Clinicopathological Features in Elderly ALK-rearranged Non-small Cell Lung Cancer Patients

Abstract

Aim: To clarify the clinicopathological features in elderly anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) patients. Patients and Methods: A retrospective study was performed in 129 ALK rearranged NSCLC patients diagnosed between April 2008 and March 2019 in fifteen Institutions of the Ibaraki prefecture, Japan. Results: Median age of patients was 63 years. In 59 patients aged 65 and older, the proportions of patients with advanced stage and those treated with ALKtyrosine kinase inhibitor (TKI) were lower than those younger than 65 years. There was no difference in overall survival (OS) between the two age groups. Among the elderly patients, no difference was observed in OS between the patients aged 65-69 and those aged 70 and older. In 89 patients treated with TKI, no significant differences were observed in the progression-free survival of TKIs and OS between patients aged 65 and older and those younger than 65, respectively. Conclusion: Evaluation of ALK gene status and TKI treatment are desirable even for elderly patients. Advances in molecular biology have led to discovery of specific driver genes in certain cancer types and therefore to development of specific therapeutics (1, 2). This new trend is evident in the clinical practice of NSCLC patients. Mutations in the anaplastic lymphoma kinase (ALK) fusion gene is one such driver gene. Long-term survival can be expected in ALKrearranged NSCLC patients, but its frequency is very rare (1, 2001 This article is freely accessible online.

ALK-positive lung adenocarcinoma in a patient with rheumatoid arthritis with long-term treatment for organizing pneumonia: A case report

“…[ 12 ] However, a number of elderly-onset ALK mutations have been reported. [ 13 ] In studies of patients with ALK-positive lung cancer, the proportion of elderly patients (≥65 years old) was reported to be 10% to 20% [ 14 ] while some studies showed a higher proportion (36–46%). [ 13 ] There has only been one reported case of ALK-positive adenocarcinoma in a patient with RA but without OP.…”

“…[ 13 ] In studies of patients with ALK-positive lung cancer, the proportion of elderly patients (≥65 years old) was reported to be 10% to 20% [ 14 ] while some studies showed a higher proportion (36–46%). [ 13 ] There has only been one reported case of ALK-positive adenocarcinoma in a patient with RA but without OP. [ 15 ] The relationship between ALK mutations and RA with OP remains unknown, and chronic inflammation may contribute to the development of lung cancer.…”