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Rare Case of STRN-ALK Rearrangement in Lung Cancer

By: Emily Rhode
Posted: Tuesday, July 13, 2021

In a case presentation, rearrangement of striatin (STRN)-ALK–positive non–small cell lung cancer (NSCLC) appeared to be associated with primary resistance to first-line therapy with the ALK inhibitor alectinib and limited clinical activity of the tyrosine kinase inhibitor crizotinib. Yuan Cheng, MD, of Peking University First Hospital, Beijing, China, and colleagues described the clinical course of a man admitted to the hospital for a chronic cough and was diagnosed with advanced lung adenocarcinoma with STRN-ALK translocation. They published their case report in the journal Thoracic Cancer.

This case involved a 65-year-old man with a 50-year history of smoking. CT and PET scans, as well as subsequent laboratory results, revealed several abnormal findings. Next-generation sequencing of the patient’s lung biopsy showed a rare STRN-ALK fusion and several exon mutations.

The patient was prescribed 600 mg twice daily of alectinib for 6 weeks. At that time, the patient experienced disease progression with an increase in the size of the lung mass. Treatment was changed to 250 mg twice daily of crizotinib. The 1-month follow-up showed a partial response to the drug. The patient remained in stable condition for several months when a CT scan revealed significant disease progression.

According to the authors, the patient’s progression-free survival was shorter than the other two reported cases that used alectinib as the first-line treatment of STRN-ALK rearrangement. “Our results suggest that patients with a lower abundance of mutations may benefit less regarding progression-free survival,” they concluded.

Disclosure: The study authors reported no conflicts of interest.



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