Author of

• 12824

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  P3.21 - Poster Session 3 - Diagnosis and Staging (ID 171)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12834

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    P3.21-010 - A retrospective compability assessment of ALK translocation diagnosis in NSCLC (ID 2212)

    09:30 - 09:30  |  Author(s): M. Niki
    • Abstract

    Background
    A fusion gene between the anaplastic lymphoma kinase (ALK) gene and echinoderm microtubule-associated protein-like 4 (EML4) occurs in nearly 5% of cases of non-small cell lung cancer (NSCLC). This fusion gene leads to the production of the EML4-ALK tyrosine kinase, which is considered as one of the oncogene driver mutations in NSCLC. The ALK inhibitor, crizotinib, showed remarkable antitumor activity in patients with advanced ALK-positive NSCLC, and was approved in Japan in 2011. Although the break apart FISH is considered as the gold standard to identify ALK rearrangement, pre-screening by immunohistochemistry (IHC) have been proposed in Japan because diagnosable number of cases is limited. However, disagreement of IHC and FISH are indicated. Therefore, the ALK rearrangements of NSCLC in our institute were screened by the IHC, FISH and RT-PCR, and that compatibility was examined.

    Methods
    EML4-ALK rearrangements of 176 examples were screened by IHC(5A4), FISH, and RT-PCR among 179 patients diagnosed as NSCLC in Kansai Medical University Hirakata Hospital from June 2012 to December 2012.

    Results
    Ten patients (5.7%) were diagnosed as ALK positive NSCLC. Five were male, and median age was 63 (46-81). The results by each technique of ten cases are shown in Table.

    patient	IHC	FISH	RT-PCR
    1	positive	positive	positive
    2	positive	positive	negative
    3	positive	positive	negative
    4	positive	positive	negative
    5	positive	positive	negative
    6	negative	positive	negative
    7	negative	positive	negative
    8	negative	positive	negative
    9	negative	negative	positive
    10	negative	negative	positive

    Conclusion
    Although IHC is useful as a large-scale screening test, many false negative do exist. According to our results, there are few cases in agreement between IHC, FISH and RT-PCR. Various laboratory tests for ALK rearrangement detection are required for effective medication.