Pneumologie 2016; 70 - P228
DOI: 10.1055/s-0036-1572216

Relatively normal lung function in ALK-positive patients – an indicator for ALK positivity as well as non-increased risk of bronchoscopic re-biopsy

K Schrödl 1, A Tufman 2, A Borgmeier 1, R Zauber 1, S Reu 3, J Behr 1, RM Huber 4
  • 1Medizinische Klinik und Poliklinik V, Klinikum der Universität München, Comprehensive Pneumology Center, Mitglied des Deutschen Zentrums für Lungenforschung
  • 2Medizinische Klinik IV, Sektion Pneumologie Innenstadt und Thorakale Onkologie, LMU Klinikum der Universität München Campus Innenstadt
  • 3Pathologisches Institut der LMU
  • 4Sektion Pneumologie Innenstadt und Thorakale Onkologie, Thoracic Oncology Centre Munich, Universität München

Background: Emerging treatment options in advanced non-small cell lung cancer (NSCLC) related to multiple molecular targets brought new hope to lung cancer patients and new technical options for clinicians.

Objective: In our study we analyzed the lung-function of ALK-positive and ALK-negative patients with adenocarcinoma of the lung to estimate the risk of re-biopsy. Furthermore, we wanted to assess whether lung-function testing could serve as a criterion to increase the yield of EML4-ALK testing.

Methods: Retrospective analysis of lung-function parameters of stage IV NSCLC patients with adenocarcinoma of the lung (27 ALK-negative patients and 11 ALK-positive patients) was performed. Break-apart FISH using archived paraffin tissues was performed in a central facility.

Results: The median age of ALK-positive patients was 52,2 years with 63,3% female patients. The median age of ALK-negative patients was 59,1 years with 33,33% female patients. Normalized values of TLC (total lung capacity), VC (vital capacity) and RV (residual volume) showed no significant differences between both groups. Also, FEV1 values (forced expiratory volume in 1 second) of both groups did not differ significantly. Tiffeneau-index was significantly lower in ALK-negative patients with 70,46% compared to 79,30% in ALK-positive patients. While normalized values of airway resistance showed no significant differences, normalized values of specific airway resistance of ALK-negative patients showed significant higher values than ALK-positive patients. ALK-negative patients had more pack-years than ALK-positive patients.

Conclusion: Whereas ALK-positive patients showed a relatively normal lung function, ALK negative patients showed a low-grade obstructive pulmonary disease. Referring to lung function parameters the risk of re-biopsy in ALK positive patients is not increased. Furthermore a relatively normal lung function could be a criterion for ALK screening.