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Transformation to SCLC after Treatment with the ALK Inhibitor Alectinib  Shiro Fujita, MD, PhD, Katsuhiro Masago, MD, PhD, Nobuyuki Katakami, MD, PhD,

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Presentation on theme: "Transformation to SCLC after Treatment with the ALK Inhibitor Alectinib  Shiro Fujita, MD, PhD, Katsuhiro Masago, MD, PhD, Nobuyuki Katakami, MD, PhD,"— Presentation transcript:

1 Transformation to SCLC after Treatment with the ALK Inhibitor Alectinib 
Shiro Fujita, MD, PhD, Katsuhiro Masago, MD, PhD, Nobuyuki Katakami, MD, PhD, Yasushi Yatabe, MD, PhD  Journal of Thoracic Oncology  Volume 11, Issue 6, Pages e67-e72 (June 2016) DOI: /j.jtho Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

2 Figure 1 Positron emission tomography and chest computed tomography before and after treatment with alectinib (paradoxical response). (A) Maximum-intensity projection image from 18F-fludeoxyglucose positron emission tomography before alectinib treatment shows intense radiotracer uptake in the primary lesion (black arrow), neck lymph node (gray arrow), and lumber vertebra (curved arrow). (B) The scan shows the left upper lobe tumor (black arrow). (C) Maximum-intensity projection image of 18F-fludeoxyglucose positron emission tomography was taken 3 months after the patient starting receiving alectinib. Progression of the primary lesion (black arrow) is seen. There is no radiotracer uptake in the other lesions. (D) An axial image of her chest shows an increase in size of the primary tumor. Journal of Thoracic Oncology  , e67-e72DOI: ( /j.jtho ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

3 Figure 2 Histopathological analysis of the tumor after treatment with alectinib. (A) Hematoxylin and eosin staining showing blue small round cell proliferation surrounded by cells in necrosis. (B) Immunohistochemical analysis for CD56, showing strong cytoplasmic expression. (C) Immunohistochemical analysis for synaptophysin shows strong immunoreactivity. (D) The tumor cells are thyroid transcription factor 1 negative. (E) Immunohistochemical analysis for ALK. These malignant cells are diffusely positive for ALK. Journal of Thoracic Oncology  , e67-e72DOI: ( /j.jtho ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

4 Figure 3 Adenocarcinoma of the left lung before treatment (A). The tumor cells are negative for CD56 (B) and synaptophysin (C). Thyroid transcription factor 1 expression is diffuse and strong (D). Immunohistochemical analysis for ALK shows strong positive staining (E). Journal of Thoracic Oncology  , e67-e72DOI: ( /j.jtho ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

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