ArticleOncology letters2025
Alectinib efficacy in advanced lung adenocarcinoma with coexistence of a novel ALK-MTUS2 and STRN3-ALK double fusion: A case report and literature review.
Article in Oncology letters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In total, >90 unique anaplastic lymphoma kinase (ALK) rearrangement fusion partners have been identified, each with a unique sensitivity to ALK tyrosine kinase inhibitors, rendering targeted therapy challenging. In the present study, the efficacy of alectinib in a patient with advanced lung adenocarcinoma harbouring a novel ALK-microtubule-associated tumour suppressor candidate 2 (MTUS2) fusion and a rare Striatin 3 (STRN3)-ALK fusion was assessed. A 20-year-old non-smoker was hospitalised with a persistent cough. Subsequent positron emission tomography/computed tomography revealed a tumour in the right lower lobe, with mediastinal, hilar, lymph node and bone metastases. Cranial magnetic resonance imaging also revealed a cerebral metastasis. Bronchoscopic biopsy revealed an adenocarcinoma in the right lower lobe nodule, resulting in a clinical stage IVB diagnosis (cT2bN3bM1c). Targeted next-generation sequencing of tissue and blood samples revealed ALK-MTUS2 and STRN3-ALK fusions. The patient was treated with alectinib as the first-line therapy and a durable partial response was achieved after 3 months, with disappearance of the brain metastases. To the best of our knowledge, the present study represents the first discovery of simultaneous ALK-MTUS2 and STRN3-ALK fusions. The clinical outcome offers potential therapeutic options for patients with rare ALK rearrangements and underscores the necessity for further research on the functions of these fusions.
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