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Speel EJM, Dafni U, Thunnissen E, Hendrik Rüschoff J, O'Brien C, Kowalski J, Kerr KM, Bubendorf L, Sansano I, Joseph L, Kriegsmann M, Navarro A, Monkhorst K, Bille Madsen L, Hernandez Losa J, Biernat W, Stenzinger A, Rüland A, Hillen LM, Marti N, Molina-Vila MA, Dellaporta T, Kammler R, Peters S, Stahel RA, Finn SP, Radonic T. ROS1 fusions in resected stage I-III adenocarcinoma: Results from the European Thoracic Oncology Platform Lungscape project. Lung Cancer 2024; 194:107860. [PMID: 39002492 DOI: 10.1016/j.lungcan.2024.107860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/10/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND ROS1 fusion is a relatively low prevalence (0.6-2.0%) but targetable driver in lung adenocarcinoma (LUAD). Robust and low-cost tests, such as immunohistochemistry (IHC), are desirable to screen for patients potentially harboring this fusion. The aim was to investigate the prevalence of ROS1 fusions in a clinically annotated European stage I-III LUAD cohort using IHC screening with the in vitro diagnostics (IVD)-marked clone SP384, followed by confirmatory molecular analysis in pre-defined subsets. METHODS Resected LUADs constructed in tissue microarrays, were immunostained for ROS1 expression using SP384 clone in a ready-to-use kit and Ventana immunostainers. After external quality control, analysis was performed by trained pathologists. Staining intensity of at least 2+ (any percentage of tumor cells) was considered IHC positive (ROS1 IHC + ). Subsequently, ROS1 IHC + cases were 1:1:1 matched with IHC0 and IHC1 + cases and subjected to orthogonal ROS1 FISH and RNA-based testing. RESULTS The prevalence of positive ROS1 expression (ROS1 IHC + ), defined as IHC 2+/3+, was 4 % (35 of 866 LUADs). Twenty-eight ROS1 IHC + cases were analyzed by FISH/RNA-based testing, with only two harboring a confirmed ROS1 gene fusion, corresponding to a lower limit for the prevalence of ROS1 gene fusion of 0.23 %. They represent a 7 % probability of identifying a fusion among ROS1 IHC + cases. Both confirmed cases were among the only four with sufficient material and H-score ≥ 200, leading to a 50 % probability of identifying a ROS1 gene fusion in cases with an H-score considered strongly positive. All matched ROS1 IHC- (IHC0 and IHC1 + ) cases were also found negative by FISH/RNA-based testing, leading to a 100 % probability of lack of ROS1 fusion for ROS1 IHC- cases. CONCLUSIONS The prevalence of ROS1 fusion in an LUAD stage I-III European cohort was relatively low. ROS1 IHC using SP384 clone is useful for exclusion of ROS1 gene fusion negative cases.
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Affiliation(s)
- Ernst-Jan M Speel
- Department of Pathology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, MUMC+ Maastricht, Netherlands & Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Urania Dafni
- ETOP IBCSG Partners Foundation, ETOP Statistical Center, Frontier Science Foundation-Hellas & National and Kapodistrian University of Athens, Athens, Greece
| | - Erik Thunnissen
- Department of Pathology, Amsterdam University Medical Centre, location VUmc, Cancer Center Amsterdam, Amsterdam, Netherlands
| | | | - Cathal O'Brien
- Department of Histopathology, St James's Hospital and Trinity College, Dublin, Ireland
| | - Jacek Kowalski
- Pathomorphology Department, Medical University of Gdansk, Gdansk, Poland
| | - Keith M Kerr
- Department of Pathology, Aberdeen Royal Infirmary - NHS Grampian, Aberdeen, United Kingdom
| | - Lukas Bubendorf
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Irene Sansano
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Leena Joseph
- Department of Pathology, Lung Cancer Group Manchester, Manchester, United Kingdom
| | - Mark Kriegsmann
- Department of Histopathology, University Hospital Heidelberg, Germany
| | - Atilio Navarro
- Department of Pathology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Kim Monkhorst
- Pathology Department, NKI-AVL - Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | | | - Wojciech Biernat
- Pathomorphology Department, Medical University of Gdansk, Gdansk, Poland
| | | | - Andrea Rüland
- Department of Pathology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, MUMC+ Maastricht, Netherlands & Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Lisa M Hillen
- Department of Pathology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, MUMC+ Maastricht, Netherlands & Department of Pathology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Nesa Marti
- Translational Research Coordination, ETOP IBCSG Partners Foundation, Bern, Switzerland
| | - Miguel A Molina-Vila
- Laboratory of Oncology, Pangaea Oncology, Dexeus University Hospital, Barcelona, Spain
| | - Tereza Dellaporta
- ETOP Statistical Center, Frontier Science Foundation-Hellas, Athens, Greece
| | - Roswitha Kammler
- Translational Research Coordination, ETOP IBCSG Partners Foundation, Bern, Switzerland
| | - Solange Peters
- Oncology Department, CHUV - Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Rolf A Stahel
- President, ETOP IBCSG Partners Foundation, Bern, Switzerland.
