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Wu S, Liu Y, Shi X, Zhou W, Zeng X. Elaboration of NTRK-rearranged colorectal cancer: Integration of immunoreactivity pattern, cytogenetic identity, and rearrangement variant. Dig Liver Dis 2023; 55:1757-1764. [PMID: 37142453 DOI: 10.1016/j.dld.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
Fused information from protein status, DNA breakage, and transcripts are still limited because of the low rate of activated-NTRK in colorectal cancer (CRC). In total, 104 archived CRC tissue samples with dMMR were analyzed using immunohistochemistry (IHC), polymerase chain reaction (PCR), and pyrosequencing to mine the NTRK-enriched CRC group, and then subjected to NTRK fusion detection using pan-tyrosine kinase IHC, fluorescence in situ hybridization (FISH), and DNA-/RNA-based next generation sequencing (NGS) assays. Of the 15 NTRK-enriched CRCs, eight NTRK fusions (53.3%, 8/15), including two TPM3(e7)-NTRK1(e10), one TPM3(e5)-NTRK1(e11), one LMNA(e10)-NTRK1(e10), two EML4(e2)-NTRK3(e14), and two ETV6(e5)-NTRK3(e15) fusions, were identified. There was no immunoreactivity for ETV6-NTRK3 fusion. In addition to cytoplasmic staining found in six specimens, membrane positive (TPM3-NTRK1 fusion) and nuclear positive (LMNA-NTRK1 fusion) were also observed in two of them. Atypical FISH-positive types were observed in four cases. Unlike IHC, NTRK-rearranged tumors appeared homogeneous on FISH. ETV6-NTRK3 may be missed in pan-TRK IHC screening for CRC. Regarding break-apart FISH, NTRK detection is difficult because of the diversity of signal patterns. Further research is warranted to identify the characteristics of NTRK-fusion CRCs.
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Affiliation(s)
- Shafei Wu
- Department of Pathology, Peking Union Medical College Hospital, Molecular Pathology Research Center, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730,China
| | - Yuanyuan Liu
- Department of Pathology, Peking Union Medical College Hospital, Molecular Pathology Research Center, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730,China
| | - Xiaohua Shi
- Department of Pathology, Peking Union Medical College Hospital, Molecular Pathology Research Center, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730,China
| | - Weixun Zhou
- Department of Pathology, Peking Union Medical College Hospital, Molecular Pathology Research Center, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730,China
| | - Xuan Zeng
- Department of Pathology, Peking Union Medical College Hospital, Molecular Pathology Research Center, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730,China.
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Liu Z, Wu Q, Li W, Li P, Huang L, Wang T, Zhou Q. A novel intergenic (between REG3A and CTNNA2-AS1)-ALK fusion responds to alectinib in lung adenocarcinoma. Lung Cancer 2023; 186:107386. [PMID: 37922771 DOI: 10.1016/j.lungcan.2023.107386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES The wide implementation of next generation sequencing (NGS) technology has led to the identification of a greater number of uncommon partners of anaplastic lymphoma kinase (ALK) fusion. The clinical significance of the intergenic-ALK fusion was deemed limited due to the ambiguous functional partner. Herein, we reported a case of lung adenocarcinoma harboring a novel intergenic (between REG3A and CTNNA2-AS1)-ALK fusion which is sensitive to alectinib. MATERIALS AND METHODS Hematoxylin-eosin staining (HE), immunohistochemistry (IHC), and DNA-based next-generation sequencing (NGS) based on a 168-gene panel were performed on the biopsy sample. RESULTS A 50-year-old Chinese male patient diagnosed with stage IVA adenocarcinoma of the upper lobe of the right lung. A novel ALK fusion, resulting from the intergenic region between REG3A and CTNNA2-AS1 fusing with intron 19 of ALK, was unveiled by NGS analysis. Furthermore, positive expression of ALK was confirmed through IHC analysis. The patient was administered alectinib at a dose of 600 mg twice daily as first-line therapy, and partial response was assessed. To date, the progression-free survival (PFS) has exceeded 14 months without any observed serious toxicities. CONCLUSION To the best of our knowledge, this represents the inaugural report of a patient harboring a novel intergenic-ALK fusion with a breakpoint situated between REG3A and CTNNA2-AS1, who exhibited favorable response to alectinib. This case warrants further investigation and offers valuable insights into the response of this novel intergenic-ALK fusion to alectinib.
