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Targeted Treatment of a Rare Vaginal Sarcoma With an Anaplastic Lymphoma Kinase Inhibitor

Forde, Gareth K. MD, PhD, MBA; Tewari, Devansu MD, MBA

doi: 10.1097/AOG.0000000000001250
Contents: Case Report
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BACKGROUND: Anaplastic lymphoma kinase is a tyrosine kinase receptor that can become oncogenic. Crizotinib is a tyrosine kinase inhibitor that shows activity in patients with anaplastic lymphoma kinase rearrangements that have failed conventional therapies.

CASE: A 34-year-old woman presented with a painful 3-cm left vulvar–vaginal mass, which was excised and determined to be a sarcoma with positive surgical margins. Fluorescence in situ hybridization testing of her tumor was conducted and demonstrated anaplastic lymphoma kinase gene rearrangements. A 3-cm mass recurred 1 month later. Treatment with 250 mg crizotinib orally twice daily resulted in complete regression of all visible or palpable tumor within 3 weeks.

CONCLUSION: Molecular evaluation techniques can be used to direct targeted therapy for select malignancies. Future technologic advances will expand the number of malignancies for which these treatment approaches can be used.

Molecular evaluation techniques can be used to direct targeted therapy for select malignancies.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California–Irvine Medical Center, Orange, and Kaiser Permanente, Southern California, Irvine, California.

Corresponding author: Gareth K. Forde, MD, PhD, MBA, 101 The City Drive, Orange, CA 92868; e-mail: gforde@uci.edu.

Dr. Forde was supported by Ruth L. Kirschstein National Research Service Award Institutional Training Research Grant No. 2T32 CA06039611.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.