分子靶向治疗EGFR基因突变和ALK基因融合肺腺癌1例并文献复习

摘要/Abstract

摘要：

表皮生长因子受体（EGFR）基因L858R突变和棘皮动物微管相关蛋白样4-间变淋巴瘤激酶（ALK）基因融合肺腺癌是一种具有特定分子特征的恶性肿瘤，其恶性程度较高，且对传统治疗手段反应有限。分子靶向治疗是一种精准治疗策略，它通过特定的分子药物针对肿瘤细胞的特定分子靶点发挥作用，从而抑制肿瘤的生长和扩散。现报道1例EGFR基因突变和ALK基因融合肺腺癌的诊疗过程，复习相关文献并讨论，以期为临床提供诊疗思路。

魏毓正, 温馨格, 孙诚诚, 范秉杰, 丛蕾. 分子靶向治疗EGFR基因突变和ALK基因融合肺腺癌1例并文献复习[J]. 国际肿瘤学杂志, 2025, 52(4): 249-252.

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参考文献24

[1]	Remon J, Steuer CE, Ramalingam SS, et al. Osimertinib and other third-generation EGFR TKI in EGFR-mutant NSCLC patients[J].Ann Oncol,2018,29(suppl_1): i20-i27. DOI:10.1093/annonc/mdx704.
[2]	Wang Z, Zhang X, Bai H, et al. EML4-ALK rearrangement and its clinical significance in Chinese patients with advanced non-small cell lung cancer[J].Oncology,2012,83(5): 248-256. DOI:10.1159/000341381. pmid:22964709
[3]	Soda M, Choi YL, Enomoto M, et al. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer[J].Nature,2007,448(7153): 561-566. DOI:10.1038/nature05945.
[4]	Shaw AT, Yeap BY, Mino-Kenudson M, et al. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK[J].J Clin Oncol,2009,27(26): 4247-4253. DOI:10.1200/JCO.2009.22.6993. pmid:19667264
[5]	Baldi L, Mengoli MC, Bisagni A, et al. Concomitant EGFR mutation and ALK rearrangement in lung adenocarcinoma is more frequent than expected: report of a case and review of the literature with demonstration of genes alteration into the same tumor cells[J].Lung Cancer,2014,86(2): 291-295. DOI:10.1016/j.lungcan.2014.09.011. pmid:25312989
[6]	Popat S, Vieira de Araújo A, Min T, et al. Lung adenocarcinoma with concurrent exon 19 EGFR mutation and ALK rearrangement responding to erlotinib[J].J Thorac Oncol,2011,6(11): 1962-1963. DOI:10.1097/JTO.0b013e31822eec5e. pmid:22005476
[7]	Rossing HH, Grauslund M, Urbanska EM, et al. Concomitant occurrence of EGFR (epidermal growth factor receptor) and KRAS (V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog) mutations in an ALK (anaplastic lymphoma kinase)-positive lung adenocarcinoma patient with acquired resistance to crizotinib: a case report[J].BMC Res Notes,2013,6: 489. DOI:10.1186/1756-0500-6-489. pmid:24279718
[8]	Santelmo C, Ravaioli A, Barzotti E, et al. Coexistence of EGFR mutation and ALK translocation in NSCLC: literature review and case report of response to gefitinib[J].Lung Cancer,2013,81(2): 294-296. DOI:10.1016/j.lungcan.2013.04.009. pmid:23683537
[9]	Jürgens J, Engel-Riedel W, Prickartz A, et al. Combined point mutation in KRAS or EGFR genes and EML4-ALK translocation in lung cancer patients[J].Future Oncol,2014,10(4): 529-532. DOI:10.2217/fon.13.194. pmid:24754584
[10]	Xu CW, Cai XY, Shao Y, et al. A case of lung adenocarcinoma with a concurrent EGFR mutation and ALK rearrangement: a case report and literature review[J].Mol Med Rep,2015,12(3): 4370-4375. DOI:10.3892/mmr.2015.4001.
