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      The applications of liquid biopsy in resistance surveillance of anaplastic lymphoma kinase inhibitor

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          Abstract

          With the clinical promotion of precision medicine and individualized medical care, molecular targeted medicine has been used to treat non-small cell lung cancer (NSCLC) patients and proved to be significantly effective. Anaplastic lymphoma kinase (ALK) inhibitor is one of the most important specific therapeutic agents for patients with ALK-positive NSCLC. It can extend the survival of patients. However, resistance to the ALK inhibitor inevitably develops in the application process. So, the real-time resistance surveillance is particularly important, and liquid biopsy is one of the most potential inspection methods. Circulating tumor cells, circulating free tumor DNA and exosome in body fluid are used as the main detection biomarkers to reflect the occurrence of resistance in real time through sequencing or counting and then to guide the follow-up treatment.

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          Global survey of phosphotyrosine signaling identifies oncogenic kinases in lung cancer.

          Klarisa Rikova, Ailan Guo, Qingfu Zeng … (2008)
          Despite the success of tyrosine kinase-based cancer therapeutics, for most solid tumors the tyrosine kinases that drive disease remain unknown, limiting our ability to identify drug targets and predict response. Here we present the first large-scale survey of tyrosine kinase activity in lung cancer. Using a phosphoproteomic approach, we characterize tyrosine kinase signaling across 41 non-small cell lung cancer (NSCLC) cell lines and over 150 NSCLC tumors. Profiles of phosphotyrosine signaling are generated and analyzed to identify known oncogenic kinases such as EGFR and c-Met as well as novel ALK and ROS fusion proteins. Other activated tyrosine kinases such as PDGFRalpha and DDR1 not previously implicated in the genesis of NSCLC are also identified. By focusing on activated cell circuitry, the approach outlined here provides insight into cancer biology not available at the chromosomal and transcriptional levels and can be applied broadly across all human cancers.
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            The distribution of secondary growths in cancer of the breast. 1889.

            S. PAGET (1989)
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              Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK.

              Alice Shaw, Beow Yeap, Mari Mino-Kenudson … (2009)
              The EML4-ALK fusion oncogene represents a novel molecular target in a small subset of non-small-cell lung cancers (NSCLC). To aid in identification and treatment of these patients, we examined the clinical characteristics and treatment outcomes of patients who had NSCLC with and without EML4-ALK. Patients with NSCLC were selected for genetic screening on the basis of two or more of the following characteristics: female sex, Asian ethnicity, never/light smoking history, and adenocarcinoma histology. EML4-ALK was identified by using fluorescent in situ hybridization for ALK rearrangements and was confirmed by immunohistochemistry for ALK expression. EGFR and KRAS mutations were determined by DNA sequencing. Of 141 tumors screened, 19 (13%) were EML4-ALK mutant, 31 (22%) were EGFR mutant, and 91 (65%) were wild type (WT/WT) for both ALK and EGFR. Compared with the EGFR mutant and WT/WT cohorts, patients with EML4-ALK mutant tumors were significantly younger (P < .001 and P = .005) and were more likely to be men (P = .036 and P = .039). Patients with EML4-ALK-positive tumors, like patients who harbored EGFR mutations, also were more likely to be never/light smokers compared with patients in the WT/WT cohort (P < .001). Eighteen of the 19 EML4-ALK tumors were adenocarcinomas, predominantly the signet ring cell subtype. Among patients with metastatic disease, EML4-ALK positivity was associated with resistance to EGFR tyrosine kinase inhibitors (TKIs). Patients in the EML4-ALK cohort and the WT/WT cohort showed similar response rates to platinum-based combination chemotherapy and no difference in overall survival. EML4-ALK defines a molecular subset of NSCLC with distinct clinical characteristics. Patients who harbor this mutation do not benefit from EGFR TKIs and should be directed to trials of ALK-targeted agents.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cancer Manag Res
                Journal ID (iso-abbrev): Cancer Manag Res
                Journal ID (publisher-id): Cancer Management and Research
                Title: Cancer Management and Research
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-1322
                Publication date Collection: 2017
                Publication date (Electronic): 07 December 2017
                Volume: 9
                Pages: 801-811
                Affiliations
                [1 ]Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
                [2 ]Department of Respiratory, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
                Author notes
                Correspondence: Peng Luo; Xin Chen, Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, 253 Gongye Road, Guangzhou 510282, People’s Republic of China, Email luopeng@ 123456smu.edu.cn ; chen_xin1020@ 123456163.com
                [*]

                These authors contributed equally to this work.

                Article
                Publisher ID: cmar-9-801
                DOI: 10.2147/CMAR.S151235
                PMC ID: 5724713
                SO-VID: 8a2cca2a-7686-4182-b1f8-0d3d4cf718b4
                Copyright © © 2017 Chen et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Subject: Review

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: nsclc,alk,resistance,liquid biopsy,ctcs,ctdna,exosome
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: nsclc, alk, resistance, liquid biopsy, ctcs, ctdna, exosome

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