Detection of an ALK Fusion in Colorectal Carcinoma by Hybrid Capture-Based Assay of Circulating Tumor DNA

The Oncologist
Andrea Z LaiFadi Braiteh

Abstract

ALK rearrangements have been observed in 0.05%-2.5% of patients with colorectal cancers (CRCs) and are predicted to be oncogenic drivers largely mutually exclusive of KRAS, NRAS, or BRAF alterations. Here we present the case of a patient with metastatic CRC who was treatment naïve at the time of molecular testing. Initial ALK immunohistochemistry (IHC) staining was negative, but parallel genomic profiling of both circulating tumor DNA (ctDNA) and tissue using similar hybrid capture-based assays each identified an identical STRN-ALK fusion. Subsequent ALK IHC staining of the same specimens was positive, suggesting that the initial result was a false negative. This report is the first instance of an ALK fusion in CRC detected using a ctDNA assay. Current guidelines for colorectal cancer (CRC) only recommend genomic assessment of KRAS, NRAS, BRAF, and microsatellite instability (MSI) status.ALK rearrangements are rare in CRC, but patients with activating ALK fusions have responded to targeted therapiesALK rearrangements can be detected by genomic profiling of ctDNA from blood or tissue, and this methodology may be informative in cases where immunohistochemistry (IHC) or other standard testing is negative.

References

Jun 13, 2006·Proceedings of the National Academy of Sciences of the United States of America·Monika KasprzyckaMariusz A Wasik
Sep 10, 2009·Molecular Cancer Research : MCR·Eva LinZora Modrusan
Feb 22, 2011·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·D Ross CamidgeRobert C Doebele
Feb 14, 2012·Nature Medicine·Doron LipsonPhilip J Stephens
Jul 20, 2012·Nature·UNKNOWN Cancer Genome Atlas Network
Jun 4, 2013·The New England Journal of Medicine·Alice T ShawPasi A Jänne
Sep 13, 2013·The New England Journal of Medicine·Jean-Yves DouillardScott D Patterson
Dec 4, 2013·Molecular Cancer Research : MCR·Dara L AisnerMarileila Varella-Garcia
Mar 13, 2014·Proceedings of the National Academy of Sciences of the United States of America·Lindsey M KellyYuri E Nikiforov
Apr 11, 2014·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J Y DouillardR Sidhu
Jul 6, 2014·Applied Immunohistochemistry & Molecular Morphology : AIMM·Michelle HouangAnthony J Gill
Sep 11, 2014·Nature Communications·Nicolas StranskyChristoph Lengauer
Apr 8, 2015·Case Reports in Oncology·Raphael Brandão MoreiraMarcelo Rocha de Sousa Cruz
Jun 2, 2015·The New England Journal of Medicine·Dung T LeLuis A Diaz
Dec 4, 2015·British Journal of Cancer·Alessio AmatuSalvatore Siena
Mar 5, 2016·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Evgeny YakirevichHoward Safran
May 7, 2016·Cell Reports·Marios GiannakisLevi A Garraway
Nov 3, 2016·Cancer Immunology Research·Douglas B JohnsonChristine M Lovly
Oct 21, 2016·Cell Reports·Marios GiannakisLevi A Garraway
Jul 1, 2014·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J Y DouillardR Sidhu

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Citations

Feb 20, 2018·Molecular Cancer·Zhenfang Du, Christine M Lovly
Jun 24, 2017·The Oncologist·Meghan J Mooradian, Justin F Gainor
Dec 29, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Catherine M AlbertTheodore W Laetsch
Jan 25, 2018·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Alexa B SchrockVincent A Miller

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Methods Mentioned

BETA
biopsy
biopsies
xenograft

Software Mentioned

FoundationOne

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