Author of

• 11745

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  P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11788

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    P2.11-043 - Analysis of clinicopathological features for Chinese patients with advanced non-small cell lung cancer harboring EML4-ALK fusion genes (ID 2968)

    09:30 - 09:30  |  Author(s): D. Li
    • Abstract

    Background
    The echinoderm microtubule-associated protein like-4—anaplastic lymphoma kinase (EML4--ALK) fusion oncogene defines a novel molecular subset of non-small cell lung cancer (NSCLC). Crizotinib (Xalkori) has been approved for patients with locally advanced or metastatic NSCLC that is ALK positive. However, the clinicopathological characteristics of patients with the EML4-ALK gene have not been identified completely.

    Methods
    The clinicopathological characteristics of 200 Chinese patients with advanced NSCLC were analyzed retrospectively．Clinical factors including age, sex, smoking history, pathological type, biopsy method, site of biopsy and interval between biopsy and the identification of EML4-ALK fusions and the status of epidermal growth factor receptor (EGFR) mutation were analyzed to investigate possible correlations with EML4-ALK fusions.

    Results
    Among the 200 patients with NSCLC enrolled, 56 (28.0%) harbored the EML4-ALK gene in this retrospective study. EML4-ALK fusions could not be detected in 22 of 200 patients (11.0%) because of insufficient tissue. The median age was 53 as a whole. The median ages of ALK positive and negative groups were 48 and 55 years, respectively. Patients with the EML4-ALK gene were significantly younger than patients without EML4-ALK (p＜0.001). The detection rate of EML4-ALK rearrangement in patients with tumor or metastatic lymph nodes resection was significantly higher than patients with needle biopsy(p=0.003). If the interval between biopsy and the identification of EML4-ALK fusions was less than 48 months, the detection rate of EML4-ALK rearrangement was significantly higher compared with the interval more than 48months(p=0.020). Among the 200 patients, 103(51.5%) patients had received EGFR mutation detection. Only 1 case harbored both EML4-ALK rearrangement and EGFR mutations. The incidence of EML4-ALK rearrangement in patients with EGFR wide type（42.5%,37/87）was significantly higher than EGFR mutant type（6.3%,1/16）. No significant difference in the distribution of sex, smoking history, pathological type, and site of biopsy(lung tumor compared with metastatic lymph nodes) was observed between ALK positive and negative groups (p = 0.140, 0.103, 0.438 and 0.217, respectively).

    Comparisons of patient characteristics according to genotype

    		EML4-ALK gene
    Characteristics	Total,n	Positive,n	Negative,n	P value
    		56	122
    Age(years)
    Median	53	48	55	＜0.001
    Range	25-76	25-74	27-76
    Sex
    Male	78	20	58	0.140
    Female	100	36	64
    Smoking history
    Never/light smokers	143	49	94	0.103
    Smokers	35	7	28
    Pathological type
    Adenocarcinoma	161	52	109	0.438
    Non- adenocarcinoma	17	4	13
    Biopsy method
    Tumor and metastatic lymph nodes resection	158	49	109	0.003
    Needle biopsy	20	7	13
    Site of biopsy
    Lung tumor	99	27	72	0.217[$]
    Metastatic lymph nodes	72	26	46
    Pleura	2	1	1
    Others	5	2	3
    Interval between biopsy and the identification of EML4-ALK fusions (months)
    ≤48	167	55	112	0.020
    ＞48	11	1	10
    EGFR mutation(n=103)
    Mutant type	16	1	15	0.005
    Wide type	87	37	50

    $:lung tumor compared with lymph nodes

    Conclusion
    We identified younger age and EGFR wide type as clinicopathological features of patients with advanced NSCLC harboring EML4-ALK fusion genes. The detection rate of EML4-ALK rearrangement was significantly higher in patients with tumor or metastatic lymph nodes resection and the interval less than 48 months between biopsy and the identification of EML4-ALK fusions.