CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1686666
This article is part of the Research TopicPrecision Medicine and Targeted Therapies in Gastrointestinal and Genitourinary Solid TumorsView all 18 articles
Response to Anaplastic Lymphoma Kinase (ALK) Inhibitor in Gastric Cancer Harboring DCTN1-ALK Fusion: A case report and review
Provisionally accepted
- Department of Medical Oncology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
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ALK rearrangements are exceedingly rare in gastric cancer, and uncommon fusion types add to the difficulties of proper, precise treatment strategies. Although detected in non-small cell lung cancer (NSCLC), inflammatory myofibroblastic tumors (IMT), and Spitz tumors, the DCTN1-ALK fusion has not previously been reported in gastric cancers. This report describes the first case of gastric adenocarcinoma harboring a DCTN1-ALK fusion that was successfully treated with the ALK-targeted agent alectinib, after first-and second-line chemotherapy-based regimens had failed. Progression-free survival on alectinib was 11.5 months until KRAS amplification emerged on serial circulating tumor DNA analysis, leading to rapid systemic relapse. The other documented cases with DCTN1-ALK fusion treated with the first or second generation of ALK inhibitors indicated this rare fusion as an actionable driver gene mutation. This successful personalized anti-tumor strategy highlights the clinical utility of comprehensive genomic profiling and liquid biopsy in detecting and monitoring actionable ALK fusions in solid tumors.
Keywords: anaplastic lymphoma kinase (ALK), circulating tumor DNA (ctDNA), Next generation sequencing (NGS), case report, review
Received: 18 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Wang, You, Pan, Qiu and Sheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jin Sheng, shengjin@zju.edu.cn
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