{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:01:07Z","timestamp":1781629267660,"version":"3.54.5"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The histologic transformation of non-small-cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) alterations remains a rare phenomenon and a challenge for treatment with ALK tyrosine kinase inhibitors (TKI). We present a seldom-reported case of transformation of lung adenocarcinoma into large-cell neuroendocrine carcinoma (LCNEC) during treatment with alectinib, a second-generation ALK inhibitor, aiming to evaluate diagnostic and therapeutic approaches. The underlying mechanisms driving this transformation\u2014likely due to a secondary resistance mechanism acquired during treatment\u2014remain poorly understood but may involve genetic alterations, changes in the tumor microenvironment, and the emergence of additional oncogenic mutations. This case adds to the limited body of evidence and underscores the importance of recognizing neuroendocrine differentiation in ALK-positive lung cancer cases that show clinical progression. Further studies are needed to elucidate the molecular drivers of this transformation and to optimize treatment strategies for affected patients.<\/jats:p>","DOI":"10.1093\/oncolo\/oyag226","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:45:00Z","timestamp":1780573500000},"source":"Crossref","is-referenced-by-count":0,"title":["Transformation of ALK-translocated lung adenocarcinoma to LCNEC under alectinib treatment \u2013 a case report and mini-review"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7152-8112","authenticated-orcid":false,"given":"Josef","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bundeswehrkrankenhaus Berlin , Berlin 10115,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Uwe","family":"Stephan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bundeswehrkrankenhaus Berlin , Berlin 10115,","place":["Germany"]},{"name":"Department of Hematology, Oncology and Tumor Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health , Berlin 10117,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Steinestel","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm , Ulm 89081,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasir Arafat","family":"Tamal","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm , Ulm 89081,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Arndt","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm , Ulm 89081,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Barck","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bundeswehrkrankenhaus Berlin , Berlin 10115,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"2026061612185987200_oyag226-B1","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1038\/nature05945","article-title":"Identification of the transforming EML4\u2013ALK fusion gene in non-small-cell lung cancer","volume":"448","author":"Soda","year":"2007","journal-title":"Nature"},{"key":"2026061612185987200_oyag226-B2","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.lungcan.2020.04.011","article-title":"Efficacy and safety of ALK inhibitors in ALK-rearranged non-small cell lung cancer: a systematic review and 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