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Concomitant EML4-ALK rearrangement and EGFR mutation in non-small cell lung cancer patients: a literature review of 100 cases

Giuseppe Lo Russo _, Martina Imbimbo, Giulia Corrao, Claudia Proto, Diego Signorelli, Milena Vitali, Monica Ganzinelli, Laura Botta, Nicoletta Zilembo, Filippo de Braud and Marina Chiara Garassino

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Oncotarget. 2017; 8:59889-59900. https://doi.org/10.18632/oncotarget.17431

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Abstract

Giuseppe Lo Russo1, Martina Imbimbo1, Giulia Corrao1, Claudia Proto1, Diego Signorelli1, Milena Vitali1, Monica Ganzinelli1, Laura Botta2, Nicoletta Zilembo1, Filippo de Braud1 and Marina Chiara Garassino1

1Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

2Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy

Correspondence to:

Giuseppe Lo Russo, email: giuseppe.lorusso@istitutotumori.mi.it

Keywords: EML4-ALK rearrangements, EGFR mutations, non-small cell lung cancer, concomitant, coexistent

Received: March 08, 2017     Accepted: March 23, 2017     Published: April 26, 2017

ABSTRACT

The discovery of EGFR mutations and EML4-ALK gene rearrangements has radically changed the therapeutic scenario for patients with advanced non-small cell lung cancer. ALK and EGFR tyrosine-kinase inhibitors showed better activity and efficacy than standard chemotherapy in the first and second line treatment settings, leading to a clear advantage in overall survival of advanced non-small cell lung cancer patients harboring these genetic alterations.

Historically the coexistence of EGFR mutations and EML4-ALK rearrangements in the same tumor has been described as virtually impossible. Nevertheless many recent observations seem to show that it is not true in all cases.

In this review we will discuss the available literature data regarding this rare group of patients in order to give some suggestions useful for their clinical management. Furthermore we report here two cases of concomitant presence of both alterations that will help us in the development of discussion.


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