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Anaplastic lymphoma kinase gene rearrangements in patients with advanced-stage non-small-cell lung cancer: CT characteristics and response to chemotherapy.
- Source :
-
Cancer medicine [Cancer Med] 2014 Feb; Vol. 3 (1), pp. 118-23. Date of Electronic Publication: 2013 Dec 27. - Publication Year :
- 2014
-
Abstract
- Few articles have been published on the imaging findings of anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC). To investigate the radiological findings of ALK-positive NSCLC in the advanced stage, CT scans were examined. In addition, the response to chemotherapy was evaluated. Of the 36 patients with ALK-rearranged NSCLC, a mass and a nodule were identified in 17 (47.2%) and 16 (44.4%), respectively, indicating that more than 40% had a small-sized tumor. Overall, 31 (86.1%) patients had lymphadenopathy, seven (19.4%) had extranodal lymph node invasion, and three (8.3%) had lymphangitis. A pleural effusion was seen in 15 patients (41.7%). All but one patient had no ground-glass opacity (GGO) lesions, indicating that most ALK-positive tumors showed a solid growth pattern without GGO on CT. Twenty were evaluable for response to chemotherapy; 10 (50.0%) had a partial response (PR), nine (45.0%) had stable disease (SD), and one (5.0%) had progressive disease (PD) with first-line chemotherapy. With second-line chemotherapy, five (26.3%) had PR, 11 (57.9%) had SD, and three (15.8%) had PD. The five patients with PR were all treated by using crizotinib. Time to progression was 8.2 months with first-line chemotherapy, and 6.0 months with second-line chemotherapy. Advanced-stage ALK-positive tumors have a relatively aggressive phenotype, which cannot be inferred from the size of the tumor alone. ALK-positive patients have a good response to first-line cytotoxic drugs and to crizotinib as second-line therapy, but a relatively poor response to cytotoxic drugs as second-line therapy.<br /> (© 2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Anaplastic Lymphoma Kinase
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung pathology
Crizotinib
Female
Gene Rearrangement
Humans
Lymph Nodes pathology
Male
Middle Aged
Neoplasm Staging
Protein Kinase Inhibitors administration & dosage
Pyrazoles administration & dosage
Pyridines administration & dosage
Tomography, X-Ray Computed
Antineoplastic Agents administration & dosage
Carcinoma, Non-Small-Cell Lung genetics
Oncogene Proteins, Fusion genetics
Receptor Protein-Tyrosine Kinases genetics
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 3
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 24403104
- Full Text :
- https://doi.org/10.1002/cam4.172