Use of crizotinib as neoadjuvant therapy for non‐small cell lung cancers patient with ROS1 rearrangement: A case report

Abstract

Crizotinib showed significant antitumor effect in patients with advanced ROS1‐rearranged non‐small cell lung cancers (NSCLC). Most recently, many studies have explored the feasibility and efficacy of target therapy for perioperative application in NSCLC. Here, we describe a female patient who was diagnosed with stage IIIB lung adenocarcinoma exhibiting a CCDC6‐ROS1 rearrangement by high‐throughput sequencing. The tumor and lymph nodes showed durable response after the treatment of crizotinib. Given that a radiological downstaging was indicated, a right lower lobectomy and systemic lymphadenectomy were successfully performed. The pathological response was 60% and the tumor, nodes, and metastases (TNM) stage was ypT2bN0M0. The PD‐L1 expression and activity of immunological cells were also investigated.

Neoadjuvant Savolitinib targeted therapy stage IIIA-N2 primary lung adenocarcinoma harboring MET Exon 14 skipping mutation: A case report

“…Previous clinical trials have already verified the availability of EGFR and ALK inhibitors neoadjuvant targeted therapy in the disease control and pathological downstaging for early-stage NSCLC patients harboring the corresponding mutation, and some case reports also observed that target therapy provided effective radiologic and pathologic response in ALK , RET and ROS1 -positive resectable NSCLC patients ( 3 , 6 , 13 – 15 ). MET ex14m is an independent oncogenic driver occurring in 2.8% of resected stage I-III NSCLC patients ( 16 ).…”

“…Immunohistochemistry outcomes were presented as: HE (A), TTF-1 (+) (B), NapsinA (+) (C), CK7 (+) (D), CK5/6 (-), CK (pan) (+), and Ki-67 (+, about 50%). some case reports also observed that target therapy provided effective radiologic and pathologic response in ALK, RET and ROS1-positive resectable NSCLC patients (3,6,(13)(14)(15). METex14m is an independent oncogenic driver occurring in 2.8% of resected stage I-III NSCLC patients (16).…”

“…Savolitinib is an oral, potent and highly selective type Ib MET inhibitor that has yielded promising activity and acceptable safety profile in patients with pulmonary sarcomatoid carcinoma and other NSCLCs harboring METex14m (2). Recently, a growing body of research has shown the feasibility of the neoadjuvant targeted therapy for early-stage resectable NSCLC patients with anaplastic lymphoma kinase (ALK) fusion gene, epidermal growth factor receptor (EGFR) mutations, RET rearrangements and ROS proto-oncogene 1 (ROS1) rearrangements (3)(4)(5)(6). The fact suggests that the untargeted patients with METex14m had a shorter disease-free survival (DFS) (7).…”

Use of Pralsetinib as Neoadjuvant Therapy for Non-Small Cell Lung Cancer Patient With RET Rearrangement

“…Pralsetinib was approved by the Food and Drug Administration (FDA) for treating RET fusion-positive NSCLC in 2020. Several studies have verified the availability of neoadjuvant-targeted therapy for NSCLC patients with ROS1, ALK, and epidermal growth factor receptor (EGFR) alterations ( 7 – 9 ); however, there are no reports regarding pralsetinib as neoadjuvant treatment for NSCLC patients with a RET rearrangement.…”

Efficacy and safety of camrelizumab (a PD‑1 inhibitor) combined with chemotherapy as a neoadjuvant regimen in patients with locally advanced non‑small cell lung cancer

“…In order to give patients the opportunity of undergoing surgery, neoadjuvant chemotherapy has been proposed, particularly in patients with locally advanced NSCLC ( 5 – 8 ). Notably, in patients with locally advanced NSCLC exhibiting sensitive gene mutations [such as epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) alterations], the addition of a tyrosine kinase inhibitor to chemotherapy as the neoadjuvant regimen could further improve the patient prognosis; however, in patients without sensitive gene alterations, these novel drugs are not applicable ( 9 – 11 ).…”