Anaplastic Lymphoma Kinase in Cutaneous Malignancies
Abstract
:1. Introduction
2. Discussion
2.1. Overview of ALK Biochemical Activity and Expression
2.2. ALK Expression in Cutaneous Lymphomas
2.2.1. Secondary Cutaneous ALCL
2.2.2. Primary Cutaneous ALCL
2.3. Trial of Therapeutic ALK Inhibition for Cutaneous-Involved ALK Lymphoma
2.4. ALK in Other Cutaneous Malignancies
2.4.1. Melanoma
2.4.2. Spitzoid Tumors
2.4.3. Epithelioid Fibrous Histocytoma
2.4.4. Merkel Cell Carcinoma
2.4.5. Basal Cell Carcinoma
3. Conclusions
Conflicts of Interest
References
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Secondary Cutaneous Systemic ALCL | Primary Cutaneous ALCL | |
---|---|---|
Role of ALK | - ALK-positive in 30–60% of cases | - Frequently negative - ALK-positive in unknown proportion of pediatric cases |
Clinical Characteristics | - Solitary or multiple papules or nodules that may ulcerate - Systemic symptoms present | - Solitary or multiple papules or nodules that may ulcerate |
Histology on Skin Biopsy | - Dermal infiltrates comprising “hallmark cells” | - Dermal infiltrates comprising “hallmark cells” |
Age of Diagnosis | - Typically dependent on ALK status: ALK-positive- first 3 decades of life ALK-negative- 5th–6th decade of life | - Typically 6th decade of life |
Gender Predominance | - Dependent on ALK status: ALK-positive—Male ALK-negative—None | - Male |
Treatment | - Antracycline-based chemotherapy regimen, e.g., CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) | - Surgical excision and/or radiation therapy |
Prognosis | - Dependent on ALK status ALK-positive 5-year survival 71–100% ALK-negative 5-year survival 15–45% | - 5-year survival >90% |
ClinicalTrials.gov Identifier | Phase | Treatment | Cutaneous Malignancy under Study | Population |
---|---|---|---|---|
NCT02419287 | Phase 2 | Crizotinib | Recurrent or refractory ALK-positive ALCL | 18 years and older |
NCT00939770 | Phase 1 and 2 | Crizotinib | Recurrent or refractory ALK-positive ALCL | 1 year to 21 years |
NCT01524926 | Phase 2 | Crizotinib | Locally advanced and/or metastatic ALK-positive ALCL | 1 year and older |
NCT01449461 | Phase 1 and 2 | Brigatinib | ALK-positive ALCL | 18 years and older |
NCT01742286 | Phase 1 | Ceritinib | ALK-positive ALCL | 12 months to 17 year |
NCT02568267 | Phase 2 | Entrectinib | ALK-positive ALCL and melanoma | 18 years and older |
Cutaneous Malignancy | ALK Mutation | Clinical Presentation | Specific Histology | References |
---|---|---|---|---|
Melanoma | Translocation | Acral melanoma presenting with ulcerations | N/A | [98] |
Alternative splicing ALKATI isoform | Nodular melanoma | Malignant amelanotic epithelioid cells or mixed spindle and epithelioid cells | [101,102,103] | |
Spitzoid tumors | Translocation with partners TPM3, NPM1, CLIP1, TPR, GTF3C2, DCTN1 | Clinically amelanotic or vascular appearing polypoid nodules on the lower extremities | Melanocytes arranged in a fascicular growth pattern oriented in a radial pattern, mostly amelanotic | [104,105,106,107] |
Epithelioid Fibrous Histocytoma | Translocations with parterns VCL and SQSTM1 | Solitary symmetric nodule on the extremities | Storiform pattern of spindle cells and histiocytes with prominent population of epithelioid cells | [108,109,110] |
Merkel Cell Carcinoma | Unknown | Flesh-colored or bluish-red nodule | N/A | [111,112] |
Basal Cell Carcinoma | Unknown | Pearly nodule with small telangiectasias and a rolled border in sun exposed areas | N/A | [113,114] |
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Cao, S.; Nambudiri, V.E. Anaplastic Lymphoma Kinase in Cutaneous Malignancies. Cancers 2017, 9, 123. https://doi.org/10.3390/cancers9090123
Cao S, Nambudiri VE. Anaplastic Lymphoma Kinase in Cutaneous Malignancies. Cancers. 2017; 9(9):123. https://doi.org/10.3390/cancers9090123
Chicago/Turabian StyleCao, Severine, and Vinod E. Nambudiri. 2017. "Anaplastic Lymphoma Kinase in Cutaneous Malignancies" Cancers 9, no. 9: 123. https://doi.org/10.3390/cancers9090123