Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Thorac Cancer. 2021 Apr;12(7):1106-1114. doi: 10.1111/1759-7714.13818. Epub 2021 Feb 9.
ALK rearrangement is a very rare subset of squamous cell carcinoma (SCC) and one of the clinical features in patients is lack of data. Here, we report eight patients diagnosed with SCC of the lung harboring ALK rearrangement.
We collected primary NSCLC samples at the Beijing Chest Hospital between January 2012 and December 2018 for Ventana (D5F3) immunohistochemical detection. Among the 148 patients was diagnosed ALK-rearranged non small cell lung cancer (NSCLC), only eight cases was SCC. We collected patients information from electronic patent records (EPRs).
The eight cases of SCC were diagnosed by immunohistochemistry (IHC). Two were given crizotinib as second-line therapy. One patient had stable disease (SD) and progression-free survival (PFS) of six months. The other patient had progressive disease (PD) but PFS was only one month. The side effects were tolerable. This report identified 31 cases of ALK rearrangement in SCC patients from a literature search (including the eight patients in this study). These fusion genes are often seen in a younger age group (mean age: 55.6 years) and non-smokers (18/31, 58.1%). A total of 20 cases received an ALK inhibitor as first- or second-line treatment which included 11 with a partial response (PR), four with SD, and five with PD. The DCR and ORR was 75.0% (15/20) and 55.0% (11/20), respectively. The median duration time of therapy was 6.4 ± 4.4 months.
Patients with ALK-rearranged SCC obtained clinical benefit from ALK-inhibitor therapy, especially those who were non-smokers and whose tumors had been identified by IHC+/FISH+.
ALK 重排是一种非常罕见的鳞状细胞癌（SCC）亚型，其临床特征之一是缺乏数据。在这里，我们报告了 8 例诊断为肺 SCC 伴 ALK 重排的患者。
我们在北京胸科医院收集了 2012 年 1 月至 2018 年 12 月期间的原发性非小细胞肺癌（NSCLC）样本，进行 Ventana（D5F3）免疫组织化学检测。在 148 例诊断为 ALK 重排非小细胞肺癌（NSCLC）的患者中，仅有 8 例为 SCC。我们从电子病历记录（EPRs）中收集患者信息。
这 8 例 SCC 患者通过免疫组化（IHC）诊断。其中 2 例给予克唑替尼作为二线治疗。1 例患者病情稳定（SD），无进展生存期（PFS）为 6 个月。另一位患者疾病进展（PD），但 PFS 仅 1 个月。副作用可耐受。通过文献检索，我们在 SCC 患者中发现了 31 例 ALK 重排（包括本研究中的 8 例患者）。这些融合基因通常见于年轻患者（平均年龄：55.6 岁）和非吸烟者（18/31，58.1%）。共有 20 例患者接受了 ALK 抑制剂的一线或二线治疗，其中 11 例获得部分缓解（PR），4 例病情稳定（SD），5 例疾病进展（PD）。DCR 和 ORR 分别为 75.0%（15/20）和 55.0%（11/20）。治疗的中位时间为 6.4±4.4 个月。
ALK 重排 SCC 患者从 ALK 抑制剂治疗中获得了临床获益，特别是那些非吸烟者和 IHC+/FISH+肿瘤的患者。
