Allen Timothy Craig, Xiao Yan, Yang Baiyu, Croix Denise, Abraham Anup, Redpath Stella, Engstrom-Melynk Julia, Shah Roma, Madala Jaya, Bernicker Eric H
Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA.
Data Services, Roche Information Solutions, Pleasanton, CA, USA.
Oncotarget. 2021 Nov 9;12(23):2308-2315. doi: 10.18632/oncotarget.28114.
This study assessed the prevalence of anaplastic lymphoma kinase (ALK) rearrangements in US oncology practices.
Using a nationwide real-world database, we included adults with advanced non-small cell lung cancer (aNSCLC, stage IIIB- IV) diagnosed January 2015 - May 2019, with documented ALK testing results and smoking status. Rearrangement prevalence was assessed overall and then stratified by patient characteristics.
The cohort included 19,895 eligible patients with a mean age 68.5 years, majority ever-smokers (85.5%) and from community centers (92.2%). The overall ALK rearrangement prevalence was 2.6%. Positivity rate varied by histology and smoking status; it was the highest among non-smoking patients with non-squamous histology (9.3%). Differences in ALK status also varied by age and race, with young patients (18-39 years) having a higher prevalence (21.6%) vs. older patients (age ≥55 = 2.2%); Asian patients had a prevalence of 6.3%. Patients that were positive for other mutations or rearrangements had a lower ALK positivity rate (0.5%) and patients positive for PD-L1 had a rate of 3.0%.
The likelihood of finding an ALK translocation was highest in younger patients and nonsmokers; however, age and smoking history were not discriminative enough to exclude testing based on clinical variables.
本研究评估了美国肿瘤治疗实践中间变性淋巴瘤激酶（ALK）重排的患病率。
利用全国性的真实世界数据库，我们纳入了2015年1月至2019年5月诊断为晚期非小细胞肺癌（aNSCLC，ⅢB - Ⅳ期）的成年患者，这些患者有记录在案的ALK检测结果和吸烟状况。总体评估重排患病率，然后按患者特征进行分层。
该队列包括19,895例符合条件的患者，平均年龄68.5岁，大多数为曾经吸烟者（85.5%），且来自社区中心（92.2%）。ALK重排的总体患病率为2.6%。阳性率因组织学类型和吸烟状况而异；在非吸烟的非鳞状组织学患者中最高（9.3%）。ALK状态的差异也因年龄和种族而异，年轻患者（18 - 39岁）的患病率较高（21.6%），而老年患者（年龄≥55岁 = 2.2%）；亚洲患者的患病率为6.3%。其他突变或重排呈阳性的患者ALK阳性率较低（0.5%），PD - L1呈阳性的患者阳性率为3.0%。
在年轻患者和非吸烟者中发现ALK易位的可能性最高；然而，年龄和吸烟史不足以根据临床变量排除检测。
