Concomitant EGFR mutation and EML4-ALK gene fusion in non-small cell lung cancer. Print this page . {; @- g9 ]6 j5 K
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$ {$ C9 U/ m3 NMolecular Targets ! e/ }4 k6 ^) D l1 I, K
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Tumor Biology
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Meeting:
* G7 i! {& _) ^6 [2 u s2011 ASCO Annual Meeting
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Session Type and Session Title:! ]% }7 Q3 B j! @6 o( [
Poster Discussion Session, Tumor Biology : o# B0 {9 \& q" t" U
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$ l; l J0 ]+ P0 a$ J( c' xAbstract No:; K/ e4 T# a' W* z! u8 }
10517
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4 `) P0 j% Z2 p- [. SJ Clin Oncol 29: 2011 (suppl; abstr 10517) 4 Z+ A9 _- m4 G; U s y8 S
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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
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5 _; n- F! q+ RAbstracts 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.- y, ]" A) Y9 u' u3 t5 |9 [2 X$ A
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Abstract Disclosures8 E& X4 _/ @* C, W: B+ y5 `
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Abstract:4 B( {% L/ I' h
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6 [+ l4 R! I P) T8 O/ u$ ^7 KBackground: 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.9 N9 l' P# O$ Q
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