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Case Reports
. 2022 Jan:6:e2100400.
doi: 10.1200/PO.21.00400.

Exceptional Clinical Response to Alectinib in Pancreatic Acinar Cell Carcinoma With a Novel ALK-KANK4 Gene Fusion

Marina Gaule  1   2 , Camilla Pesoni  1   2 , Alberto Quinzii  1   2 , Camilla Zecchetto  1   2 , Simona Casalino  1   2 , Valeria Merz  2   3 , Serena Contarelli  2 , Silvia Pietrobono  2 , Elena Vissio  4 , Luca Molinaro  4 , Enrica Manzin  5 , Roberta Volpatto  5 , Giorgio Vellani  5 , Davide Melisi  1   2
Affiliations
Case Reports

Exceptional Clinical Response to Alectinib in Pancreatic Acinar Cell Carcinoma With a Novel ALK-KANK4 Gene Fusion

Marina Gaule et al. JCO Precis Oncol. 2022 Jan.
No abstract available

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Conflict of interest statement

Valeria MerzConsulting or Advisory Role: Amgen Davide MelisiConsulting or Advisory Role: Baxter, Lilly, Evotec, Incyte, iOncturaResearch Funding: Shire, Celgene, Incyte, iOnctura, RocheNo other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
Histologic features of the tumor. (A) Micrograph of the lesion, consisting of large nodules of tumor cells. (B) Micrograph of the tumor at higher magnification, showing tumor cells disposed in acinar structures and characterized by rounded nuclei with finely dispersed chromatin and conspicuous nucleoli. (C) Negative immunohistochemical reaction for chromogranin A with some scattered non–neoplastic-positive cells. (D) Negative immunohistochemical stain for synaptophysin with a remaining cluster of non–neoplastic-positive cells.
FIG 2.
FIG 2.
(A) Fluorescence in situ hybridization analysis using a break-apart probe. A fusion of the red and green signals corresponds to the intact chromosome, and the split signals are indicative of the ALK rearrangement. (B) Immunohistochemistry for ALK by using 5A4 antibody. Tumor cells show cytoplasmic expression of the protein (40×) while the rest of cells are completely negative (10×). ALK, anaplastic lymphoma kinase.
FIG 3.
FIG 3.
CT scan showing (A) supraclavicular left lymph node, (D) liver, and (G) abdominal lymph nodes before and during treatment with alectinib after the detection of a novel KANK4-ALK genes fusion. After (B, E, and H) 2 and (C, F, and I) 4 months of alectinib, CT scan detected decreasing of target metastasis. Colored lines indicate lesions' major diameters. CT, computed tomography.
See this image and copyright information in PMC

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