A long-term survivor of non-small-cell lung cancer harboring concomitant EGFR mutation and ALK translocation Fumio Imamura, Takako Inoue, Madoka Kimura,

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Presentation transcript:

A long-term survivor of non-small-cell lung cancer harboring concomitant EGFR mutation and ALK translocation Fumio Imamura, Takako Inoue, Madoka Kimura, Kazumi Nishino, Toru Kumagai Respiratory Medicine Case Reports Volume 19, Pages 137-139 (January 2016) DOI: 10.1016/j.rmcr.2016.09.002 Copyright © 2016 The Authors Terms and Conditions

Fig. 1 Treatment history with an EGFR-TKI and ALK-TKIs. The vertical axis showed serum CEA values. Arrows indicated by A and B in the upper half show the time when CT images A and B in Fig. 2 were obtained, respectively. The numbers in the lower half indicate the time when CT images with the corresponding number in Fig. 3 and 5 were obtained, respectively. An asterisk indicates a 3rd generation of EGFR-TKI. Respiratory Medicine Case Reports 2016 19, 137-139DOI: (10.1016/j.rmcr.2016.09.002) Copyright © 2016 The Authors Terms and Conditions

Fig. 2 Chest CT images during the treatment with an EGFR-TKI. A) extensive disease progression throughout in the left thorax before the start of gefitinib, and B) remarkable regression of the disease was attained with gefitinib. Respiratory Medicine Case Reports 2016 19, 137-139DOI: (10.1016/j.rmcr.2016.09.002) Copyright © 2016 The Authors Terms and Conditions

Fig. 3 Chest CT images during the treatment with ALK-TKIs and the combination of an EGFR-TKI with an ALK-TKI. Arrow heads in the right, central, and left column indicate the lesion in the left lung, a left axillar lymph node, and a metastatic lesion to the thoracic wall, respectively. Respiratory Medicine Case Reports 2016 19, 137-139DOI: (10.1016/j.rmcr.2016.09.002) Copyright © 2016 The Authors Terms and Conditions

Fig. 4 Immunocytochemical staining with an ALK antibody (Roche D5F3F). Almost all cancer cells were positive for ALK. Respiratory Medicine Case Reports 2016 19, 137-139DOI: (10.1016/j.rmcr.2016.09.002) Copyright © 2016 The Authors Terms and Conditions

Fig. 5 Chest CT images before (4) and during (5) the treatment with a 3rd generation EGFR-TKI. Each column corresponds to that in Fig. 3. Appreciable response was observed. Respiratory Medicine Case Reports 2016 19, 137-139DOI: (10.1016/j.rmcr.2016.09.002) Copyright © 2016 The Authors Terms and Conditions