Case Report|Articles in Press

Anaplastic Lymphoma Kinase (ALK) Positive Neuroendocrine Tumor of Lung With Favorable Response to Alectinib (ALK Inhibitor)

Published:December 25, 2022DOI:

      Clinical Practice Points

      • Various genetic alterations act as driver mutations in different lung cancers. ALK gene alterations are commonly encountered in non–small cell lung cancer, and ALK inhibitors are widely used to treat such cases. The presence of ALK mutations in neuroendocrine tumors of the lung is rare, and the literature regarding the use of ALK inhibitors in such cases is extremely limited. Even with treatment, survival of extensive-stage SCLC or LCNEC of the lung is very poor.
      • We present a case of ALK+ high–grade NET of the lung, who responded well to one of the ALK inhibitors (alectinib). The patient has survived for more than 60 months, which is rare in such extensive-stage neuroendocrine malignancy. Our case adds more evidence to the presence of ALK mutation in NETs of the lung, and treatment response to ALK inhibitors.
      • Based on our case and review of prior reports, we believe ALK inhibitors can be a viable therapeutic option in NETs of the lung in the presence of targetable ALK mutations. Larger studies analyzing ALK inhibitors use in NETs of the lung might not be achievable due to the rarity of the condition. However, with potentially efficacious treatment options available, screening for ALK genetic alterations should be considered in all cases of neuroendocrine lung tumors.


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