Abstract

Background: In non-small cell lung cancer (NSCLC), anaplastic lymphoma kinase (ALK) gene rearrangement is a critical therapeutic biomarker. Partner LMO7 gene was discovered in patients with NSCLC fused to ALK gene as reported (L15: A20), (L16: A20). Investigating the relationship between various breakpoints and prognosis was significant.

Method: The Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) was used to evaluate therapeutic responses. Next-generation sequencing (NGS) detected the genomic data.

Case presentation: A 59-year-old male with a 40-pack year smoking history was diagnosed with lung adenocarcinoma. The patient was clinically classified as stage χ A (cT1bN3M1b) NSCLC. A novel LMO7-ALK fusion breakpoint (L13: A20) was identified in a biopsy sample that underwent NGS for gene mutation. Crizotinib was chosen as the first-line therapy, and the patient experienced a partial response. However, significant disease-progression was confirmed at the fourth follow-up at the neighbourhood hospital, which was done five months later. The pneumocystis jiroveci infection the patient had unfortunately led to severe obstructive pneumonia and his death.

Conclusion: LMO7-ALK rearrangement in advanced NSCLC is a potentially sensitive fusion mutation. The poor prognosis in this patient suggested that the novel breakpoint (L13: A20) LMO7-ALK rearrangement may be a hyperprogressive marker.