当前位置： SCI文献检索 > BMC Pulmonary Medicine期刊下所有文献 > Spontaneous regression of ALK fusion protein-positive non-small cell lung carcinoma: a case report and review of the literature.

Spontaneous regression of ALK fusion protein-positive non-small cell lung carcinoma: a case report and review of the literature.

Abstract：

BACKGROUND:ALK-rearrangement is observed in < 5% non-small cell lung cancer (NSCLC) cases and prior to the advent of oral tyrosine kinase inhibitors, the natural history of oncogenic NSCLC was typically poor. Literature relating to regression of treatment-naïve NSCLC is limited, and regression without treatment has not been noted in the ALK-rearranged sub-population. CASE PRESENTATION:A 76 year old 'never smoker' female with an ALK-rearranged left upper lobe T2 N0 NSCLC experienced a stroke following elective DC cardioversion for new atrial fibrillation. Following a good recovery, updated imaging demonstrated complete regression of the left upper lobe lesion and a reduction of the previously documented mediastinal lymph node. Remaining atelectasis was non-avid on repeat PET-CT imaging, 8 months from the baseline PET-CT. When the patient developed new symptoms 6 months later a further PET-CT demonstrated FDG-avid local recurrence. She completed 55 Gy in 20 fractions but at 18 months post-radiotherapy there was radiological progression in the lungs with new pulmonary metastases and effusion and new bone metastases. Owing to poor performance status, she was not considered fit for targeted therapy and died 5 months later. CONCLUSION:All reported cases of spontaneous regression in lung cancer have been collated within. Documented precipitants of spontaneous regression across tumour types include biopsy and immune reconstitution; stroke has not been reported previously. The favourable response achieved with radical radiotherapy alone in this unusual case of indolent oncogenic NSCLC reinforces the applicability of radiotherapy in locally advanced ALK-rearranged tumours, in cases not behaving aggressively. As a common embolic event affecting the neurological and pulmonary vasculature is less likely, an immune-mediated mechanism may underpin the phenomenon described in this patient, implying that hitherto unharnessed principles of immuno-oncology may have relevance in oncogenic NSCLC. Alternatively, high electrical voltage applied percutaneously adjacent to the tumour during cardioversion in this patient may have induced local tumour cell lethality.

journal_name

BMC Pulm Med

journal_title

BMC pulmonary medicine

authors

Walls M,Walls GM,James JA,Crawford KT,Abdulkhalek H,Lynch TB,Peace AJ,McManus TE,Evans OR

doi

10.1186/s12890-020-01249-w

subject

Has Abstract

pub_date

2020-08-06 00:00:00

pages

209

issue

issn

1471-2466

pii

10.1186/s12890-020-01249-w

journal_volume

pub_type

杂志文章

在线工具

Spontaneous regression of ALK fusion protein-positive non-small cell lung carcinoma: a case report and review of the literature.