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Alectinib is a highly selective tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) that is approved as first-line treatment in adult patients with ALK-positive non-small cell lung cancer (NSCLC) and as second-line in patients previously treated with crizotinib, and has been shown in the literature to significantly prolong progression-free survival compared to chemotherapy in patients with advanced non-small cell lung cancer. The authors describe a clinical case of a 24-year-old woman with malignant massive pleural effusion caused by ALK rearranged pulmonary adenocarcinoma with pleural and pericardial metastasis, in which, despite a dramatic clinical debut, the correct and timely management of the diagnostic and therapeutic path allowed for extraordinary therapeutic success.
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http://dx.doi.org/10.4081/monaldi.2022.2388 | DOI Listing |
Korean J Clin Oncol
August 2025
Department of Clinical Medicine (IKM), University of Copenhagen, Copenhagen, Denmark.
Approximately 3% to 5% of individuals with oncogenic rearrangements in the anaplastic lymphoma kinase (ALK) gene develop non-small cell lung cancer (NSCLC). Brigatinib, a potent next-generation ALK tyrosine kinase inhibitor (TKI), has demonstrated significant systemic and intracranial responses, as well as improved progression-free survival, with an acceptable safety profile. According to European Society for Medical Oncology guidelines patients with ALK translocation and performance status 0-3 can be offered 1st line treatment with TKI (brigatinib, alectinib, or lorlatinib).
View Article and Find Full Text PDFESMO Open
September 2025
Department of Medical Oncology, Kanazawa University Hospital, Kanazawa, Japan. Electronic address:
Background: Resistance to alectinib, the standard first-line therapy for anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC), remains a major clinical challenge. This study aimed to investigate resistance mechanisms using next-generation sequencing (NGS) of plasma cell-free DNA (cfDNA).
Materials And Methods: Plasma samples from 67 patients in the alectinib group of the J-ALEX study were collected at baseline, on day 57, and at treatment discontinuation.
Int J Surg Pathol
September 2025
Pathology Institute Enge, Zurich, Switzerland.
Anaplastic lymphoma kinase ()-rearranged myxoid spindle cell tumors represent a recently recognized subgroup of kinase fusion-positive mesenchymal neoplasms. These tumors often arise in the superficial soft tissues but may occasionally be found in deeper tissues, or, rarely, within visceral organs. The term (SAMS) comprises a distinct subset of cutaneous soft tissue tumors with superficial location and spindle cell morphology, exhibiting bland cytomorphology and favorable clinical outcomes.
View Article and Find Full Text PDFThorac Cancer
September 2025
Yokohama City Minato Red Cross Hospital, Pathology, Yokohama, Kanagawa, Japan.
Chest wall sarcomas are rare and may exhibit aggressive behavior, posing diagnostic challenges-particularly in young adults. Although multidisciplinary treatments involving chemotherapy, radiotherapy, and surgery are recommended, prognosis remains poor. We report a case of a 43-year-old man referred with left-sided chest pain, dyspnea, and massive pleural effusion.
View Article and Find Full Text PDFJ Cutan Pathol
September 2025
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
FUS::TFCP2-rearranged rhabdomyosarcoma is a recently identified malignant neoplasm characterized by immunohistochemical evidence of the co-expression of rhabdomyoblastic markers and ALK. Herein, we report a case of cutaneous spindle cell/sclerosing rhabdomyosarcoma with FUS::TFCP2 fusion that was initially interpreted as an ALK-rearranged mesenchymal neoplasm in a 43-year-old male due to negative desmin expression, a rhabdomyoblastic marker. RNA sequencing was performed to detect ALK fusion counterparts; however, no ALK counterpart fusion was observed, and FUS::TFCP2 fusion was detected.
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