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Transformation of ALK expression and PD-L1 0% to PD-L1 90% only after surgery: the need for rebiopsy in lung cancer patients

Authors Kosmidis C, Koimtzis G, Giannakidis D, Tteralli N, Mantalovas S, Tsakalidis A, Tsopouridou K, Atmatzidis S, Liavas L, Zarogoulidis P

Received 19 October 2018

Accepted for publication 21 November 2018

Published 11 January 2019 Volume 2019:12 Pages 15—20


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Ronald Prineas

Christoforos Kosmidis,1 Georgios Koimtzis,1 Dimitrios Giannakidis,1 Nikos Tteralli,1 Stylianos Mantalovas,1 Alexandros Tsakalidis,1 Konstantina Tsopouridou,1 Stefanos Atmatzidis,1 Lazaros Liavas,1 Paul Zarogoulidis2

13rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece; 2Department of Pharmacology and Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract: Lung cancer is still diagnosed at a late stage although novel diagnostic techniques are in use. However, as pharmacogenomics have evolved novel targeted therapies either with tyrosine kinase inhibitors or immunotherapy can be currently used as daily treatment. We present the case of a woman with anaplastic lymphoma-positive expression and programmed death-ligand 1 (PD-L1) 0% score upon diagnosis who underwent therapeutic surgery and represented PD-L1 90% expression, however, without anaplastic lymphoma kinase expression. Transformation of the tumor or new tumor is a question to be answered for this patient and possibly we should try and direct rebiopsies for this group of targeted therapy patients.

Keywords: lung cancer, adenocarcinoma, EBUS, PD-L1, ALK

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