Identification of a Novel ALK G1123S Mutation in a Patient with ALK-rearranged Non– small-cell Lung Cancer Exhibiting Resistance to Ceritinib Gouji Toyokawa,

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Identification of a Novel ALK G1123S Mutation in a Patient with ALK-rearranged Non– small-cell Lung Cancer Exhibiting Resistance to Ceritinib Gouji Toyokawa, MD, PhD, Eiko Inamasu, MD, Shinichiro Shimamatsu, MD, Tsukihisa Yoshida, MD, Kaname Nosaki, MD, Fumihiko Hirai, MD, PhD, Masafumi Yamaguchi, MD, PhD, Takashi Seto, MD, PhD, Mitsuhiro Takenoyama, MD, PhD, Yukito Ichinose, MD, PhD Journal of Thoracic Oncology Volume 10, Issue 7, Pages e55-e57 (July 2015) DOI: 10.1097/JTO.0000000000000509 Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Computed tomography scans showed metastatic liver metastases (A) before and (B) approximately 5 months after the administration of ceritinib. C and D, Computed tomography and positron emission tomography/computed tomography indicated exacerbation of the hepatic metastases. Scale bar: 1 cm. Journal of Thoracic Oncology 2015 10, e55-e57DOI: (10.1097/JTO.0000000000000509) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Direct sequencing with capillary electrophoresis of biopsy samples obtained from the liver metastases (A) before and (B) after the administration of ceritinib using an ABI PRISM 310 Genetic analyzer. C, Computed tomography scans performed 6 weeks after the administration of alectinib showing the rapid response of the hepatic metastases to alectinib. Scale bar: 1 cm. Journal of Thoracic Oncology 2015 10, e55-e57DOI: (10.1097/JTO.0000000000000509) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions