阿法替尼治疗一例ALK突变阳性肺鳞癌患者疗效分析

Analysis of the Efficacy of Afat-inib in the Treatment of ALK-Positive Squamous Cell Carcinoma

探讨针对ALK突变阳性肺鳞癌患者的肿瘤靶向治疗,提高对其诊治水平。报道一例ALK突变阳性肺鳞癌及其靶向治疗,同时对国内外报道的相关文献进行复习。患者,男,54岁,因“干咳伴发热1月余”入院。经气管镜活检诊断为肺鳞状细胞癌,基因检测(NGS)示EML4-ALK基因融合。行阿来替尼靶向联合化疗治疗2周期,后单药阿来替尼靶向治疗6周,复查CT显示病情进展。猜测可能含有ALK重排的肺鳞癌对阿来替尼的反应较低,但肺鳞癌中ALK基因融合非常罕见,针对ALK基因突变阳性肺鳞癌患者的ALK-TKI治疗效果尚需进一步的研究证实。

To explore the tumor targeted therapyfor patients with ALK mutation positive lung squamous cell carcinoma and toimprove the level of diagnosis and treatment. This paper reports a case of ALKmutation positive lung squamous cell carcinoma and its targeted therapy, andreviews the relevant literature at home and abroad. The patient, male, 54 yearsold, suffered from “dry cough with fever for more than 1 month” behospitalized. Lung squamous cell carcinoma was diagnosed by tracheoscopic biopsy. Gene detection (NGS) showedEML4-ALK gene fusion. The patients were treated with targetedcombination chemotherapy of afatinib for 2 cycles, followed by targetedtreatment of single drug afatinib for 6 weeks, and the CT reexamination showedthe progress of the disease. It is speculated that lung squamous cell carcinomawith ALK rearrangement may have a low response to afatinib. But ALK gene fusionin lung squamous cell carcinoma is very rare, the therapeutic effect ofafatinib on patients with ALK gene mutation positive lung squamous cellcarcinoma needs to be confirmed by further research.