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F. Wang
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P3.02a - Poster Session with Presenters Present (ID 470)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02a-002 - Pulmonary Sarcomatoid Carcinoma with ALK Rearrangement: Frequency, Clinical-Pathologic Characteristics, and Response to ALK Inhibitor (ID 3876)
14:30 - 14:30 | Author(s): F. Wang
- Abstract
Background:
Pulmonary sarcomatoid carcinoma (PSC) is a poorly differentiated subtype of non-small cell lung cancer (NSCLC). Compared with other subtypes of NSCLC, PSC has higher aggressive courses and far worse survival. The incidence of anaplastic lymphoma kinase (ALK) rearrangement is controversial, and clinical benefit from anti-ALK treatment in PSC remains unknown.This study aimed to reveal the reliable frequency and the clinical-pathologic characteristics of pulmonary sarcomatoid carcinoma (PSC) with anaplastic lymphoma kinase (ALK) rearrangement, and to provide insight into the translatability of anti-ALK treatment in this treatment-refractory disease.
Methods:
Immunohistochemistry (IHC) staining using a Ventana anti-ALK (D5F3) rabbit monoclonal antibody was performed in 141 PSC specimens collected from multiple medical centers. IHC-positive cases were then confirmed using ALK fluorescent in situ hybridization (FISH). The incidence rates and clinical-pathologic characteristics of ALK-rearranged PSC were then analyzed. Response to the ALK inhibitor crizotinib in a patient with ALK-rearranged PSC was evaluated according to the response evaluation criteria for solid tumors (RECIST) version 1.1.
Results:
A total of 5 of 141 (3.5%) of PSCs showed ALK rearrangement-positive by IHC and then were confirmed by FISH. Two were carcinosarcomas and the other three were pulmonary pleomorphic carcinoma (PPC). Strong positive ALK rearrangement was observed in both the epithelioid and sarcomatoid components. ALK rearrangement was mutually exclusive with mutations in EGFR and KRAS. The median age of ALK-positive patients was younger than that of ALK-negative patients. PSCs in never-smokers was more likely to harbor ALK rearrangement than those in former or current smokers (P <0.05). A 40-year-old woman diagnosed with ALK-rearranged PPC experienced a partial response (-32%) to the ALK inhibitor crizotinib.
Conclusion:
The incidence rates of ALK rearrangement in PSC in the Chinese population are similar to those of other subtypes of NSCLC. PSCs in younger never-smokers are more often to harbor ALK rearrangement. ALK inhibitors may serve as an effective treatment for ALK-rearranged PSC.
