Pulmonary Sarcomatoid Carcinoma with ALK Rearrangement: Frequency,Clinical-Pathologic Characteristics,and Response to ALK Inhibitor |
| |
Authors: | Xinru Chen Yu Zhang Jiabin Lu Chunwei Xu Jianzhong Liang Fang Wang Wenyong Sun Sangao Fang Jingping Yuan Huijuan Wang Hui Wang Xuewen Liu Likun Chen |
| |
Institution: | 2. State Key Laboratory of Oncology in South, China;3. Collaborative Innovation Center for Cancer Medicine;4. Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, PR China;5. Department of Pathology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, PR China;11. Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, PR China;12. Department of Respiratory Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China;8. Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, PR China;9. Key Laboratory of Translational Radiation Oncology, Hunan Province |
| |
Abstract: | PURPOSE: The incidence of anaplastic lymphoma kinase (ALK) rearrangement in pulmonary sarcomatoid carcinoma (PSC) is controversial. In this study, we aimed to reveal the reliable frequency and the clinical-pathologic characteristics of pulmonary sarcomatoid carcinoma (PSC) with ALK rearrangement in Chinese population, and to provide insight into the translatability of anti-ALK treatment in this treatment-refractory disease. METHODS: Immunohistochemistry (IHC) 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 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: Five 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. The median age of ALK-positive patients was younger than that of ALK-negative patients. PSCs in never-smokers were more likely to harbor ALK rearrangement than those in former or current smokers (P < .05). A 40-year-old woman diagnosed with ALK-rearranged PPC experienced a partial response (?32%) to the ALK inhibitor crizotinib. CONCLUSIONS: 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. |
| |
Keywords: | Address all correspondence to: Xuewen Liu Department of Radiation Oncology Hunan Cancer Hospital 283 Tongzipo Road Changsha 410013 Hunan P R China or Likun Chen Department of Medical Oncology Sun Yat-sen University Cancer Center 651 Dongfeng Road East Guangzhou 510060 Guangdong PR China |
本文献已被 ScienceDirect 等数据库收录! |
|