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Zhiwei Xiao
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P84 - Targeted Therapy - Clinically Focused - ALK (ID 261)
- Event: WCLC 2020
- Type: Posters
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P84.18 - Primary Resistance to Brigatinib in a Patient with Lung Adenocarcinoma Harboring ALK G1202R Mutation and LIPI-NTRK1 Rearrangement (ID 1307)
00:00 - 00:00 | Presenting Author(s): Zhiwei Xiao
- Abstract
Introduction
Anaplastic lymphoma kinase (ALK)-targeted therapy changes the management of ALK gene rearrangement in patients with non-small-cell lung cancer (NSCLC). However, most patients develop primary or acquired resistance to ALK inhibitors through different molecular mechanisms. Therefore, identifying specific variants is crucial for guiding clinical practice. Here we report a 43-year-old patient with harboring ALK G1202R mutation and LIPI-NTRK1 rearrangement who failed to be treated with brigatinib.
Methods
Circulating tumor DNA (ct-DNA)-based next-generation sequencing (NGS) was performed in the peripheral blood of patient to detect potential alternation.
Results
A 43-year-old woman who had no history of smoking was diagnosed with stage IVa (T2bN2M1b) lung adenocarcinoma. Three different mutation type were detected, including the classical EML4-ALK fusion, the ALK G1202R acquired resistance mutation and a new fusion form of NTRK rearrangement (LIPI-NTRK1). Ultimately, This patient had a progression-free survival of 7 months with crizotinib but of only one month with brigatinib treatment.
Figure 1 An illustrated summary of the treatment regimen received by the patient including investigator-assessed objective responses (OR) based on Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1, progression-free survival (PFS) (expressed in months [m]) from each line of treatment. Thoracic computed tomography (CT) at (A) baseline revealed the 3.6 cm × 2.9 cm mass in the left lung, with lymph node and hepatic segment metastasis, no brain metastases were found. (B) At evaluation of progress response (PD) after 7month of crizotinib and new brain metastases revealed. (C) At progress response (PD) after 1.7 months of brigatinib.
Conclusion
Our findings provide valuable information about responses to brigatinib in NSCLC patients with the ALK G1202R mutation and a better understanding of ALK-TKI applications.
