Bo Zhang1, Yanwei Zhang1, Jianlin Xu1, Xueyan Zhang1, Tianqing Chu1, Shuyuan Wang1, Jie Qian1, Rong Qiao1, Jun Lu1, Lele Zhang1, Baohui Han2. 1. Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Huaihai West Road No. 241, Shanghai, People's Republic of China. 2. Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Huaihai West Road No. 241, Shanghai, People's Republic of China. 18930858216@163.com.
Abstract
BACKGROUND: Oncogenic fusion genes consisting of echinoderm microtubule-associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK) can be detected in 5-7% of lung adenocarcinoma cases. The prevalence of ALK rearrangement in non-adenocarcinoma, non-small cell lung cancers (NA-NSCLC) is currently unknown. In addition, the efficacy of crizotinib in these patients has not been well established. OBJECTIVES: The aim of this study was to investigate the prevalence of ALK rearrangement in NA-NSCLC patients and the therapeutic efficacy of crizotinib in these patients. METHODS: We included NA-NSCLC patients who were tested for the presence of ALK rearrangement in our institution from January 2013 to May 2018. The effectiveness of crizotinib in ALK-positive patients was retrospectively analyzed. A literature review was performed and eligible previously published cases were analyzed in combination with our data. RESULTS: A total of 4662 patients were screened and 1696 NA-NSCLC patients were tested for the presence of ALK rearrangement during the study period. Thirty-two positive patients were identified (1.9%, 95% CI, 1.2-2.5%). A statistically higher percentage of younger (58.0 vs. 63.0, p = 0.01), female patients (53.1% vs. 10.8%, p < 0.01) who were non-smokers (71.9% vs. 40.6%, p < 0.01) and whose tumors contained adenocarcinoma components (34.4% vs. 6.1%, p < 0.01) were observed in the ALK-positive group. Eighteen patients were excluded from the study and 14 eligible patients were included for survival analysis. The median duration of crizotinib treatment (MDT) as a proxy for progression-free survival of the 14 eligible patients in our institution was 6.0 months (95% CI, 1.2-10.8 months). We combined our data with sporadic cases from 16 previous publications (total n = 37) and found that the MDT was 7.0 months (95% CI, 6.0-8.0 months). CONCLUSIONS: Our study suggests the opportunity to test ALK rearrangement in NA-NSCLC patients, especially in younger, female, non-smoking patients containing adenocarcinoma components. Crizotinib provides an option for the treatment of NA-NSCLC patients who have an ALK rearrangement.
BACKGROUND: Oncogenic fusion genes consisting of echinoderm microtubule-associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK) can be detected in 5-7% of lung adenocarcinoma cases. The prevalence of ALK rearrangement in non-adenocarcinoma, non-small cell lung cancers (NA-NSCLC) is currently unknown. In addition, the efficacy of crizotinib in these patients has not been well established. OBJECTIVES: The aim of this study was to investigate the prevalence of ALK rearrangement in NA-NSCLCpatients and the therapeutic efficacy of crizotinib in these patients. METHODS: We included NA-NSCLCpatients who were tested for the presence of ALK rearrangement in our institution from January 2013 to May 2018. The effectiveness of crizotinib in ALK-positive patients was retrospectively analyzed. A literature review was performed and eligible previously published cases were analyzed in combination with our data. RESULTS: A total of 4662 patients were screened and 1696 NA-NSCLCpatients were tested for the presence of ALK rearrangement during the study period. Thirty-two positive patients were identified (1.9%, 95% CI, 1.2-2.5%). A statistically higher percentage of younger (58.0 vs. 63.0, p = 0.01), female patients (53.1% vs. 10.8%, p < 0.01) who were non-smokers (71.9% vs. 40.6%, p < 0.01) and whose tumors contained adenocarcinoma components (34.4% vs. 6.1%, p < 0.01) were observed in the ALK-positive group. Eighteen patients were excluded from the study and 14 eligible patients were included for survival analysis. The median duration of crizotinib treatment (MDT) as a proxy for progression-free survival of the 14 eligible patients in our institution was 6.0 months (95% CI, 1.2-10.8 months). We combined our data with sporadic cases from 16 previous publications (total n = 37) and found that the MDT was 7.0 months (95% CI, 6.0-8.0 months). CONCLUSIONS: Our study suggests the opportunity to test ALK rearrangement in NA-NSCLCpatients, especially in younger, female, non-smoking patients containing adenocarcinoma components. Crizotinib provides an option for the treatment of NA-NSCLCpatients who have an ALK rearrangement.
Authors: Sai-Hong Ignatius Ou; Jin Seok Ahn; Luigi De Petris; Ramaswamy Govindan; James Chih-Hsin Yang; Brett Hughes; Hervé Lena; Denis Moro-Sibilot; Alessandra Bearz; Santiago Viteri Ramirez; Tarek Mekhail; Alexander Spira; Walter Bordogna; Bogdana Balas; Peter N Morcos; Annabelle Monnet; Ali Zeaiter; Dong-Wan Kim Journal: J Clin Oncol Date: 2015-11-23 Impact factor: 44.544
Authors: Thomas Huang; Brigitte J Engelmann; Rachael M Morgan; Kimberly J Absher; Jill M Kolesar; John L Villano Journal: Cancer Chemother Pharmacol Date: 2018-04-02 Impact factor: 3.333
Authors: D Ross Camidge; Yung-Jue Bang; Eunice L Kwak; A John Iafrate; Marileila Varella-Garcia; Stephen B Fox; Gregory J Riely; Benjamin Solomon; Sai-Hong I Ou; Dong-Wan Kim; Ravi Salgia; Panagiotis Fidias; Jeffrey A Engelman; Leena Gandhi; Pasi A Jänne; Daniel B Costa; Geoffrey I Shapiro; Patricia Lorusso; Katherine Ruffner; Patricia Stephenson; Yiyun Tang; Keith Wilner; Jeffrey W Clark; Alice T Shaw Journal: Lancet Oncol Date: 2012-09-04 Impact factor: 41.316
Authors: Kyeong Seok Kim; Chunxue Jiang; Ji Young Kim; Jae Hyeon Park; Hae Ri Kim; Su Hyun Lee; Hyung Sik Kim; Sungpil Yoon Journal: Front Oncol Date: 2020-05-12 Impact factor: 6.244
Authors: Barbara D Cruz; Mariana M Barbosa; Lucas L Torres; Pamela S Azevedo; Vânia E A Silva; Brian Godman; Juliana Alvares-Teodoro Journal: Oncol Ther Date: 2021-06-11