Birden Fazla Sürücü Mutasyonlu Küçük Hücre Olmayan Akciğer Kanserli Hastalarda Optimum Yaklaşım İçin Hangi Tedavi Seçilmelidir? Bir Vaka Raporu ve Literatür İncelemesi

59 yaşındaki bir hastada küçük hücreli olmayan akciğer kanserinde (KHDAK) bir anaplastik lenfoma kinaz (ALK) ve c-ros onkogen 1 (ROS1) füzyonu vakasını sunuyoruz ve ko-mutasyonların tedavi etkinliğini gözden geçiriyoruz. Tedavinin seçimi ve nadir ko-mutasyonlarla etkinliği oldukça ilgi çeken bir konudur. Bu derleme, birden fazla sürücü mutasyonu olan KHDAK hastalarına optimal tedavi yaklaşımına dair ipuçları sağlayacaktır. Bununla birlikte, hangi hastaların uygun TKI veya kemoterapiden fayda görebileceğini netleştirmek için randomize çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Akciğer, Mutasyon, Alk, Ros
Anahtar Kelimeler:

ALK, ROS, MUTASYON, AKCİĞER

WHICH TREATMENT SHOULD BE SELECTED FOR THE OPTIMUM APPROACH TO PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH DRIVER MUTATION? A CASE REPORT AND LITERATURE REVIEW

We present a case of concomitant c-ros oncogene 1 (ROS1) and anaplastic lymphoma kinase (ALK) and fusion in non small cell lung cancer (NSCLC) in a 59-year-old patient and review the treatment efficacy of co-mutations. The choice of the treatment and its effectiveness with rare co-mutations is a subject of considerable interest. This review will provide clues to the optimal treatment approach to NSCLC patients with more than one driver mutations. However, randomized studies are needed to clarify which patients with concurrent mutations may benefit from chemotherapy or related tki.
Keywords:

LUNG, ALK, ROS, MUTATION,

___

  • 1. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, Wang C, Zhang S, Wang J. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol, 2011;12(8):735-742.
  • 2. Mitsudomi T, Morita S, Yatabe Y, Negoro S, Okamoto I, Tsurutani J, Seto T. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol, 2010;11(2):121-128.
  • 3. Mok TS, Wu Y, Thongprasert S, Yang, C, Chu D, Saijo N, Sunpaweravong P, Gefitinib or carboplatin–paclitaxel in pulmonary adenocarcinoma. New England Journal of Medicine, 2009;361(10): 947-957. 4. Zhang X, Zhang S, Yang Z, Yang J, Zhou Q, Yin Y, An S. Fusion of EML4 and ALK is associated with development of lung adenocarcinomas lacking EGFR and KRAS mutations and is correlated with ALK expression. Mol Cancer, 2010;9(1):1-12.
  • 5. An SJ, Chen ZH, Su J, Zhang WZ, Zhong WZ, Yang JL, Zhou Q. Identification of enriched driver gene alterations in subgroups of non-small cell lung cancer patients based on histology and smoking status. PLoS One, 2012;7(6): e40109.
  • 6. Cote ML, Haddad R, Edwards DJ, Atikukke G, Gadgeel S, Soubabi AO, Leonardo F. Frequency and type of epidermal growth factor receptor mutations in African Americans with non-small cell lung cancer. J Thorac Oncol, 2011;6(3): 627-30.
  • 7. Kohno T, Takashi N, Tsuta K, Tsuchihara K, Matsumoto S, Yoh K, Goto K. Beyond ALK-RET, ROS1 and other oncogene fusions in lung cancer. Transl Lung Cancer Res, 2015;4(2):156.
  • 8. Mazières J, Zalcman G, Crino L, Biondani P, Barlesi F, Filleron T, Dingemans AM. Crizotinib therapy for advanced lung adenocarcinoma and a ROS1 rearrangement: results from the EUROS1 cohort. J Clin Oncol, 2015;33(9):992-999.
  • 9. Peters S, Mok TS, Gadgeel SM, Rosell R, Dziadziuszko R, Kim DW, Perol M. Updated overall survival (OS) and safety data from the randomized, phase III ALEX study of alectinib (ALC) versus crizotinib (CRZ) in untreated advanced ALK+ NSCLC. J Clin Oncol, 2020;38(15):9518-9518.
  • 10. Soria JC, Ohe Y, Vansteenkiste J, Reungwetwattana T, Chewaskulyong B, Lee KH, Dechaphunkul A. Osimertinib in Untreated EGFR-Mutated Advanced Non–Small-Cell Lung Cancer. New England Journal of Medicine, 2018;378(2):113-125.
  • 11. Shen L, Qiang T, Li Z, Ding D, Yu Y, Lu S. First-line crizotinib versus platinum-pemetrexed chemotherapy in patients with advanced ROS1-rearranged non-small-cell lung cancer. Cancer Med, 2020;9(10):3310-3318.
  • 12. Zhang Y, Sun Y, Pan Y, Li C, Shen L, Li Y, Luo X, Ye T. Frequency of driver mutations in lung adenocarcinoma from female never-smokers varies with histologic subtypes and age at diagnosis. Clin. Cancer Res,2012;18(7):1947-1953.
  • 13. Zhu YC, Zhang XG, Lin XP, Wang WX, Li XF, Wu LX, Chen HF. Clinicopathological features and clinical efficacy of crizotinib in Chinese patients with ROS1-positive non-small cell lung cancer. Oncol Lett, 2019;17(3):3466-3474.
  • 14. Zhu YC, Liao XH, Wang WX, Xu CW, Zhuang W, Wei JG, Du K. Dual drive coexistence of EML4-ALK and TPM3-ROS1 fusion in advanced lung adenocarcinoma.Thorac Cancer, 2018;9(2):324-327.
  • 15. Sahnane N, Frattini M, Bernosconi B, Zappa F, Schiavone G, Wannesson L, Antonelli P, Balzarini P. EGFR and KRAS Mutations in ALK-Positive Lung Adenocarcinomas: Biological and Clinical Effect. Clin Lung Cancer, 2016;17(1):56-61.
  • 16. Schmid S, Gautschi O, Rothscill S, Mark M, Froesch P, Klingbiel D, Reichegger H. Clinical Outcome of ALK-Positive Non-Small Cell Lung Cancer (NSCLC) Patients with De Novo EGFR or KRAS Co-Mutations Receiving Tyrosine Kinase Inhibitors (TKIs). JThorac Oncol, 2017;12(4):681-688.
  • 17. He Y, Sheng W, Hu W, Lin J, Liu J, Yu B, Mao X. Different Types of ROS1 Fusion Partners Yield Comparable Efficacy to Crizotinib.Oncol Res, 2019;27(8):901-910.
  • 18. Lin JJ, Ritterhouse LL, Ali SM, Bailey M, Schrock AB, Gainor JF, Ferris LA. ROS1 Fusions Rarely Overlap with Other Oncogenic Drivers in Non-Small Cell Lung Cancer. J Thorac Oncol, 2017;12(5):872-877.
  • 19. Zhu YC, Xu CW, Ye XQ, Yin MX, Zhang JX, Du KQ, Zhang ZH. Lung cancer with concurrent EGFR mutation and ROS1 rearrangement: a case report and review of the literature. Onco Targets Ther, 2016;9:4301-5.
  • 20. Chen RL, Yang JJ, Zhang XC, Lou NN, Chen H, Zhoujian Q, Guo W. ROS1 rearrangement coexists with EGFR mutation in non-small-cell lung cancer. American Society of Clinical Oncology, 2015;33(15):e19003-e19003.
  • 21. Pan W, Yang Y, Zhu H, Zhang Y, Zhou R, Sun X. KRAS mutation is a weak, but valid predictor for poor prognosis and treatment outcomes in NSCLC: A meta-analysis of 41 studies.Oncotarget,2016;7(7):8373.
  • 22. Uguen A, Schick U, Quere G. A Rare Case of ROS1 and ALK Double Rearranged Non-Small Cell Lung Cancer. J Thorac Oncol, 2017;12(6):e71-e72.
  • 23. Song Z, Zheng Y, Wang X, Su H, Zhang Y, Song Y. ALK and ROS1 rearrangements, coexistence and treatment in epidermal growth factor receptor-wild type lung adenocarcinoma: a multicenter study of 732 cases. J Thorac Dis, 2017;9(10):3919-3926.
Akdeniz Tıp Dergisi-Cover
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2015
  • Yayıncı: Akdeniz Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Akrep Sokması Nedeniyle Başvuran Çocuk Olguların Değerlendirilmesi: 182 Olgu

