ABSTRACT
Objective:To investigate the efficacy and safety of targeted therapy with Crizotinib for children with ALK gene mutation positive inflammatory myofibroblastic tumor (IMT). Methods:A retrospective analysis was performed on 4 children with ALK gene mutation positive IMT admitted to Shanghai Children′s Hospital from January 2019 to June 2021.Among them, 3 cases were given the targeted drug Crizotinib[280 mg/(m 2· time), q12h] orally, and 1 case was observed after complete tumor resection to analyze the efficacy and adverse drug reactions. Results:All 4 cases were male, aged from 2 years and 3 months to 11 years and 3 months.The tumors originated from the abdominal cavity in 2 cases, the right orbit in 1 case, and the right lung in 1 case.Pathological immunohistochemistry and fluorescence in situ hybridization were both positive for ALK gene mutation, and complete remission was achieved after comprehensive treatment.Among them, 3 patients were treated with oral Crizotinib, and 2 patients were tried to stop taking the drug for 1 year, relapsed 1 month later, and still achieved complete remission after the second treatment.The 4 cases were followed up for 8-30 months, and all survived.All the cases showed no abnormalities in blood image, liver and kidney function, myocardial enzyme profile, cardiac function, hearing and vision, and 2 cases showed prolonged Q-T interval in the course of Crizotinib treatment, which could be recovered by temporary withdrawal of drug, and no abnormality in electrocardiogram was found in continued drug use. Conclusions:Crizotinib was used to treat ALK mutation positive IMT, shrink tumor and consolidate postoperative treatment, which is a good choice for IMT in children with difficult surgical resection and refractory recurrence.
ABSTRACT
The incidence of ALK gene rearrangement in non-small cell lung cancer (NSCLC) was about 3% to 5%. ALK gene inhibitors have made great breakthrough in recent years, significantly extending the survival period of patients with ALK(+) advanced NSCLC. But the majority of patients will be acquired drug resistance after treatment. This article has been explained separately from the ALK genetic background, the detection method, the treatment of the three generations of ALK inhibitors and the strategy after drug resistance. It is desire to have reference value and reference meaning for clinical work. .
Subject(s)
Humans , Anaplastic Lymphoma Kinase , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Genetics , Drug Resistance, Neoplasm , Genetics , Gene Fusion , Lung Neoplasms , Drug Therapy , Genetics , Protein Kinase Inhibitors , Pharmacology , Therapeutic Uses , Receptor Protein-Tyrosine Kinases , GeneticsABSTRACT
Objective To investigate the characteristics and clinical significance of epidermal growth factor receptor(EGFR) gene mutation and anaplastic lymphoma kinase(ALK) gene rearrangement in the patients with pneumonia-type lung adenocarcinoma.Methods A total of 154 cases of lung adenocarcinoma definitely diagnosed by histopathology in Xinqiao Hospital from January to August 2016 servedas the research subjects and divided into pheumonia-type lung carcinoma(PTLC,30 cases) and non-pneumonia-type lung carcinoma(non-PTLC,124 cases) according to the imaging manifestations.The EGFR gene detection was performed in 154 cases,among them 87 cases simultaneously conducted the ALK gene rearrangement detection.The EGFR mutation rate andALK gene rearrangement rate were compared between PTLC and non-PTLC,and their clinical characteristics differences were investigated.Results The mutation rate of EGFR,which PTLC occurred less frequently than non-PTLC in lung adenocarcinoma (20.0 ％ vs.47.6 ％,P＜0.05).The age,smoking history,sex,tumor family history,ALK gene rearrangement and TNM stage had no statistical differences between the two groups(P＞0.05).The total mutation rate of EGFR gene was 42.2％ (65/154).The smoking history and sex were related with the EGFR gene mutation,while the age and tumor family history had no obvious relation with EGFR gene mutation.The total ALK gene rearrangement rate was 11.5 ％.The smoking history,tumor family history,sex and age had no obvious relation with the ALK gene rearrangement.Among 87 cases of EGFR and ALK simultaneous gene detection,the co-existence of EGFR gene mutation and ALK rearrangement was not found.Conclusion Imaging findlings of patients with PTLC,it should be conducted to detection that EGFR gene mutation and ALK gene rearrangenment,in order to formulate comprehensive management scheme in the patients with advanced tumor.
ABSTRACT
Objective To investigate the characteristics and clinical significance of epidermal growth factor receptor(EGFR) gene mutation and anaplastic lymphoma kinase(ALK) gene rearrangement in the patients with pneumonia-type lung adenocarcinoma.Methods A total of 154 cases of lung adenocarcinoma definitely diagnosed by histopathology in Xinqiao Hospital from January to August 2016 servedas the research subjects and divided into pheumonia-type lung carcinoma(PTLC,30 cases) and non-pneumonia-type lung carcinoma(non-PTLC,124 cases) according to the imaging manifestations.The EGFR gene detection was performed in 154 cases,among them 87 cases simultaneously conducted the ALK gene rearrangement detection.The EGFR mutation rate andALK gene rearrangement rate were compared between PTLC and non-PTLC,and their clinical characteristics differences were investigated.Results The mutation rate of EGFR,which PTLC occurred less frequently than non-PTLC in lung adenocarcinoma (20.0 ％ vs.47.6 ％,P＜0.05).The age,smoking history,sex,tumor family history,ALK gene rearrangement and TNM stage had no statistical differences between the two groups(P＞0.05).The total mutation rate of EGFR gene was 42.2％ (65/154).The smoking history and sex were related with the EGFR gene mutation,while the age and tumor family history had no obvious relation with EGFR gene mutation.The total ALK gene rearrangement rate was 11.5 ％.The smoking history,tumor family history,sex and age had no obvious relation with the ALK gene rearrangement.Among 87 cases of EGFR and ALK simultaneous gene detection,the co-existence of EGFR gene mutation and ALK rearrangement was not found.Conclusion Imaging findlings of patients with PTLC,it should be conducted to detection that EGFR gene mutation and ALK gene rearrangenment,in order to formulate comprehensive management scheme in the patients with advanced tumor.