| | - Stephen P Finn
- Department of Histopathology, St James's Hospital and Trinity College, Dublin, Ireland
| | - Teodora Radonic
- Department of Pathology, Amsterdam University Medical Centre, location VUmc, Cancer Center Amsterdam, Amsterdam, Netherlands
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Peng Y, Ernani V, Liu D, Guo Q, Hopps M, Cappelleri JC, Gupta R, de Andrade M, Chen J, Yi ES, Yang P. Lung adenocarcinoma patients with ROS1-rearranged tumors by sex and smoking intensity. Heliyon 2024; 10:e28285. [PMID: 38560203 PMCID: PMC10981064 DOI: 10.1016/j.heliyon.2024.e28285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Background ROS1 rearrangements (ROS1+) define a distinct molecular subset of lung adenocarcinomas. ROS1 + tumors are known to occur more in never-smokers, but the frequency and outcome of ROS1 positivity by sex and smoking intensity are not clearly documented. Patients and methods This patient cohort study included all never- (<100 cigarettes lifetime) and light- (100 cigarettes-20 pack-years) smokers, and a sample of heavy-smokers. ROS1 + rates by sex and smoking intensity were compared within and beyond our study. Survival outcomes were analyzed using Kaplan-Meier curves and Cox proportional hazards models. Results Of the 571 total patients, ROS1 + was detected in 24 (4.2%): 6.4% in men and 3.0% in women; 5.1% in never-, 5.7% in light-, and 1.8% in heavy-smokers (P=0.05). Among the 209 stage IIIB-IV patients, men had much higher ROS1 + rate (11.1%) not only than women (1.7%, P=0.004) in our study, but also than men (0.4%-1.8%) in 8 published studies (Ps = 0.0019-0.0001). ROS1+ rates were similar between never- (9.3%) and light-smokers (8.1%) and significantly lower in heavy-smokers (1.2%, P=0.017), a finding confirmed by 6 published studies (Ps = 0.041-0.0001). Overall survival of ROS1 + patients were significantly better than the ROS1- (P=0.023) mainly due to targeted therapy. Among patients who exhibited resistance to crizotinib, follow-up treatment of entrectinib and lorlatinib showed remarkable survival benefits. Conclusions The ROS1 + rates were higher in men than in women, and similar in never- and light-smokers, more pronounced in stage IIIB-IV patients. Newer-generation ALK/ROS1-targeted drugs showed efficacy in a cohort of crizotinib resistant ROS1 + patients. These results, when validated, could assist efficiently accruing ROS1 + patients.
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Affiliation(s)
- Yanmei Peng
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, AZ, 85259, USA
- Department of Oncology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, 102400, China
| | - Vinicius Ernani
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, AZ, 85054, USA
| | - Dan Liu
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, AZ, 85259, USA
- Division of Pulmonary & Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610064, China
| | - Qian Guo
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, AZ, 85259, USA
- Department of Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Markay Hopps
- Vaccine R&D, Pfizer Inc, New York, NY, 10017, USA
| | | | - Ruchi Gupta
- Division of Biostatistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Mariza de Andrade
- Division of Biostatistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Jun Chen
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, AZ, 85259, USA
- The Second Affiliated Hospital of Dalian Medical University, Shahekou District, Dalian, 116023, China
| | - Eunhee S. Yi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ping Yang
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, AZ, 85259, USA
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Li S, Zhang H, Chen T, Zhang X, Shang G. Current treatment and novel insights regarding ROS1-targeted therapy in malignant tumors. Cancer Med 2024; 13:e7201. [PMID: 38629293 PMCID: PMC11022151 DOI: 10.1002/cam4.7201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 03/22/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The proto-oncogene ROS1 encodes an intrinsic type I membrane protein of the tyrosine kinase/insulin receptor family. ROS1 facilitates the progression of various malignancies via self-mutations or rearrangements. Studies on ROS1-directed tyrosine kinase inhibitors have been conducted, and some have been approved by the FDA for clinical use. However, the adverse effects and mechanisms of resistance associated with ROS1 inhibitors remain unknown. In addition, next-generation ROS1 inhibitors, which have the advantage of treating central nervous system metastases and alleviating endogenous drug resistance, are still in the clinical trial stage. METHOD In this study, we searched relevant articles reporting the mechanism and clinical application of ROS1 in recent years; systematically reviewed the biological mechanisms, diagnostic methods, and research progress on ROS1 inhibitors; and provided perspectives for the future of ROS1-targeted therapy. RESULTS ROS1 is most expressed in malignant tumours. Only a few ROS1 kinase inhibitors are currently approved for use in NSCLC, the efficacy of other TKIs for NSCLC and other malignancies has not been ascertained. There is no effective standard treatment for adverse events or resistance to ROS1-targeted therapy. Next-generation TKIs appear capable of overcoming resistance and delaying central nervous system metastasis, but with a greater incidence of adverse effects. CONCLUSIONS Further research on next-generation TKIs regarding the localization of ROS1 and its fusion partners, binding sites for targeted drugs, and coadministration with other drugs is required. The correlation between TKIs and chemotherapy or immunotherapy in clinical practice requires further study.
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Affiliation(s)
- Shizhe Li
- Department of OrthopedicsShengjing Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - He Zhang
- Department of OrthopedicsShengjing Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Ting Chen
- Department of OrthopedicsShengjing Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Xiaowen Zhang
- Medical Research CenterShengjing Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Guanning Shang
- Department of OrthopedicsShengjing Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
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Nguyen Hoang TP, Nguyen TA, Tran NHB, Nguyen Hoang VA, Thi Dao HT, Tran VU, Nguyen YN, Nguyen AT, Nguyen Thi CT, Do Thi TT, Nguyen DS, Nguyen HN, Giang H, Tu LN. Analytical validation and clinical utilization of K-4CARE™: a comprehensive genomic profiling assay with personalized MRD detection. Front Mol Biosci 2024; 11:1334808. [PMID: 38404964 PMCID: PMC10886136 DOI: 10.3389/fmolb.2024.1334808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
Background: Biomarker testing has gradually become standard of care in precision oncology to help physicians select optimal treatment for patients. Compared to single-gene or small gene panel testing, comprehensive genomic profiling (CGP) has emerged as a more time- and tissue-efficient method. This study demonstrated in-depth analytical validation of K-4CARE, a CGP assay that integrates circulating tumor DNA (ctDNA) tracking for residual cancer surveillance. Methods: The assay utilized a panel of 473 cancer-relevant genes with a total length of 1.7 Mb. Reference standards were used to evaluate limit of detection (LOD), concordance, sensitivity, specificity and precision of the assay to detect single nucleotide variants (SNVs), small insertion/deletions (Indels), gene amplification and fusion, microsatellite instability (MSI) and tumor mutational burden (TMB). The assay was then benchmarked against orthogonal methods using 155 clinical samples from 10 cancer types. In selected cancers, top tumor-derived somatic mutations, as ranked by our proprietary algorithm, were used to detect ctDNA in the plasma. Results: For detection of somatic SNVs and Indels, gene fusion and amplification, the assay had sensitivity of >99%, 94% and >99% respectively, and specificity of >99%. Detection of germline variants also achieved sensitivity and specificity of >99%. For TMB measurement, the correlation coefficient between whole-exome sequencing and our targeted panel was 97%. MSI analysis when benchmarked against polymerase chain reaction method showed sensitivity of 94% and specificity of >99%. The concordance between our assay and the TruSight Oncology 500 assay for detection of somatic variants, TMB and MSI measurement was 100%, 89%, and 98% respectively. When CGP-informed mutations were used to personalize ctDNA tracking, the detection rate of ctDNA in liquid biopsy was 79%, and clinical utility in cancer surveillance was demonstrated in 2 case studies. Conclusion: K-4CARE™ assay provides comprehensive and reliable genomic information that fulfills all guideline-based biomarker testing for both targeted therapy and immunotherapy. Integration of ctDNA tracking helps clinicians to further monitor treatment response and ultimately provide well-rounded care to cancer patients.
