title: Crizotinib Response in a Late Relapse of ALK-positive Lung Adenocarcinoma.
abstract: Anaplastic lymphoma kinase (ALK) rearrangement is a therapeutic target in non-small cell lung cancer. To date, few reports have been provided related to ALK-rearranged late recurrence and sensitivity to the treatment with specific ALK inhibitors. We report a case of a 35-year-old man who underwent a right lower lobe lobectomy for lung adenocarcinoma, and treated with the platinum-based chemotherapy regimen. After 10 healthy years, he developed a lung nodule in the same site as the previous. Cytopathologic diagnosis was lung adenocarcinoma. Furthermore, the pulmonary nodule was considered a late recurrence in relation to the lymph node involvement, the same histotype and the site, ALK fluorescence in situ hybridization test and epidermal growth factor receptor analysis were performed on the formalin-fixed paraffin-embedded specimens of the previous resected tumor, because of inadequacity cytologic sample. Being positive for ALK rearrangement, the patient was treated with crizotinib with a good response. To the best of our knowledge, it is the first case of a late relapse of ALK-positive lung adenocarcinoma sensitive to crizotinib in the literature.
authors.affiliation: *Pathology Unit †Medical Oncology Unit, Department of Thoracic Surgical and Medical Oncology §Department of Thoracic Surgical and Medical Oncology, Division of Thoracic Surgery, Istituto Nazionale dei Tumori "Fondazione G. Pascale"-IRCCS ∥Department of Oncology and Anatomic Pathology, Hospital of National Relevance (AORN) Vincenzo Monaldi ¶Pathology Unit, Department of Psychiatry, University of Naples SUN, Naples ‡Division of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Zito Marino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morabito
authors.forename: Cesare
authors.initials: C
authors.lastname: Gridelli
authors.forename: Gaetano
authors.initials: G
authors.lastname: Rocco
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Liguori
authors.forename: Nicla
authors.initials: N
authors.lastname: De Rosa
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Renato
authors.initials: R
authors.lastname: Franco
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077547:Crizotinib; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011720:Pyrazoles / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases