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Case Reports
. 2022 Feb 14:12:804330.
doi: 10.3389/fonc.2022.804330. eCollection 2022.

Case Report: Dramatic Response to Crizotinib in a Patient With Non-Small Cell Lung Cancer Positive for a Novel ARL1-MET Fusion

Qing Ma  1 , Lingping Kong  1 , Diansheng Zhong  1
Affiliations
Case Reports

Case Report: Dramatic Response to Crizotinib in a Patient With Non-Small Cell Lung Cancer Positive for a Novel ARL1-MET Fusion

Qing Ma et al. Front Oncol. .

Abstract

It is imperative to know the status of oncogenic drivers in patients with non-small cell lung cancer (NSCLC). Compared with ALK and ROS1 fusion, MET fusion is relatively rare in NSCLC. In this case, we report the case of a female patient with NSCLC positive for a novel ARL1-MET fusion. The patient achieved about a 5-month progression-free survival (PFS) after receiving crizotinib for unresectable right lung malignancies. To the best of our knowledge, this case provides the first clinical evidence that the novel ARL1-MET fusion might be an actionable mutation in NSCLC.

Keywords: ARL1-MET fusion; case report; crizotinib; non-small cell lung cancer; targeted therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Radiographic imaging at diagnosis and pathological findings. (A) The subsolid nodule under the pleura of the upper left lobe and the soft tissue density nodule in the right middle lobe and near the hilum revealed by computed tomography (CT) or positron emission tomography (PET). (B) Pathological examination revealed the subsolid nodule under the pleura of the upper left lobe was adenocarcinoma. Pathology showed the initial and the second biopsy of soft tissue density nodule in the right lung were adenosquamous carcinoma and squamous carcinoma, respectively. Interpretation of immunohistochemistry (IHC) performed on the initial biopsy was challenging as most tumor cells were TTF-1 positive suggesting adenocarcinoma. However, there was clear and diffuse positivity for p40 in some cells with corresponding lack of Napsin A. This suggested both glandular and squamous differentiation. In the second biopsy, p40 was diffuse with complete lack of adenocarcinoma markers TTF-1 and Napsin A, consistent with squamous cell carcinoma.
Figure 2
Figure 2
ARL1-MET fusion was detected in the patient. (A) Sequencing reads of the ARL1-MET fusion revealed by the Integrative Genomics Viewer (IGV). (B) Illustration of ARL1-MET fusion.
Figure 3
Figure 3
Dynamic imaging of the soft tissue density nodule in the right middle lobe and near the hilum during the treatment with crizotinib.
Figure 4
Figure 4
Case timeline. * a premature stop codon due to frameshift mutation or deletion mutation.
See this image and copyright information in PMC

References

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