Case Overview

ctDNA + ctRNA liquid biopsy test detected ALK fusion in patient with metastatic lung cancer when ctDNA-only liquid biopsy test was not able to detect any actionable targets.

Tissue biopsy NGS was not performed due to insufficient tissue sample for testing.

This case highlights the clinical utility of ctDNA + ctRNA liquid biopsy testing

• as a viable test when tissue NGS testing is not possible

• to detect fusion that may be missed with ctDNA-only liquid biopsy tests

Patient Information

Presentation

Diagnostic Workup

Lab tests and results (e.g. protein tumor markers)	NA
Imaging findings  (e.g. CT, MRI, PET, etc.)	PET/CT scan
Pathology / histology report summary (e.g. HER2, ER/PR, etc.)	Inadequate tissue from cervical lymph node biopsy to conduct testing.
Genomic / molecular testing results (e.g. FISH, qPCR, NGS, etc.)	FDA-approved plasma ctDNA liquid biopsy NGS testNo actionable targets detectedLiquidHALLMARK ctDNA + ctRNA liquid biopsy NGS testActionable ALK fusion detected

Diagnosis

ALK+ metastatic lung cancer

Treatment

ALK-targeted therapy (alectinib) initiated

Patient Outcome

Patient weaned off ventilator and eventually discharged.

6 month follow-up:

PET/CT scan showed patient's cancer responded to therapy

Treating Oncologist

Dr Gilberto de Lima Lopes Junior

Professor of Clinical Medicine

Medical Director for International Programs

Associate Director for the Cancer Center

Chief, Division of Medical Oncology

Sylvester Comprehensive Cancer Center, University of Miami 

Miller School of Medicine

Disclaimer: The case study is for educational, scientific presentation purposes only, and individual case outcomes and results may vary. The image, case detail, or other descriptions of the case are provided directly by the treating physician/oncologist in a de-identified manner and reproduced with express permission of the treating physician/oncologist.