TY - JOUR
T1 - ALK inhibitor response in melanomas expressing EML4-ALK fusions and alternate ALK isoforms
AU - Couts, Kasey L.
AU - Bemis, Judson
AU - Turner, Jacqueline A.
AU - Bagby, Stacey M.
AU - Murphy, Danielle
AU - Christiansen, Jason
AU - Hintzsche, Jennifer D.
AU - Le, Anh
AU - Pitts, Todd M.
AU - Wells, Keith
AU - Applegate, Allison
AU - Amato, Carol
AU - Multani, Pratik
AU - Chow-Maneval, Edna
AU - Tentler, John J.
AU - Shellman, Yiqun G.
AU - Rioth, Matthew J.
AU - Tan, Aik Choon
AU - Gonzalez, Rene
AU - Medina, Theresa
AU - Doebele, Robert C.
AU - Robinson, William A.
N1 - Funding Information:
We thank the patient and her family for her clinical trial participation and previous patients at the University of Colorado Hospital for donating tumor tissue used in this study. We also thank the clinical trial staff at the University of Colorado, the University of Colorado Denver Genomics and Microarray Core, and the University of Colorado Cancer Center (UCCC) Molecular Pathology Shared Resource for cytogenetic analysis. This work was funded in part by the Paul R. Ohara II Seed Grant Program, an American Cancer Society Institutional Research Grant to University of Colorado Cancer Center, the Amy Davis Foundation, and the Moore Family Foundation.
Funding Information:
This work wassupported in part by the NIH/NCATS Colorado CTSA Grant (UL1 TR001082) and the NIH/NCI Cancer Center Support Grant (P30CA046934).
PY - 2018/1
Y1 - 2018/1
N2 - Oncogenic ALK fusions occur in several types of cancer and can be effectively treated with ALK inhibitors; however, ALK fusions and treatment response have not been characterized in malignant melanomas. Recently, a novel isoform of ALK (ALK ATI ) was reported in 11% of melanomas but the response of melanomas expressing ALK ATI to ALK inhibition has not been well characterized. We analyzed 45 melanoma patientderived xenograft models for ALK mRNA and protein expression. ALK expression was identified in 11 of 45 (24.4%) melanomas. Ten melanomas express wild-type (wt) ALK and/or ALK ATI and one mucosal melanoma expresses multiple novel EML4-ALK fusion variants. Melanoma cells expressing different ALK variants were tested for response to ALK inhibitors. Whereas the melanoma expressing EML4-ALK were sensitive to ALK inhibitors in vitro and in vivo, the melanomas expressing wt ALK or ALK ATI were not sensitive to ALK inhibitors. In addition, a patient with mucosal melanoma expressing ALK ATI was treated with an ALK/ROS1/TRK inhibitor (entrectinib) on a phase I trial but did not respond. Our results demonstrate ALK fusions occur in malignant melanomas and respond to targeted therapy, whereas melanomas expressing ALK ATI do not respond to ALK inhibitors. Targeting ALK fusions is an effective therapeutic option for a subset of melanoma patients, but additional clinical studies are needed to determine the efficacy of targeted therapies in melanomas expressing wt ALK or ALK ATI .
AB - Oncogenic ALK fusions occur in several types of cancer and can be effectively treated with ALK inhibitors; however, ALK fusions and treatment response have not been characterized in malignant melanomas. Recently, a novel isoform of ALK (ALK ATI ) was reported in 11% of melanomas but the response of melanomas expressing ALK ATI to ALK inhibition has not been well characterized. We analyzed 45 melanoma patientderived xenograft models for ALK mRNA and protein expression. ALK expression was identified in 11 of 45 (24.4%) melanomas. Ten melanomas express wild-type (wt) ALK and/or ALK ATI and one mucosal melanoma expresses multiple novel EML4-ALK fusion variants. Melanoma cells expressing different ALK variants were tested for response to ALK inhibitors. Whereas the melanoma expressing EML4-ALK were sensitive to ALK inhibitors in vitro and in vivo, the melanomas expressing wt ALK or ALK ATI were not sensitive to ALK inhibitors. In addition, a patient with mucosal melanoma expressing ALK ATI was treated with an ALK/ROS1/TRK inhibitor (entrectinib) on a phase I trial but did not respond. Our results demonstrate ALK fusions occur in malignant melanomas and respond to targeted therapy, whereas melanomas expressing ALK ATI do not respond to ALK inhibitors. Targeting ALK fusions is an effective therapeutic option for a subset of melanoma patients, but additional clinical studies are needed to determine the efficacy of targeted therapies in melanomas expressing wt ALK or ALK ATI .
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U2 - 10.1158/1535-7163.MCT-17-0472
DO - 10.1158/1535-7163.MCT-17-0472
M3 - Article
C2 - 29054983
AN - SCOPUS:85040064177
VL - 17
SP - 222
EP - 231
JO - Molecular Cancer Therapeutics
JF - Molecular Cancer Therapeutics
SN - 1535-7163
IS - 1
ER -