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Affiliation(s)
- Thien-Phuc Nguyen Hoang
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Tien Anh Nguyen
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Nam H. B. Tran
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Van-Anh Nguyen Hoang
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Hong Thuy Thi Dao
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Vu-Uyen Tran
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Yen Nhi Nguyen
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Anh Tuan Nguyen
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Cam Tu Nguyen Thi
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | | | - Duy Sinh Nguyen
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Hoai-Nghia Nguyen
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Hoa Giang
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
| | - Lan N. Tu
- Medical Genetics Institute, Ho Chi Minh City, Vietnam
- Gene Solutions, Ho Chi Minh City, Vietnam
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Yang X, Tang Z, Li J, Jiang J, Liu Y. Progress of non-small-cell lung cancer with ROS1 rearrangement. Front Mol Biosci 2023; 10:1238093. [PMID: 38187090 PMCID: PMC10766828 DOI: 10.3389/fmolb.2023.1238093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
ROS1 rearrangement is found in 0.9%-2.6% of people with non-small-cell lung cancers (NSCLCs). Tyrosine kinase inhibitors (TKIs) target ROS1 and can block tumor growth and provide clinical benefits to patients. This review summarizes the current knowledge on ROS1 rearrangements in NSCLCs, including the mechanisms of ROS1 oncogenicity, epidemiology of ROS1-positive tumors, methods for detecting rearrangements, molecular characteristics, therapeutic agents, and mechanisms of drug resistance.
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Affiliation(s)
- Xin Yang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhe Tang
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Li
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jizong Jiang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Liu
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Brisudová A, Bielniková-Kryštofová H, Motyka O, Fritzová D, Katuchová V, Ponikelská N, Skanderová D, Raclavský V, Michálek J, Mitták M, Švecová P, Jakubec P, Rozsivalová D, Szkorupa M, Klein JI, Škarda J, Kolář Z, Skopelidou V. Microbiota Diversity in Non-Small Cell Lung Cancer Gut and Mouth Cavity Microbiota Diversity in Non-Small Cell Lung Cancer Patients. Pol J Microbiol 2023; 72:467-475. [PMID: 38103007 PMCID: PMC10725158 DOI: 10.33073/pjm-2023-044] [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: 08/10/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023] Open
Abstract
Lung malignancies have a substantial impact on cancer incidence and mortality worldwide. Even though many factors involved in the development of the disease are known, many questions remain unanswered. Previous studies suggest that the intestinal microbiota may have a role in developing malignant diseases. According to some findings, the microbiota has proven to be a key modulator of carcinogenic processes and the immune response against cancer cells, potentially influencing the effectiveness of immunotherapy. In our study, we characterized culturable microorganisms associated with non-small cell lung cancer (NSCLC) that can be recovered from rectal swabs and mouthwash. In addition, we also explored differences in the culturable microbiota with two main types of NSCLC - adenocarcinoma (ADC) and squamous cell carcinoma (SCC). With 141 patients included in the study (86 ADC and 55 SCC cases), a significant difference was observed between the two types in seven bacterial species (Collinsella, Corynebacterium, Klebsiella, Lactobacillus, Neisseria, Rothia, and Streptococcus), including the site of origin. The relationship between microbial dysbiosis and lung cancer is poorly understood; future research could shed light on the links between gut microbiota and lung cancer development.
