Successful treatment of hepatic oligometastases with stereotactic ablative radiotherapy and radiofrequency ablation in an anaplastic lymphoma kinase fusion‐positive lung cancer patient

Weber, Britta; Liu, Mitchell; Sobkin, Paul; Morris, Stephan W.; Hout, David R.; Westhuizen, Nicholas van der; Tonseth, R. Petter; Saltman, David L.

doi:10.1002/jmrs.144

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…First of all, while FISH and IHC detect relatively indirect signs of the presence of ALK translocation, RT‐PCR usually reveals the exact variant of the rearrangement and therefore provides definitive evidence of ALK fusion. Furthermore, RT‐PCR has high sensitivity and specificity, with a rapid turnaround time and ease of analysis, and can detect a small number (1%) of ALK ‐driven NSCLC cells in the presence of normal tissues . In addition, RT‐PCR analysis utilizes the same technical platform as other kinds of molecular NSCLC diagnosis, for example EGFR testing.…”

Section: Alk Rearrangement Detection Methods In Nsclc Patientsmentioning

confidence: 99%

“…Furthermore, RT-PCR has high sensitivity and specificity, with a rapid turnaround time and ease of analysis, and can detect a small number (1%) of ALK-driven NSCLC cells in the presence of normal tissues. [64][65][66] In addition, RT-PCR analysis utilizes the same technical platform as other kinds of molecular NSCLC diagnosis, for example EGFR testing. Finally, a number of commercial RT-PCR kits for detection of ALK rearrangements have been developed recently, including: the ALK RGQ RT-PCR Kit (Qiagen, Valencia, CA, USA); the EML4-ALK Fusion Gene Detection Kit (Amoy Diagnostics, Xiamen, China); and EML4 ALK Gene Fusion, PCR (Quest Diagnostics, Secaucus, NJ, USA).…”

Section: Types Of Oncogenesis In Alkmentioning

confidence: 99%

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ALK‐rearrangement in non‐small‐cell lung cancer (NSCLC)

et al. 2018

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The ALK gene encodes a transmembrane tyrosine kinase receptor. ALK is physiologically expressed in the nervous system during embryogenesis, but its expression decreases postnatally. ALK first emerged in the field of oncology in 1994 when it was identified to fuse to NPM1 in anaplastic large‐cell lymphoma. Since then, ALK has been associated with other types of cancers, including non‐small‐cell lung cancer (NSCLC). More than 19 different ALK fusion partners have been discovered in NSCLC, including EML4, KIF5B, KLC1, and TPR. Most of these ALK fusions in NSCLC patients respond well to the ALK inhibitor, crizotinib. In this paper, we reviewed fusion partner genes with ALK, detection methods for ALK‐rearrangement (ALK‐R), and the ALK‐tyrosine kinase inhibitor, crizotinib, used in NSCLC patients.

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Section: Alk Rearrangement Detection Methods In Nsclc Patientsmentioning

confidence: 99%

Section: Types Of Oncogenesis In Alkmentioning

confidence: 99%

ALK‐rearrangement in non‐small‐cell lung cancer (NSCLC)

et al. 2018

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“…Recently, a case report of a patient with ALKpositive NSCLC whose disease progressed during administration of both crizotinib and ceritinib and in whom a new hepatic metastatic lesion developed showed that RFA can be effectively used to treat oligoprogressive NSCLC. 75 Limitations of Available Data. Despite evidence supporting the use of LAT for oligoprogressive NSCLC, the aforementioned studies need to be interpreted with caution.…”

Section: Use Of Lat For Oligoprogressive Diseasementioning

confidence: 99%

Role of Local Ablative Therapy in Patients with Oligometastatic and Oligoprogressive Non–Small Cell Lung Cancer

