On May 13, 2011, our mother, Cindy, was diagnosed with stage 4 Non small cell lung cancer (adenocarcinoma). She has never smoked a day in her life. Since being diagnosed, as a self-employed and charitable family law attorney she continued to work hard for others in need. We sincerely thank you for your contribution, prayers, and support for our mother.

-John, Vanessa, and Michael Hudson

Please enjoy reading our blog below with updates on Cindy's well-being and information about the disease, conditions, and treatments. God bless!

Please read and know that we are all so appreciative to you.

Friday, December 23, 2011

Information on Alimta in regards to the ALK mutation.

Journal of Thoracic Oncology:
April 2011 - Volume 6 - Issue 4 - pp 774-780
doi: 10.1097/JTO.0b013e31820cf053
Original Articles

Anaplastic Lymphoma Kinase Gene Rearrangements in Non-small Cell Lung Cancer are Associated with Prolonged Progression-Free Survival on Pemetrexed

Camidge, D. Ross MD, PhD*; Kono, Scott A. DO*; Lu, Xian PhD†; Okuyama, Sonia MD*; Barón, Anna E. PhD†; Oton, Ana B. MD*; Davies, Angela M. MD*; Varella-Garcia, Marileila PhD*‡; Franklin, Wilbur MD‡; Doebele, Robert C. MD, PhD*

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Abstract

Hypothesis: To explore whether the progression-free survival (PFS) with pemetrexed differs between anaplastic lymphoma kinase (ALK)-positive and other major molecular subtypes of non-small cell lung cancer.
Methods: In an ALK-enriched population, patients with metastatic non-small cell lung cancer were screened by ALK fluorescence in situ hybridization and for epidermal growth factor receptor (EGFR) and KRAS mutations. Triple-tested, pemetrexed-treated patients (monotherapy or combination therapy) were identified and PFS with pemetrexed captured retrospectively.
Results: Eighty-nine eligible cases were identified (19 ALK fluorescence in situ hybridization positive, 12 EGFR mutant, 21 KRAS mutant, and 37 triple negatives). Eighty-three cases (93%) were adenocarcinomas, two were adenosquamous, one squamous, and three had large cell histology. None of the ALK-positive patients had received crizotinib before pemetrexed. Pemetrexed was first-line therapy in 48% (72% as platinum-based combinations). Median PFS (95% confidence interval) data were EGFR mutant (5.5 months; 1–9), KRAS mutant (7 months; 1.5–10), ALK positive (9 months; 3–12), and triple negative (4 months; 3–5). In a multivariate analysis adjusting for line of therapy, mono- versus platinum and nonplatinum combination therapy, age, sex, histology, and smoking status, the only variable associated with prolonged PFS on pemetrexed was ALK+ (hazard ratio = 0.36 [95% confidence interval: 0.17–0.73], p = 0.0051).
Conclusions: In this exploratory analysis, ALK-positive patients have a significantly longer PFS on pemetrexed compared with triple-negative patients, whereas EGFR or KRAS mutant patients do not. This information should be considered when sizing randomized studies in ALK-positive patients that involve pemetrexed. Pemetrexed should also be prioritized as a cytotoxic to explore further in patients with known ALK-positive disease.
© 2011International Association for the Study of Lung Cancer
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