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S. Holzer
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-025 - Real-Life Experience and Clinical Characterization in Patients with ALK Positive NSCLC: A Multicentre Study of the Austrian Lung Cancer Group (ID 1754)
09:30 - 09:30 | Author(s): S. Holzer
- Abstract
Background:
ALK translocations, occuring in 3-5% of patients with NSCLC (non-small cell lung cancer), has improved the treatment for these patients. We examined the clinical characteristics, diagnosis modalities and treatment outcomes of these ALK + NSCLC patients.
Methods:
Data from patients with adenocarcinoma and NSCLC/NOS (Not Otherwise Specified) whose tumors were routinely analyzed for EML4-ALK were reviewed. Patient characteristics including age, sex, race, smoking history, localization of biopsy, response to ALK inhibitors and presence/absence of brain metastasis were collected. All data were obtained from 4 hospitals in Austria with high expertise in the management of lung cancer from August 2011 till October 2014. EML4-ALK was identified by a two-step procedure. First an immunhistochemical staining was done with the Ventana anti ALK (D5F3), Opti View DAB IHC DetectionKit and Opti View Amplifikation Kit®. Further, all positive cases (weak to strong) were tested by ALK FISH (dual colour breakapart FISH/Abbott Vysis[®]).
Results:
1754 consecutive patients were tested for EML4-ALK mutation. EML4-ALK positive immunohistochemical staining was found in 226 patients (12.9 %). 37 of these patients (2.1 %) showed positive ALK FISH analysis. However 2 patients with strong immunohistochemical staining showed no rearrangement in FISH analysis. These 2 patients were also treated with an ALK Inhibitor and showed tumour shrinkage. From these EML4-ALK translocation positive 39 patients, 23 patients were women and 16 men. 24 patients (61%) were Never-Smoker, 9 were former smokers (23 %) and 6 smokers (15 %). Biopsies were taken in 24 patients from the primary tumor and in 8 patients from the lymph nodes; in 6 patients the analysis was performed by drainage of pleura effusions and in 1 patient by drainage of a pericardial effusion. 24 patients received an ALK inhibitor. 5 patients had a complete response, 18 patients a partial response, 0 patients a stable disease and 1 patient showed a progressive disease. 15 patients did not receive an ALK Inhibitor, because they were in an operable stage. Before therapy with an ALK inhibitor, 5 patients had initial brain metastasis and additional 8 patients developed brain metastasis during treatment.
Conclusion:
ALK rearrangements are observed in 2.2 % of Adenocarcinoma and NSCLC/NOS. It can be detected in all patients independent of any clinical characterization and/or smoking behavior. Therefore, reflex testing is recommended, since patients treated with an ALK inhibitor had a clear benefit from treatment.