Şule DEMİR, Zülfükar GÖRDÜ, Serkan KIRIK, Yağmur KÖKSAL YASİN, Özlem DEMİREL

Brusatol'ün Renal İskemi Reperfüzyon Hasarına Karşı Renoprotektif Etkileri

Fazile Nur EKİNCİ AKDEMİR, Ayhan TANYELİ, Ersen ERASLAN, Mustafa Can GÜLER, Ömer TOPDAĞI, Tuncer NACAR

Vajinal Pessere Karşılık Vajinal Pesser ve Lokal Östrojen Tedavisi: Pelvik Organ Prolapsusu Olan Postmenapozal Kadınlarda Genitoüriner Etkilerinin Karşılaştırılması

Bugra SAHİN, Gizem CURA ŞAHİN

Covid-19 aşılanma sürecinde henüz aşılanmamış kişilerin bilgi, tutum ve davranışlarının değerlendirilmesi

Hacer DEMİRKÖSE, Mehmet Enes GÖKLER

Kontrollü Ovaryen Hiperstimulasyon Uterusta Apelin ve Apelin Reseptör Ekspresyonunu Arttırır

Sema AVCI, Çiler ÇELİK-ÖZENCİ

AĞIRLIK EGZERSİZİ SONRASI GELİŞEN KANAT SKAPULA: OLGU SUNUMU

Ceren KARA, Şebnem KOLDAŞ DOĞAN

Katarakt Operasyonu Uygulanan Hastalarda Pseudoeksfoliasyon Sendromu Prevalansı ve İntraoperatif Komplikasyonlar

Miray FAİZ TURAN, Mehmet ÇUBUK, Asım KAYIKLIK, Savaş ÇETİNKAYA

Akrilamidin Koryoallantoik Membran Modelinde Oksidatif ve Anti-Anjiogenik Etkileri

Mehmet Enes SÖZEN, Özgür AKKAYA, Hasan Basri SAVAŞ, Oğuz KARAHAN

Sars-Cov-2 Pandemisinin Sağlıklı Kadınlarda Doğum Yönetimine ve Gebelik Komplikasyonlarına Etkisi

Serap FIRTINA TUNCER, Aysel DERBENT

COVID-19 pandemisinin meme kanseri tanısına etkisinin değerlendirilmesi

Cihat AKSOY, Koray KOÇ, Kamil ÇIRA, Emel EMİR YETİM, Özgür ÖZBİLEK, Sinem ÇİL GÖNÜLCÜ, Günhan CAN