Introduction: With advancements in the understanding of lung cancer biology, targeted therapy has become the rule rather than the exception. Patients with ALK rearrangements are amenable to therapy with Alectinib and other ALK inhibitors, which has been associated with better patient outcomes. While ALK rearrangement should be routinely tested in non-squamous non-small cell lung cancer (NSCLC), the cost and availability of this test is a prohibitive factor, particularly in the Philippine setting. Objectives: This study aimed (1) to determine the prevalence of ALK-rearranged NSCLC among adult Filipino lung cancer patients in St. Luke’s Medical Center (SLMC) from 2016 to 2018 and (2) to determine the clinico-pathologic features of adult Filipinos with ALK-rearranged NSCLC. Methodology: This is a retrospective cross-sectional descriptive study wherein the prevalence of ALK-rearranged NSCLC, detected using fluorescence in-situ hybridization (FISH) or immunohistochemistry (IHC), was determined. Clinical data of patients for whom ALK testing was performed were collected. Hematoxylin and Eosin (H&E) slides were retrieved and reviewed for the presence of certain morphologic features. Patients whose H&E slides cannot be retrieved were excluded from the study. Results: ALK rearrangement was seen in 7.8% (8/103) of tumors submitted for ALK testing. Patients with ALK-rearranged tumors were generally young, light smokers, and presented with advanced clinical stage. Clear cell features and solid pattern were noted in one case and three cases, respectively. However, due to small sample size, further statistical analysis could not be performed to analyze the association of these features with the presence of ALK rearrangement. Conclusion Despite a small sample size, the prevalence and clinical profile of ALK-rearranged NSCLC in our institution are congruent with those previously described in Western populations. The association of clinical profile and morphologic features with the presence of ALK rearrangement can be further explored in future studies.
Lung Neoplasms ; Anaplastic Lymphoma Kinase

BACKGROUND: Unstable angina and non-ST elevation myocardial infarction (NSTEMI) are common acute coronary events with serious clinical sequelae. However, clinical profiles are scarce, particularly in Filipinos.

OBJECTIVE: The aim of this study is to determine the clinical risk factor profiles (age, diabetes, smoking, hypertension, dyslipidemia and homocysteine levels) of Filipino survivors of unstable angina and NSTEMI.

METHODOLOGY: From August, 2003 to September, 2006, 240 subjects with unstable angina (intermediate-and high-risk) or NSTEMI with onset in the past 2 weeks were screened and included in a randomized controlled trial on folic acid supplementation. The participants were interviewed and blood test for lipid profile and homocysteine were done.

RESULTS: The mean age is 59.4 +/- 10.1 years, with males at 57.4 +/- 10 years, and female at 62.1 +/- 9.7 years. Subjects are found to be mostly males (57.8 percent), hypertensive (66.7 percent), with significant smoking history (85.6 percent) and, for most women, menopausal (89.2 percent). Most subjects were diagnosed to have intermediate-risk unstable (45.4 percent), followed by NSTEMI (37.1 percent), then high-risk unstable angina (17.5 percent). More men had at least a previous acute coronary event than women (45.3 percent vs. 80.2 percent, p=0.0004). About 85 percent has 2 or more risk factors. The mean homocysteine levels is 12.8 umol/li with 16.4 percent > 16 umol/li. Increased body mass index was associated with unstable angina than NSTEMI, while homocysteinemia was associated more with NSTEMI.

CONCLUSION: Most Filipinos in hospitals in Metro Manila who survived non-ST elevation acute coronary syndrome are typically about 60 years old, male, with significant smoking history, and, for women, menopausal. About one-fifth has high homocysteine levels, which is associated with poorer prognosis.

Homocysteine ; Angina, Unstable ; Myocardial Infarction