Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation

Viola W Zhu,1 Alexa B Schrock,2 Thangavijayan Bosemani,3 Bryan S Benn,4 Siraj M Ali,2 Sai-Hong Ignatius Ou1 1Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California, Irvine School of Medicine, Orange, CA, USA; 2Clinical Development,...

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Autores principales:	Zhu VW, Schrock AB, Bosemani T, Benn BS, Ali SM, Ou SI
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	alectinib VKORC1L1 ALK T1151 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/cf8d2154987d49228f29c29d9f614742
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spelling	oai:doaj.org-article:cf8d2154987d49228f29c29d9f6147422021-12-02T00:52:53ZDramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation1179-2728https://doaj.org/article/cf8d2154987d49228f29c29d9f6147422018-11-01T00:00:00Zhttps://www.dovepress.com/dramatic-response-to-alectinib-in-a-lung-cancer-patient-with-a-novel-v-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Viola W Zhu,1 Alexa B Schrock,2 Thangavijayan Bosemani,3 Bryan S Benn,4 Siraj M Ali,2 Sai-Hong Ignatius Ou1 1Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California, Irvine School of Medicine, Orange, CA, USA; 2Clinical Development, Foundation Medicine, Inc., Cambridge, MA, USA; 3Department of Radiological Sciences, University of California, Irvine School of Medicine, Orange, CA, USA; 4Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of California, Irvine School of Medicine, Orange, CA, USA Abstract: ALK-rearranged lung cancer defines a distinctive molecular cohort of patients whose outcomes are significantly improved by the availability of ALK inhibitors. Thus, it is imperative for clinicians to screen appropriate patients for this driver mutation with a molecular testing platform capable of capturing all ALK fusions. Here, we report a novel VKORC1L1-ALK fusion and an ALK T1151K resistance mutation detected in a lung cancer patient who had been on crizotinib for over 8 years. Alectinib induced a dramatic response in this patient demonstrating its clinical activity against T1151K. This case illustrates the importance of performing repeat biopsy to explore mechanism(s) of resistance when patients experience disease progression on an ALK inhibitor. The approach has a direct therapeutic impact particularly when an ALK resistance mutation is identified. Keywords: VKORC1L1, T1151, fusion, resistance, crizotinib, lorlatinibZhu VWSchrock ABBosemani TBenn BSAli SMOu SIDove Medical PressarticlealectinibVKORC1L1ALKT1151Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 9, Pp 111-116 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	alectinib VKORC1L1 ALK T1151 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	alectinib VKORC1L1 ALK T1151 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Zhu VW Schrock AB Bosemani T Benn BS Ali SM Ou SI Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
description	Viola W Zhu,1 Alexa B Schrock,2 Thangavijayan Bosemani,3 Bryan S Benn,4 Siraj M Ali,2 Sai-Hong Ignatius Ou1 1Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California, Irvine School of Medicine, Orange, CA, USA; 2Clinical Development, Foundation Medicine, Inc., Cambridge, MA, USA; 3Department of Radiological Sciences, University of California, Irvine School of Medicine, Orange, CA, USA; 4Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of California, Irvine School of Medicine, Orange, CA, USA Abstract: ALK-rearranged lung cancer defines a distinctive molecular cohort of patients whose outcomes are significantly improved by the availability of ALK inhibitors. Thus, it is imperative for clinicians to screen appropriate patients for this driver mutation with a molecular testing platform capable of capturing all ALK fusions. Here, we report a novel VKORC1L1-ALK fusion and an ALK T1151K resistance mutation detected in a lung cancer patient who had been on crizotinib for over 8 years. Alectinib induced a dramatic response in this patient demonstrating its clinical activity against T1151K. This case illustrates the importance of performing repeat biopsy to explore mechanism(s) of resistance when patients experience disease progression on an ALK inhibitor. The approach has a direct therapeutic impact particularly when an ALK resistance mutation is identified. Keywords: VKORC1L1, T1151, fusion, resistance, crizotinib, lorlatinib
format	article
author	Zhu VW Schrock AB Bosemani T Benn BS Ali SM Ou SI
author_facet	Zhu VW Schrock AB Bosemani T Benn BS Ali SM Ou SI
author_sort	Zhu VW
title	Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
title_short	Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
title_full	Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
title_fullStr	Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
title_full_unstemmed	Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation
title_sort	dramatic response to alectinib in a lung cancer patient with a novel vkorc1l1-alk fusion and an acquired alk t1151k mutation
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/cf8d2154987d49228f29c29d9f614742
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Dramatic response to alectinib in a lung cancer patient with a novel VKORC1L1-ALK fusion and an acquired ALK T1151K mutation

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