Author of

• 12853

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12857

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    P3.24-004 - Lung adenocarcinoma with EML4-ALK traslocation and ovarian teratoma in a 20-year-old woman. A case report. (ID 181)

    09:30 - 09:30  |  Author(s): G. Cairo
    • Abstract

    Background
    The echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) is a recently identified fusion-type oncoprotein that occurs in about 4-5% of non small cell lung cancer (NSCLC). Important features associated with ALK-positive lung cancers include younger age, adenocarcinoma histology, and never or light smoking habit.

    Methods
    Review of medical record and of pathology slides.

    Results
    A 20 year old no-smoker girl presented in August 2012 with weight loss (8 kg over 6 months), intermittent fever, cough and thrombosis of the popliteal and subclavian veins. A total body Computed Tomography (tbCT) scan showed lymphadenopathy in the mediastinum, in the supraclavear and laterocervical areas, a lung mass in the right inferior lobe with omolateral pleural effusion, a nodule in the controlateral lung and an ovarian teratoma. A supraclavear node biopsy demonstrated a lung adenocarcinoma (cytokeratin (CK) 7 and thyroid transcription factor-1 (TTF-1) positive). Molecular analysis showed translocation of ALK and absence of mutations of the epidermal growth factor receptor (EGFR). Because of worsening of symptoms, a first line chemotherapy with cisplatin and docetaxel was started, while waiting for the molecular analysis. After three cycles, in Dicember 2012, the tbCT scan showed a substantial stable disease. By cause of the worsening of symptoms and of the chemotherapy toxicity (G4 neutropenia, G2 anemia), an oral treatment with Crizotinib was started. It was well tolerated. After 13 weeks of treatment the CT scan showed a partial response (40% according to Recist criteria); the ovarian teratoma and the thrombosis were stable.

    Conclusion
    Patients with EML4-ALK mutant NSCLC are reportedly significantly younger than patients with wild-type, however, to our knowledge, only a younger case of our patient was until today reported (14-year old[1]). This case confirms that Crizotinib is effective and well tollerated in very young patients. [1] Kim SJ, J Clin Oncol. 2012 Jun 1;30(16):e147-50. Realized with the support of: "Associazione Genitori "Per un sorriso in piu'".