Evaluation of Crizotinib Treatment in a Patient With Unresectable GOPC-ROS1 Fusion Agminated Spitz Nevi

Abstract

We thank the patient's parents for granting permission to publish this information.

Successful treatment of adult-onset auricular agminated Spitz nevi with cryotherapy: A case report with an 11-year follow-up and literature review

“…The use of crizotinib-targeted therapy (280 mg/m 2 twice daily) was reported in a 30-month-old girl with unresectable ASN and known GOPC-ROS1 kinase fusion. 3 Complete flattening of the periocular, scalp, and auricular lesions to faintly pigmented macules was achieved after 20 weeks of treatment. Crizotinib was well tolerated, apart from mild nausea and vomiting, but a nasogastric tube was required for drug administration, and lesions reappeared gradually following treatment.…”

“…Our literature review identified several procedural and pharmacologic interventions for ASN, including surgical excision with or without a skin graft, electrodesiccation, cryotherapy, and the use of crizotinib, a multitargeted tyrosine kinase inhibitor. 3 , 4 The undertaking of nonsurgical techniques such as cryotherapy of Spitzoid melanocytic neoplasms rests on accurate diagnosis and exclusion of similar neoplasms that have uncertain or malignant biologic behavior, such as Spitz tumors and Spitzoid melanomas.…”

“…However, complete excision is not always feasible, 5 and recurrence after excision has been reported. 3 , 6 Clinical presentation and histopathologic features should be considered when determining the follow-up duration and frequency of postoperative monitoring. One case of temporary clearance with electrodesiccation was reported for a 9-year-old girl with over 20 lesions of ASN on her upper portion of the right arm since birth, but all lesions returned 8 years after treatment.…”

“… 1 , 2 Genetic anomalies associated with ASN include mosaic mutations and oncogene translocations. 3 Given the absence of recommendations for treating adult-onset ASN, we reviewed the literature on treatment options and present a case of adult-onset auricular ASN successfully treated with cryotherapy.…”

Cancer Therapy Guided by Mutation Tests: Current Status and Perspectives

“…NTRK1/2/3 gene rearrangements, which are found at a reasonable frequency in pediatric tumors but are exceptionally rare in adults, are associated with the tumor's responsiveness to entrectinib or larotrectinib [105][106][107][108]. ALK, ROS1 and RET rearrangements, although not formally classified as agnostic markers, occur in multiple tumor types and render sensitivity to appropriate inhibitors [63,[109][110][111][112]. HER2 amplification accompanied by gene overexpression may also be considered as an example of a more or less agnostic druggable event [113][114][115].…”