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Conde E, Suárez-Gauthier A, Benito A, Garrido P, García-Campelo R, Biscuola M, Paz-Ares L, Hardisson D, de Castro J, Camacho MC, Rodriguez-Abreu D, Abdulkader I, Ramirez J, Reguart N, Salido M, Pijuán L, Arriola E, Sanz J, Folgueras V, Villanueva N, Gómez-Román J, Hidalgo M, López-Ríos F. Accurate identification of ALK positive lung carcinoma patients: novel FDA-cleared automated fluorescence in situ hybridization scanning system and ultrasensitive immunohistochemistry. PLoS One 2014; 9:e107200. [PMID: 25248157 PMCID: PMC4172507 DOI: 10.1371/journal.pone.0107200] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/07/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Based on the excellent results of the clinical trials with ALK-inhibitors, the importance of accurately identifying ALK positive lung cancer has never been greater. However, there are increasing number of recent publications addressing discordances between FISH and IHC. The controversy is further fuelled by the different regulatory approvals. This situation prompted us to investigate two ALK IHC antibodies (using a novel ultrasensitive detection-amplification kit) and an automated ALK FISH scanning system (FDA-cleared) in a series of non-small cell lung cancer tumor samples. METHODS Forty-seven ALK FISH-positive and 56 ALK FISH-negative NSCLC samples were studied. All specimens were screened for ALK expression by two IHC antibodies (clone 5A4 from Novocastra and clone D5F3 from Ventana) and for ALK rearrangement by FISH (Vysis ALK FISH break-apart kit), which was automatically captured and scored by using Bioview's automated scanning system. RESULTS All positive cases with the IHC antibodies were FISH-positive. There was only one IHC-negative case with both antibodies which showed a FISH-positive result. The overall sensitivity and specificity of the IHC in comparison with FISH were 98% and 100%, respectively. CONCLUSIONS The specificity of these ultrasensitive IHC assays may obviate the need for FISH confirmation in positive IHC cases. However, the likelihood of false negative IHC results strengthens the case for FISH testing, at least in some situations.
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Affiliation(s)
- Esther Conde
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Ana Suárez-Gauthier
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | | | | | | | | | | | - David Hardisson
- IdiPAZ (Hospital La Paz Institute for Health Research), University Hospital La Paz, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Javier de Castro
- IdiPAZ (Hospital La Paz Institute for Health Research), University Hospital La Paz, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | | | | | - Ihab Abdulkader
- C.H.U. Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Marta Salido
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Lara Pijuán
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | | | | | | | | | | | - Manuel Hidalgo
- Oncology Department, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Fernando López-Ríos
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
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Akiba J, Kawahara A, Abe H, Azuma K, Yamaguchi T, Taira T, Fukumitsu C, Takase Y, Yasumoto M, Umeno Y, Todoroki K, Kurita T, Yamaguchi R, Kage M, Yano H. Evaluation of immunohistochemistry using two different antibodies and procedures for primary lung adenocarcinoma harboring anaplastic lymphoma kinase rearrangement. Oncol Lett 2014; 8:2155-2159. [PMID: 25295103 PMCID: PMC4186587 DOI: 10.3892/ol.2014.2511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/07/2014] [Indexed: 01/15/2023] Open
Abstract
Rearrangements of anaplastic lymphoma kinase (ALK) have been recently identified in non-small cell lung carcinomas. Previous studies have revealed characteristic features, including adenocarcinoma histology and mucin production, in ALK-positive lung carcinoma. The present study evaluated immunohistochemistry (IHC) in ALK-positive lung carcinoma using two different antibodies, clone 5A4 and D5F3, and compared the results. On the basis of the aforementioned characteristic features, out of 359 primary lung carcinomas, the ALK status of 14 adenocarcinomas was screened using the intercalated antibody-enhanced polymer (iAEP) method with antibody 5A4, and this was compared with the ALK status obtained using rabbit monoclonal antibody D5F3 and fluorescence in situ hybridization for ALK. Eight cases were demonstrated to be ALK-positive by IHC. Seven cases exhibited ALK rearrangement, which was demonstrated by fluorescence in situ hybridization. The IHC for ALK obtained using D5F3 was comparable with that of the iAEP and exhibited low heterogeneity. This finding suggests that IHC for ALK could be useful in limited tissue samples, such as biopsy specimens or cytology, for the screening of ALK-positive lung carcinoma. In the present study, it was demonstrated that IHC with ALK monoclonal antibody D5F3 was useful for screening lung adenocarcinoma harboring ALK rearrangement.
