Summary of the top ten biomarkers that cancer doctors must not miss: ALK/ROS1

Compile: Tumor Information Editorial Department

Source: Tumor Information

ALK/ROS1 rearrangement is one of the important therapeutic targets for advanced NSCLC, currently targeting ALK/The ROS1 rearrangement has been approved for the corresponding targeted therapies. How to perform appropriate tests to identify patients with ALK/ROS1 rearrangement is the focus of clinical testing. The current approved methods for ALK/ROS1 rearrangement testing are detailed below.

Biological significance:

The activated ALK gene rearrangement fused the ALK gene to other genes, resulting in damaging apoptosis and abnormal cell proliferation.

Clinical significance:

ALK and ROS1 rearrangements are generally mutually exclusive in patients with NSCLC; the incidence of ALK gene fusion in patients with advanced NSCLC is 3-5%, ROS1 rearrangement The incidence in patients with advanced NSCLC is 1-2%.

Applicable tumor type:

Non-scale NSCLC (rare in patients with lung squamous cell carcinoma).

Current drug indications:

  • Crizotinib: ALK-positive or ROS1-positive metastatic NSCLC.
  • Seritinib: ALK-positive metastatic NSCLC.
  • Aletinib: ALK-positive metastatic NSCLC.
  • Brigatinib: ALK-positive metastatic NSCLC that progresses or is unable to tolerate crizotinib after treatment with crizotinib.

Test Recommendations:

Recommended for ALK rearrangement testing for recurrent or metastatic NSCLC, histological subtype for adenocarcinoma, large cell lung cancer or tissue The type of undetermined NSCLC, as well as non-smoking squamous cell carcinoma.

All non-adenocarcinoma patients are recommended for ROS1 testing regardless of their clinical characteristics. Positive ROS1 IHC detection should be confirmed by another molecular or cytogenetic method.

For non-adenocarcinoma patients, molecular markers can be considered when clinical features suggest that they are highly likely to be driving-positive patients.

Pathologists may use cell clumps or other cytological specimens as suitable specimens for lung cancer biomarker testing. Compared to other molecular assays, the FISH method is more suitable for detecting ALK and ROS1 rearrangements.

FDA-approved companion diagnosis

The top ten biomarkers not to be missed by oncologists: ALK/ROS1

Editor: Cancer Information-Grace

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