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Different screening test leads to better tailored treatment for lung cancer patients

08 March 2017

​A test other than the current standard one is better able to predict whether a lung cancer patient will respond to tailored treatment in the case of patients with non-small-cell lung cancer who have a particular genetic abnormality (ALK translocation). The test detects the genetic abnormality more easily and quickly, enabling the patient to receive better tailored treatment sooner. This is the finding of a UMCG study led by respiratory physician Anthonie van der Wekken published in Clinical Cancer Research.

Lung cancer is the fourth most common type of cancer. Every year over 12,000 people in the Netherlands contract it, the non-small-cell form in over 9,000 of these cases. Five percent of these patients have an abnormality in the ALK gene (ALK translocation). Patients need to be screened for this translocation so that they can be given tailored treatment. The current treatment guidelines prescribe what is known as the ‘ALK-FISH’ test.

The ALK-FISH test shows whether the patient has an ALK translocation and whether he or she is suitable for tailored treatment using the drug crizotinib instead of the standard chemotherapy. However, not all patients shown as suitable for the tailored treatment by this test actually respond to it. In addition, the ALK-FISH test can only be carried out in a specialist laboratory and it takes a few weeks to establish whether there is an ALK translocation. As a result, the test is sometimes skipped and the patient placed on standard chemotherapy.

Research at the UMCG now shows that another existing test, the ALK-IHC test, is better able to predict whether the patient will respond to the tailored treatment. ‘This test can be carried out by any lab, and it shows within a few days whether there is an ALK translocation. It also predicts whether the patient will respond to the tailored treatment, enabling patients to be given better treatment sooner’, says respiratory physician Van der Wekken. The ALK-IHC test is already being used at the UMCG. The researchers argue that it should be adopted as the standard test in the international treatment guidelines.

Full article can be read in Clinical Cancer Research