1
|
Fallet V, Cadranel J, Doubre H, Toper C, Monnet I, Chinet T, Oliviero G, Foulon G, De Cremoux H, Vieira T, Antoine M, Wislez M. Prospective screening for ALK: clinical features and outcome according to ALK status. Eur J Cancer 2014; 50:1239-46. [PMID: 24589437 DOI: 10.1016/j.ejca.2014.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/09/2014] [Accepted: 02/03/2014] [Indexed: 01/30/2023]
Abstract
The aim of this study was to analyse the clinico-pathological characteristics and outcomes of a cohort of French patients who were prospectively screened for Anaplastic Lymphoma Kinase (ALK) rearrangement. One hundred and sixteen consecutive patients screened for ALK rearrangement to be recruited into a crizotinib registration trial were included from eight French centres. ALK rearrangement was detected by fluorescence in situ hybridization. Seventeen patients (14.6%) were positive for ALK. ALK+ patients were younger (p = 0.049) and more likely to be males (p=0.032), non- or light-smokers (p = 0.048) and without underlying respiratory disease (p=0.025) compared to ALK- patients. Thyroid-transcription factor-1 expression was present in all ALK+ tumours. ALK+ tumours tended to have lymph node and brain metastases. In multivariate analyses, gender, smoking history and N stage were independently associated with ALK status. Median overall survival (OS) was not reached for ALK+ patients and was significantly longer than for ALK- patients (hazard ratio for death for ALK- patients 2.98; 95% CI [1.29-6.90], p=0.01). French ALK+ patients present a specific phenotype. ALK rearrangement should be determined to improve OS with an effective targeted therapy.
Collapse
Affiliation(s)
- Vincent Fallet
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Jacques Cadranel
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Hélène Doubre
- Service de Pneumologie, Hôpital Foch, Suresnes, France
| | - Cécile Toper
- Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Isabelle Monnet
- Service de Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Thierry Chinet
- Service de Pneumologie, Hôpital Ambroise Paré APHP, Boulogne-Billancourt, France
| | - Gérard Oliviero
- Service de Pneumologie, Centre Hospitalier de Longjumeau, Longjumeau, France
| | - Guillaume Foulon
- Service de Pneumologie, Hôpital Max Fourestier, Nanterre, France
| | - Hubert De Cremoux
- Service de Pneumologie, Centre Hospitalier d'Argenteuil, Argenteuil, France
| | - Thibault Vieira
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France
| | - Martine Antoine
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service d'Anatomo-Pathologie, Hôpital Tenon APHP, Paris, France
| | - Marie Wislez
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France.
| |
Collapse
|
2
|
Vieira T, Cazes A, Pierre B, Zemoura L, Monnet I, De Cremoux H, Chouaid C, Duruisseaux M, Giroux Leprieur E, Belmont L, Lavole A, Cadranel J, Wislez M. Is conventional chemotherapy effective in advanced sarcomatoid lung cancers? J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e18102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18102 Background: Sarcomatoid lung cancers (SC) are associated with poor prognosis. A few studies suggest that these tumors are resistant to platinum-based chemotherapy. Methods: Between January 1994 and October 2011, all consecutive patients with SC were screened from six French centers. Patients with advanced disease and treated with first-line chemotherapy were included in this study. Clinical data, staging (TNM 2009 classification), drugs and response to chemotherapy (RECIST 1.1) at first tumor assessment were reported. Factors associated with progressive disease (PD) in univariate (p<0.2) were included in multivariate analysis. Results: 111 patients with SC were screened. 51 had advanced stage and were treated by a first-line chemotherapy. Among them, 27 (53%) had initial advanced disease and 24 (47%) had relapse after radical surgery or radiotherapy. Patients were 60.7±3 years old, 69% were male, 86% smokers and 86% were symptomatic. PS was 0 (57%), 1 (39%) 2 (4%). Stages at the diagnosis were I (15.5%), II (13.5%), IIIA (20%), IIIB (6%), IV (45%). Histological subtype were pleomorphic (70%), pure sarcoma-like (20%) unspecified (6%), carcino-sarcoma (4%). 38 (75%) received a platinum based-combination and 13 (25%) a monotherapy. Drug given alone or combined with platin were gemcitabine (23%), navelbine (16%), placlitaxel (16%), docetaxel (12%), pemetrexed (9.8%), ifosfamide (9.8%), vepeside (4%) and others (11%). At first tumor assessment, PD and disease control rates were 71% and 29%, respectively. Median progression free survival was 2 months IC95% [1.3, 2.7]. Median overall survival was 6 months [3.2, 8.8]. In univariate analysis, age, gender, smoking status, numbers of metastatic locations, histological subtypes, monotherapy vs platin-based combinations, relapse after radical treatment vs initial advanced disease were not associated with PD. In multivariate analysis, initial advanced disease was the only independent factor of PD (OR 4.59 [1.17, 18] p=0.03). Conclusions: Our series confirm that advanced SC are refractory to conventional chemotherapy. Molecular characterizations are needed to improve therapeutic strategy.
Collapse
Affiliation(s)
- Thibault Vieira
- Service de Pneumologie et de Réanimation, Hôpital Tenon APHP, Paris, France
| | - Aurelie Cazes
- Service d'Anatomo-Pathologie, Hôpital Européen Georges Pompidou APHP, Paris, France
| | - Bonnette Pierre
- Service de Chirurgie Thoracique, Hôpital Foch, Suresne, France
| | - Leila Zemoura
- Service d'Anatomo-Pathologie Hôpital Foch, Suresne, France
| | - Isabelle Monnet
- Service de Pneumologie et Pathologie Professionnel, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Hubert De Cremoux
- Service de Pneumologie Hôpital d'Argenteuil, Argenteuil Cedex, France
| | - Christos Chouaid
- Service de Pneumologie, Hopital Saint-Antoine APHP, Paris, France
| | - Michael Duruisseaux
- Laboratoire ER2 Université Pierre et Marie Curie, Hopital Tenon, Paris, France
| | | | - Laure Belmont
- Service de Pneumologie Hopital Tenon Université Pierre et Marie Curie, Paris, France
| | - Armelle Lavole
- Hôpital Tenon, AP-HP and Faculté de Médecine Pierre et Marie Curie, Université Paris VI, Paris, France
| | - Jacques Cadranel
- Service de Pneumologie Hopital Tenon Université Pierre et Marie Curie, Paris, France
| | - Marie Wislez
- Service de Pneumologie Hopital Tenon Université Pierre et Marie Curie, Paris, France
| |
Collapse
|