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Affiliation(s)
- Aneta Brisudová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Hana Bielniková-Kryštofová
- Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine University of Ostrava, Ostrava, Czech Republic
| | - Oldřich Motyka
- Faculty of Mining and Geology, VŠB – Technical University of Ostrava, Ostrava, Czech Republic
- Nanotechnology Centre, CEET, VŠB – Technical University of Ostrava, Ostrava, Czech Republic
| | - Dominika Fritzová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Vladimíra Katuchová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Natálie Ponikelská
- Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine University of Ostrava, Ostrava, Czech Republic
| | - Daniela Skanderová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Vladislav Raclavský
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jaroslav Michálek
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Marcel Mitták
- Faculty of Medicine University of Ostrava, Ostrava, Czech Republic
- Department of Surgical Studies, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petra Švecová
- Department of Respiratory Diseases, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Petr Jakubec
- Department of Respiratory Diseases, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Denisa Rozsivalová
- Department of Respiratory Diseases, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Marek Szkorupa
- Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - JIří Klein
- Surgical Clinic, Thomas Bat’a Regional Hospital, PragueCzech Republic
| | - Jozef Škarda
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
- Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine University of Ostrava, Ostrava, Czech Republic
| | - Zdeněk Kolář
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Valeria Skopelidou
- Institute of Molecular and Clinical Pathology and Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
- Faculty of Medicine University of Ostrava, Ostrava, Czech Republic
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Qin H, Tan Y, Diao L, Hui AM, Wu Z, Zhou Y, Sun J, Xiang X, Qiu J, Hu W. Effect of High-Fat Food on the Pharmacokinetic Profile and Safety of SAF-189s, an ALK/ROS1 Inhibitor, in Healthy Chinese Adults. Drugs R D 2023; 23:465-473. [PMID: 37934354 PMCID: PMC10676332 DOI: 10.1007/s40268-023-00446-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to investigate the effect of high-fat meals on the pharmacokinetics (PK) and safety profile of SAF-189s, a novel ALK/ROS1 inhibitor. METHODS This was a single-center, phase I, open-label, crossover study in which healthy adults (≥18 years) were randomized (1:1) to two sequences of SAF-189s administration (fasted-fed or fed-fasted) separated by a 14-day washout. After a ≥10-h overnight fast, volunteers received SAF-189s 160 mg orally in a fasted state or 30 min after a high-fat, high-calorie meal. Similarity of pharmacokinetic parameters was concluded if the 90% CI for the geometric mean ratio (GMR) between the fed and fasted group fell within the predefined range of 0.80-1.25. RESULTS In total, 24 subjects were enrolled and 23 completed the study. SAF-189s maximum plasma concentration (Cmax; GMR: 109.1% [90% CI 103.1-115.4]) was comparable under fed (high-fat meal, n = 24) versus fasted (n = 23) conditions, with no effect on area under the plasma concentration-time curve from time 0 to t (AUC0-t; GMR: 105.1% [90% CI 100.3-110.2]) and AUC from time 0 to infinity (AUC0-∞; GMR: 105.5% [90% CI, 100.6-110.6]). In both groups, the median time to maximum plasma concentration (tmax) was around 6 h and mean plasma half-life (t½) was around 35 h. Fed administration led to a lower incidence of treatment-emergent adverse events (TEAEs; 29.2% vs 54.2%), including gastrointestinal disorders (4.2% vs 41.7%) and headache (0.0% vs 12.5%), versus fasted administration. CONCLUSIONS A high-fat meal had minimal effect on the pharmacokinetic profile of SAF-189s compared with a fasted state following a single dose of 160 mg. Administration with a high-fat meal led to a lower incidence of TEAEs.
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Affiliation(s)
- Huiling Qin
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yan Tan
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Lei Diao
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Ai-Min Hui
- EnCureGen Pharma, 9 Yayingshi Road, Huangpu District, Guangzhou, 510700, China
| | - Zhuli Wu
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Yongchun Zhou
- Wanbang Biopharmaceuticals, 6 Yangshan Road, Economic Zone, Xuzhou, 221004, Jiangsu, China
| | - Juan Sun
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Xiao Xiang
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Jingjun Qiu
- Shanghai Fosun Pharmaceutical Development Co., Ltd., 1289 Yishan Road, Shanghai, 200233, China
| | - Wei Hu
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
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8
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Spitaleri G, Trillo Aliaga P, Attili I, Del Signore E, Corvaja C, Corti C, Crimini E, Passaro A, de Marinis F. Sustained Improvement in the Management of Patients with Non-Small-Cell Lung Cancer (NSCLC) Harboring ALK Translocation: Where Are We Running? Curr Oncol 2023; 30:5072-5092. [PMID: 37232842 DOI: 10.3390/curroncol30050384] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
ALK translocation amounts to around 3-7% of all NSCLCs. The clinical features of ALK+ NSCLC are an adenocarcinoma histology, younger age, limited smoking history, and brain metastases. The activity of chemotherapy and immunotherapy is modest in ALK+ disease. Several randomized trials have proven that ALK inhibitors (ALK-Is) have greater efficacy with respect to platinum-based chemotherapy and that second/third generation ALK-Is are better than crizotinib in terms of improvements in median progression-free survival and brain metastases management. Unfortunately, most patients develop acquired resistance to ALK-Is that is mediated by on- and off-target mechanisms. Translational and clinical research are continuing to develop new drugs and/or combinations in order to raise the bar and further improve the results attained up to now. This review summarizes first-line randomized clinical trials of several ALK-Is and the management of brain metastases with a focus on ALK-I resistance mechanisms. The last section addresses future developments and challenges.
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Affiliation(s)
- Gianluca Spitaleri
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Pamela Trillo Aliaga
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Ilaria Attili
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Ester Del Signore
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Carla Corvaja
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Chiara Corti
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Department of Oncology and Haematology (DIPO), University of Milan, 20122 Milan, Italy
| | - Edoardo Crimini
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Department of Oncology and Haematology (DIPO), University of Milan, 20122 Milan, Italy
| | - Antonio Passaro
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Filippo de Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
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9
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Grodzka A, Knopik-Skrocka A, Kowalska K, Kurzawa P, Krzyzaniak M, Stencel K, Bryl M. Molecular alterations of driver genes in non-small cell lung cancer: from diagnostics to targeted therapy. EXCLI JOURNAL 2023; 22:415-432. [PMID: 37346803 PMCID: PMC10279966 DOI: 10.17179/excli2023-6122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023]
Abstract
Lung cancer is the leading cause of cancer death all over the world. The majority (80-85 %) of lung cancer cases are classified as non-small cell lung cancer (NSCLC). Within NSCLC, adenocarcinoma (AC) and squamous cell carcinoma (SCC) are the most often recognized. The histological and immunohistochemical examination of NSCLC is a basic diagnostic tool, but insufficient for comprehensive therapeutic decisions. In some NSCLC patients, mainly adenocarcinoma, molecular alterations in driver genes, like EGFR, KRAS, HER2, ALK, MET, BRAF, RET, ROS1, and NTRK are recognized. The frequency of some of those changes is different depending on race, and between smokers and non-smokers. The molecular diagnostics of NSCLC using modern methods, like next-generation sequencing, is essential in estimating targeted, personalized therapy. In recent years, a breakthrough in understanding the importance of molecular studies for the precise treatment of NSCLC has been observed. Many new drugs were approved, including tyrosine kinase and immune checkpoint inhibitors. Clinical trials testing novel molecules like miRNAs and trials with CAR-T cells (chimeric antigen receptor - T cells) dedicated to NSCLC patients are ongoing.
