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Study: Redefining the Criteria for ALK Positive Lung Cancer
Date:9/10/2013

Pulmonary Hospital describes a patient who traveled halfway across the world for a second opinion at the University of Colorado, where much of the research leading to ALK-targeted drugs has taken place.

“We were thrilled this patient had sought out an opinion from one of the leading centers in lung cancer and could not have been happier with the collaboration that developed,” Ren says.

The patient was originally classified ALK-negative using the standard FISH assay. However, Dr. Garcia recognized that an atypical negative pattern was present. One way of looking closer at ALK uses the technique of immunohistochemistry (IHC), which looks directly for the protein the aberrant ALK gene creates. Using an IHC assay for ALK conducted within the laboratory of Fred R. Hirsch, MD, PhD, associate director for international programs at the CU Cancer Center, the team quickly confirmed that the patient’s tumor was making the ALK protein and should really be considered ALK-positive. Another test called RT-PCR conducted in Shanghai on the same specimen looked at the ALK gene in a third way, confirming the presence of messages coming from the gene that were telling the cell to make the abnormal protein.

"Amazingly, crizotinib was being licensed in China the following week and so we simply wrote the patient a prescription and sent him back to Dr. Ren in Shanghai, where his latest scans show he is responding beautifully to the drug," Camidge says. "All of the early work on ALK positive lung cancer has really helped to clarify what can be achieved by personalized medicine, but we have to keep pushing the envelope to maximize this approach in routine cancer care. For ALK-positive lung cancer, basically our goal now is to make sure that everyone who could benefit from an ALK inhibitor gets an ALK inhibitor."

The CU Cancer Center’s Thoracic Oncology Program is world renowned for its pioneering treatment of lung cancer. The program in
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