Presence of anaplastic lymphoma kinase translocation in sarcomatoid carcinoma of head and neck and treatment effect of crizotinib: A case series

Head Neck. 2015 May;37(5):E66-9. doi: 10.1002/hed.23884. Epub 2015 Mar 29.

Abstract

Background: Sarcomatoid carcinoma of the upper aerodigestive tract, a variant of squamous cell carcinoma, is a rare biphasic tumor consisting of epithelial and mesenchymal components.

Methods and results: We report a case of 34-year-old woman with a relapsed refractory sarcomatoid carcinoma in the maxillary sinus. Because anaplastic lymphoma kinase (ALK) translocation is common in sarcoma, ALK fluorescence in situ hybridization (FISH) was performed and the result was positive. After crizotinib was administered, clinical improvement and stable disease lasted for 4 months. To identify the incidence of ALK rearrangement in this disease entity, ALK FISH was performed on tumor samples of 10 patients. Among them, 2 patients were positive.

Conclusion: To the best of our knowledge, this is the first case report demonstrating the clinical benefit of crizotinib in sarcomatoid carcinoma of the head and neck with ALK translocation. Our results suggest that the ALK FISH test may be suitable and encouraged for patients with sarcomatoid carcinoma of the head and neck.

Keywords: anaplastic lymphoma kinase (ALK) fluorescence in situ hybridization (FISH); crizotinib; head and neck cancer; sarcomatoid carcinoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / genetics*
  • Carcinoma, Squamous Cell / pathology
  • Cohort Studies
  • Crizotinib
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / genetics*
  • Head and Neck Neoplasms / pathology
  • Humans
  • In Situ Hybridization, Fluorescence
  • Pyrazoles / therapeutic use*
  • Pyridines / therapeutic use*
  • Receptor Protein-Tyrosine Kinases / genetics*
  • Retrospective Studies
  • Sarcoma / drug therapy
  • Sarcoma / genetics
  • Sarcoma / pathology
  • Translocation, Genetic
  • Treatment Outcome

Substances

  • Pyrazoles
  • Pyridines
  • Crizotinib
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases