{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T04:41:33Z","timestamp":1760589693568,"version":"build-2065373602"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Malignant peritoneal mesothelioma (MPM) is an exceptionally rare tumor type, and its molecular properties are poorly understood. In recent years, gene rearrangement has been found in a subset of MPMs. However, <jats:italic>ROS1<\/jats:italic> rearrangement has not been previously reported in MPM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Here, we present the first case report of MPM with <jats:italic>TFG-ROS1<\/jats:italic> rearrangement in a 56-year-old female with no history of asbestos exposure. The patient did not respond to immunotherapy but exhibited sensitivity to crizotinib with a progression-free survival (PFS) of 6 months. Importantly, we identified <jats:italic>ROS1 p.K1991N<\/jats:italic> as a potential acquired drug resistance mutation to crizotinib, suggesting that entrectinib may serve as a targeted therapy to overcome this resistance mechanism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>ROS1<\/jats:italic> rearrangement could potentially represent a novel driver mutation in MPM, especially in female adults. This case report illustrates the benefits of molecular detection in MPM and underscores the potential for lessons learned from other solid tumors to inform treatment strategies for rare diseases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1617457","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T04:16:58Z","timestamp":1760588218000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Malignant peritoneal mesothelioma with TFG-ROS1 fusion responds to crizotinib"],"prefix":"10.3389","volume":"15","author":[{"given":"Wei","family":"Ye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"20190024","DOI":"10.1515\/pp-2019-0024","article-title":"Multicystic peritoneal mesothelioma: a systematic review of the literature","volume":"4","author":"Noiret","year":"2019","journal-title":"Pleura Peritoneum"},{"key":"B2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.amjms.2022.07.008","article-title":"Malignant peritoneal mesothelioma","volume":"365","author":"Chun","year":"2023","journal-title":"Am J Med Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1309\/2h0n-vrer-pp2l-jdua","article-title":"Malignant peritoneal mesothelioma in women: a study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis","volume":"123","author":"Baker","year":"2005","journal-title":"Am J Clin Pathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.14735\/amko2019333","article-title":"Treatment of Malignant peritoneal mesothelioma","volume":"32","author":"Lev\u00fd","year":"2019","journal-title":"Klin Onkol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.2868","article-title":"Pemetrexed plus gemcitabine as first-line chemotherapy for patients with peritoneal mesothelioma: final report of a phase II trial","volume":"26","author":"Simon","year":"2008","journal-title":"J Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1038\/s41416-022-01979-0","article-title":"Genomic landscape of pleural and peritoneal mesothelioma tumours","volume":"127","author":"Hiltbrunner","year":"2022","journal-title":"Br J Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2019.11.011","article-title":"Anaplastic lymphoma kinase gene rearrangement in children and young adults with mesothelioma","volume":"15","author":"Mian","year":"2020","journal-title":"J Thorac Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000864","article-title":"Antonescu CR. 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