Home > Oncology > WCLC 2018 > Crizotinib-treated ALK IHC-positive advanced NSCLC is associated with an unfavourable prognosis when FISH negative

Crizotinib-treated ALK IHC-positive advanced NSCLC is associated with an unfavourable prognosis when FISH negative

*ALK* rearrangement detection using fluorescence *in situ* hybridisation (FISH) or dichotomous immunohistochemical staining (IHC) is a standard test to identify patients with NSCLC eligible for treatment with ALK inhibitors [7].

A European, prospective, multicentre study compared response to treatment with crizotinib in ALK FISH+ and ALK FISH- in patients with ALK IHC+. Central collection of stage 4 ALK IHC+ NSCLC cases treated with crizotinib took place from April 2014 to November 2017. Slides were centrally validated for ALK IHC and ALK FISH. Monthly recording showed that of 3,523 registered ALK IHC tests, 94 (2.6%) were ALK IHC+; less than 0.01% were ALK IHC+ FISH- cases. Local ALK FISH analysis identified 46 concordant (ALK IHC+/FISH+) cases and 18 that were discordant (ALK IHC+/FISH-).

Central validation in Antwerp, Belgium, found 37 concordant and 6 discordant cases, 5 of which had follow-up. Limited tissue in the biopsy samples hampered validation. Time to tr...



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