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We report a case of concomitant  EML4‐ALK  and  TPM3‐ROS1  fusion in non‐small cell lung cancer (NSCLC) in a 47‐year‐old Chinese man and review the clinical characteristics of this type double of fusion. The patient presented with a local tumor of the left upper lobe and underwent thoracoscopy. Postoperative surgical pathologic staging revealed T 1a N 0 M 0  stage IA. Histological examination of the tumor showed lung adenocarcinoma. Ventana ALK (D5F3) assay of the left lung tissue was ALK negative; however, immunohistochemical assay was positive for ROS1 protein. Using next generation sequencing, we found that the tumor had concomitant  EML4‐ALK  and  TPM3‐ROS1  fusion. No recurrence was observed during seven months of follow‐up. Precise diagnostic techniques allow the detection of concomitant  ROS1  fusion and other driver genes, including  ALK  or  EGFR ; therefore oncologists should consider this rare double mutation in NSCLC patients. Further exploration of treatment models is required to provide additional therapeutic options.

Dual drive coexistence of EML4‐ALK and TPM3‐ROS1 fusion in advanced lung adenocarcinoma