Effective Treatment With Endostar and Crizotinib Sequential Alectinib in a Lung Adenocarcinoma Patient With Brain Metastases Harboring a Novel CLHC1/RNT4 Intergenic Region- ALK Fusion

Abstract Background: Anaplastic lymphoma kinase (ALK) fusion, an important driven oncogene mutation, occurrs in 3%~7% non-small cell lung cancers (NSCLC), and EML4 is the most common partner gene. With the widespread application of next-generation sequencing (NGS), more gene breakpoint fusions have been discovered, and functional fusion transcripts can bring targeted clinical benefits. Clinical trials have shown that NSCLC patients with ALK fusion can obtain significant survival benefits through ALK tyrosine kinase inhibitor (ALK-TKI) treatment. In our case, a novel CLHC1/RNT4 intergenic region- ALK fusion was identified for the first time in a LUAD patient with BM, and the patient benefited from endostar and crizotinib sequential alectinib. Our case suggested the advantages of NGS for fusion detection and provided promising treatment options for NSCLC patients with BM harboring ALK fusions.