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Affiliation(s)
- Anna Grodzka
- Department of Cell Biology, Faculty of Biology, Adam Mickiewicz University of Poznan, Poland
| | | | - Katarzyna Kowalska
- Department of Oncological Pathology, University Clinical Hospital in Poznan, Poznan University of Medical Sciences, Poland
| | - Pawel Kurzawa
- Department of Oncological Pathology, University Clinical Hospital in Poznan, Poznan University of Medical Sciences, Poland
- Department of Clinical Pathology and Immunology, Poznan University of Medical Sciences, Poland
| | - Monika Krzyzaniak
- Department of Oncological Pathology, University Clinical Hospital in Poznan, Poznan University of Medical Sciences, Poland
| | - Katarzyna Stencel
- Department of Clinical Oncology with the Subdepartment of Diurnal Chemotherapy, E. J. Zeyland Wielkopolska Center of Pulmonology and Thoracic Surgery, Poznan, Poland
| | - Maciej Bryl
- Department of Clinical Oncology with the Subdepartment of Diurnal Chemotherapy, E. J. Zeyland Wielkopolska Center of Pulmonology and Thoracic Surgery, Poznan, Poland
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10
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Li D, Jiang H, Jin F, Pan L, Xie Y, Zhang L, Li C. Concurrent classic driver oncogenes mutation with ROS1 rearrangement predicts superior clinical outcome in NSCLC patients. Genes Genomics 2023; 45:93-102. [PMID: 36445572 DOI: 10.1007/s13258-022-01326-w] [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: 06/08/2022] [Accepted: 10/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is high mortality rate and poor prognosis in lung cancer, especially non-small-cell lung cancer (NSCLC). Recent study showed that concurrent classic driver oncogene mutation with ROS1 rearrangement was found in NSCLC patients. However, whether this would affect the development and prognosis of NSCLC is still unclear. OBJECTIVE To explore the clinical characteristics and prognosis of NSCLC patients harboring concurrent classic driver oncogene mutation with ROS1 rearrangement. METHODS A retrospective study was conducted on 220 patients diagnosed with NSCLC. All samples were screened for EGFR and KRAS using amplification-refractory mutation system assay, and for ALK, ROS1 using RT-PCR. The clinical characteristics and clinical outcomes of concurrent gene alterations with ROS1 rearrangement were analyzed. RESULTS In 220 patients, 12 (5.45%) were ROS1 rearrangement, who tend to be younger, non-smokers. The mutation rates of EGFR, KRAS, ALK and ROS1 in NSCLC were 28.64%, 1.82%, 3.64% and 5.45%, respectively. ROS1 rearrangement was identified to co-occur in 5 (2.27%) NSCLC patients. ROS1/EGFR co-alterations were found in 3.17% of NSCLC patients, 16.67% of ROS1-positive NSCLC patients. Concomitant ROS1/ALK rearrangement constituted 37.50% in ALK-positive patients, and 25.00% in ROS1-positive patients. SDC4-ROS1 was the most common fusion partner in concurrent ROS1 rearrangement patients. The median overall survival of NSCLC with concurrent ROS1 rearrangement group and single ROS1 rearrangement group were 25 months and 14 months. CONCLUSION Concurrent driver oncogenes mutation with ROS1 rearrangement defines a unique subgroup of NSCLC. Patients with concomitant ROS1 rearrangement might have a better prognosis.
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Affiliation(s)
- Dandan Li
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China
| | - Hua Jiang
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China
| | - Faguang Jin
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China
| | - Lei Pan
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China
| | - Yonghong Xie
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China
| | - Liang Zhang
- Medical Team of Chinese People's Liberation Army of 93932 Unit, Qinghai, 810000, China
| | - Chunmei Li
- Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, 710000, China.
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11
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Anca S, Catrina M, Coculescu I, Popa V, Serbanescu G, Voinea O. LP-10 Experimental Evaluation of Skin Toxicity of Vesicant Chemicals and the Effectiveness of a New Complex Treatment. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Bahnassy AA, Ismail H, Mohanad M, El-Bastawisy A, Yousef HF. The prognostic role of PD-1, PD-L1, ALK, and ROS1 proteins expression in non-small cell lung carcinoma patients from Egypt. J Egypt Natl Canc Inst 2022; 34:23. [DOI: 10.1186/s43046-022-00121-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Programmed death ligand-1 (PD-L1), anaplastic lymphoma kinase (ALK), and c-ros oncogene1 (ROS1) expression may influence the prognosis of non-small cell lung carcinoma (NSCLC). We aimed to investigate the prognostic and predictive significance of PD-1/PD-L1 along with c-ros ROS1 and ALK in NSCLC patients.
Methods
Immunohistochemistry used to identify ALK, ROS1, PD-1, and PD-L1 proteins expression as well as ROS1 rearrangement via fluorescence in situ hybridization, in 70 NSCLC patients. Results were related to clinicopathological feature, survival, and treatment response.
Results
Expression of ROS1, ALK, PD-1, and PD-L1 and ROS1-rearrangement were detected in 18.57%, 54.29%, 84.29%, 87.14%, and 15.71% of the cases, respectively. No association was found between ROS1, PD-1, and PD-L1 and any clinicopathological features, survival, or treatment outcome. ALK expression significantly associated with stage-IV and left-sided tumors. Epidermal growth factor receptor (EGFR) mutation and ALK-positive patients had significantly reduced progression-free survival than patients with wild type EGFR [HR: 1.99, 95% CI: 1.37–2.93, p < 0.001] and negative-ALK expression [HR: 1.46, 95% CI: 1.03–2.07, p = 0.03]. In multivariate analysis, lymph node metastasis, EGFR-mutations, and ALK were independent predictors of NSCLC. PD-L1 expression was significantly correlated with PD-1 but not with ROS1, ALK, or EGFR-mutation.
