Lung adenocarcinoma harboring concomitant EGFR mutation and EML4-ALK fusion that benefits from three kinds of tyrosine kinase inhibitors: a case report and literature review.

The concomitant presence of echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase (EML4-ALK) and epidermal growth factor receptor (EGFR) is extremely rare. Previous studies have shown that EGFR mutation and EML4-ALK fusion are mutually exclusive and that the coexistence of these 2 genes are associated with resistance to EGFR tyrosine kinase inhibitors (TKIs) and ALK inhibitors. We report a case of lung adenocarcinoma harboring a concomitant EGFR mutation and EML4-ALK fusion that benefited for a short period from 3 TKIs. Additional study is warranted to clarify the therapeutic strategies in such patients with a concomitant EGFR mutation and EML4-ALK fusion. (C) 2015 Elsevier Inc. All rights reserved.