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ALK (D5F3) CDx: an immunohistochemistry assay to identify ALK-positive NSCLC patients

Authors Uruga H, Mino-Kenudson M

Received 7 June 2018

Accepted for publication 10 July 2018

Published 17 September 2018 Volume 2018:11 Pages 147—155

DOI https://doi.org/10.2147/PGPM.S156672

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Martin H. Bluth


Hironori Uruga,1 Mari Mino-Kenudson2

1Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan; 2Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

Abstract: Screening for anaplastic lymphoma kinase (ALK) rearrangements is a very important process in treatment decision making for advanced non-small-cell lung cancer (NSCLC). Although fluorescent in situ hybridization (FISH) is considered the universally accepted reference standard, it is associated with technical difficulties and high costs that have made global implementation of this assay challenging. Conversely, ALK immunohistochemistry has shown high sensitivity and specificity compared to FISH and other molecular assays and is more cost-effective. In fact, the ALK (D5F3) CDx immunohistochemistry assay was approved by the US Food and Drug Administration as a standalone test for ALK rearrangements in lung cancer in 2015. In this review, we will discuss the overview of ALK rearrangements in NSCLC, various testing methods for ALK rearrangements, and the details of immunohistochemistry for ALK, in particular one with the ALK antibody clone D5F3.

Keywords: anaplastic lymphoma kinase gene ALK, D5F3 antibody, ALK (D5F3) CDx, non-small-cell lung cancer, adenocarcinoma

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