alexa ALK Rearrangement in Anaplastic Thyroid Carcinoma: A Discovery Towards a Personalized Approach? | OMICS International
ISSN: 2155-9619
Journal of Nuclear Medicine & Radiation Therapy

Like us on:

Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

ALK Rearrangement in Anaplastic Thyroid Carcinoma: A Discovery Towards a Personalized Approach?

Eivind Blais*, Axelle Dutertre and Yann Godbert

Thyroid Group, Institut Bergonie, 229 Cours de l'Argonne, 33000 Bordeaux, France

*Corresponding Author:
Eivind Blais
Thyroid Group, Institut Bergonie, 229 Cours de l'Argonne, 33000 Bordeaux, France
Tel: 33 5 56 33 33 33
E-mail: [email protected]

Received date: December 18, 2015, Accepted date: January 07, 2016, Published date: January 11, 2016

Citation: Blais E, Dutertre A, Godbert Y (2016) ALK Rearrangement in Anaplastic Thyroid Carcinoma: A Discovery Towards a Personalized Approach?. J Nucl Med Radiat Ther 7:275. doi:10.4172/2155-9619.1000275

Copyright: © 2016 Blais E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.

Visit for more related articles at Journal of Nuclear Medicine & Radiation Therapy

Anaplastic thyroid carcinoma (ATC) represents about 1% of all thyroid carcinomas [1]. ATC is the most aggressive form of thyroid carcinoma especially when metastatic - accounting for 14-50% of all thyroid cancer related deaths [2]. Prognosis and outcomes following local progression or metastasis are poor using conventional therapies - such as surgery, chemotherapy, and external beam radiation therapy - with only 20% survival at 1 year [3]. So far, previous attempts to use multi-target tyrosine kinase inhibitors have not improved survival outcomes [4]. Therefore, molecular screening for specific genetic alterations in ATC tumors may provide an opportunity for an efficient, targeted therapy.

In recent years, the discovery of a variety of molecular and genetic alterations in different malignancies leading to oncogenesis has provided an insight into the complexity of tumorigenesis. This information can be used to target specific markers with the objective of improving patient outcomes. Yoshihara et al. described potentially ‘druggable’ kinase fusions in 8.7% of thyroid carcinomas [5]. The anaplastic lymphoma kinase (ALK) TK receptor (TKR) has recently emerged as a potentially relevant biomarker and a therapeutic target in solid and hematologic tumors. The ALK TKR gene is located at 2p23.2 and belongs to the insulin receptor superfamily [6]. A variety of alterations in the ALK gene such as mutations, overexpression, amplification, translocations, or other structural rearrangements have been implicated in tumorigenesis [7]. Hamatani et al. reported that, in 10 out of 19 papillary thyroid cancer (PTC) cases, ALK rearrangements are involved in the development of radiation-induced adult-onset PTC [8]. Demeure et al. identified an EML4-ALK translocation as the driver of PTC [9].

We previously reported the identification of a recurrent Striatin- ALK (STRN-ALK) fusion - the result of a complex rearrangement involving the short arm of chromosome 2 - in thyroid carcinomas [10]. Kelly et al. showed that STRN-ALK fusion occurred with a higher prevalence in poorly-differentiated ATCs without other overlapping known driver mutations in these tumors [11]. These data demonstrate that STRN-ALK fusion occurs in a subset of patients with highly aggressive types of thyroid cancer and could be a potential therapeutic target in these patients

These recent reports also highlight the potential use of drugs such as crizotinib that target ALK rearrangement with proven efficiency in non-small cell lung carcinomas [12] for highly aggressive types of thyroid cancer. We previously described a remarkable response to crizotinib in a 71-year-old woman suffering from a chemoresistant ATC with lung metastases. Three months after the initiation of crizotinib, an exceptional response of more than 90% across all pulmonary lesions was observed [13]. The patient is still alive two years after the introduction of crizotinib. CT evaluation has shown a complete response and the treatment has been well tolerated without any grade 2 or higher adverse effect.

This encouraging outcome aside, the prevalence of ALK rearrangements in ATC and poorly-differentiated thyroid tumors still remains unknown emphasizing the need for such studies. Currently, a multi-institutional French study is evaluating the prevalence of ALKrearrangements (ALK+) in ATC (Tuthyref network). At present, the methods to detect the different molecular alterations of ALK1 gene are limited to immunohistochemistry, fluorescence in situ hybridization (FISH) and reverse transcriptase PCR methods. Further efforts are warranted to determine the optimal, cost-effective method for routine diagnostic detection of ALK fusions in thyroid cancers.

In our previous case report, using FISH, an ALK rearrangement was identified in more than 50% of cells in the various components of the tumor (well-differentiated and ATC components as well as in a lung metastasis). Nevertheless, establishing the best percentage cut-off for ALK+ tumor cells, as determined by FISH, for deciding the introduction of a drug targeting ALK-rearrangement remains a challenge. Currently, a phase II multi-institutional study to evaluate crizonitib’s efficacy in ATC ALK+ tumors is ongoing in France. Rare neoplasia with poor outcomes, such as ATC could be interesting to identify potential targets for new drugs based on molecular screening of gene alterations.


Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Recommended Conferences

Article Usage

  • Total views: 8281
  • [From(publication date):
    January-2016 - Aug 20, 2018]
  • Breakdown by view type
  • HTML page views : 8217
  • PDF downloads : 64

Review summary

  1. Buğra Gouveia
    Posted on Oct 24 2016 at 2:56 pm
    I hope future research studies enable us to find more economically feasible methods for the developed of personalized medicines for the treatment of thyroid carcinomas. At present the FISH and reverse transcriptase PCR methods as in this communication give us the best percentage cut-off for ALK+ tumor cells, for deciding the introduction of a drug targeting ALK-rearrangement remains a challenge. Today the crizonitib's efficacy studies in ATC ALK+ tumors is going on in France, but this research is in phase II.

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

+1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A


[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


porn sex

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

Gaziantep Escort

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A


[email protected]

1-702-714-7001Extn: 9037


James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

mp3 indir

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals


Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T


[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
Leave Your Message 24x7