Conclusion
Positive ALK expression and EGFR-mutations are independent adverse predictors of NSCLC. Overexpression of PD-1/PD-L1 is not a significant prognostic marker in NSCLC patients receiving chemotherapy, making them susceptible to immunotherapy. Since PD-1/PD-L1 expression is independent to oncogenic driver mutations, future studies into specific immune checkpoint inhibitors combined with targeted therapies for individualized treatment of NSCLC is warranted.
Positive ALK expression and EGFR mutations are independent risk factors for NSCLC. Overexpression of PD-1/PD-L1 is not a significant prognostic factor in patients with NSCLC who are receiving chemotherapy, making them immunotherapy susceptible. Given that PD-1/PD-L1 expression is not dependent on oncogenic driver mutations, additional research into specific immune checkpoint inhibitors in combination with targeted therapies for the treatment of NSCLC on an individual basis is warranted.
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13
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Gendarme S, Bylicki O, Chouaid C, Guisier F. ROS-1 Fusions in Non-Small-Cell Lung Cancer: Evidence to Date. Curr Oncol 2022; 29:641-658. [PMID: 35200557 PMCID: PMC8870726 DOI: 10.3390/curroncol29020057] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
The ROS-1 gene plays a major role in the oncogenesis of numerous tumors. ROS-1 rearrangement is found in 0.9–2.6% of non-small-cell lung cancers (NSCLCs), mostly lung adenocarcinomas, with a significantly higher rate of women, non-smokers, and a tendency to a younger age. It has been demonstrated that ROS-1 is a true oncogenic driver, and tyrosine kinase inhibitors (TKIs) targeting ROS-1 can block tumor growth and provide clinical benefit for the patient. Since 2016, crizotinib has been the first-line reference therapy, with two-thirds of the patients’ tumors responding and progression-free survival lasting ~20 months. More recently developed are ROS-1-targeting TKIs that are active against resistance mechanisms appearing under crizotinib and have better brain penetration. This review summarizes current knowledge on ROS-1 rearrangement in NSCLCs, including the mechanisms responsible for ROS-1 oncogenicity, epidemiology of ROS-1-positive tumors, methods for detecting rearrangement, phenotypic, histological, and molecular characteristics, and their therapeutic management. Much of this work is devoted to resistance mechanisms and the development of promising new molecules.
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Affiliation(s)
- Sébastien Gendarme
- INSERM, IMRB (Clinical Epidemiology and Ageing Unit), University Paris Est Créteil, F-94010 Créteil, France;
- Pneumology Department, Centre Hospitalier Intercommunal de Créteil, 40, Avenue de Verdun, F-94010 Créteil, France
- Correspondence:
| | - Olivier Bylicki
- Respiratory Disease Unit, HIA Sainte-Anne, 2, Boulevard Saint-Anne, F-83000 Toulon, France;
| | - Christos Chouaid
- INSERM, IMRB (Clinical Epidemiology and Ageing Unit), University Paris Est Créteil, F-94010 Créteil, France;
- Pneumology Department, Centre Hospitalier Intercommunal de Créteil, 40, Avenue de Verdun, F-94010 Créteil, France
| | - Florian Guisier
- Department of Pneumology, Rouen University Hospital, 1 Rue de Germont, F-76000 Rouen, France;
- Clinical Investigation Center, Rouen University Hospital, CIC INSERM 1404, 1 Rue de Germont, F-76000 Rouen, France
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14
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Korkmaz M, Eryilmaz MK. Fifty-five months progression-free survival with crizotinib treatment in coexistence of ALK and ROS1 rearrangements in lung adenocarcinoma: an extremely rare case and review of the literature. Anticancer Drugs 2022; 33:e799-e801. [PMID: 34459458 DOI: 10.1097/cad.0000000000001224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We wanted to present a case with coexistence of anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) rearrangements that has been in remission for a long time with crizotinib. A 62-year-old nonsmoker male patient was diagnosed with Non-small cell lung cancer. Progression developed 9 months after the treatment, and coexistence of ALK and ROS1 positivity were detected in driver mutation analysis performed with fluorescent in situ hybridization. Crizotinib 2 × 250 mg was started in November 2016. The treatment of the patient, who has been in remission for approximately 55 months since then, continues. Until recently, the use of next-generation sequencing (NGS) was not common, but the more frequent epidermal growth factor receptor, then ALK, and finally ROS1 mutation were studied in tumor tissues. Sometimes ROS1 was not studied because there was not enough tissue left. We think that this rate will increase a little more with the widespread use of NGS from now on. Showing that ALK and ROS1 are positive together, longer survivals can be obtained by choosing therapies that are responsive to both.
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Affiliation(s)
- Mustafa Korkmaz
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
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15
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Azelby CM, Sakamoto MR, Bowles DW. ROS1 Targeted Therapies: Current Status. Curr Oncol Rep 2021; 23:94. [PMID: 34125313 DOI: 10.1007/s11912-021-01078-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Molecular drivers are increasingly identified as therapeutic targets for non-small cell lung cancer (NSCLC). This review focuses on the role of ROS1 inhibitors in treating relapsed/metastatic ROS-1 altered (ROS1+) NSCLC. RECENT FINDINGS Four FDA-approved drugs have significant activity against ROS1+ NSCLC: crizotinib, ciritinib, lorlatinib, and entrectinib. Each drug yields an overall response rates exceeding 60% with ciritinib, lorlatinib, and entrectinib possessing intracranial activity. The drugs have manageable toxicity profiles. ROS1 alterations are rare molecular drivers of NSCLC that can be effectively treated with a variety of ROS1-targetd drugs. New agents are being identified that may treat resistance mutations.
