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Cancers 2017, 9(8), 106;

ALK Status Assessment with Liquid Biopsies of Lung Cancer Patients

Laboratory of Clinical and Experimental Pathology, Côte d’Azur University, FHU OncoAge, 06001 Nice Cedex 01, France
Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 30 Avenue De La Voie Romaine, 06001 Nice Cedex 01, France
Academic Editor: Raymond Lai
Received: 17 July 2017 / Revised: 6 August 2017 / Accepted: 10 August 2017 / Published: 12 August 2017
(This article belongs to the Special Issue Targeting ALK in Cancer)
Full-Text   |   PDF [219 KB, uploaded 12 August 2017]


Patients with advanced stage non-small cell lung carcinoma (NSCLC) harboring an anaplastic lymphoma kinase ALK gene rearrangement, detected from a tissue sample, can benefit from targeted ALK inhibitor treatment. However, while treatment is initially effective in most cases, relapse or progression occurs due to different resistance mechanisms including mutations in the tyrosine kinase domain of echinoderm microtubule-associated protein-like 4 (EML44)-ALK. The liquid biopsy concept has recently radically changed the clinical care of NSCLC patients, in particular for those harboring an epidermal growth factor receptor (EGFR) gene mutation. Therefore, liquid biopsy is an alternative or complementary method to tissue biopsy for the detection of some resistance mutations in EGFR arising during tyrosine kinase inhibitor treatment. Moreover, in some frail patients, or if the tumor lesion is not accessible to a tissue biopsy, a liquid biopsy can also detect some activating mutations in EGFR on initial assessment. Recent studies have evaluated the possibility of also using a liquid biopsy approach to detect an ALK rearrangement and/or the emergence during inhibitor treatment of some resistance mutations in ALK. These assessments can be performed by studying circulating tumor cells by fluorescent in situ hybridization and by immunocytochemistry and/or after the isolation of RNA from plasma samples, free or associated with platelets. Thus, the liquid biopsy may be a complementary or sometimes alternative method for the assessment of the ALK status in certain NSCLC patients, as well as a non-invasive approach for early detection of ALK mutations. In this review, we highlight the current data concerning the role of the liquid biopsy for the ALK status assessment for NSCLC patients, and we compare the different approaches for this evaluation from blood samples. View Full-Text
Keywords: ALK; rearrangement; mutations; lung cancer; liquid biopsy; circulating tumor cells; platelets; plasma ALK; rearrangement; mutations; lung cancer; liquid biopsy; circulating tumor cells; platelets; plasma
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hofman, P. ALK Status Assessment with Liquid Biopsies of Lung Cancer Patients. Cancers 2017, 9, 106.

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