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Affiliation(s)
- Jun Akiba
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Hideyuki Abe
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Koichi Azuma
- Department of Internal Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Tomohiko Yamaguchi
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Tomoki Taira
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Chihiro Fukumitsu
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Yorihiko Takase
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Makiko Yasumoto
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Yumi Umeno
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Keita Todoroki
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Takashi Kurita
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Rin Yamaguchi
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Masayoshi Kage
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Hirohisa Yano
- Department of Pathology, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
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Yan B, Kuick CH, Lim M, Venkataraman K, Tennakoon C, Loh E, Lian D, Leong MY, Lakshmanan M, Tergaonkar V, Sung WK, Soh SY, Chang KTE. Platform comparison for evaluation of ALK protein immunohistochemical expression, genomic copy number and hotspot mutation status in neuroblastomas. PLoS One 2014; 9:e106575. [PMID: 25188507 PMCID: PMC4154751 DOI: 10.1371/journal.pone.0106575] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 07/30/2014] [Indexed: 01/17/2023] Open
Abstract
ALK is an established causative oncogenic driver in neuroblastoma, and is likely to emerge as a routine biomarker in neuroblastoma diagnostics. At present, the optimal strategy for clinical diagnostic evaluation of ALK protein, genomic and hotspot mutation status is not well-studied. We evaluated ALK immunohistochemical (IHC) protein expression using three different antibodies (ALK1, 5A4 and D5F3 clones), ALK genomic status using single-color chromogenic in situ hybridization (CISH), and ALK hotspot mutation status using conventional Sanger sequencing and a next-generation sequencing platform (Ion Torrent Personal Genome Machine (IT-PGM)), in archival formalin-fixed, paraffin-embedded neuroblastoma samples. We found a significant difference in IHC results using the three different antibodies, with the highest percentage of positive cases seen on D5F3 immunohistochemistry. Correlation with ALK genomic and hotspot mutational status revealed that the majority of D5F3 ALK-positive cases did not possess either ALK genomic amplification or hotspot mutations. Comparison of sequencing platforms showed a perfect correlation between conventional Sanger and IT-PGM sequencing. Our findings suggest that D5F3 immunohistochemistry, single-color CISH and IT-PGM sequencing are suitable assays for evaluation of ALK status in future neuroblastoma clinical trials.
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Affiliation(s)
- Benedict Yan
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- * E-mail: (BY); (KTEC)
| | - Chik Hong Kuick
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Malcolm Lim
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | | | - Eva Loh
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Derrick Lian
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - May Ying Leong
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Manikandan Lakshmanan
- Mouse Models for Human Cancer Unit, Institute of Molecular and Cell Biology, Singapore, Singapore
| | - Vinay Tergaonkar
- Mouse Models for Human Cancer Unit, Institute of Molecular and Cell Biology, Singapore, Singapore
| | - Wing-Kin Sung
- Genome Institute of Singapore, Singapore, Singapore
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Shui Yen Soh
- Haematology/Oncology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kenneth T. E. Chang
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- * E-mail: (BY); (KTEC)
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Ormanns S, Assmann G, Reu S, Gallmeier E, Bader DC, Kleespies A, Haas M, Kruger S, Heinemann V, Kirchner T, Boeck S. ALK expression is absent in pancreatic ductal adenocarcinoma. J Cancer Res Clin Oncol 2014; 140:1625-8. [PMID: 25017418 DOI: 10.1007/s00432-014-1774-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 07/03/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE It has not yet been clearly defined whether anaplastic lymphoma kinase (ALK) expression can be detected in pancreatic ductal adenocarcinoma (PDAC). METHODS Within a retrospective study, archival PDAC surgical specimens were screened for ALK expression in tumor and normal tissue by immunohistochemistry (IHC) with the use of a specific ALK detection kit on a tissue microarray (TMA). RESULTS PDAC tumor tissue was available from 99 resected cases: fifty-eight out of 99 patients (59 %) had nodal-positive disease, and 80 patients (81 %) had pT3 tumors. Forty-nine patients underwent R0 resection, and in 48 cases, resection status was classified R1. Regarding ALK expression, five cases showed faint immunoreactivity on TMA, which was negative on whole mount sections. All other 94 cases showed no ALK expression. CONCLUSION In 99 PDAC cases, no ALK expression was detected by IHC; ALK thus may not serve as a relevant drug target in PDAC.
