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Bebb DG, Agulnik J, Albadine R, Banerji S, Bigras G, Butts C, Couture C, Cutz JC, Desmeules P, Ionescu DN, Leighl NB, Melosky B, Morzycki W, Rashid-Kolvear F, Lab C, Sekhon HS, Smith AC, Stockley TL, Torlakovic E, Xu Z, Tsao MS. Crizotinib inhibition of ROS1-positive tumours in advanced non-small-cell lung cancer: a Canadian perspective. Curr Oncol 2019; 26:e551-e557. [PMID: 31548824 PMCID: PMC6726257 DOI: 10.3747/co.26.5137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The ros1 kinase is an oncogenic driver in non-small-cell lung cancer (nsclc). Fusion events involving the ROS1 gene are found in 1%-2% of nsclc patients and lead to deregulation of a tyrosine kinase-mediated multi-use intracellular signalling pathway, which then promotes the growth, proliferation, and progression of tumour cells. ROS1 fusion is a distinct molecular subtype of nsclc, found independently of other recognized driver mutations, and it is predominantly identified in younger patients (<50 years of age), women, never-smokers, and patients with adenocarcinoma histology. Targeted inhibition of the aberrant ros1 kinase with crizotinib is associated with increased progression-free survival (pfs) and improved quality-of-life measures. As the sole approved treatment for ROS1-rearranged nsclc, crizotinib has been demonstrated, through a variety of clinical trials and retrospective analyses, to be a safe, effective, well-tolerated, and appropriate treatment for patients having the ROS1 rearrangement. Canadian physicians endorse current guidelines which recommend that all patients with nonsquamous advanced nsclc, regardless of clinical characteristics, be tested for ROS1 rearrangement. Future integration of multigene testing panels into the standard of care could allow for efficient and cost-effective comprehensive testing of all patients with advanced nsclc. If a ROS1 rearrangement is found, treatment with crizotinib, preferably in the first-line setting, constitutes the standard of care, with other treatment options being investigated, as appropriate, should resistance to crizotinib develop.
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Affiliation(s)
- D G Bebb
- Alberta: Tom Baker Cancer Centre and University of Calgary, Calgary (Bebb); Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton (Bigras); Cross Cancer Institute and University of Alberta, Edmonton (Butts); Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Calgary Laboratory Services, Calgary (Rashid-Kolvear)
| | - J Agulnik
- Quebec: Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal (Agulnik); Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal (Albadine); Service d'anatomopathologie et de cytologie, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec City (Couture, Desmeules)
| | - R Albadine
- Quebec: Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal (Agulnik); Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal (Albadine); Service d'anatomopathologie et de cytologie, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec City (Couture, Desmeules)
| | - S Banerji
- Manitoba: Department of Medical Oncology, University of Manitoba, Winnipeg (Banerji)
| | - G Bigras
- Alberta: Tom Baker Cancer Centre and University of Calgary, Calgary (Bebb); Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton (Bigras); Cross Cancer Institute and University of Alberta, Edmonton (Butts); Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Calgary Laboratory Services, Calgary (Rashid-Kolvear)
| | - C Butts
- Alberta: Tom Baker Cancer Centre and University of Calgary, Calgary (Bebb); Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton (Bigras); Cross Cancer Institute and University of Alberta, Edmonton (Butts); Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Calgary Laboratory Services, Calgary (Rashid-Kolvear)
| | - C Couture
- Quebec: Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal (Agulnik); Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal (Albadine); Service d'anatomopathologie et de cytologie, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec City (Couture, Desmeules)
| | - J C Cutz
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
| | - P Desmeules
- Quebec: Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal (Agulnik); Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal (Albadine); Service d'anatomopathologie et de cytologie, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec City (Couture, Desmeules)
| | - D N Ionescu
- British Columbia: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver (Ionescu); BC Cancer-Vancouver Centre, Vancouver (Melosky)
| | - N B Leighl
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
| | - B Melosky
- British Columbia: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver (Ionescu); BC Cancer-Vancouver Centre, Vancouver (Melosky)
| | - W Morzycki
- Nova Scotia: Queen Elizabeth iiHealth Sciences Centre and Dalhousie University, Halifax (Morzycki, Xu)
| | - F Rashid-Kolvear
- Alberta: Tom Baker Cancer Centre and University of Calgary, Calgary (Bebb); Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton (Bigras); Cross Cancer Institute and University of Alberta, Edmonton (Butts); Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Calgary Laboratory Services, Calgary (Rashid-Kolvear)
- Quebec: Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal (Agulnik); Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal (Albadine); Service d'anatomopathologie et de cytologie, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Quebec City (Couture, Desmeules)
- Manitoba: Department of Medical Oncology, University of Manitoba, Winnipeg (Banerji)
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
- British Columbia: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver (Ionescu); BC Cancer-Vancouver Centre, Vancouver (Melosky)
- Nova Scotia: Queen Elizabeth iiHealth Sciences Centre and Dalhousie University, Halifax (Morzycki, Xu)
- Saskatchewan: Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority and University of Saskatchewan, Saskatoon (Torlakovic)
| | - Clin Lab
- Alberta: Tom Baker Cancer Centre and University of Calgary, Calgary (Bebb); Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton (Bigras); Cross Cancer Institute and University of Alberta, Edmonton (Butts); Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, and Calgary Laboratory Services, Calgary (Rashid-Kolvear)
| | - H S Sekhon
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
| | - A C Smith
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
| | - T L Stockley
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
| | - E Torlakovic
- Saskatchewan: Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority and University of Saskatchewan, Saskatoon (Torlakovic)
| | - Z Xu
- Nova Scotia: Queen Elizabeth iiHealth Sciences Centre and Dalhousie University, Halifax (Morzycki, Xu)
| | - M S Tsao
- Ontario: St. Joseph's Healthcare, Hamilton Regional Laboratory Medicine Program, Department of Pathology and Molecular Medicine, McMaster University, Hamilton (Cutz); Princess Margaret Cancer Centre, University of Toronto, Toronto (Leighl); Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa (Sekhon); Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto (Smith, Stockley); Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto (Tsao)
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