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

Abstract

// <![CDATA[ $('.header-date').hide();$('#titleAuthors').hide();$('#abstractHeader').hide(); // ]]> 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.