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C. Wu
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-014 - High Concordance of ALK Fusion between Primary Tumor and Paired Metastatic Lymph Node in Patients with Adenocarcinoma (ID 1086)
09:30 - 09:30 | Author(s): C. Wu
- Abstract
Background:
Anaplastic lymphoma kinase gene (ALK) rearrangement represents a novel oncogenic gene in NSCLC patients which show response to crizotinib, an ALK inhibitor. Lung cancer is a heterogeneous tumor. It remains unclear whether ALK rearrangement was distributed heterogeneously in tumor from different anatomic site of the same patient. To address this issue, we compared the concordance of ALK gene fusion status between primary tumor and paired lymphatic metastasis. Meanwhile, we evaluated the effectiveness of crizotinib treatment of advanced NSCLC patients with ALK rearrangement detected on biopsy or cytology from primary tumors or metastatic lymph nodes by RT-PCR.
Methods:
A total of 101 NSCLC patients with metastatic lymph nodes by surgical resection were enrolled from September 2013 to Auguast 2014, including 33 patients with N1 and N2 lymphatic metastasis. We performed immuohistochemical(IHC) staining for the ALK protein with Ventana D5F3 antibody on primary tumor and paired metastatic lymph nodes. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to confirm ALK fusion status. Discordance of ALK fusion gene status between primary tumor and paired metastatic lymph nodes was further confirmed by fluorescence in Situ hybridization (FISH). Progression-free survival (PFS) was evaluated in 13 ALK positive advanced adenocarcinoma patients with crizotinib treatment including 7 patients who harbored ALK rearrangement detected on primary tumor and 6 patients detected on metastatic lymph nodes.
Results:
The concordance rate of ALK rearrangement between primary tumor and paired metastatic lymph nodes was 98%. ALK fusion gene status between different groups of metastatic lymph nodes in the same patient showed totally concordant. PFS (11.1 months) was similar in patients with ALK rearrangement detected on primary tumor and patients (PFS, 10.8 months, P=0.2) detected on metastatic lymph nodes by RT-PCR.
Conclusion:
The current results indicated that ALK rearrangement showed a high concordance between primary tumor and lymphatic metastasis and successfully predict response to ALK inhibitor. RT-PCR detecting ALK rearrangement on biopsy or cytology with limited tissue from primary tumors and metastatic lymph nodes can be important for ALK inhibitor treatment in advanced NSCLC patients.
