STRN-ALK Fusion in Lung Adenocarcinoma with Brain Metastasis Responded Well to Ensartinib: A Case Report
Round 1
Reviewer 1 Report
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The current case report appears to be well-described with support of imagings and satisfying literature review. To our best knowledge, less than ten cases of STRN-ALK fusion had been reported. Moreover, we believe that the case has clinical relevance, due to the strong interest around management of ALK rare fusions.
In the following section, I propose some minor corrections:
- Line 2: “Efficiency” should be substituted with “Effectiveness”
⁃ The background is lacking one important clinical trial about the efficacy of Ensartinib in ALK-positive NSCLC: “ensartinb versus Crizotinib for patients with Anaplastic Lymphoma Kinase – Positive Non-small cell lung cancer” (eXalt3 trial, JAMA Oncology 2021)
Author Response
Point 1: Line 2: “Efficiency” should be substituted with “Effectiveness” .
Response 1: "Efficiency" in Line 2 was replaced by “Effectiveness”.
Point 2: The background is lacking one important clinical trial about the efficacy of Ensartinib in ALK-positive NSCLC: “ensartinb versus Crizotinib for patients with Anaplastic Lymphoma Kinase – Positive Non-small cell lung cancer” (eXalt3 trial, JAMA Oncology 2021)
Response 2: Thank you for your advice. The important clinical trial for ensartinib (eXalt3 trial) was added in the revised version of the manuscript.
Reviewer 2 Report
Ms. Ref. No.: curroncol-1912088
Title: STRN-ALK fusion in lung adenocarcinoma with brain metastasis responded well to ensartinib: A case report
This case report identified a rare ALK rearrangement in a non-small cell lung cancer (NSCLC) patient with brain metastasis. Additionally, this patient responded well to ensartinib. The authors concluded that this case provided a valuable clinical evidence of NSCLC patient with brain metastasis harboring STRN-ALK fusion treated effectively with ensartinib.
The STRN-ALK fusion was first described in 2013 using RNA sequencing (J Pathol. 2013;230(3):270–276.). However, the efficacy of targeting rare ALK fusions using different ALK-tyrosine-kinase-inhibitors is still not well understood. This case report adds additional interpretation that would advance our understanding of the current and emerging therapies for NSCLC with rare STRN-ALK fusion. Overall, the manuscript is well-written and well-organized.
Author Response