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Affiliation(s)
- Christine M Azelby
- Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, AU, USA
| | - Mandy R Sakamoto
- Department of Medicine, University of Colorado Anschutz Medical Campus, Colorado, AU, USA
| | - Daniel W Bowles
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E 17th Ave, 1665 Aurora Court, Colorado, AU, USA. .,Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.
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16
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Ji X, Xie H, Zhu R, Chen B, Jiang S, Luo J. Different clinical features between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer. J Int Med Res 2021; 49:300060521993643. [PMID: 33583243 PMCID: PMC7890737 DOI: 10.1177/0300060521993643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To compare the baseline clinical characteristics between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer (NSCLC), and the correlations of these subtypes with the distribution of metastases. Methods We compared the clinical characteristics and imaging features of patients with ROS1-positive and ALK-positive NSCLC using statistical methods. Results Data for 232 patients were analyzed. Compared with ALK-positive NSCLC, ROS1-positive NSCLC was more likely to occur in women (71% vs 53%), and primary lesions ≤3 cm were more common in patients with ROS1-positive compared with ALK-positive NSCLC (58% vs 37%). There was no significant difference in the distribution of metastases between the two groups. Subgroup analysis within the ROS1-positive group showed that, compared with primary lesions >3 cm, primary lesions ≤3 cm were more likely to present as peripheral tumors (72% vs 43%) and more likely to exhibit non-solid density (44% vs 4%). Conclusions Although ROS1-positive and ALK-positive NSCLCs show similar clinical features, the differences may help clinicians to identify patients requiring further genotyping at initial diagnosis.
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Affiliation(s)
- Xianxiu Ji
- Department of Oncology, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Huikang Xie
- Department of Pathology, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Ren Zhu
- Department of Medical administration, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Bin Chen
- Department of Oncology, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Sen Jiang
- Department of Radiology, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Jie Luo
- Department of Oncology, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
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Wang Y, Yuan X, Xiong J, Hao Z, Peng X, Chen W, Cui L, Li H, Wang X, He X, Yang M, Liang C, Ma Y, Ding L, Mao L. [Pharmacology and Clinical Evaluation of Ensartinib Hydrochloride Capsule]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:719-729. [PMID: 32838492 PMCID: PMC7467989 DOI: 10.3779/j.issn.1009-3419.2020.102.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
肺癌是全世界发病率和致死率最高的恶性肿瘤,其中非小细胞肺癌(non-small cell lung cancer, NSCLC)约占肺癌的85%。间变性淋巴瘤激酶(anaplastic lymphoma kinase, ALK)重排阳性的NSCLC仅占全部NSCLC的5%,但预后较差,因此积极的治疗非常迫切。盐酸恩沙替尼胶囊(ensartinib hydrochloride capsule,X-396,商品名贝美纳TM)是第二代ALK抑制剂,对ALK的抑制活性和肺癌中枢神经系统转移的有效性较克唑替尼更强,并且可抑制多个克唑替尼耐药突变位点,临床拟用于治疗克唑替尼耐药的ALK阳性NSCLC。文中对盐酸恩沙替尼胶囊在国内外开展的Ⅰ期-Ⅲ期临床试验进行了总结,并对其药理作用、药代动力学和药效学、临床疗效和安全性评价进行了综述。
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Affiliation(s)
- Yang Wang
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Xiaobin Yuan
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Jiayan Xiong
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Zhidong Hao
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Xingzhe Peng
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Wanlin Chen
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Lingling Cui
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Hua Li
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Xiulan Wang
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Xiangbo He
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Min Yang
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Congxin Liang
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Yongbin Ma
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Lieming Ding
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
| | - Li Mao
- Betta Pharmaceuticals Co., Ltd, Hangzhou 311100, China
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Bi H, Ren D, Ding X, Yin X, Cui S, Guo C, Wang H. Clinical characteristics of patients with ROS1 gene rearrangement in non-small cell lung cancer: a meta-analysis. Transl Cancer Res 2020; 9:4383-4392. [PMID: 35117804 PMCID: PMC8797378 DOI: 10.21037/tcr-20-1813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/26/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND ROS1 gene rearrangement has been reported in several types of cancers, including non-small cell lung cancer (NSCLC). It is reported that tyrosine kinase inhibitors are effective in the treatment of ROS1-rearranged NSCLC. Therefore, the identification of ROS1 rearrangement can be used as potential therapeutic target in lung cancer. Epidemiological data indicates that ROS1 gene rearrangement occurs in approximately 1-2% of NSCLC patients. The small sample sizes of the existing associated studies only represent the characteristics of patients in specific regions or countries, and there is still no latest statistical analysis on ROS1 gene rearrangement anywhere in the world. METHODS We conducted a systematic search of the PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, CNKI, Wanfang, and VIP databases to identify studies on ROS1 gene rearrangement in NSCLC patients from January 1, 2015 to October 27, 2019. We conducted a meta-analysis to investigate the relationship between ROS1 gene rearrangement and clinical characteristics of NSCLC patients. The four clinical features are as follows: gender, smoking status, pathological type, and lung cancer stage. RESULTS Thirty-nine studies constituting of 25,055 NSCLC patients were eligible for inclusion in this meta-analysis. A prominently higher rate of ROS1 gene rearrangement was observed in female NSCLC patients (OR =1.94, 95% CI: 1.62-2.32%, P<0.05), patients with no smoking history (OR =2.82, 95% CI: 2.24-3.55%, P<0.05), patients with adenocarcinoma (OR =1.55, 95% CI: 1.14-2.11%, P<0.05), and patients with stage III-IV disease (OR =1.50, 95% CI: 1.15-1.94%, P<0.05). Our meta-analysis also showed that the prevalence of ROS1 rearrangement in adenocarcinoma was 2.49% (95% CI: 1.92-3.11%), while it was lower in non-adenocarcinoma patients (1.37%). CONCLUSIONS ROS1 gene rearrangement was more predominant in female patients, patients without smoking history, patients with adenocarcinoma and patients with advanced-stage disease (stages III to IV).
