| Concomitant EGFR mutation and EML4-ALK gene fusion in non-small cell lung cancer.  Print this page ' y$ l: M" F+ I2 Y/ A- U: k$ b8 F. e! {/ y; A% y4 J: f+ Q  u4 Y* o
 ! M0 ?, u( d( c$ i* m, @
 Sub-category:- X$ {; c4 ?7 I) s" M! L. A& v' w
 Molecular Targets 6 k, ?" n6 U+ l2 R! v! C" D; P
 ) K: d4 @# R( s; i5 |; G
 
 % J4 @$ V- r+ @2 T7 J' H* ECategory:+ u& {& @' M" U! o, e1 |4 b
 Tumor Biology
 " s4 W# E) \3 O" a+ W/ Q4 T$ E$ _3 N' i2 S3 O# x
 
 6 {7 F4 B& z/ ~% \9 c- [Meeting:1 p) d. c: ^& M" t# V
 2011 ASCO Annual Meeting
 + C, n6 \: M" Y% t1 E. D8 }5 s, e0 N! @+ N, e9 N
 
 7 O+ z. A2 A( R/ F! XSession Type and Session Title:# h% [* W: D. ~# Z7 g. f. A# ]7 @
 Poster Discussion Session, Tumor Biology
 # C/ Y- M; }/ `5 q1 c+ y: q
 - w; Z1 T7 F1 V. b6 U5 ]; S  [
 % H- H2 ?# Q: ?* U- o! DAbstract No:
 9 W' `9 `$ m) {" N3 n/ s% J2 l, x& o5 x10517
 / V3 E% O2 v* e1 ]. @2 R! g
 ; D. M. ~) A$ w3 ]' J
 6 s* e  i+ ^5 h, p1 D# q% ?Citation:7 {7 T4 v: B& o5 a6 l; c( U
 J Clin Oncol 29: 2011 (suppl; abstr 10517)
 / W7 y5 n9 R7 @4 y9 b1 L8 q: W3 ^( Z5 j$ u* J
 
 $ k& j8 {; @2 c0 pAuthor(s):1 r4 z7 G7 D, t2 q8 z
 J. Yang, X. Zhang, J. Su, H. Chen, H. Tian, Y. Huang, C. Xu, Y. L. Wu; Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China; Guangdong Lung Cancer Institute, Medical Research Center of Guangdong General Hospital, Guangzhou, China; Guangdong Lung Cancer Institute, Guangzhou, China; Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China 9 D" W! u4 H# O
 
 9 m/ j; e; f  l' @( _7 r. B# H0 J  c- N  B
 ^; F% K! l( K3 g
 Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^) here and in the printed Proceedings.  s5 J1 p' t3 g/ F) r% ]( [4 R7 D
 3 Q" r( E3 d3 j3 I) X# g. u8 V( x
 Abstract Disclosures
 $ Y$ w% @( `8 W: M' [" ?# k& C, R+ [4 m; s8 J! }8 R
 Abstract:
 : h" c, \: ^( [( l9 a: |- O9 ?) c+ T; ^/ g) g
 
 5 k' c$ g/ V- r) TBackground: The fusion of the anaplastic lymphoma kinase (ALK) with the echinoderm microtubule-associated protein-like 4 (EML4) and epidermal growth factor receptor (EGFR) mutations are considered mutually exclusive. Advanced non-small cell lung cancer (NSCLC) patients with EML4-ALK did not benefit from EGFR tyrosine kinase inhibitors (TKIs). Methods: Multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) followed by sequencing was performed for EML4-ALK fusion status detection. EGFR and KRAS mutations were determined by direct DNA sequencing. Positive results of EML4-ALK fusion were also confirmed by RACE-coupled PCR sequencing. Results: From April 2010 to January 2011, 412 patients (398 with NSCLC; 14 with SCLC) were tested for mutation status of EGFR, KRAS and EML4-ALK respectively. Frequency of EML4-ALK fusion was 10.6% (42/398) in NSCLC patients. No patients with SCLC were found to have positive EML4-ALK fusion. Frequency of concomitant EGFR and EML4-ALK gene mutations was 1.0% (4/398) in NSCLC patients, and their variants of EML4-ALK gene mutations were Variant 1 (3 patients) and Variant 6 (1 patient); being never smokers, all of them were diagnosed with advanced (3 with stage †W and 1 with stage IIIB) adenocarcinoma harbouring wild type KRAS. Two female stage †W patients with double gene mutations (1 with L858R and Variant 1; 1 with exon19 deletion and Variant 6) received first-line gefitinib which is one kind of EGFR TKIs and achieved partial response. Conclusions: Though being rare events, NSCLC patients harbouring concomitant EGFR mutation and EML4-ALK gene fusion are sensitive to first-line EGFR TKIs. Whether they could also benefit from ALK inhibition after failure to EGFR TKIs warranted further investigation.
 4 D3 M/ M. x+ D" E, J$ y0 y& [' z3 Z& o* e( E. f. F0 N$ L5 @$ M
 
 ! Q1 k/ {! b  L8 g* ^8 K) P6 V3 X
 |