TEST:

VENTANA ALK (D5F3) CDx Assay

Long-term outcomes remain to be determined. This case expands the spectrum of ALK rearrangements and highlights the critical role of molecular profiling in guiding adjuvant treatment decisions for early-stage, high-risk non-small cell lung cancer (NSCLC).

Recent functional studies have demonstrated that ATXN1::DUX4 activates CIC target genes in an AXH domain-dependent manner, supporting its classification within the emerging family of CIC/ATXN1 pathway-altered sarcomas. This case expands the anatomic spectrum of ATXN1::DUX4-fusion sarcomas and provides further epigenetic evidence supporting their inclusion within the CIC/ATXN1 pathway-altered sarcoma family.

P4, N=41, Active, not recruiting, Guangdong Association of Clinical Trials | Not yet recruiting --> Active, not recruiting | Trial primary completion date: Jul 2025 --> Apr 2026

This case highlights distinctive CT features of ALK-RCC that may raise suspicion in young patients and guide molecular testing. The identification of the DCTN1::ALK fusion expands the molecular landscape of ALK-RCC and supports the potential utility of ALK inhibitors.

P2, N=33, Active, not recruiting, Fundación GECP | Trial primary completion date: Nov 2025 --> Nov 2026

P1/2, N=12, Active, not recruiting, University of Colorado, Denver | Recruiting --> Active, not recruiting

P3, N=210, Not yet recruiting, Shanghai Oriental Hospital; Fosun Wanbang (Jiangsu) Pharmaceutical Group Co., Ltd.

P4, N=300, Not yet recruiting, The Fourth Hospital of Hebei Medical tniversity Hebei Tuor Hospital; The Fourth Hospital of Hebei Medical tniversity Hebei Tuor Hospital

In case 1, no indications of disease progression or metastasis was observed within the limited follow-up (36 months). However, the patient in case 2 experienced a rapid recurrence and metastasis.

The high concordance between IHC and qRTPCR underscores their reliability in detecting ALK rearrangements, crucial for the precise diagnosis and treatment of lung adenocarcinoma in Indonesia. These findings support the use of either method, depending on available resources and expertise, to enhance lung cancer management.

P2, N=33, Active, not recruiting, Fundación GECP | Trial completion date: Apr 2025 --> Dec 2026 | Trial primary completion date: Dec 2024 --> Nov 2025

PD-L1 expression was associated with poor prognostic factors, including shorter survival. Further investigation is needed to understand the mechanisms of the association between PD-L1 expression and unfavorable CRC prognosis.