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‹ Thu · 28 May 2026
Promising but preliminary

Pancreatic Ductal Adenocarcinoma with ITSN1-ALK Fusion: Sustained Response to Alectinib with 19-Month Progression-Free Survival.

Genetic testing found a rare, highly treatable fusion in pancreatic cancer, suggesting broader molecular screening benefits patients with unusual genetics.

The first report of an ITSN1-ALK fusion in pancreatic ductal adenocarcinoma demonstrates that comprehensive NGS including fusion detection can identify actionable rare alterations in otherwise treatment-refractory KRAS-wildtype PDAC, yielding 19-month PFS with alectinib — far exceeding prior ALK fusion GI cancer benchmarks. This case reinforces broad molecular profiling in KRAS-wildtype PDAC to identify rare but highly treatable fusions.

What the study was

Study design
Single case report
Population
Stage IV PDAC with ITSN1-ALK fusion, KRAS-wildtype
Sample size
1
Category
Treatment Innovation
Maturity
Exploratory
Journal
The Oncologist

Why it surfaced

Novel ITSN1-ALK fusion in PDAC with durable alectinib response is a compelling hypothesis-generating case; single patient and case report design cap triage_score at 4 per rubric. Important signal for molecular tumor boards.

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