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Spontaneous regression of ALK fusion protein-positive non-small cell lung carcinoma: a case report and review of the literature.

Maria WallsGerard M WallsJacqueline A JamesKyle T CrawfordHossam AbdulkhalekTom B LynchAaron J PeaceTerry E McManusO Rhun Evans
Published in: BMC pulmonary medicine (2020)
All reported cases of spontaneous regression in lung cancer have been collated within. Documented precipitants of spontaneous regression across tumour types include biopsy and immune reconstitution; stroke has not been reported previously. The favourable response achieved with radical radiotherapy alone in this unusual case of indolent oncogenic NSCLC reinforces the applicability of radiotherapy in locally advanced ALK-rearranged tumours, in cases not behaving aggressively. As a common embolic event affecting the neurological and pulmonary vasculature is less likely, an immune-mediated mechanism may underpin the phenomenon described in this patient, implying that hitherto unharnessed principles of immuno-oncology may have relevance in oncogenic NSCLC. Alternatively, high electrical voltage applied percutaneously adjacent to the tumour during cardioversion in this patient may have induced local tumour cell lethality.
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