EML4-ALK Rearrangement as a Mechanism of Resistance to Osimertinib in Metastatic Lung Adenocarcinoma: A Case Report

AbstractOsimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the preferred frontline therapy for EGFR-mutant advanced NSCLC. However, despite its high initial response rates, multiple EGFR-independent mechanisms of resistance have been reported in patients receiving osimertinib. One su...

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Bibliographic Details
Published in:JTO clinical and research reports 2021-06, Vol.2 (6), p.100179-100179, Article 100179
Main Authors: von Buttlar, Xinyu, MD, MS, Reuss, Joshua E., MD, Liu, Stephen V., MD, Kim, Chul, MD, MPH
Format: Article
Language:English
Subjects:
ALK
Case Report
EGFR
Hematology, Oncology, and Palliative Medicine
Osimertinib
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Summary:AbstractOsimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the preferred frontline therapy for EGFR-mutant advanced NSCLC. However, despite its high initial response rates, multiple EGFR-independent mechanisms of resistance have been reported in patients receiving osimertinib. One such mechanism is the emergence of acquired, targetable oncogenic fusion events. It has been documented in other case reports that combination therapies can be efficacious in these scenarios. In our case report, we present a patient with EGFR-mutant advanced NSCLC who developed an acquired EML4-ALK rearrangement mediating resistance to osimertinib, which was overcome by using a combination of osimertinib with the ALK tyrosine kinase inhibitor alectinib.
ISSN:2666-3643
2666-3643
DOI:10.1016/j.jtocrr.2021.100179