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- W4361952404 abstract "<div>Abstract<p><b>Purpose:</b> Despite initial benefit from tyrosine kinase inhibitors (TKIs), patients with advanced non–small cell lung cancer (NSCLC) harboring <i>ALK</i> (ALK<sup>+</sup>) and <i>ROS1</i> (ROS1<sup>+</sup>) gene fusions ultimately progress. Here, we report on the potential resistance mechanisms in a series of patients with ALK<sup>+</sup> and ROS1<sup>+</sup> NSCLC progressing on different types and/or lines of <i>ROS1/ALK</i>–targeted therapy.</p><p><b>Experimental Design:</b> We used a combination of next-generation sequencing (NGS), multiplex mutation assay, direct DNA sequencing, RT-PCR, and FISH to identify fusion variants/partners and copy-number gain (CNG), kinase domain mutations (KDM), and copy-number variations (CNVs) in other cancer-related genes. We performed testing on 12 <i>ROS1<sup>+</sup></i> and 43 <i>ALK<sup>+</sup></i> patients.</p><p><b>Results:</b> One of 12 ROS1<sup>+</sup> (8%) and 15 of 43 (35%) ALK<i><sup>+</sup></i> patients harbored KDM. In the ROS1<sup>+</sup> cohort, we identified <i>KIT</i> and β-catenin mutations and HER2-mediated bypass signaling as non-ROS1–dominant resistance mechanisms. In the ALK<sup>+</sup> cohort, we identified a novel <i>NRG1</i> gene fusion, a <i>RET</i> fusion, 2 <i>EGFR</i>, and 3 <i>KRAS</i> mutations, as well as mutations in <i>IDH1, RIT1, NOTCH</i>, and <i>NF1</i>. In addition, we identified CNV in multiple proto-oncogenes genes including <i>PDGFRA, KIT, KDR, GNAS, K/HRAS, RET, NTRK1, MAP2K1,</i> and others.</p><p><b>Conclusions:</b> We identified a putative TKI resistance mechanism in six of 12 (50%) ROS1<i><sup>+</sup></i> patients and 37 of 43 (86%) ALK<sup>+</sup> patients. Our data suggest that a focus on KDMs will miss most resistance mechanisms; broader gene testing strategies and functional validation is warranted to devise new therapeutic strategies for drug resistance. <i>Clin Cancer Res; 24(14); 3334–47. ©2018 AACR</i>.</p></div>" @default.
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- W4361952404 date "2023-03-31" @default.
- W4361952404 modified "2023-09-26" @default.
- W4361952404 title "Data from Resistance Mechanisms to Targeted Therapies in <i>ROS1</i><sup>+</sup> and <i>ALK</i><sup>+</sup> Non–small Cell Lung Cancer" @default.
- W4361952404 doi "https://doi.org/10.1158/1078-0432.c.6525788.v1" @default.
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