Author of

• 16722

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  P1.04 - Poster Session with Presenters Present (ID 456)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Pulmonology
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16735

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    P1.04-013 - Diagnostics and Treatment of ALK-Positive NSCLC Patients - A Single Center Experience (ID 5152)

    14:30 - 15:45  |  Author(s): P.-. Mukensnabl
    • Abstract

    Background:
    ALK positive advanced NSCLC patients could get significant benefit of targeted therapy. In Czech Republic, targeted therapy is payed just as second-and more line treatment, required positive FISH result of ALK-positive NSCLC tumour.
    
    Methods:
    We investigate ALK-rearrangement in selected group of NSCLC patients starting from January 2011 via fluorescence in situ hybridization (FISH) with the Vysis ALK Break Apart FISH Probe Kit (Abbott Molecular). We evaluate frequence of positive and inconclusive results. In the group of ALK positive patients we evaluate clinical behaviour of tumours and effectivity and side effects of ALK inhibitors.
    
    Results:
    From January 2011 till June 2016, 798 nonsquamous NSCLC tumour samples were evaluated by FISH method. 20 (3.2 %) of evaluable 660 samples were positive, 138 tumour samples were clasified as ALK break inconclusive (17.3 %). ALK break positive group of patients consist of 13 men and 7 women, median age 68.5 years. 17 of them were adenocarcinomas, in two there were adenosquamous histology and in one NSCLC-NOS was found. The limit of ALK positivity was 10 % positive cells, the range of our positive results were 10 – 72 %. 6/20 patients were treated by crizotinib. Two of them received second ALK inhibitor ceritinib after failure of crizotinib, those patients are alive and well 5 and 8 years from diagnosis of adenocarcinoma st. IV. Three patients died before they could get an access to targeted therapy, seven others with low PS died before start of targeted therapy, in three others there is not actual need for targeted treatment. One patient on crizotinib died after 11 months of targeted treatment, two other died after one month of treatment, in one patient targeted therapy was refused due to intolerance.
    
    Conclusion:
    Patients suffering from advanced ALK rearranged NSCLC should have perspectives of long lasting tumour response on ALK inhibitors. ALK rearrangement investigations should be done in nonsquamous NSCLC routinely. In our departments, we have relatively high frequency of inconclusive ALK testing results. However, it is not easy to get adequate tissue sample from routine investigations. Positive results are found most frequently in adenocarcinoma patients. We consider due to rapid progression of ALK positive tumours on chemotherapy that targeted therapy should be realised as a first line option.