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Affiliation(s)
- Steffen Ormanns
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Thalkirchnerstr. 36, 80337, Munich, Germany,
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105
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Blackhall FH, Peters S, Bubendorf L, Dafni U, Kerr KM, Hager H, Soltermann A, O'Byrne KJ, Dooms C, Sejda A, Hernández-Losa J, Marchetti A, Savic S, Tan Q, Thunnissen E, Speel EJM, Cheney R, Nonaka D, de Jong J, Martorell M, Letovanec I, Rosell R, Stahel RA. Prevalence and Clinical Outcomes for Patients With ALK-Positive Resected Stage I to III Adenocarcinoma: Results From the European Thoracic Oncology Platform Lungscape Project. J Clin Oncol 2014; 32:2780-7. [DOI: 10.1200/jco.2013.54.5921] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose The prevalence of anaplastic lymphoma kinase (ALK) gene fusion (ALK positivity) in early-stage non–small-cell lung cancer (NSCLC) varies by population examined and detection method used. The Lungscape ALK project was designed to address the prevalence and prognostic impact of ALK positivity in resected lung adenocarcinoma in a primarily European population. Methods Analysis of ALK status was performed by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) in tissue sections of 1,281 patients with adenocarcinoma in the European Thoracic Oncology Platform Lungscape iBiobank. Positive patients were matched with negative patients in a 1:2 ratio, both for IHC and for FISH testing. Testing was performed in 16 participating centers, using the same protocol after passing external quality assessment. Results Positive ALK IHC staining was present in 80 patients (prevalence of 6.2%; 95% CI, 4.9% to 7.6%). Of these, 28 patients were ALK FISH positive, corresponding to a lower bound for the prevalence of FISH positivity of 2.2%. FISH specificity was 100%, and FISH sensitivity was 35.0% (95% CI, 24.7% to 46.5%), with a sensitivity value of 81.3% (95% CI, 63.6% to 92.8%) for IHC 2+/3+ patients. The hazard of death for FISH-positive patients was lower than for IHC-negative patients (P = .022). Multivariable models, adjusted for patient, tumor, and treatment characteristics, and matched cohort analysis confirmed that ALK FISH positivity is a predictor for better overall survival (OS). Conclusion In this large cohort of surgically resected lung adenocarcinomas, the prevalence of ALK positivity was 6.2% using IHC and at least 2.2% using FISH. A screening strategy based on IHC or H-score could be envisaged. ALK positivity (by either IHC or FISH) was related to better OS.
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Affiliation(s)
- Fiona H. Blackhall
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Solange Peters
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Lukas Bubendorf
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Urania Dafni
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Keith M. Kerr
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Henrik Hager
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Alex Soltermann
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Kenneth J. O'Byrne
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Dooms
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Aleksandra Sejda
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Javier Hernández-Losa
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Antonio Marchetti
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Spasenija Savic
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Qiang Tan
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Erik Thunnissen
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Ernst-Jan M. Speel
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Richard Cheney
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Daisuke Nonaka
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Jeroen de Jong
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Miguel Martorell
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Igor Letovanec
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Rafael Rosell
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
| | - Rolf A. Stahel
- Fiona H. Blackhall and Daisuke Nonaka, Manchester University and The Christie National Health Services Foundation Trust, Manchester; Keith M. Kerr, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen, United Kingdom; Solange Peters and Igor Letovanec, Centre Hospitalier Universitaire Vaudois, Lausanne; Lukas Bubendorf and Spasenija Savic, Institute for Pathology, University Hospital Basel, Basel; Alex Soltermann and Rolf A. Stahel, University Hospital Zurich, Zurich, Switzerland
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Cha YJ, Lee JS, Kim HR, Lim SM, Cho BC, Lee CY, Shim HS. Screening of ROS1 rearrangements in lung adenocarcinoma by immunohistochemistry and comparison with ALK rearrangements. PLoS One 2014; 9:e103333. [PMID: 25058391 PMCID: PMC4109990 DOI: 10.1371/journal.pone.0103333] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/27/2014] [Indexed: 01/15/2023] Open
Abstract
ROS1 rearrangement is a predictive biomarker for response to the tyrosine kinase inhibitor, crizotinib. We investigated the usefulness of ROS1 immunohistochemistry (IHC) for the detection of patients who harbor ROS1 rearrangements in two separate cohorts. We also compared ROS1 IHC with ALK IHC in terms of diagnostic performance to predict each gene rearrangement. In a retrospective cohort, IHC was performed in 219 cases of lung adenocarcinoma with already known genetic alterations. In a prospective cohort, we performed IHC for 111 consecutive cases of lung adenocarcinoma and confirmed the results by subsequent FISH. In the retrospective cohort, all 8 ROS1-rearranged tumors were immunoreactive, and 14 of 211 ROS1-wild cases were immunoreactive (sensitivity 100% and specificity 93.4%). In the prospective cohort, all IHC-negative cases were FISH-negative, and 5 of 34 ROS1 immunoreactive cases were ROS1-rearranged (sensitivity 100% and specificity 72.6%). In ROS1-wild tumors, ROS1 protein was more expressed in the tumors of ever-smokers than in those of never-smokers (p = 0.003). ALK IHC showed 100% sensitivity and 98.1 to 100% specificity in both patient cohorts. In conclusion, ROS1 IHC is highly sensitive, but less specific compared with ALK IHC for detection of the corresponding rearrangement. ROS1 IHC-reactive tumors, especially when the tumor is stained with moderate to strong intensity or a diffuse pattern, are recommended to undergo FISH to confirm the gene rearrangement.
