AUTHOR=Isaka Yuri , Sasaki Akinori , Saito Akira , Motomura Yasuaki , Ando Yayoi , Nakamura Yoshiaki 

TITLE=Exceptional response to alectinib for duodenal carcinoma with ALK fusion: A case report and literature review

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1064944

DOI=10.3389/fonc.2022.1064944

ISSN=2234-943X

ABSTRACT=<p>Patients with advanced duodenal carcinoma usually have a poor prognosis due to limited effective chemotherapy options. The study for genotype-directed therapy in patients with duodenal carcinoma is progressing. However, no clinical data assessing the efficacy of molecularly targeted therapy are presently available. We report the case of a 64-year-old woman who was diagnosed with anaplastic lymphocyte kinase (<italic>ALK</italic>) fusion-positive advanced duodenal carcinoma. Echinoderm microtubule associated protein like-4 (<italic>EML4</italic>)<italic>-ALK</italic> rearrangement was detected by comprehensive genomic profiling after resistance to first-line chemotherapy. The patient received alectinib, an ALK inhibitor, with marked shrinkage in primary tumor and liver metastases. She is currently being treated with alectinib for 6 months or more. This is the first report of the efficacy of alectinib in a patient with duodenal carcinoma harboring <italic>ALK</italic> fusion. Additionally, this case report suggests that the practical use of next-generation sequencing may expand optimal treatment choices in rare solid tumors, including duodenal carcinoma.</p>