title: Clinicopathologic characteristics and therapeutic responses of Chinese patients with non-small cell lung cancer who harbor an anaplastic lymphoma kinase rearrangement.
abstract: BACKGROUND
  The rearrangement of the anaplastic lymphoma kinase (ALK) gene accounts for approximately 1%-6% of lung adenocarcinoma cases and defines a molecular subgroup of tumors characterized by clinical sensitivity to ALK inhibitors such as crizotinib. This study aimed to identify the relationship between ALK rearrangement and the clinicopathologic characteristics of non-small cell lung cancer (NSCLC) and to analyze the therapeutic responses of crizotinib and conventional chemotherapy to ALK rearrangement in NSCLC patients.
  
  
  METHODS
  A total of 487 lung cancer patients who underwent testing for ALK rearrangement in our department were included in this study. ALK rearrangement was examined by using fluorescence in situ hybridization (FISH) assay.
  
  
  RESULTS
  Among the 487 patients, 44 (9.0%) were diagnosed with ALK rearrangement by using FISH assay. In 123 patients with adenocarcinoma who were non-smokers and of a young age (≤ 58 years old), the frequency of ALK rearrangement was 20.3% (25/123). Short overall survival (OS) was associated with non-adenocarcinoma tumor type (P = 0.006), poorly differentiated tumors (P = 0.001), advanced-stage tumors (P < 0.001), smoking history (P = 0.008), and wild-type epidermal growth factor receptor (EGFR) (P = 0.008). Moreover, patients with poorly differentiated and advanced-stage tumors had a shorter time to cancer progression compared with those with well differentiated (P = 0.023) and early-stage tumors (P = 0.001), respectively.
  
  
  CONCLUSIONS
  ALK-rearranged NSCLC tends to occur in younger individuals who are either non-smokers or light smokers with adenocarcinoma. Patients with ALK rearrangement might benefit from ALK inhibitor therapy.
authors.affiliation: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. fusha@sysucc.org.cn.|Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. fusha@sysucc.org.cn.
authors.forename: Sha
authors.initials: S
authors.lastname: Fu
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden. wanghaiy99@gmail.com.
authors.forename: Hai-Yun
authors.initials: HY
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. wangfang@sysucc.org.cn.|Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. wangfang@sysucc.org.cn.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China. huangmy@sysucc.org.cn.
authors.forename: Ma-Yan
authors.initials: MY
authors.lastname: Huang
authors.affiliation: Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. dengling@sysucc.org.cn.
authors.forename: Ling
authors.initials: L
authors.lastname: Deng
authors.affiliation: Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. zhangxiao@sysucc.org.cn.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. yezl@sysucc.org.cn.
authors.forename: Zu-Lu
authors.initials: ZL
authors.lastname: Ye
authors.affiliation: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China. shaojy@sysucc.org.cn.|Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 21 Qing Cai Gang Road, Guangzhou, Guangdong, 510060, P. R. China. shaojy@sysucc.org.cn.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Shao
mesh_terms: D000230:Adenocarcinoma; D000077192:Adenocarcinoma of Lung; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents; D044466:Asian People; D002289:Carcinoma, Non-Small-Cell Lung; D000077547:Crizotinib; D066246:ErbB Receptors; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms; D011720:Pyrazoles; D011725:Pyridines; D020794:Receptor Protein-Tyrosine Kinases; D012307:Risk Factors; D012907:Smoking; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases