Concomitant Presence of EGFR and ALK Fusion Gene Mutation in Adenocarcinoma of Lung: A Case Report and Review of the Literature

J Pharm Pract. 2018 Apr;31(2):244-248. doi: 10.1177/0897190017704751. Epub 2017 Apr 25.

Abstract

Empirical evidence has long suggested that oncogenic driver mutations in non-small-cell lung cancer are mutually independent. However, recent studies reported in pertinent literature reveal that concomitant epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangement can occur in a subset of patients with NSCLC. In order to shed further light on this issue, we report a case of adenocarcinoma of lung harboring both EGFR mutation in exon 21 (L861Q) and ALK rearrangement. This allows us to speculate on likely molecular mechanisms underlying this uncommon phenomenon, while also offering some practical guidelines on the therapeutic options that could benefit patients diagnosed with this dual-positive tumor.

Keywords: ALK; EGFR; acquired resistance; adenocarcinoma; concomitant; driver mutation; lung.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / genetics*
  • Adenocarcinoma of Lung
  • Aged
  • Anaplastic Lymphoma Kinase
  • ErbB Receptors / genetics*
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / genetics*
  • Male
  • Mutation / genetics*
  • Receptor Protein-Tyrosine Kinases / genetics*

Substances

  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • EGFR protein, human
  • ErbB Receptors
  • Receptor Protein-Tyrosine Kinases