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Affiliation(s)
- Yoon Jin Cha
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Seok Lee
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Ryun Kim
- Division of Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Min Lim
- Division of Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Chul Cho
- Division of Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Young Lee
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Sup Shim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Brega E, Brandao G. Non-Small Cell Lung Carcinoma Biomarker Testing: The Pathologist's Perspective. Front Oncol 2014; 4:182. [PMID: 25077070 PMCID: PMC4099940 DOI: 10.3389/fonc.2014.00182] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/27/2014] [Indexed: 12/01/2022] Open
Abstract
Biomarker testing has become standard of care for patients diagnosed with non-small cell lung carcinoma (NSCLC). Although, it can be successfully performed in circulating tumor cells, at present, the vast majority of investigations are carried out using direct tumor sampling, either through aspiration methods, which render most often isolated cells, or tissue sampling, that could range from minute biopsies to large resections. Consequently, pathologists play a central role in this process. Recent evidence suggests that refining NSCLC diagnosis might be clinically significant, particularly in cases of lung adenocarcinomas (ADC), which in turn, has prompted a new proposal for the histologic classification of such pulmonary neoplasms. These changes, in conjunction with the mandatory incorporation of biomarker testing in routine NSCLC tissue processing, have directly affected the pathologist’s role in lung cancer work-up. This new role pathologists must play is complex and demanding, and requires a close interaction with surgeons, oncologists, radiologists, and molecular pathologists. Pathologists often find themselves as the central figure in the coordination of a process, that involves assuring that the tumor samples are properly fixed, but without disruption of the DNA structure, obtaining the proper diagnosis with a minimum of tissue waste, providing pre-analytical evaluation of tumor samples selected for biomarker testing, which includes assessment of the proportion of tumor to normal tissues, as well as cell viability, and assuring that this entire process happens in a timely fashion. Therefore, it is part of the pathologist’s responsibilities to assure that the samples received in their laboratories, be processed in a manner that allows for optimal biomarker testing. This article goal is to discuss the essential role pathologists must play in NSCLC biomarker testing, as well as to provide a summarized review of the main NSCLC biomarkers of clinical interest.
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Affiliation(s)
- Elisa Brega
- Department of Pathology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
| | - Guilherme Brandao
- Department of Pathology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal, QC , Canada
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108
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Cooper WA, Lam DCL, O'Toole SA, Minna JD. Molecular biology of lung cancer. J Thorac Dis 2014; 5 Suppl 5:S479-90. [PMID: 24163741 DOI: 10.3978/j.issn.2072-1439.2013.08.03] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 08/01/2013] [Indexed: 12/16/2022]
Abstract
Lung cancers are characterised by abundant genetic diversity with relatively few recurrent mutations occurring at high frequency. However, the genetic alterations often affect a common group of oncogenic signalling pathways. There have been vast improvements in our understanding of the molecular biology that underpins lung cancer in recent years and this has led to a revolution in the diagnosis and treatment of lung adenocarcinomas (ADC) based on the genotype of an individual's tumour. New technologies are identifying key and potentially targetable genetic aberrations not only in adenocarcinoma but also in squamous cell carcinoma (SCC) of the lung. Lung cancer mutations have been identified in v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS), epidermal growth factor receptor (EGFR), BRAF and the parallel phosphatidylinositol 3-kinase (PI3K) pathway oncogenes and more recently in MEK and HER2 while structural rearrangements in ALK, ROS1 and possibly rearranged during transfection (RET) provide new therapeutic targets. Amplification is another mechanism of activation of oncogenes such as MET in adenocarcinoma, fibroblastgrowth factor receptor 1 (FGFR1) and discoidin domain receptor 2 (DDR2) in SCC. Intriguingly, many of these genetic alternations are associated with smoking status and with particular racial and gender differences, which may provide insight into the mechanisms of carcinogenesis and role of host factors in lung cancer development and progression. The role of tumour suppressor genes is increasingly recognised with aberrations reported in TP53, PTEN, RB1, LKB11 and p16/CDKN2A. Identification of biologically significant genetic alterations in lung cancer that lead to activation of oncogenes and inactivation of tumour suppressor genes has the potential to provide further therapeutic opportunities. It is hoped that these discoveries may make a major contribution to improving outcome for patients with this poor prognosis disease.
