ALK (D5F3) IHC reflex to FISH for NSCLC

The ALK (D5F3) immunohistochemistry (IHC) test is a laboratory procedure that uses an antibody called D5F3 to detect the presence of anaplastic lymphoma kinase (ALK) protein in tissue samples. FISH (Fluorescence in situ hybridization) test will be performed if IHC is positive.

• To diagnose non-small cell lung cancer (NSCLC): ALK rearrangements are found in about 5% of NSCLC cases. The ALK (D5F3) IHC test can help to diagnose NSCLC and determine if it is ALK-positive or ALK-negative.
• To guide treatment decisions: ALK-positive NSCLC is often more sensitive to certain types of targeted therapy than ALK-negative NSCLC. The ALK (D5F3) IHC test can help to determine if a patient is eligible for targeted therapy.
• To monitor treatment response: The ALK (D5F3) IHC test can be used to monitor the response to targeted therapy. If the test results become negative after treatment, it may mean that the treatment is working.
• To diagnose other types of cancer: The ALK (D5F3) IHC test can also be used to diagnose other types of cancer, such as lymphoma and inflammatory myofibroblastic tumor.
• To identify individuals at risk of developing cancer: In some cases, the ALK (D5F3) IHC test may be used to identify individuals who are at high risk of developing cancer, such as those with a family history of ALK-positive cancer.

The ALK (D5F3) IHC test may be recommended for people who have symptoms of NSCLC or other types of cancer that are known to be associated with ALK rearrangements. The test may also be recommended for people who are at high risk of developing one of these types of cancer.

Abnormal results may indicate the presence of ALK gene rearrangements, which can help guide treatment decisions for NSCLC patients. However, abnormal results do not confirm a diagnosis and should be discussed with your doctor for proper interpretation and further evaluation.

A small sample of tissue is removed from the patient and sent to a laboratory for testing. The tissue sample is then stained with the D5F3 antibody. If ALK protein is present in the tissue sample, it will bind to the antibody and turn a brown color. The stained tissue sample is then examined under a microscope to see if there are any ALK-positive cells present. If IHC is positive, FISH test is performed. 

• Ensure that you provide paraffin blocks of your tumour sample along with relevant clinical and radiological details.
• No additional preparations, such as fasting or dietary restrictions, are usually required.
• Please reach out to your healthcare provider for any specific instructions or requirements.

• EGFR mutation analysis: Determines mutations in the epidermal growth factor receptor gene
• PD-L1 testing: Assesses PD-L1 protein expression in NSCLC tumour cells
• Next-generation sequencing (NGS): Identifies multiple genetic alterations associated with NSCLC

• ALK IHC testing
• ALK FISH testing 

NSCLC stands for non-small cell lung cancer, which is the most common type of lung cancer. It refers to a group of lung cancers that are not small cell carcinomas.