ArticleFrontiers in oncology2026
Case Report: Tyrosine kinase inhibitors in ROS1-rearranged and granulocyte colony-stimulating factor-producing lung squamous cell carcinoma.
Article in Frontiers in oncology, 2026. 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
Background: c-ros oncogene 1 (ROS1) fusions occur in less than 0.2% of lung squamous cell carcinomas (SqCCs). Concurrent production of granulocyte colony-stimulating factor (G-CSF) induces marked leukocytosis and is associated with aggressive tumor behavior and resistance to conventional therapies. Here, we report a case with this rare and aggressive dual-pathology subtype response to tyrosine kinase inhibitors. Case presentation: A 53-year-old male smoker with stage IVb SqCC (cT3N3M1) presented marked leukocytosis, and elevated serum G-CSF. The disease progressed following platinum-doublet chemotherapy and immunotherapy, despite a programmed death ligand 1 (PD-L1) tumor proportion score of 50% or greater. Next-generation sequencing revealed an Ezrin (EZR)-ROS1 fusion. Initiation of crizotinib induced rapid partial response and leukocytosis normalization for 6 months. Sequential lorlatinib achieved sustained disease control for 10 months. Due to economic considerations, entrectinib was initiated and that maintained over 15-month ongoing response with minimal toxicity of grade 1 anemia. Conclusion: This report suggests ROS1 fusion, G-CSF-producing lung SqCC could achieve a favorable response to molecularly-guided therapy with ROS1-tyrosine kinase inhibitors, highlighting a potential therapeutic strategy for this rare subgroup.
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