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Affiliation(s)
- Wendy A Cooper
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia; ; School of Medicine, University of Western Sydney, NSW, Australia
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109
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Shi Y, Yang X. [Driver genes and its clinical significance in non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:481-6. [PMID: 24949689 PMCID: PMC6000100 DOI: 10.3779/j.issn.1009-3419.2014.06.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With the development of molecular biology technology and the transforming patterns of drug research, guiding molecular targeted therapy according to the drive gene mutation spectrum in lung cancer has gradually become a reality. Definition of the mutation incidence and whether existing advantage population groups in non-small cell lung cancer (NSCLC) have important guiding significance in clinical practice. The purpose of this paper will draw a summary on the general characteristics, demographic features and clinical significance of driver genes in NSCLC.
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Affiliation(s)
- Yuequan Shi
- Seven-Year System, Clinical Medicine, China Medical University, Shenyang 110001, China
| | - Xianghong Yang
- Department of Pathology, Shengjing Hospital, China Medical University, Shenyang 110004, China
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110
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Le Quesne J, Maurya M, Yancheva SG, O’Brien M, Popat S, Wotherspoon AC, de Castro DG, Nicholson AG. A comparison of immunohistochemical assays and FISH in detecting the ALK translocation in diagnostic histological and cytological lung tumor material. J Thorac Oncol 2014; 9:769-74. [PMID: 24787965 PMCID: PMC4132045 DOI: 10.1097/jto.0000000000000157] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Detection of the ALK rearrangement in a solid tumor gives these patients the option of crizotinib as an oral form of anticancer treatment. The current test of choice is fluorescence in situ hybridization (FISH), but various cheaper and more convenient immunohistochemical (IHC) assays have been proposed as alternatives. METHODS Fifteen FISH-positive cases from patients, seven with data on crizotinib therapy and clinical response, were evaluated for the presence of ALK protein using three different commercially available antibodies: D5F3, using the proprietary automated system (Ventana), ALK1 (Dako), and 5A4 (Abcam). A further 14 FISH-negative and three uncertain (<15% rearrangement detected) cases were also retrieved. Of the total 32 specimens, 17 were excisions and 15 were computed tomography-guided biopsies or cytological specimens. All three antibodies were applied to all cases. Antibodies were semiquantitatively scored on intensity, and the proportion of malignant cells stained was documented. Cutoffs were set by receiver operating curve analysis for positivity to optimize correct classification. RESULTS All three IHC assays were 100% specific but sensitivity did vary: D5F3 86%, ALK 79%, 5A4 71%. Intensity was the most discriminating measure overall, with a combination of proportion and intensity not improving the test. No FISH-negative IHC-positive cases were seen. Two FISH-positive cases were negative with all three IHC assays. One of these had been treated with crizotinib and had failed to show clinical response. The other harbored a second driving mutation in the EGFR gene. CONCLUSIONS IHC with all three antibodies is especially highly specific (100%) although variably sensitive (71%-86%), specifically in cases with scanty material. D5F3 assay was most sensitive in these latter cases. Occasional cases are IHC-positive but FISH-negative, suggesting either inaccuracy of one assay or occasional tumors with ALK rearrangement that do not express high levels of ALK protein.
