1303P - Demographic and epidemiological characteristic of EGFR mutation and ALK gene rearrangement among Indian patients with lung adenocarcinoma

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Aetiology, Epidemiology, Screening and Prevention
Pathology/Molecular Biology
Non-Small Cell Lung Cancer
Translational Research
Basic Scientific Principles
Basic Principles in the Management and Treatment (of cancer)
Presenter Dinesh Chandra Doval
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors D.C. Doval1, K. Prabhash2, S. Patil3, H. Chaturvedi4, C. Goswami5, A.K. Vaid6, S. Desai7, S. Dutt8, V.H. Veldore9, N. Jambhekar10, A. Mehta11, D. Hazarika9, S. Azam12, S. Gupta13, S. Gawande14
  • 1Medical Oncology, Rajiv Gandhi Cancer Institute & Research Center, 110085 - Delhi/IN
  • 2Dept. Medical Oncology, Tata Memorial Hospital Centre, Mumbai/IN
  • 3Medical Oncology, Bangalore Institute of Oncology, IN-560027 - Bangalore/IN
  • 4Surgical Oncology, Max Super Speciality Hospital, Delhi/IN
  • 5Medical Oncology, B.P. Poddar Hospital and Medical Research Ltd, IN-700053 - Kolkata/IN
  • 6Medical Oncology, Medanta-The Medicity, Gurgaon/IN
  • 7Dept Of Pathology, Tata Memorial Hospital, Mumbai/IN
  • 8Dept Of Pathology, Oncquest Laboratories Ltd, Delhi/IN
  • 9Pathology, Bangalore Institute of Oncology, IN-560027 - Bangalore/IN
  • 10Dept. Pathology, Tata Memorial Hospital Centre, Mumbai/IN
  • 11Pathology, Rajiv Gandhi Cancer Institute & Research Center, 110085 - Delhi/IN
  • 12Research, Rajiv Gandhi Cancer Institute & Research Center, 110085 - Delhi/IN
  • 13Research, Catalyst Clinical Services Pvt Ltd, Delhi/IN
  • 14Research, Pfizer India Ltd, Mumbai/IN



A fusion gene between echinoderm microtubule-associated protein-like 4 (EML4) and the intracellular domain of anaplastic lymphoma kinase (ALK), named EML4-ALK, has been identified in a subset of non-small cell lung cancer (NSCLC) tumors. The objective of this study was to determine the prevalence of epidermal growth factor receptor (EGFR) mutations and EML4-ALK fusions in Indian patients with NSCLC (adenocarcinoma) along with the evaluation of thei.r clinical characteristics


Patients with NSCLC, adenocarcinoma histology, whose tumours had been tested for EGFR mutation over the last 2 years, were considered for this study. Stored formalin fixed paraffin embedded tissue blocks from six centers were used for this study. Permission was obtained from the Ethics Committee at each centre before the start of the study. Clinical characteristics and treatment details were collected from the patient's medical records. ALK gene rearrangement was detected by fluorescence in-situ hybridization using the Vysis ALK Break Apart Rearrangement Probe Kit (Abbott Molecular) on the tissue blocks. ALK mutation was tested in samples that were negative for EGFR mutation.


A total of 500 NSCLC adenocarcinoma patients were enrolled across 6 centres. There were 337(67.4%) males and 163(32.6%) females with a median age of 58 years. Of the 500 patients, 250 (50%) were never smokers and 357 (71.4%) had stage-IV disease at the time of initial diagnosis. 165 (33%) patients were positive for EGFR mutation whereas 335 (67%) were EGFR negative. Of the 335 EGFR negative patients, EML4-ALK fusion gene was present in 15 (4.5%) patients. The overall incidence of EML4-ALK fusion gene was 3% (15/500).


The incidence of EGFR mutations (33%) in this Indian population is close to the reported incidence in Asian patients. EML4-ALK gene fusions are present in lung adenocarcinoma from Indian patients but the incidence of 3% is lower than that observed in other populations. Implementation of testing to detect tumours harbouring ALK rearrangements is essential to identify patients that can benefit from newer targeted therapies.


S. Gawande: Employee Pfizer India Ltd. All other authors have declared no conflicts of interest.