Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy

He, Hengqiu; Yang, Wendi; Huang, Yu‐Sheng; Zhang, Xiaoyue; Peng, Yinglin; Yang, Zhenzhou

doi:10.1007/s10456-021-09811-8

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…However, a limitation of this case report is the lack of measurement of mutation abundance and downstream pathway activation. Additionally, the overexpression of PD-L1 (>90%) in our patient may potentially negatively impact the efficacy of TKIs and further complicate treatment options ( He et al, 2022 ). Patients with ALK mutations have a significantly higher incidence of high PD-L1 expression (≥50%).…”

Section: Discussionmentioning

confidence: 99%

Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer

Hu,

Tan,

Xie

et al. 2023

Front. Pharmacol.

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In non-small cell lung cancer (NSCLC), two key genetic alterations, epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements, are commonly believed to be mutually exclusive. Studies have reported that concurrent EGFR/ALK co-mutation in non-small cell lung cancer patients is rare, with a prevalence ranging from 0.1% to 1.6%. However, the clinical and pathological characteristics of these patients are not well-defined, and the optimal treatment approach for such cases remains controversial. In this report, we present a case of stage IV lung adenocarcinoma with both epidermal growth factor receptor and anaplastic lymphoma kinase mutations, along with high PD-L1 expression. The patient initially received treatment with epidermal growth factor receptor tyrosine kinase inhibitors (TKIs), but the disease progressed. However, following a switch to ALK-TKI therapy and local radiotherapy, the lesion showed regression. Our report also provides a comprehensive summary of the clinical and pathological features, as well as treatment strategies, for non-small cell lung cancer patients with concurrent epidermal growth factor receptor mutation and anaplastic lymphoma kinase rearrangement.

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Section: Discussionmentioning

confidence: 99%

Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer

Hu,

Tan,

Xie

et al. 2023

Front. Pharmacol.

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“…Under this treatment regimen, the curative effect reached PR and was followed by ALK-TKI maintenance therapy. [ 24 ] Ultimately, the patient achieved sustained remission. In general, treatment in patients with combined mutations have poorer efficacy and treatment options will need further study.…”

Section: Discussionmentioning

confidence: 99%

Response to treatment with an ALK-TKI in a patient with advanced lung adenocarcinoma with concurrent ALK fusion and high PD-L1 expression: A case report

et al. 2022

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Rationale: Previous studies have shown that PD-L1 TPS ≥50% in lung cancer rarely overlaps with driver oncogenes such as epidermal growth factor receptor and anaplastic lymphoma kinase (ALK). The initial gene detection of the patient in this study showed ALK fusion combined with high expression of PD-L1. We explored the treatment options for this patient. Patient concerns: A 34-year-old woman presented for the first time with “repeated fever and cough for 20 days.” The patient denied any underlying medical history. Diagnosis: After a series of imaging examinations and needle biopsy, the patient was diagnosed as stage IV lung adenocarcinoma with multiple liver and bone metastases (EML4-ALK fusion, PD-L1 TPS 80%). Interventions: The patient was initially given alectinib targeted therapy. After progression, a second round of genetic testing was performed and the patient was detected to have both ALK fusion and BRAF mutation. The patient was then successively changed to treatment with ensatinib combined with dabrafenib, and lorlatinib combined with dabrafenib. Outcomes: The initial efficacy evaluation of alectinib was PR, but its PFS was only 4 months. The patient only achieved an overall survival of 10 months. Lessons: Non–small cell lung cancer with an ALK fusion and high PD-L1 expression responds poorly to most current treatment options, with survival time after ALK-tyrosine kinase inhibitor treatment notably shorter than that of patients with an ALK fusion alone.

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“…Akhoundova's published work in the same journal that discusses the involvement of ALK in lung neuroendocrine tumors. [31][32][33][34][35] According to Zhang's published work in the Journal of Thoracic Disease suggests that NAPSA serves as a valuable indicator for identifying lung adenocarcinoma. Li's published work in the same journal suggests that the presence of NAPSA expression is linked to a more favorable prognosis in individuals diagnosed with lung adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol

Sadeghi,

Kiaei,

Boush

et al. 2024

Preprint

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Background: Adenocarcinoma of the lung is the most common type of lung cancer, and it is characterized by distinct cellular and molecular features. It occurs when abnormal lung cells multiply out of control and form a tumor in the outer region of the lungs. Adenocarcinoma of the lung is a serious and life-threatening condition that requires effective and timely management to improve the survival and quality of life of the patients. One of the challenges in this cancer treatment is finding the optimal combination of drugs that can target the genes or proteins that are involved in the disease process. Method: In this article, we propose a novel method to recommend combinations of trending drugs to target its associated proteins/genes, using a Graph Neural Network (GNN) under the RAIN protocol. The RAIN protocol is a three-step framework that consists of: 1) Applying graph neural networks to recommend drug combinations by passing messages between trending drugs for managing disease and genes that act as potential targets for disease; 2) Retrieving relevant articles with clinical trials that include those proposed drugs in previous step using Natural Language Processing (NLP); 3) Analyzing the network meta-analysis to measure the comparative efficacy of the drug combinations. Result: We applied our method to a dataset of nodes and edges that represent the network, where each node is a drug or a gene, and each edge is a p-value between them. We found that the graph neural network recommends combining Gefitinib, Paclitaxel, and Icotinib as the most effective drug combination to target this cancer associated proteins/genes. We reviewed the clinical trials and expert opinions on these medications and found that they support our claim. The network meta-analysis also confirmed the effectiveness of these drugs on associated genes. Conclusion: Our method is a novel and promising approach to recommend trending drugs combination to target cancer associated proteins/genes, using graph neural networks under the RAIN protocol. It can help clinicians and researchers to find the best treatment options for patients, and also provide insights into the underlying mechanisms of the disease.

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Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy

Cited by 4 publications

References 8 publications

Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer

Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer

Response to treatment with an ALK-TKI in a patient with advanced lung adenocarcinoma with concurrent ALK fusion and high PD-L1 expression: A case report

A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol

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