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. 2016 Oct 2;17(10):1089-1093.
doi: 10.1080/15384047.2016.1219822. Epub 2016 Sep 10.

Long Time Response With Chemotherapy in ROS1 NSCLC Patient With Unusual Metastatic Site

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Free PMC article

Long Time Response With Chemotherapy in ROS1 NSCLC Patient With Unusual Metastatic Site

Tindara Franchina et al. Cancer Biol Ther. .
Free PMC article

Abstract

During the last decade the therapeutic landscape of Non Small Cell Lung Cancer (NSCLC) has profoundly changed with the identification of actionable genetic alterations that defined molecularly selected subgroups of patients with specific clinic-pathological characteristics and increased sensitivity to specific targeted agents. The presence of ROS1 rearrangements defines a small subgroup of lung adenocarcinomas (∼1-2%) with peculiar clinic-pathological characteristics and increased sensitivity to Crizotinib. It has been reported that ROS1-tranlslocated NSCLCs may also respond well to Pemetrexed-based chemotherapy. Moreover, patients with oncogene-addicted NSCLC may present peculiar pattern of metastatization and, in some instances, are associated with unusual site of metastases. Herein, we present a case of a young woman with bilateral ovarian metastases from a ROS1-positive adenocarcinoma of the lung with a lengthy progression-free survival on Pemetrexed-containing chemotherapy.

Keywords: NSCLC; ROS1; genetic rearrangements; long survivor; ovarian metastases; pemetrexed.

Figures

Figure 1.
Figure 1.
(A) Baseline 18FDG-PET scan; [B] FDG-PET after the first 3 cycles of 1st line Cisplatin-Pemetrexed chemotherapy.
Figure 2.
Figure 2.
(A) FDG-PET after 18 courses of Pemetrexed maintenance; (B) ROS1 FISH assay performed on ovarian metastases with the SPEC ROS1 Dual Color Break Apart Probe (band 6q22.1); (C) FDG-PET after surgery removal of ovarian metastases, documenting the persistence of disease limited to the right lung and homolateral pleura.
Figure 3.
Figure 3.
CT scans showing progressive disease with emergence of pleural effusion, an hepatic lesion, ascites and peritoneal nodules.

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