2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.069 Sarah Waliany NACLC23 Abstract

PP01.069 Sarah Waliany NACLC23 Abstract

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This study discusses the genomic profiling and molecular characteristics of two cases of atypical lung carcinoid with ALK fusion. The first case involves a 66-year-old female with a mediastinal mass and an azygoesophageal recess nodule. Biopsies revealed adenosquamous carcinoma and atypical carcinoid, and ALK immunoreactivity was detected. Next-generation sequencing confirmed an EML4-ALK fusion at both disease sites. The patient was treated with lorlatinib and achieved a partial response after 5 months. <br /><br />The second case involves a 58-year-old female with a mediastinal mass, pleural nodularity, and osseous lesions. Biopsies confirmed atypical carcinoid, and NGS testing detected EML4-ALK fusion. The patient initially had tumor shrinkage on alectinib but experienced progression at 5 months. Liquid biopsy NGS revealed ALK resistance mutations. Second-line treatment with lorlatinib resulted in a partial response for 7 months. Further resistant plasma NGS showed multiple ALK mutations. <br /><br />The results demonstrate that patients with ALK fusion-positive advanced atypical lung carcinoids can benefit from ALK tyrosine kinase inhibitor therapy. This highlights the importance of genomic biomarker profiling in lung carcinoids, which typically have limited systemic therapy options. <br /><br />Further molecular analysis of the first case is ongoing and planned for inclusion in a congress presentation. The study emphasizes the need for more data and research on optimal management and mechanisms of resistance in this patient population.

Keywords

genomic profiling

molecular characteristics

atypical lung carcinoid

ALK fusion

lorlatinib

partial response

liquid biopsy NGS

ALK tyrosine kinase inhibitor therapy

genomic biomarker profiling

systemic therapy options