case_images: PMC9530790_01
case_images: Course of management for (A) patients 1 and (B) 2 and representative imaging findings by brain MRI and pulmonary and liver CT scans since the start of ALK-targeted therapy. Red arrowheads indicate lesions. CT, computed chromatography. MRI, magnetic resonance imaging. PD, progressive disease. PR, partial response. Red arrowheads indicate brain lesions detected on MRI.
case_images: fonc-12-915502-g001.jpg
case_images: PMC9530790_02_fonc-12-915502-g001.jpg
case_images: f1
case_images: PE, and multiple hyperdense lymph nodes in the mediastinum and bilateral hila ( Figure 1B ). Pathologic review of the pleural drainage suggested poorly differentiated lung adenocarcinoma, which was subsequently found positive for ALK rearrangement by amplification-refractory mutation system - polymerase chain reaction (ARMS-PCR). Crizotinib was accordingly started and achieved a PFS of 25 months, when imaging studies showed an enlarged mediastinal lymph node (1.9 cm) and multiple enhancing foci in the brain and the T12 and L4 vertebrae ( Figure 1B ). Figure 1B ). Follow-up brain MRI in December showed intracranial progression manifested as newly emerged enhanced foci in the parietal, frontal, and left occipital lobe and cerebellum.
case_images: Integrative Genomics View snapshots showing the ALK C1156F missense mutation identified by next-generation sequencing from (A) patient 1 and (B) patient 2.
case_images: fonc-12-915502-g002.jpg
case_images: PMC9530790_02_fonc-12-915502-g002.jpg
case_images: f2
case_images: Genomic profiling of the blood revealed EML4-ALK fusion (E13:A20) and ALK C1156F (VAF 2.04%;  Figure 2B ), and the patient was placed on alectinib (600 mg BID) for second-line treatment in Sep 2020.
case_images: PMC9530790_02
case_images: Course of management for (A) patients 1 and (B) 2 and representative imaging findings by brain MRI and pulmonary and liver CT scans since the start of ALK-targeted therapy. Red arrowheads indicate lesions. CT, computed chromatography. MRI, magnetic resonance imaging. PD, progressive disease. PR, partial response. Red arrowheads indicate brain lesions detected on MRI.
case_images: fonc-12-915502-g001.jpg
case_images: PMC9530790_02_fonc-12-915502-g001.jpg
case_images: f1
case_images: PE, and multiple hyperdense lymph nodes in the mediastinum and bilateral hila ( Figure 1B ). Pathologic review of the pleural drainage suggested poorly differentiated lung adenocarcinoma, which was subsequently found positive for ALK rearrangement by amplification-refractory mutation system - polymerase chain reaction (ARMS-PCR). Crizotinib was accordingly started and achieved a PFS of 25 months, when imaging studies showed an enlarged mediastinal lymph node (1.9 cm) and multiple enhancing foci in the brain and the T12 and L4 vertebrae ( Figure 1B ). Figure 1B ). Follow-up brain MRI in December showed intracranial progression manifested as newly emerged enhanced foci in the parietal, frontal, and left occipital lobe and cerebellum.
case_images: Integrative Genomics View snapshots showing the ALK C1156F missense mutation identified by next-generation sequencing from (A) patient 1 and (B) patient 2.
case_images: fonc-12-915502-g002.jpg
case_images: PMC9530790_02_fonc-12-915502-g002.jpg
case_images: f2
case_images: Genomic profiling of the blood revealed EML4-ALK fusion (E13:A20) and ALK C1156F (VAF 2.04%;  Figure 2B ), and the patient was placed on alectinib (600 mg BID) for second-line treatment in Sep 2020.