title: Clinical outcome for EML4-ALK-positive patients with advanced non-small-cell lung cancer treated with first-line platinum-based chemotherapy.
abstract: BACKGROUND
  The EML4-ALK fusion oncogene represents a recently identified molecular target in a subset of patients with non-small-cell lung cancer (NSCLC). Limited data have been available, however, on the outcome of first-line platinum-based chemotherapy in patients with EML4-ALK-positive advanced NSCLC who have not been treated with an ALK kinase inhibitor.
  
  
  METHODS
  The efficacy of platinum-based chemotherapy was compared between patients with advanced nonsquamous NSCLC who harbor EML4-ALK and those who harbor EGFR mutations and those with neither molecular abnormality.
  
  
  RESULTS
  Among 200 patients with advanced nonsquamous NSCLC, 18 (9.0%) were positive for EML4-ALK, 31 (15.5%) harbored EGFR mutations, and 151 (75.5%) were wild type for both abnormalities. Platinum-based combination chemotherapy showed similar efficacies in the EML4-ALK, EGFR mutation, and wild-type cohorts in terms of response rate and progression-free survival, and overall survival in the EML4-ALK cohort closely resembled that in the wild-type cohort. Within the EML4-ALK cohort, patients with variants 1 or 3 of the fusion gene were predominant and did not appear to differ in their sensitivity to the platinum-based regimens.
  
  
  CONCLUSIONS
  Patients with EML4-ALK-positive advanced NSCLC manifest an aggressive clinical course similar to that of those with wild-type tumors if the effective targeted therapy is not instituted.
authors: Departments of Medical Oncology.
authors: M
authors: M
authors: Takeda
authors: Departments of Medical Oncology. Electronic address: chi-okamoto@dotd.med.kindai.ac.jp.
authors: I
authors: I
authors: Okamoto
authors: Genome Biology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors: K
authors: K
authors: Sakai
authors: Departments of Medical Oncology.
authors: H
authors: H
authors: Kawakami
authors: Genome Biology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors: K
authors: K
authors: Nishio
authors: Departments of Medical Oncology.
authors: K
authors: K
authors: Nakagawa
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000235:genetics / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009154:Mutation; D015514:Oncogene Proteins, Fusion / Q000235:genetics*; D017671:Platinum Compounds / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D017422:Sequence Analysis, DNA
chemical_list: D000970:Antineoplastic Agents; C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion; D017671:Platinum Compounds; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors