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ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy

BACKGROUND: Anaplastic lymphoma kinase (ALK) gene rearrangement is detected in 3 % to 13 % of non-small cell lung carcinoma patients, and these patients benefit from ALK inhibitors. The aim of this study was to determine the prevalence, the clinical and histological characteristics and the treatment...

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Autores principales: Incharoen, Pimpin, Reungwetwattana, Thanyanan, Saowapa, Sakditad, Kamprerasart, Kaettipong, Pangpunyakulchai, Duangjai, Arsa, Lalida, Jinawath, Artit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855782/
https://www.ncbi.nlm.nih.gov/pubmed/27142166
http://dx.doi.org/10.1186/s12957-016-0893-6
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author Incharoen, Pimpin
Reungwetwattana, Thanyanan
Saowapa, Sakditad
Kamprerasart, Kaettipong
Pangpunyakulchai, Duangjai
Arsa, Lalida
Jinawath, Artit
author_facet Incharoen, Pimpin
Reungwetwattana, Thanyanan
Saowapa, Sakditad
Kamprerasart, Kaettipong
Pangpunyakulchai, Duangjai
Arsa, Lalida
Jinawath, Artit
author_sort Incharoen, Pimpin
collection PubMed
description BACKGROUND: Anaplastic lymphoma kinase (ALK) gene rearrangement is detected in 3 % to 13 % of non-small cell lung carcinoma patients, and these patients benefit from ALK inhibitors. The aim of this study was to determine the prevalence, the clinical and histological characteristics and the treatment outcomes of ALK-rearranged lung adenocarcinoma using immunohistochemistry (IHC) IHC, reverse transcription polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) methodologies. METHODS: A total of 268 pulmonary adenocarcinoma patients were screened for ALK expression by ALK IHC, which was confirmed by FISH and/or RT-PCR for ALK gene rearrangement. The treatment outcomes of ALK-rearranged patients were retrospectively reviewed. RESULTS: ALK gene rearrangement was identified in 26 cases (9.7 %) with no EGFR co-mutation, and it showed significant associations with younger age, female sex and non-smoker status (p < 0.05). A cribriform growth pattern was identified as the dominant histologic feature, and a solid signet ring cell component was focally present in a minority of the cases. Among 12 ALK-rearranged patients with conventional treatment, seven cases in the early stage of disease were cured and alive, and five patients in the late stage of the disease progressed and died, with a median overall survival (OS) at 14 months. Of the 14 patients receiving crizotinib, all of them had clinical benefit from crizotinib treatment, with one patient having a complete response (CR), 12 patients having a partial response (PR) and one patient having stable disease (SD). On the cutoff date, six of 14 patients were continuing crizotinib treatment with a median time of response of 7.5 (3–13) months, while eight patients had disease progression, and five of them died with a median OS at 8 months. CONCLUSION: ALK gene rearrangement tended to occur in younger, non-smoking, female patients. ALK IHC is a reliable screening method to detect ALK gene rearrangement. Crizotinib therapy provided treatment benefit in ALK-rearranged adenocarcinoma patients especially in advanced stages of the disease.
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spelling pubmed-48557822016-05-05 ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy Incharoen, Pimpin Reungwetwattana, Thanyanan Saowapa, Sakditad Kamprerasart, Kaettipong Pangpunyakulchai, Duangjai Arsa, Lalida Jinawath, Artit World J Surg Oncol Research BACKGROUND: Anaplastic lymphoma kinase (ALK) gene rearrangement is detected in 3 % to 13 % of non-small cell lung carcinoma patients, and these patients benefit from ALK inhibitors. The aim of this study was to determine the prevalence, the clinical and histological characteristics and the treatment outcomes of ALK-rearranged lung adenocarcinoma using immunohistochemistry (IHC) IHC, reverse transcription polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) methodologies. METHODS: A total of 268 pulmonary adenocarcinoma patients were screened for ALK expression by ALK IHC, which was confirmed by FISH and/or RT-PCR for ALK gene rearrangement. The treatment outcomes of ALK-rearranged patients were retrospectively reviewed. RESULTS: ALK gene rearrangement was identified in 26 cases (9.7 %) with no EGFR co-mutation, and it showed significant associations with younger age, female sex and non-smoker status (p < 0.05). A cribriform growth pattern was identified as the dominant histologic feature, and a solid signet ring cell component was focally present in a minority of the cases. Among 12 ALK-rearranged patients with conventional treatment, seven cases in the early stage of disease were cured and alive, and five patients in the late stage of the disease progressed and died, with a median overall survival (OS) at 14 months. Of the 14 patients receiving crizotinib, all of them had clinical benefit from crizotinib treatment, with one patient having a complete response (CR), 12 patients having a partial response (PR) and one patient having stable disease (SD). On the cutoff date, six of 14 patients were continuing crizotinib treatment with a median time of response of 7.5 (3–13) months, while eight patients had disease progression, and five of them died with a median OS at 8 months. CONCLUSION: ALK gene rearrangement tended to occur in younger, non-smoking, female patients. ALK IHC is a reliable screening method to detect ALK gene rearrangement. Crizotinib therapy provided treatment benefit in ALK-rearranged adenocarcinoma patients especially in advanced stages of the disease. BioMed Central 2016-05-03 /pmc/articles/PMC4855782/ /pubmed/27142166 http://dx.doi.org/10.1186/s12957-016-0893-6 Text en © Incharoen et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Incharoen, Pimpin
Reungwetwattana, Thanyanan
Saowapa, Sakditad
Kamprerasart, Kaettipong
Pangpunyakulchai, Duangjai
Arsa, Lalida
Jinawath, Artit
ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title_full ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title_fullStr ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title_full_unstemmed ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title_short ALK-rearranged pulmonary adenocarcinoma in Thai Patients: From diagnosis to treatment efficacy
title_sort alk-rearranged pulmonary adenocarcinoma in thai patients: from diagnosis to treatment efficacy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855782/
https://www.ncbi.nlm.nih.gov/pubmed/27142166
http://dx.doi.org/10.1186/s12957-016-0893-6
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