[11]	吴菡, 孙苏安, 刘海燕, 等. 非小细胞肺癌EGFR基因突变与EML4-ALK融合基因的表达及其临床病理特征[J].实用医学杂志,2018,34(13): 2119-2122. DOI:10.3969/j.issn.1006-5725.2018.13.007.
[12]	Kuo YW, Wu SG, Ho CC, et al. Good response to gefitinib in lung adenocarcinoma harboring coexisting EML4-ALK fusion gene and EGFR mutation[J].J Thorac Oncol,2010,5(12): 2039-2040. DOI:10.1097/JTO.0b013e3181f43274.
[13]	Shin HJ, Kho BG, Kim MS, et al. Co-alteration of EGFR mutation and ALK rearrangement in non-small cell lung cancer: case series[J].Medicine (Baltimore),2019,98(9): e14699. DOI:10.1097/MD.0000000000014699.
[14]	Yang JJ, Zhang XC, Su J, et al. Lung cancers with concomitant EGFR mutations and ALK rearrangements: diverse responses to EGFR-TKI and crizotinib in relation to diverse receptors phosphorylation[J].Clin Cancer Res,2014,20(5): 1383-1392. DOI:10.1158/1078-0432.CCR-13-0699.
[15]	Lee JK, Kim TM, Koh Y, et al. Differential sensitivities to tyrosine kinase inhibitors in NSCLC harboring EGFR mutation and ALK translocation[J].Lung Cancer,2012,77(2): 460-463. DOI:10.1016/j.lungcan.2012.04.012. pmid:22622260
[16]	Miyanaga A, Shimizu K, Noro R, et al. Activity of EGFR-tyrosine kinase and ALK inhibitors for EML4-ALK-rearranged non-small-cell lung cancer harbored coexisting EGFR mutation[J].BMC Cancer,2013,13: 262. DOI:10.1186/1471-2407-13-262. pmid:23714228
[17]	Tanaka H, Hayashi A, Morimoto T, et al. A case of lung adenocarcinoma harboring EGFR mutation and EML4-ALK fusion gene[J].BMC Cancer,2012,12: 558. DOI:10.1186/1471-2407-12-558. pmid:23181703
[18]	Rosell R, Moran T, Queralt C, et al. Screening for epidermal growth factor receptor mutations in lung cancer[J].N Engl J Med,2009,361(10): 958-967. DOI:10.1056/NEJMoa0904554.
[19]	Paz-Ares L, Moecks J, Klughammer B. Reply to watkins and rukazenkov (J Cell Mol Med 2010), re-letter of response to manuscript entitled ‘clinical outcomes in NSCLC patients with EGFR mutations: pooled analysis’ (Paz-Ares et al., J Cell Mol Med, 2010, 14(1-2): 51-69)[J].J Cell Mol Med,2011,15(5): 1225. DOI:10.1111/j.1582-4934.2011.01295.x.
[20]	Solomon BJ, Mok T, Kim DW, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer[J].N Engl J Med,2014,371(23): 2167-2177. DOI:10.1056/NEJMoa1408440.
[21]	孔晓艳, 王明娟, 汤巧云, 等. EGFR和ALK基因异时性突变非小细胞肺癌1例报告并文献复习[J].中国肺癌杂志,2024,27(7): 559-564. DOI:10.3779/j.issn.1009-3419.2024.106.15.
[22]	Hu Y, Xiao L, Yang N, et al. Tyrosine kinase inhibitor acquired resistance mechanism alternates between EGFR and ALK in a lung adenocarcinoma patient[J].Thorac Cancer,2019,10(5): 1252-1255. DOI:10.1111/1759-7714.13015. pmid:30788907
[23]	宁婷婷, 胡钦勇, 李倩, 等. 奥希替尼与埃克替尼一线治疗EGFR阳性转移性NSCLC临床疗效观察[J].国际肿瘤学杂志,2023,50(2): 65-70. DOI:10.3760/cma.j.cn371439-20221028-00014.
[24]	He H, Yang W, Huang Y, et al. Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy[J].Angiogenesis,2022,25(1): 5-8. DOI:10.1007/s10456-021-09811-8.

分子靶向治疗EGFR基因突变和ALK基因融合肺腺癌1例并文献复习

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