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Affiliation(s)
- John Le Quesne
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Manisha Maurya
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Slaveya G. Yancheva
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Mary O’Brien
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Sanjay Popat
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Andrew C. Wotherspoon
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - David Gonzalez de Castro
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
| | - Andrew G. Nicholson
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London; Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, Surrey; Department of Oncology, The Royal Marsden Hospital; and Department of Histopathology, Royal Marsden Hospital, Chelsea, London, United Kingdom
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111
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Kim TJ, Park CK, Yeo CD, Park K, Rhee CK, Kim J, Kim SJ, Lee SH, Lee KY, Yoon HK. Simultaneous diagnostic platform of genotyping EGFR, KRAS, and ALK in 510 Korean patients with non-small-cell lung cancer highlights significantly higher ALK rearrangement rate in advanced stage. J Surg Oncol 2014; 110:245-51. [PMID: 24888607 DOI: 10.1002/jso.23646] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/17/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Simultaneous genotyping has advantages in turnaround time and detecting the real mutational prevalence in unresectable non-small-cell lung cancer (NSCLC), a group not previously genetically characterized. METHODS We developed simultaneous panel of screening EGFR and KRAS mutations by direct sequencing or PNA clamping, and ALK rearrangement by fluorescent in situ hybridization (FISH) in multicenter manner. RESULTS Of 510 NSCLC Korean patients, simultaneous genotyping identified mutations of EGFR (29.0%) and KRAS (8.6%) and rearrangement of ALK (9.2%). Seven patients had overlaps in mutations. Although several well-known associations between genotypes and clinical characteristics were identified, we found no relationship between ALK rearrangement and sex or smoking history. Unlike the other genotype mutations, ALK rearrangement was associated with advanced disease. Among the ALK-negative group, patients with 10-15% of ALK FISH split shared characteristics, such as younger age and advanced stage disease, more with the ALK-positive group (>15% ALK FISH split) than <10% ALK FISH split group. CONCLUSIONS Simultaneous panel genotyping revealed more prevalent ALK rearrangements than reported in previous studies and their strong association with advanced stage irrespective of sex or smoking history. ALK rearrangement seems to be a marker for aggressive tumor biology and should be assessed in advanced disease.
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Affiliation(s)
- Tae-Jung Kim
- Department of Hospital Pathology, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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112
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Abel HJ, Al-Kateb H, Cottrell CE, Bredemeyer AJ, Pritchard CC, Grossmann AH, Wallander ML, Pfeifer JD, Lockwood CM, Duncavage EJ. Detection of gene rearrangements in targeted clinical next-generation sequencing. J Mol Diagn 2014; 16:405-17. [PMID: 24813172 DOI: 10.1016/j.jmoldx.2014.03.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 02/24/2014] [Accepted: 03/06/2014] [Indexed: 12/30/2022] Open
Abstract
The identification of recurrent gene rearrangements in the clinical laboratory is the cornerstone for risk stratification and treatment decisions in many malignant tumors. Studies have reported that targeted next-generation sequencing assays have the potential to identify such rearrangements; however, their utility in the clinical laboratory is unknown. We examine the sensitivity and specificity of ALK and KMT2A (MLL) rearrangement detection by next-generation sequencing in the clinical laboratory. We analyzed a series of seven ALK rearranged cancers, six KMT2A rearranged leukemias, and 77 ALK/KMT2A rearrangement-negative cancers, previously tested by fluorescence in situ hybridization (FISH). Rearrangement detection was tested using publicly available software tools, including Breakdancer, ClusterFAST, CREST, and Hydra. Using Breakdancer and ClusterFAST, we detected ALK rearrangements in seven of seven FISH-positive cases and KMT2A rearrangements in six of six FISH-positive cases. Among the 77 ALK/KMT2A FISH-negative cases, no false-positive identifications were made by Breakdancer or ClusterFAST. Further, we identified one ALK rearranged case with a noncanonical intron 16 breakpoint, which is likely to affect its response to targeted inhibitors. We report that clinically relevant chromosomal rearrangements can be detected from targeted gene panel-based next-generation sequencing with sensitivity and specificity equivalent to that of FISH while providing finer-scale information and increased efficiency for molecular oncology testing.
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Affiliation(s)
- Haley J Abel
- Department of Genetics, Washington University, St. Louis, Missouri
| | - Hussam Al-Kateb
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri
| | - Catherine E Cottrell
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri
| | - Andrew J Bredemeyer
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri
| | - Colin C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Allie H Grossmann
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, Utah
| | | | - John D Pfeifer
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri
| | - Christina M Lockwood
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri
| | - Eric J Duncavage
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri.