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Affiliation(s)
- Zhenkun Liu
- Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Wu
- Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen Li
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pengfei Li
- Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Huang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ting Wang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qinghua Zhou
- Lung Cancer Center & Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Jia X, He Q, Xing X, Yang Y, Ma Y. A Novel LOC101927967 Intergenic Region ALK Fusion Identified by NGS and Validated by IHC and FISH in a Patient with Early Stage Adenocarcinoma of Lung. Onco Targets Ther 2022; 15:251-254. [PMID: 35313528 PMCID: PMC8933637 DOI: 10.2147/ott.s347200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Xiaojing Jia
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, People’s Republic of China
| | - Qianru He
- The Medical Department, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, People’s Republic of China
- Nanjing Simcere Medical Laboratory Science Co., Ltd, Nanjing, People's Republic of China
- The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, People's Republic of China
| | - Xiaodan Xing
- The Medical Department, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, People’s Republic of China
- Nanjing Simcere Medical Laboratory Science Co., Ltd, Nanjing, People's Republic of China
- The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, People's Republic of China
| | - Yanming Yang
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, People’s Republic of China
- Correspondence: Yanming Yang; Yan Ma, Department of Radiotherapy, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, People’s Republic of China, Email ;
| | - Yan Ma
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, People’s Republic of China
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Pisapia P, Pepe F, Sgariglia R, Nacchio M, Russo G, Gragnano G, Conticelli F, Salatiello M, De Luca C, Girolami I, Eccher A, Iaccarino A, Bellevicine C, Vigliar E, Malapelle U, Troncone G. Methods for actionable gene fusion detection in lung cancer: now and in the future. Pharmacogenomics 2021; 22:833-847. [PMID: 34525844 DOI: 10.2217/pgs-2021-0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Although gene fusions occur rarely in non-small-cell lung cancer (NSCLC) patients, they represent a relevant target in treatment decision algorithms. To date, immunohistochemistry and fluorescence in situ hybridization are the two principal methods used in clinical trials. However, using these methods in routine clinical practice is often impractical and time consuming because they can only analyze single genes and the quantity of tissue material is often insufficient. Thus, novel technologies, able to test multiple genes in a single run with minimal sample input, are being under investigation. Here, we discuss the utility of next-generation sequencing and nCounter technologies in detecting simultaneous gene fusions in NSCLC patients.
