2022 World Conference on Lung Cancer (ePosters)-EP14.01-007. Next-Generation Sequencing to Dynamically Detect Mechanisms of Resistance to ALK Inhibitors in ALK-positive SCLC Patient: A Case Report

EP14.01-007. Next-Generation Sequencing to Dynamically Detect Mechanisms of Resistance to ALK Inhibitors in ALK-positive SCLC Patient: A Case Report

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This case report discusses a patient with ALK-positive small-cell lung cancer (SCLC) who underwent treatment with tyrosine kinase inhibitors (TKIs) and experienced disease progression. The patient was initially treated with chemotherapy but later received Alectinib, a TKI. The response to Alectinib was initially positive, but after 9 cycles of treatment, the disease progressed. The patient also underwent radiotherapy to treat brain lesions, but the disease continued to progress. Analysis of liquid biopsies revealed a new mutation, ALK p.G1202R, which was responsible for resistance to Alectinib. The mutant allele frequency of RB1 and TP53 mutations also increased. The patient then received Ensartinib as third-line treatment, but the primary lung lesion continued to grow and the mutant allele frequency of RB1, TP53, and ALK p.G1202R increased. The concentrations of NSE, CA19-9, and CEA also increased. The patient is currently receiving Anlotinib in combination with CPT-11 and has been stable for over 13 months.<br /><br />This case report highlights the challenges of treating ALK-positive SCLC and the need for better understanding of the mechanisms of resistance to ALK-TKIs. It also suggests the potential of non-invasive tumor molecular profiling using next-generation sequencing (NGS) to monitor treatment response and detect resistance mutations. The report concludes by noting that the treatment of ALK-TKIs resistance in SCLC needs further discussion.

Asset Subtitle

Renhong Guo

Meta Tag

Speaker Renhong Guo

Topic Small Cell Lung Cancer and Neuro-endocrine Tumours - Informing ES-SCLC

Keywords

ALK-positive small-cell lung cancer

tyrosine kinase inhibitors

Alectinib

disease progression

liquid biopsies

ALK p.G1202R mutation

Ensartinib

treatment response

next-generation sequencing

resistance mutations