused promoter of ATAD2B had driven the expression of ALK kinase domain. The patient is currently treated with crizotinib.
Conclusion
The novel ALK fusion gene probably served as oncogenic driver of the patient’s tumor. This case is the first report of ATAD2B-ALK fusion in clinical tumor samples and could provide a new diagnostic and therapeutic candidate target for patients with lung cancer.