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Affiliation(s)
- Huanhuan Bi
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Dunqiang Ren
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Xiaoqian Ding
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Xiaojiao Yin
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Shichao Cui
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Caihong Guo
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Hongmei Wang
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
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Tan B, Jiang X, Wang R, Tang C, Liu S, Wu X, Xia L, Yu X, Yang Z. Genomic Profiling Reveals Synchronous Bilateral Lung Adenocarcinomas With Distinct Driver Alterations of EML4-ALK or TPM3-ROS1 Fusion: A Case Report. Front Oncol 2019; 9:1319. [PMID: 31828041 PMCID: PMC6890554 DOI: 10.3389/fonc.2019.01319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/12/2019] [Indexed: 12/31/2022] Open
Abstract
Background:ALK and ROS1 rearrangement accounts for 3–6% and 1–3% of non-small cell lung cancers, respectively, while coexistence of them in the same patient is extremely rare. Only three cases have ever been reported with concurrent ALK/ROS1 fusions in the same tumor indicating tumor heterogeneity. Therefore, comprehensive genetic profiling via next-generation sequencing (NGS) is needed to provide fully molecular diagnosis. Case Presentation: A 50-year old Chinese female with resectable stage IB bilateral lung adenocarcinomas (ADCs) harbored EML4 exon 6-ALK exon 19 and TPM3 exon 8-ROS1 exon 35 fusions in the right lower and the left upper tumors, respectively, identified by clinical NGS test targeting 425 cancer-relevant genes. The results were further confirmed at RNA level using RNA-seq. Genomic evolution analysis reveals that these bilateral tumors are synchronous multiple primary lung cancers with no shared somatic alterations for both genes and arm-level copy number variations (CNVs). No recurrence was observed during 12 months of post-surgery follow-up. Conclusions: Our case is the first report of concurrent ALK/ROS1 fusions as distinct driver events of synchronous multiple primary lung cancers, and highlights the importance of individual genetic testing for each of the multiple primary tumors for fully molecular diagnosis and precise treatment decision-making.
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Affiliation(s)
- Benxu Tan
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Jiang
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruping Wang
- Department of Research and Development, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Cuiping Tang
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Sisi Liu
- Department of Research and Development, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Xue Wu
- Translational Medicine Research Institute, Geneseeq Technology Inc., Toronto, ON, Canada
| | - Lei Xia
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xian Yu
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenzhou Yang
- Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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20
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Zhu YC, Zhang XG, Lin XP, Wang WX, Li XF, Wu LX, Chen HF, Xu CW, Du KQ. Clinicopathological features and clinical efficacy of crizotinib in Chinese patients with ROS1-positive non-small cell lung cancer. Oncol Lett 2019; 17:3466-3474. [PMID: 30867785 DOI: 10.3892/ol.2019.9949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/10/2018] [Indexed: 12/11/2022] Open
Abstract
C-ros oncogene 1 receptor tyrosine kinase (ROS1) rearrangement forms a novel molecular subgroup of non-small cell lung cancer (NSCLC). The present study explored the clinicopathological features and clinical efficacy of crizotinib in patients with ROS1-positive NSCLC. A retrospective analysis of 2,617 cases of NSCLC diagnosed between January 2013 and December 2016 was performed. ROS1 fusion genes were detected by reverse transcription-quantitative polymerase chain reaction, fluorescence in situ hybridization or next-generation sequencing techniques, and patients positive for the ROS1 fusion gene received oral treatment with crizotinib. The ROS1 fusion was identified in 67 out of 2,617 cases (2.56%), including 21 cases that were male and 46 cases that were female. The median age was 68 years. Among these cases, 59 (88.06%) were adenocarcinoma and 8 were non-adenocarcinoma. According to Tumor-Node-Metastasis (TNM) staging, 4 cases were stage I-IIIa and 63 (94.02%) were stage IIIb-IV. The epidermal growth factor receptor (EGFR) gene status included 60 cases of wild-type, 1 case of co-mutation and 6 unknown cases. Statistically significant differences were identified for sex, TNM staging and EGFR gene status between ROS1 fusion gene-positive and -negative patients (P<0.001). A total of 23 patients received oral treatment with crizotinib, of which 13 (56.52%), 5 (21.74%) and 5 (21.74%) patients demonstrated a partial response, stable disease and progressive disease, respectively. The objective response rate was 56.52% and the disease control rate was 78.26%. Among all patients, the median progression-free survival (mPFS) time was 14.5 months. No differences were revealed in the mPFS time with regard to age, sex, smoking history, performance status score, histopathological type, TNM staging, tumor protein p53 gene status, EGFR gene status and first-line crizotinib treatment, whether by single or multiple factor analysis. The grade 3/4 treatment-associated adverse events included gastrointestinal disturbance, followed by increased transaminase concentration. In conclusion, the rate of ROS1 fusion in NSCLC among the patients is low, and crizotinib is an effective and safe drug for the treatment of ROS1-positive advanced NSCLC.
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Affiliation(s)
- You-Cai Zhu
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
| | - Xin-Gen Zhang
- Department of Surgery, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
| | - Xue-Ping Lin
- Department of Pathology, Jiaxing University College of Medicine, Jiaxing, Zhejiang 314000, P.R. China
| | - Wen-Xian Wang
- Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Xiao-Feng Li
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
| | - Li-Xin Wu
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
| | - Hua-Fei Chen
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
| | - Chun-Wei Xu
- Department of Pathology, Fujian Provincial Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian 350014, P.R. China
| | - Kai-Qi Du
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang 314000, P.R. China
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