ALK Rearrangement


**Note 1:** This SSDI is effective for diagnosis years 2021+ * For cases diagnosed 2018-2020, leave this SSDI blank **Note 2:** Physician statement of ALK rearrangement for non-small cell carcinoma can be used to code this data item when no other information is available. **Note 3:** ALK may be recorded for all histologies and stages; however, it is primarily performed for advanced non-small cell carcinomas. If information is not available, code 9. **Note 4:** The absence or presence of ALK protein expression determines if the tumor will respond to treatment with a targeted inhibitor. ALK protein expression predicts the ALK rearrangement gene, which are more likely to respond to the targeted inhibitor treatment. The most common ALK rearrangements are * EML4-ALK * KIF5B-ALK * TFG-ALK * KLC1-ALK **Note 5:** If ALK Rearrangement is positive and there is no mention of the specific rearrangement, code 4. **Note 6:** If neoadjuvant therapy is given, record the assay from tumor specimens prior to neoadjuvant therapy. * If neoadjuvant therapy is given and there are no ALK results from pre-treatment specimens, report the findings from post-treatment specimens **Note 7:** Code 9 when * Insufficient amount of tissue available to perform test * Test done and documented to be equivocal * No microscopic confirmation of tumor * ALK Rearrangement not ordered or not done, or unknown if ordered or done




NAACCR #3938


SSDI 2021–
Code Description
0 Normal ALK negative Negative for rearrangement, no rearrangement identified, no mutations (somatic) identified, not present, not detected
1 Abnormal Rearrangement identified/detected: EML4-ALK, KIF5B-ALK, TFG-ALK, and/or KLC1-ALK
2 Rearrangement identified/detected: Other ALK Rearrangement not listed in code 1
4 Rearrangement, NOS
7 Test ordered, results not in chart
8 Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error.)
9 Not documented in medical record ALK Rearrangement not assessed or unknown if assessed
<BLANK> N/A - Diagnosis year is prior to 2021