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Efficacy of crizotinib in ALK mutant non-small cell lung cancers that are positive by IHC but negative by FISH compared to FISH positive cases.
Indian J Cancer 2017 Oct-Dec; 54(4):678-680IJ

Abstract

BACKGROUND

A small proportion of Non-Small Cell Lung Cancers (NSCLC) are detected with Anaplastic Lymphoma Kinase (ALK) mutation by immunohistochemistry (IHC) but are negative by Fluorescence in situ Hybridization (FISH). Data on responses and outcome of this subset of patients when treated with crizotinib is limited. We analyzed the outcomes of such patients who received crizotinib.

PATIENTS AND METHODS

Demographics, treatment details, response to treatment, date of progression and date of death were collected for patients who were IHC positive and FISH negative for ALK mutation from a prospectively maintained database. Depending upon feasibility, patients received either platinum based doublet chemotherapy or the ALK inhibitor crizotinib as first line therapy. Outcomes were compared to our previously published historical cohort of FISH positive patients who were treated with crizotinib.

RESULTS

Thirteen patients were detected to be IHC+/FISH- and out of these seven received crizotinib. Objective response rate for crizotinib was 57.15% with an estimated mean PFS of 9.6 months (95% CI 3.8 -15.5 months). The difference in ORR of ALK IHC+/FISH- when compared to our historical cohort of ALK FISH positive treated with crizotinib was not statistically significant (57.15% vs 69.8%; P = 0.265). Estimated mean and median PFS was similar between the two cohorts (median PFS 6.0 months vs 14 months; mean PFS 9.6 months versus 14.7 months; P = 0.467).

CONCLUSION

NSCLCs positive for ALK mutation by IHC but not detected by FISH show good response to crizotinib and merit treatment with the same.

Authors+Show Affiliations

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30082557

Citation

Zanwar, Saurabh, et al. "Efficacy of Crizotinib in ALK Mutant Non-small Cell Lung Cancers That Are Positive By IHC but Negative By FISH Compared to FISH Positive Cases." Indian Journal of Cancer, vol. 54, no. 4, 2017, pp. 678-680.
Zanwar S, Noronha V, Joshi A, et al. Efficacy of crizotinib in ALK mutant non-small cell lung cancers that are positive by IHC but negative by FISH compared to FISH positive cases. Indian J Cancer. 2017;54(4):678-680.
Zanwar, S., Noronha, V., Joshi, A., Patil, V. M., Kaushal, R., Chougule, A., ... Prabhash, K. (2017). Efficacy of crizotinib in ALK mutant non-small cell lung cancers that are positive by IHC but negative by FISH compared to FISH positive cases. Indian Journal of Cancer, 54(4), pp. 678-680. doi:10.4103/ijc.IJC_532_16.
Zanwar S, et al. Efficacy of Crizotinib in ALK Mutant Non-small Cell Lung Cancers That Are Positive By IHC but Negative By FISH Compared to FISH Positive Cases. Indian J Cancer. 2017;54(4):678-680. PubMed PMID: 30082557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of crizotinib in ALK mutant non-small cell lung cancers that are positive by IHC but negative by FISH compared to FISH positive cases. AU - Zanwar,Saurabh, AU - Noronha,Vanita, AU - Joshi,Amit, AU - Patil,Vijay M, AU - Kaushal,Rajiv, AU - Chougule,Anuradha, AU - Janu,Amit, AU - Mahajan,Abhishek, AU - Kapoor,Akhil, AU - Prabhash,Kumar, PY - 2018/8/8/entrez PY - 2018/8/8/pubmed PY - 2018/11/1/medline KW - Anaplastic lymphoma kinase positive KW - crizotinib KW - fluorescence in situ hybridization KW - immunohistochemistry SP - 678 EP - 680 JF - Indian journal of cancer JO - Indian J Cancer VL - 54 IS - 4 N2 - BACKGROUND: A small proportion of Non-Small Cell Lung Cancers (NSCLC) are detected with Anaplastic Lymphoma Kinase (ALK) mutation by immunohistochemistry (IHC) but are negative by Fluorescence in situ Hybridization (FISH). Data on responses and outcome of this subset of patients when treated with crizotinib is limited. We analyzed the outcomes of such patients who received crizotinib. PATIENTS AND METHODS: Demographics, treatment details, response to treatment, date of progression and date of death were collected for patients who were IHC positive and FISH negative for ALK mutation from a prospectively maintained database. Depending upon feasibility, patients received either platinum based doublet chemotherapy or the ALK inhibitor crizotinib as first line therapy. Outcomes were compared to our previously published historical cohort of FISH positive patients who were treated with crizotinib. RESULTS: Thirteen patients were detected to be IHC+/FISH- and out of these seven received crizotinib. Objective response rate for crizotinib was 57.15% with an estimated mean PFS of 9.6 months (95% CI 3.8 -15.5 months). The difference in ORR of ALK IHC+/FISH- when compared to our historical cohort of ALK FISH positive treated with crizotinib was not statistically significant (57.15% vs 69.8%; P = 0.265). Estimated mean and median PFS was similar between the two cohorts (median PFS 6.0 months vs 14 months; mean PFS 9.6 months versus 14.7 months; P = 0.467). CONCLUSION: NSCLCs positive for ALK mutation by IHC but not detected by FISH show good response to crizotinib and merit treatment with the same. SN - 1998-4774 UR - https://www.unboundmedicine.com/medline/citation/30082557/Efficacy_of_crizotinib_in_ALK_mutant_non_small_cell_lung_cancers_that_are_positive_by_IHC_but_negative_by_FISH_compared_to_FISH_positive_cases_ L2 - http://www.indianjcancer.com/article.asp?issn=0019-509X;year=2017;volume=54;issue=4;spage=678;epage=680;aulast=Zanwar DB - PRIME DP - Unbound Medicine ER -