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Avances en Patología Pulmonar Eduardo Salido Ruiz Hospital Universitario Canarias. Tenerife

Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

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Page 1: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

Avances en Patología

Pulmonar

Eduardo Salido Ruiz

Hospital Universitario Canarias. Tenerife

Page 2: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 3: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 4: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 5: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 6: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 7: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 8: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 9: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 10: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 11: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

ASS(-) tumors are susceptible to Arg-starvation therapies

(Arg-deiminase treatment)

Page 12: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 13: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

morphology TTF1+p63- AC

TTF1+p40- AC

TTF1-p63+ SCC

TTF1-p40+ SCC

sensitivity 92% 60% 76% 82% 90%

specificity 100% 100% 100% 96% 96%

Page 14: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

Retos principales: 1.- Pacientes frágiles, técnicas menos invasivas…… más ESCASO 2.- Variabilidad biológica, subclasificación ………. más FENOTIPADO

3.- Crecimiento de dianas terapéuticas……….. más GENOTIPADO

Page 15: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

Extras:

6 to 10

Page 16: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

missing, previously reported (NG,2012): SOX2 ampl. (27%), RLF-MYCL1

Page 17: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 18: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 19: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 20: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and

8 /41 (20%): TKI resistance with morphologic evolution, from well/mod diff. AdCa to:

- SCLC (n=4), chromogr., synaptoph., CD56 +

- Ca+sarcomatoid (n=4), focal vimentin, aberrant (cytopl.) E-cadh.

# same EGFR mutations as primary tumor, lack T790M

Page 21: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and
Page 22: Avances en Patología Pulmonar...Title: Clinicopathologic Features of Non-Small Cell Lung Cancer (NSCLC) with ALK Gene Rearrangement Based on New (2011) IASLC/ATS Classification and