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Hutarew G, Hauser-Kronberger C, Strasser F, Llenos IC, Dietze O. Immunohistochemistry as a screening tool for ALK rearrangement in NSCLC: evaluation of five different ALK antibody clones and ALK FISH. Histopathology 2014; 65:398-407. [PMID: 24612196 DOI: 10.1111/his.12399] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 02/19/2014] [Indexed: 01/20/2023]
Abstract
AIMS ALK FISH analysis is used as the reference standard to demonstrate ALK rearrangements, which qualify patients with pulmonary adenocarcinomas for therapy with ALK inhibitors. The aim of this study was to find screening ALK antibody clones with the best positive and best negative percentage agreement with ALK FISH. METHODS AND RESULTS Three hundred and three pulmonary adenocarcinomas were evaluated with ALK FISH and stained with five ALK antibody clones (5A4; D5F3; ALK1; ALK01; SP8) with standardized detection systems. D5F3 was additionally assessed using the OptiView enhanced detection and amplification system. ALK FISH found 14 cases (4.6%) that harboured ALK rearrangements. These stained at all intensities for D5F3 and 5A4. To identify rearranged cases among stained cases, we subsequently analysed all immunohistochemically positive cases with ALK FISH. CONCLUSIONS D5F3 with OptiView exclusively stained rearranged cases with strong intensity, without a single false-positive or false-negative case. The number of subsequent ALK FISH analyses required would have decreased from 303 to 14 cases (-95.4%), reducing significantly the time, work and costs without any loss of diagnostic quality and accuracy.
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Affiliation(s)
- Georg Hutarew
- Department of Pathology, University Hospital and Paracelsus Medical University Salzburg, Salzburg, Austria
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114
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115
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ALK Status Testing in Non–Small-Cell Lung Carcinoma by FISH on ThinPrep Slides with Cytology Material. J Thorac Oncol 2014; 9:464-8. [DOI: 10.1097/jto.0000000000000104] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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116
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Accurate and economical detection of ALK positive lung adenocarcinoma with semiquantitative immunohistochemical screening. PLoS One 2014; 9:e92828. [PMID: 24667320 PMCID: PMC3965450 DOI: 10.1371/journal.pone.0092828] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/26/2014] [Indexed: 12/27/2022] Open
Abstract
Right detection of anaplastic lymphoma kinase (ALK) gene rearrangement is pivotal to selection of patients with lung adenocarcinoma for ALK-targeted therapy. We explored the potential of combination of immunohistochemistry (IHC) screening and fluorescence in situ hybridization (FISH) as an affordable practice. We analyzed 410 unselected lung adenocarcinomas by ALK IHC (D5F3 clone) and FISH. Some equivocal cases were further analyzed by RT-PCR. The EGFR mutation was detected by pyrosequencing assay. In total 368 cases which got all IHC, FISH, EGFR mutation results were eligible for analysis. Cases were evaluated as IHC score 3+ (n = 26), score 2+ (n = 9), score 1+ (n = 51), and score 0 (n = 282), respectively. 23 of 26 IHC 3+ and 5 of 9 IHC 2+ cases were FISH positive, whereas 3 of 26 IHC 3+, 4 of 9 IHC 2+ and all 333 IHC 1+/0 cases were FISH negative. If considering FISH as the standard, the sensitivity and specificity of ALK IHC 3+/2+ as ALK positive were 100% and 97.9%, respectively. Three IHC 3+ cases reported as FISH “negative” were actually ALK positive confirmed by ALK RT-PCR or re-detected. Based on the final classify, ALK IHC 3+/2+ was 100% sensitive and 98.8% specific. However, FISH was 90.3% sensitive and 100% specific. IHC 2+ was regarded as equivocal and need to be confirmed by FISH or RT-PCR. In the 368 cases, 8.4% cases had ALK positive, 52.2% cases had EGFR mutation, and only one case had a coexisting. Manually semiquantitative ALK IHC (primary antibody D5F3 coupled with secondary DAKO Envision system) used as the initial screening combined with auxiliary FISH confirmation is a reliable, economical approach to identify ALK positive lung adenocarcinoma. The IHC can find some ALK positive cases which would be missed by FISH only.
