Abstract 415: A new, highly sensitive ALK antibody improves the screening of rearranged-ALK by IHC

Abstract

Abstract All non-small cell lung cancer (NSCLC) patients are recommended to be screened for anaplastic lymphoma kinase (ALK)-rearrangement despite its low occurrence (< 7%). This is due to recent advances in treatment for patients with ALK-positive NSCLC with receptor tyrosine kinase inhibitors Crizotinib and Ceritini. Current rearranged-ALK testing includes fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry (IHC). Despite the high sensitivities and specificities, the limitations of the first two assays include time-consuming, infeasible, and specialized techniques that make them unsuitable for the routine screening for which IHC has been proposed. However, the biggest obstacle to detecting rearranged-ALK in lung cancer patients by IHC is the lack of highly sensitive ALK antibodies that detect the extremely low abundance of ALK in patients. To overcome this limitation, we have developed an ALK mouse monoclonal antibody (clone OTI1A4) with higher sensitivity in comparison to a rabbit ALK antibody (clone D5F3). Moreover, OTI1A4 identified ALK-positive NSCLC samples (16/16 cases) and showed negative staining for ALK-negative samples (11/11 cases) previously validated by FISH (10/16 ALK-positive cases) or qPCR (10/16 ALK-positive cases). This indicated the potential advantage of using clone OTI1A4 over FISH or qPCR to detect ALK rearrangements. Lastly, there was 100% concordance between OTI1A4 and D5F3 in detecting ALK-rearranged NSCLC samples previously confirmed by FISH (76 ALK-positive and 438 ALK-negative samples). These results support the possibility that ALK clone OTI1A4 could be used for routine screening of patients with ALK-positive NSCLC by IHC. Citation Format: Hsiangmin Lu, Rachel Gonzalez, Yi Shen, Mu-lan Jin, Yipan Wu, Yungang Zhang, Kehu Yuan, Boyang Chu, Lili Qi, Huibo Liu, Chenlin Wang, Guangli Wang, Youmin Shu, Julie McDowell, Donghui Ma, Wei-wu He, Jian Chen, Ray Lin. A new, highly sensitive ALK antibody improves the screening of rearranged-ALK by IHC. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 415.