| Lung cancer continues to have the highest incidence and mortality rates. Targeted therapy has brought hope for the treatment of lung cancer patients with gene mutations. EGFR mutations are relatively common in non-small cell lung cancer (NSCLC), while the co-occurrence of EGFR mutations and ALK gene fusion in NSCLC is rare. However, with advances in molecular diagnostic techniques, the detection rate of such dual mutations is gradually increasing, yet their diagnosis and treatment strategies still face numerous challenges. For instance, there is currently no unified standard for treating locally advanced lung adenocarcinoma patients with dual mutations in ALK gene fusion and EGFR, and their therapeutic outcomes and prognoses vary significantly. In May 2023, the Affiliated Hospital of Guangdong Medical University admitted a case of locally advanced lung adenocarcinoma with ALK gene fusion combined with EGFR 21-L858R mutation. This report presents the diagnosis, treatment process, efficacy, and prognosis of this case, supplemented by a literature review. It explores the clinical diagnosis, treatment, and prognostic approaches for lung adenocarcinoma patients with dual mutations in ALK gene fusion and EGFR, including detection methods, treatment options, and drug selection, with a particular focus on the sequence of targeted therapies, drug resistance mechanisms, and the latest research advancements. The study highlights the selection of dual-targeted therapies and potential challenges while investigating optimal models for postoperative adjuvant treatment. This work aims to provide insights into the clinical management of dual-mutation lung adenocarcinoma patients and offer guidance for future research. |
