2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.69 (Poster) Atypical Lung Carcinoids with EML4::ALK Fusion and Responses to ALK Inhibitors

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This study presents two cases of atypical lung carcinoids with EML4::ALK fusion and their responses to ALK tyrosine kinase inhibitors (TKIs). Case #1 is a 66-year-old female with metastatic mixed histology non-small cell lung carcinoma, including atypical carcinoid, squamous, and adenocarcinoma components. The tumor was positive for EML4::ALK fusion and she was treated with lorlatinib as first-line therapy, achieving a partial response that is ongoing at 5 months. Case #2 is a 58-year-old female with metastatic atypical carcinoid also positive for EML4::ALK fusion. She received alectinib as first-line therapy, resulting in stable disease for 5.2 months, followed by lorlatinib as second-line therapy, leading to a partial response with a progression-free survival of 6.7 months. Both patients underwent genomic profiling, and the molecular alterations detected in their tumors were consistent with the response to ALK TKIs.<br /><br />The study highlights the potential clinical benefit of ALK TKI therapy in patients with ALK fusion-positive atypical lung carcinoids. These findings suggest the importance of genomic biomarker profiling in this particular subtype of lung carcinoids, which typically have limited systemic therapy options. The use of ALK TKIs in these cases resulted in meaningful clinical responses and highlights the potential for personalized treatment approaches based on genomic alterations. Further studies are needed to better understand the prevalence and clinical significance of ALK fusions in atypical lung carcinoids, as well as to explore the efficacy of ALK TKIs in larger patient populations. Overall, this study provides valuable insights into the management of atypical lung carcinoids with EML4::ALK fusion and underscores the importance of genomic profiling in informing treatment decisions for these patients.

Asset Subtitle

Sarah Waliany

Keywords

atypical lung carcinoids

EML4::ALK fusion

ALK tyrosine kinase inhibitors

lorlatinib

alectinib

genomic profiling

molecular alterations

systemic therapy options

personalized treatment approaches

genomic biomarker profiling