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Affiliation(s)
- Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Francesco Pepe
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Roberta Sgariglia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Mariantonia Nacchio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Gianluca Russo
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Gianluca Gragnano
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Floriana Conticelli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Salatiello
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Caterina De Luca
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Ilaria Girolami
- Division of Pathology, Central Hospital Bolzano, Bolzano, Italy
| | - Albino Eccher
- Department of Pathology & Diagnostics, University & Hospital Trust of Verona, Verona, Italy
| | - Antonino Iaccarino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Wagner F, Greim R, Krebs K, Luebben F, Dimmler A. Characterization of an ETV6-NTRK3 rearrangement with unusual, but highly significant FISH signal pattern in a secretory carcinoma of the salivary gland: a case report. Diagn Pathol 2021; 16:73. [PMID: 34372873 PMCID: PMC8353763 DOI: 10.1186/s13000-021-01133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Fusions of neurotrophic tropomyosin receptor kinase genes NTRK1, NTRK2 and NTRK3 with various partner genes occur in both common and rare tumours and are of paramount predictive value due to the availability of very effective pan-Trk inhibitors like Larotrectinib and Entrectinib. Detection of NTRK fusions is mainly performed by fluorescence in situ hybridization (FISH) and next generation sequencing (NGS). The case described here showed a very unusual, but highly significant FISH signal pattern with an NTRK3 break apart probe, indicative of a functional NTRK3 rearrangement. Case presentation We describe here the case of a male patient who was originally diagnosed with an adenocarcinoma of the parotid gland without evidence of metastases. After the development of multiple lung metastases, an extensive immunohistochemical and molecular examination of archived tumour tissue including analysis of NTRK was performed. NTRK expression was detected by immunohistochemistry (IHC) and then comprehensively analysed further by FISH, quantitative reverse transcription PCR (RT-qPCR), and NGS. NTRK3 break apart FISH showed multiple and very faint single 3′ signals in addition to fusion signals. Quantitative reverse transcription PCR and NGS confirmed an ETV6:exon5-NTRK3:exon15 fusion. Diagnosis was therefore revised to metastatic secretory carcinoma of the salivary gland, and the patient subsequently treated with Larotrectinib, resulting in persisting partial remission. Conclusions Our findings underline the importance to be aware of non-canonical signal patterns during FISH analysis for detection of NTRK rearrangements. Very faint single 3′ signals can indicate a functional NTRK rearrangement and therefore be of high predictive value.
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Affiliation(s)
| | | | | | - Finn Luebben
- Medizinische Klinik 2, Hämatologie, Onkologie, Immunologie, Palliativmedizin, St. Vincentius-Kliniken Karlsruhe, ViDia Christliche Kliniken, Karlsruhe, Germany
| | - Arno Dimmler
- Institut und Gemeinschaftspraxis für Pathologie, St. Vincentius-Kliniken Karlsruhe, ViDia Christliche Kliniken, Karlsruhe, Germany
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Zito Marino F, Brunelli M, Rossi G, Calabrese G, Caliò A, Nardiello P, Martignoni G, Squire JA, Cheng L, Massi D, Franco R. Multitarget fluorescence in situ hybridization diagnostic applications in solid and hematological tumors. Expert Rev Mol Diagn 2021; 21:161-173. [PMID: 33593207 DOI: 10.1080/14737159.2021.1887733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Multitarget FISH (mFISH) is a technique allowing for simultaneous detection of multiple targets sequences on the same slide through the choice of spectrally distinct fluorophore labels. The mFISH could represent a useful tool in the field of precision oncology.Areas covered: This review discusses the potential applications of mFISH technology in the molecular diagnosis of different solid and hematological tumors, including non-small cell lung cancers, melanomas, renal cell carcinomas, bladder carcinomas, germ cell tumors, and multiple myeloma, as commonly required in the clinical practice.Expert Opinion: In this emerging era of the tailored therapies and newer histo-molecular classifications, there are increasing numbers of predictive and diagnostic biomarkers required for effective clinical care. The mFISH approach may have several applications in the common clinical practice, improving the molecular diagnosis in terms of time, cost and preservation of biomaterial for tumors with a limited amount of tumor available. The mFISH provides several advantages compared to other high-throughput technologies; however, it requires high level of expertise required to interpret complex results.
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Affiliation(s)
- Federica Zito Marino
- Department of Mental and Physic Health and Preventive Medicine, Pathology Unit, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Verona, Italy
| | - Giulio Rossi
- Pathology Unit, Ospedale Santa Maria Delle Croci, Ravenna, Italy
| | | | - Anna Caliò
- Department of Pathology, University of Verona, Verona, Italy
| | - Pamela Nardiello
- Section of Pathology, Department of Health Sciences, University of Florence Florence, Italy
| | - Guido Martignoni
- Pathology Unit, Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Jeremy A Squire
- Departments of Genetics, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence Florence, Italy
| | - Renato Franco
- Department of Mental and Physic Health and Preventive Medicine, Pathology Unit, University of Campania Luigi Vanvitelli, Napoli, Italy
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