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A. Tulbah



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    P2.02 - Poster Session 2 - Novel Cancer Genes and Pathways (ID 148)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P2.02-010 - Frequency of ALK Gene Rearrangement in Saudi Lung Cancer (ID 1864)

      12:03 - 12:20  |  Author(s): A. Tulbah

      • Abstract

      Background
      Lung carcinoma is the fifth common cancer affecting Saudi men. Recently, translocation of the anaplastic lymphoma kinase (ALK) gene is found to play a predictive role in adenocarcinoma tumor genesis. ALK gene rearrangement can identify patients with adenocarcinoma who are sensitive to ALK inhibitors. However, no data are available on the prevalence of ALK rearrangements changes in Middle Eastern population. Therefore, we carried out this study to evaluate the prevalence of ALK rearrangements in lung adenocarcinoma of Saudi patients.

      Methods
      ALK gene rearrangements were studied using fluorescence in situ hybridization (FISH) on 97 adenocarcinoma samples utilizing tissue microarray format. ALK gene translocations identified by BAC clone RP11-328L16 were studied by the break part probe from Vysis (Abott Molecular, Il, USA).

      Results
      Ninety seven (97) lung adenocarcinoma cases were evaluated. There were 3 cases exhibited ALK gene rearrangement (3%). All of these 3 cases was moderately differentiated adenocarcinoma. None of our cases showed signet cells or abundant intracellular mucin.

      Conclusion
      This is the first study that reveals frequency of ALK translocation in a ethically unique cohort of Saudi lung cancer patients. The findings of this study show that incidence of ALK adenocarcinoma is similar to the published western data and these patients can benefit from targeted therapy like Crizotinib- a dual ALK and MET inhibitor that has shown promising results in clinical trials.

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    P3.18 - Poster Session 3 - Pathology (ID 177)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Pathology
    • Presentations: 1
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      P3.18-008 - EGFR Mutation Testing in Saudi Arabian Lung Adenocarcinoma (ID 1847)

      09:30 - 09:30  |  Author(s): A. Tulbah

      • Abstract

      Background
      Lung cancer is the fifth leading cause of cancer in males in Saudi Arabia. As per current World Health Organization (WHO), lung carcinoma is subdivided into small cell and non-small cell carcinoma (NSCLC). The latter compromise 70-80% of lung carcinoma and consists of heterogenous groups that is further divided into adenocarcinoma, squamous cell carcinoma and large cell carcinoma. Due to poor prognosis of lung cancer, there is an increasing need to find molecular biomarkers which can be used for diagnosis, risk stratification, early detection, treatment selection, prognosis and monitoring for recurrence. Increasing interest in adenocarcinoma of lung has been raised lately for various reasons. One reason is the increasing incidence of adenocarcinoma, which is now the most predominant histologic subtype. Other reason is the possible use of targeted therapy in cases showing EGFR mutations or ALK rearrangements. Adenocarcinoma comprise approximately 70% of primary lung cancer in Saudi population. The aim of this study is to review the incidence of EGFR mutation in lung adenocarcinoma in Saudi patients.

      Methods
      A cohort of 37 primary lung adenocarcinoma diagnosed histologically and confirmed by Immunohistochemistry was collected. DNA was manually extracted from paraffin embedded tissue and was paired with histology-guided tissue macrodissection to target tumor cells. The mutation status of EGFR exons 18-21 was evaluated using Polymerase chain reaction (PCR) and bi-directional sequencing.

      Results
      EGFR mutation was detected in 10 cases (27%). Of the 10 cases, 80% of mutations (deletions) were located in exon 19 and 10% in exons 20 and 21 respectively. All mutations detected conferred increased sensitivity to tyrosine kinase inhibitors (TKI).

      Conclusion
      The incidence of EGFR mutation in lung adenocarcinoma in our patients (27%) is slightly higher than western population (15-23%). To our knowledge, this is the first molecular analysis of EGFR gene mutational analysis in lung adenocarcinoma in Saudi Arabia.