Lung Adenocarcinoma Expressing an EML4‐ALK Fusion Transcript With Premature Stop Codons and Response to Alectinib: A Case Report.

ALK fusions are well‐established oncogenic drivers in lung cancer, typically resulting in ALK activation through dimerization mediated by partner proteins. However, alternative mechanisms of ALK activation have also been reported. We herein report an 80‐year‐old man with metastatic lung adenocarcino...

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Publicado en:Thoracic Cancer Vol. 16; no. 15; pp. 1 - 5
Autores principales: Ozaki, Mami, Ikushima, Hiroaki, Suzuki, Masaki, Yokoyama, Akira, Fukuda, Kensuke, Watanabe, Kousuke, Shinozaki‐Ushiku, Aya, Kato, Motohiro, Ushiku, Tetsuo, Aburatani, Hiroyuki, Oda, Katsutoshi, Kage, Hidenori
Formato: case study diagnostic images pictorial tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2025
      vid: 16
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      pub: Wiley-Blackwell
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        10.1111/1759-7714.70146
        187391066
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        atl: Lung Adenocarcinoma Expressing an EML4‐ALK Fusion Transcript With Premature Stop Codons and Response to Alectinib: A Case Report.
      aug:
        au:
          Ozaki, Mami
          Ikushima, Hiroaki
          Suzuki, Masaki
          Yokoyama, Akira
          Fukuda, Kensuke
          Watanabe, Kousuke
          Shinozaki‐Ushiku, Aya
          Kato, Motohiro
          Ushiku, Tetsuo
          Aburatani, Hiroyuki
          Oda, Katsutoshi
          Kage, Hidenori
        affil: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
      sug:
        subj:
          Adenocarcinoma of Lung Familial and Genetic
          Anaplastic Lymphoma Kinase
          Proteins
          Mutation
          Adenocarcinoma of Lung Diagnosis
          Adenocarcinoma of Lung Drug Therapy
          Antineoplastic Agents Administration and Dosage
          Tyrosine Kinase Inhibitors Administration and Dosage
          Treatment Outcomes
          Male
          Aged, 80 and Over
          Japan
          Genetic Screening
          Sequence Analysis
          Tumor Markers, Biological Drug Effects
          Gene Expression Profiling
          Immunohistochemistry
          Radiography, Thoracic
          Positron Emission Tomography Computed Tomography
          Biopsy
          Aged, 80 & over
          Male
      ab: ALK fusions are well‐established oncogenic drivers in lung cancer, typically resulting in ALK activation through dimerization mediated by partner proteins. However, alternative mechanisms of ALK activation have also been reported. We herein report an 80‐year‐old man with metastatic lung adenocarcinoma, who initially tested negative for ALK rearrangement using a polymerase chain reaction‐based assay. RNA‐based hybrid capture targeted sequencing later identified an EML4‐ALK fusion transcript in which EML4 exon 15 and ALK intron 19 were fused. This resulted in a stop codon being retained in the unspliced ALK intron 19, preventing fusion protein translation. However, immunohistochemistry revealed overexpression of ALK, suggesting the existence of alternative translation initiation sites in exon 20 or downstream. The patient showed a marked response to alectinib therapy. This case underscores the importance of using multiple methods to detect actionable gene fusions and to ensure appropriate targeted therapy selection.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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