Responses to crizotinib and chemotherapy in patients with lung adenocarcinoma harboring a concomitant mutation and gene rearrangement: A case report and review of the literature.

Previous studies have indicated that, in lung cancers, the gene rearrangement of is mutually exclusive with mutations in the epidermal growth factor receptor () gene. However, the coexistence of fusions and mutations (double positive) has been occasionally reported, with frequencies ranging from 0-8%. Currently, no consensus standard therapy exists for tumors with double positive mutations. In the present case report, the case is described of a 53-year-old woman with stage IV lung adenocarcinoma, harboring a concomitant mutation and gene rearrangement, who was refractory to gefitinib administration but demonstrated a good response to crizotinib and pemetrexed chemotherapy. A review of the literature revealed a total of 65 cases, including our case, harboring double positive mutations, and of these cases, 39 (60.0%) patients had received an EGFR tyrosine kinase inhibitor (EHGR-TKI), and 15 (23%) patients had received crizotinib treatment, the majority of whom had crizotinib selected for them as a second-line or third-line therapy. The disease control rate (DCR) of EGFR-TKI was 72.2%, with the progression-free survival (PFS) being 11.9 months, whereas the DCR of crizotinib was 93.3%, with the PFS being 10 months.