Kim

Hoang

Kesarwala

et al. 2017

Journal of Thoracic Oncology

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Because of an improved understanding of lung cancer biology and improvement in systemic treatment, an oligometastatic state in which metastatic disease is present at a limited number of anatomic sites is being increasingly recognized. An oligoprogressive state, which is a similar but distinct entity, refers to disease progression at a limited number of anatomic sites, with continued response or stable disease at other sites of disease. Such an oligoprogressive state is best described in patients with NSCLC treated with molecular targeted therapy. Possible explanations for development of the oligoprogressive state include the presence of underlying clonal heterogeneity and extrinsic selection pressure due to the use of targeted therapy. Traditionally, local ablative therapy (LAT) has been limited to symptom palliation in patients with advanced NSCLC, but the presence of oligometastatic or oligoprogressive disease provides a unique opportunity to evaluate the role of LAT such as surgery, radiation therapy, radiofrequency ablation, or cryoablation. There is increasing evidence to support the clinical benefit of LAT in patients with NSCLC with limited metastatic disease and in selected individuals in whom resistance to targeted therapies develops. In the latter instance, adequate treatment of drug-resistant clones by LAT could potentially help in avoiding switching systemic therapy prematurely. This review focuses on the biology of oligometastatic and oligoprogressive NSCLC and describes the role of LAT in the treatment of these conditions.

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“…However, recent studies using FISH and IHC or FISH alone in comparison to RT-PCR have demonstrated that RT-PCR has a high sensitivity and specificity [ 14 , 15 , 16 ]. These tests have the advantages of a rapid turn-around time and ease of analysis, and can be used on biopsy or cytology specimens with lower tumor content than needed for accurate FISH and IHC testing [ 14 , 15 , 17 ]. In the study described in this report, we compare a commercially available RT-PCR assay (ALK RGQ RT-PCR Kit, QIAGEN, Manchester, UK) designed to identify mRNA produced by all ALK rearrangements regardless of the fusion partner or variant ( Figure 1 ), with IHC that detects the ALK protein and FISH that directly identifies ALK genomic rearrangements in FFPE samples from patients with NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Performance of a RT-PCR Assay in Comparison to FISH and Immunohistochemistry for the Detection of ALK in Non-Small Cell Lung Cancer

Hout

Schweitzer

Lawrence

et al. 2017

Cancers

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Patients with lung cancers harboring an activating anaplastic lymphoma kinase (ALK) rearrangement respond favorably to ALK inhibitor therapy. Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are validated and widely used screening tests for ALK rearrangements but both methods have limitations. The ALK RGQ RT-PCR Kit (RT-PCR) is a single tube quantitative real-time PCR assay for high throughput and automated interpretation of ALK expression. In this study, we performed a direct comparison of formalin-fixed paraffin-embedded (FFPE) lung cancer specimens using all three ALK detection methods. The RT-PCR test (diagnostic cut-off ΔCt of ≤8) was shown to be highly sensitive (100%) when compared to FISH and IHC. Sequencing of RNA detected full-length ALK transcripts or EML4-ALK and KIF5B-ALK fusion variants in discordant cases in which ALK expression was detected by the ALK RT-PCR test but negative by FISH and IHC. The overall specificity of the RT-PCR test for the detection of ALK in cases without full-length ALK expression was 94% in comparison to FISH and sequencing. These data support the ALK RT-PCR test as a highly efficient and reliable diagnostic screening approach to identify patients with non-small cell lung cancer whose tumors are driven by oncogenic ALK.

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Successful treatment of hepatic oligometastases with stereotactic ablative radiotherapy and radiofrequency ablation in an anaplastic lymphoma kinase fusion‐positive lung cancer patient

Cited by 7 publications

References 6 publications

ALK‐rearrangement in non‐small‐cell lung cancer (NSCLC)

ALK‐rearrangement in non‐small‐cell lung cancer (NSCLC)

Role of Local Ablative Therapy in Patients with Oligometastatic and Oligoprogressive Non–Small Cell Lung Cancer

Performance of a RT-PCR Assay in Comparison to FISH and Immunohistochemistry for the Detection of ALK in Non-Small Cell Lung Cancer

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