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Treatment of Lung Cancer with an ALK Inhibitor After EML4-ALK Fusion Gene Detection Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration 

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Presentation on theme: "Treatment of Lung Cancer with an ALK Inhibitor After EML4-ALK Fusion Gene Detection Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration "— Presentation transcript:

1 Treatment of Lung Cancer with an ALK Inhibitor After EML4-ALK Fusion Gene Detection Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration  Takahiro Nakajima, MD, PhD, Hideki Kimura, MD, PhD, Kengo Takeuchi, MD, PhD, Manabu Soda, MD, PhD, Hiroyuki Mano, MD, PhD, Kazuhiro Yasufuku, MD, PhD, Toshihiko Iizasa, MD, PhD  Journal of Thoracic Oncology  Volume 5, Issue 12, Pages (December 2010) DOI: /JTO.0b013e3181f77b58 Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 A, Chest computed tomography showed a narrowing of the right main bronchus due to massive lymphadenopathy. B, FDG-PET suggested multiple lymph node metastases and bone metastases. C, Six weeks after administration of the ALK inhibitor, the effect of the treatment was judged as partial response based on RECIST. D, Five months after administration of the ALK inhibitor, abnormal accumulation on FDG-PET had disappeared. FDG-PET, fluorodeoxyglucose positron emission tomography. Journal of Thoracic Oncology 2010 5, DOI: ( /JTO.0b013e3181f77b58) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 A, Bronchoscopic examination showed tumor compression of the right main bronchus, and the tumor had hyperplastic vessels on its surface. B, EBUS-TBNA was performed for a pretracheal lymph node (#2R). C, Histologic core revealed metastatic adenocarcinoma in #2R node. D, Immunohistochemistry was positive for ALK protein using the iAEP method. E, FISH revealed the EML4-ALK fusion gene. EML4-ALK split assay with labeled probes for the upstream (red) and downstream (green, arrow) region of the ALK locus. EML4-ALK fusion assay with labeled probes for EML4 (green, arrow) or ALK (red, arrow). Fusion gene showed EML4-ALK (arrow). F, RT-PCR using specific primer set for each variant also confirmed the presence of EML4-ALK variant 1 (274bp). The presence of variant 1 type fusion was also confirmed by direct sequence of the RT-PCR product (data not shown). RT-PCR, reverse transcriptase-polymerase chain reaction; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology 2010 5, DOI: ( /JTO.0b013e3181f77b58) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

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