PMC9372703_01
Histological findings (40x magnification). (a) Hematoxylin and eosin-stained biopsy specimen reveals adenocarcinoma; (b) immunohistochemical analysis showing ALK-positive staining; (c) keratin 7 (CK7)-positive staining; and (d) thyroid transcription factor-1 (TTF-1)-positive staining. Scale bars represent 50 mum.
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Besides, there was a positive staining for ALK-V and a negative staining for ROS-1 expression (Figure 1).
(a) Sequencing reads of ALK and SLC8A1 are shown by the Integrative Genomics Viewer. SLC8A1 and ALK both located on chromosome 2, the two genes translocation leading to a new fusion oncogene SLC8A1-ALK. (b) Schematic structure of the genomic DNA sequence shows fusion points for the SLC8A1-ALK fusion gene. Exon 2 of the SLC8A1 gene rearranged with exon 20 of the ALK gene.
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The patient's tumor tissues were subjected to next-generation sequencing at the DNA level based on 61 genetic panels on biopsy specimens (Nova-Seq 6000, Illumina Corporation), which revealed a rare ALK rearrangement, SLC8A1-ALK (allele frequency = 10.39%) (Figure 2a and b).
Lung adenocarcinoma shown by radiologic. Dynamic imaging of CT scan of patients treated with alectinib showing target lesions, mass invasion of the left pulmonary artery and response of liver metastases at baseline, 2 and 4 months of treatment.
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After 2 months of this therapy, CT scans were repeated, and the images showed that the lesions had obviously decreased in size to 1.9 cm x 1.7 cm (Figure 3).