Alectinib-targeted Therapy in Squamous Cell Lung Carcinoma with Multiple Target Mutations after Chemotherapy Failure:a Case Report
Objective To summarize effective treatments for coexisting squamous cell lung carcinoma with anaplastic lymphoma kinase(ALK)gene fusion,epidermal growth factor receptor(EGFR)gene mutation,and human epidermal growth factor receptor 2(HER2)gene mutation.Methods A retrospective analysis of the treatment of a patient(female,51 years old,no smoking history)with squamous lung cancer with polygenic mutations in the ALK gene,EGFR gene,and HER2 gene was performed.Results The patient presented with"coughing up sputum with blood in the sputum for 2 days",and imaging,bronchoscopy and pathologic biopsy suggested squamous carcinoma.The diagnosis was squamous carcinoma of the left lung(cT3N2M0 stage ⅢB),with lymph node metastasis in the left hilar and mediastinum.The patient initially received chemotherapy plus immunotherapy(Albumin paclitaxel 200 mg+carboplatin 380 mg+Tislelizumab 200 mg)for anti-tumor treatment,and was subsequently treated with alectinib 600 mg bid for targeted therapy due to intolerance of drug toxicities.The mass was significantly reduced after 1 month of targeted therapy,and after 5 cycles of Alectinib use,the patient underwent thoracoscopic lobectomy;the postoperative pathology reached pathologic complete response(pCR);the patient continued to take oral Alectinib-targeted therapy and did not complained of any other significant symptoms.Conclusion For non-smoking female squamous cell lung cancer patients who have failed chemotherapy,our findings suggest that it is necessary to improve genetic testing to find opportunities for targeted therapy.Squamous lung cancer patients with polygenic mutations,mainly ALK fusion mutations,can benefit clinically from ALK inhibitor therapy,which also suggests the safety and possibility of targeted neoadjuvant therapy for squamous lung cancer.
万方数据
维普
