ALK rearrangement

P2, N=118, Completed, Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest | Active, not recruiting --> Completed

These findings suggest that osimertinib crosses the placenta with a moderate tissue uptake, while alectinib and its metabolite M4 do not appear to be transferred to the fetus but accumulate significantly within the placental tissue. Further studies are needed to guide treatment selection for NSCLC in pregnant women.

P2/3, N=410, Recruiting, Sinocelltech Ltd.

We present the case of a 60-year-old non-smoking woman previously treated for luminal B human epidermal growth factor receptor 2 (HER2)-positive invasive breast carcinoma with surgery, AC60 chemotherapy, trastuzumab, breast radiotherapy, and hormone therapy at the Mohammed VI Oncology Center in Casablanca, Morocco. The patient received neoadjuvant vinorelbine-cisplatin chemotherapy followed by volumetric modulated arc therapy (VMAT) thoracic radiotherapy at 66 Gy, achieving clinical and radiological stabilization. This case highlights the occurrence of a second driver-negative primary lung adenocarcinoma in a non-smoker and underscores the importance of integrated histopathological, immunohisto chemical, and targeted molecular evaluation in distinguishing primary tumors from metastases, as well as the potential role of post-therapeutic carcinogenesis.

P=N/A, N=20, Suspended, M.D. Anderson Cancer Center

This case highlights the metastatic potential of ALK-rearranged unclassified mesenchymal neoplasms, particularly those exhibiting a tyrosine kinase phenotype (co-expression of S100 and CD34), supporting their classification within the intermediate, rarely metastasizing category according to soft tissue tumor stratification principles. It further emphasizes the need for heightened clinical vigilance and thorough surgical management, which may influence long-term outcomes.

This case highlights the possibility that alectinib may impair postoperative wound repair. Comprehensive perioperative drug evaluation, multidisciplinary collaboration, and carefully monitored treatment interruption are recommended to maintain the balance between oncologic control and effective tissue healing.

The achievement of over 24 months of disease control underscores lorlatinib's potent activity against these complex molecular profiles. Our findings highlight the importance of recognizing and targeting rare ALK fusion variants-even when coexisting with other ALK rearrangements and resistance-associated mutations and expand the therapeutic landscape of precision oncology for advanced NSCLC.

One case harbored an ALK rearrangement, guiding effective targeted therapy with alectinib...Accurate histopathological assessment is essential to establish a correct diagnosis and guide appropriate therapy. A multidisciplinary approach remains the cornerstone of diagnostic precision in CUP cases.

In this cohort of surgically resected NSCLC, preoperative corrected serum calcium and smoking exposure were more closely associated with tumor metabolic activity than with specific molecular alterations. These findings suggest that simple clinical and biochemical parameters may provide complementary information, although their utility for discriminating individual molecular subgroups appears limited.

This study demonstrates very high molecular concordance between primary lung adenocarcinomas and their synchronous pleural or intrapulmonary metastases. The observed 100% concordance of actionable driver alterations across paired specimens supports the clinical reliability of thoracic metastatic biopsies for baseline molecular profiling in treatment-naïve disease. Although limited by sample size, these findings support the biological stability of actionable driver alterations during early thoracic metastatic dissemination.

P1, N=16, Recruiting, Memorial Sloan Kettering Cancer Center