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117
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Iwama E, Okamoto I, Harada T, Takayama K, Nakanishi Y. Development of anaplastic lymphoma kinase (ALK) inhibitors and molecular diagnosis in ALK rearrangement-positive lung cancer. Onco Targets Ther 2014; 7:375-85. [PMID: 24623980 PMCID: PMC3949762 DOI: 10.2147/ott.s38868] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The fusion of echinoderm microtubule-associated protein-like 4 with anaplastic lymphoma kinase (ALK) was identified as a transforming gene for lung cancer in 2007. This genetic rearrangement accounts for 2%–5% of non-small-cell lung cancer (NSCLC) cases, occurring predominantly in younger individuals with adenocarcinoma who are never- or light smokers. A small-molecule tyrosine-kinase inhibitor of ALK, crizotinib, was rapidly approved by the US Food and Drug Administration on the basis of its pronounced clinical activity in patients with ALK rearrangement-positive NSCLC. Next-generation ALK inhibitors, such as alectinib, LDK378, and AP26113, are also being developed in ongoing clinical trials. In addition, the improvement and validation of methods for the detection of ALK rearrangement in NSCLC patients will be key to the optimal clinical use of ALK inhibitors. We here summarize recent progress in the development of new ALK inhibitors and in the molecular diagnosis of ALK rearrangement-positive NSCLC.
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Affiliation(s)
- Eiji Iwama
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan ; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Taishi Harada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
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Kim H, Shim HS, Kim L, Kim TJ, Kwon KY, Lee GK, Chung JH. Guideline Recommendations for Testing of ALK Gene Rearrangement in Lung Cancer: A Proposal of the Korean Cardiopulmonary Pathology Study Group. KOREAN JOURNAL OF PATHOLOGY 2014; 48:1-9. [PMID: 24627688 PMCID: PMC3950228 DOI: 10.4132/koreanjpathol.2014.48.1.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 01/27/2014] [Indexed: 01/15/2023]
Abstract
Rearrangement of anaplastic lymphoma kinase (ALK) gene is the best predictor of response to crizotinib, an ALK tyrosine kinase inhibitor. However, the prevalence of the ALK fusion is low, so accurate patient identification is crucial for successful treatment using ALK inhibitors. Furthermore, most patients with lung cancer present with advanced-stage disease at the time of diagnosis, so it is important for pathologists to detect ALK-rearranged patients while effectively maximizing small biopsy or cytology specimens. In this review, we propose a guideline recommendation for ALK testing approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.
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Affiliation(s)
- Hyojin Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyo Sup Shim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Lucia Kim
- Department of Pathology, Inha University School of Medicine, Incheon, Korea
| | - Tae-Jung Kim
- Department of Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kun Young Kwon
- Department of Pathology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Geon Kook Lee
- Department of Pathology, National Cancer Center, Goyang, Korea
| | - Jin-Haeng Chung
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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119
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Kim H, Chung JH. ALK testing for the right patients: integration into practice and impact on clinics. Lung Cancer Manag 2014. [DOI: 10.2217/lmt.13.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Patients with non-small-cell lung cancer who harbor ALK gene rearrangements can derive significant clinical benefit from ALK tyrosine kinase inhibitor. However, the prevalence of the ALK fusion is low, therefore, accurate patient identification is crucial for successful treatment using the ALK inhibitor. There are several methods used to detect the ALK gene rearrangement: fluorescence/chromogenic in situ hybridization, immunohistochemistry, reverse transcriptase-PCR and next-generation sequencing. This review is focused on practical issues of each testing methodology for ALK rearrangement and how they may impact on clinical decision-making.
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Affiliation(s)
- Hyojin Kim
- Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Republic of Korea
- Department of Pathology, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jin-Haeng Chung
- Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Republic of Korea
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120
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Gremel G, Grannas K, Sutton LA, Pontén F, Zieba A. In situ Protein Detection for Companion Diagnostics. Front Oncol 2013; 3:271. [PMID: 24199171 PMCID: PMC3814083 DOI: 10.3389/fonc.2013.00271] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 10/17/2013] [Indexed: 01/29/2023] Open
Abstract
The emergence of targeted therapies for cancer has created a need for the development of companion diagnostic tests. Assays developed in recent years are aimed at determining both the effectiveness and safety of specific drugs for a defined group of patients, thus, enabling the more efficient design of clinical trials and also supporting physicians when making treatment-related decisions. Immunohistochemistry (IHC) is a widely accepted method for protein expression analyses in human tissues. Immunohistochemical assays, used to localize and quantitate relative protein expression levels within a morphological context, are frequently used as companion diagnostics during clinical trials and also following drug approval. Herein, we describe established immunochemistry-based methods and their application in routine diagnostics. We also explore the possibility of using IHC to detect specific protein mutations in addition to DNA-based tests. Finally, we review alternative protein binders and proximity ligation assays and discuss their potential to facilitate the development of novel, targeted therapies against cancer.
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Affiliation(s)
- Gabriela Gremel
- Science for Life Laboratory, Department of Immunology, Genetics and Pathology, Uppsala University , Uppsala , Sweden
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