4.4 Review

Fusion-positive non-small cell lung carcinoma: Biological principles, clinical practice, and diagnostic implications

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Identification of NTRK gene fusions in lung adenocarcinomas in the Chinese population

Ruiying Zhao et al.

Summary: Functional NTRK fusions are rare but present in early-stage LUAD. They are independent oncogenic drivers and mutually exclusive with other driver mutations. NTRK rearrangement analysis should be verified with an RNA-based assay.

JOURNAL OF PATHOLOGY CLINICAL RESEARCH (2021)

Article Oncology

FDA Approval Summary: Pralsetinib for the Treatment of Lung and Thyroid Cancers With RET Gene Mutations or Fusions

Janice Kim et al.

Summary: The FDA granted accelerated approval for pralsetinib for non-small cell lung cancer and thyroid cancer, based on substantial overall response rates and durable responses in patients with RET-altered tumors. However, the product label includes warnings and precautions for various adverse events and risks.

CLINICAL CANCER RESEARCH (2021)

Article Oncology

Prolonged Disease Control on Nivolumab for Primary Pulmonary NUT Carcinoma

Alexander Davis et al.

Summary: In young never-smoking patients with primary lung squamous cell carcinoma, consideration should be given to the presence of pulmonary nuclear protein in testis (NUT) and the exclusion of this factor. Further investigation into the control of pulmonary NUT with immunotherapy and the use of immune checkpoint inhibitors in this histologic group is warranted. In young patients without a clear smoking history, the availability of complex genomic testing platforms is crucial for understanding disease biology and enabling personalized medicine.

CLINICAL LUNG CANCER (2021)

Article Cell Biology

Validation of ROS1 by immunohistochemistry against fluorescent in situ hybridisation on cytology and small biopsy samples in a large teaching hospital

Nadira Narine et al.

Summary: Immunohistochemistry (IHC) for ROS1 protein product on cytology cell blocks and small biopsy samples is a promising screening method for assessing eligibility for TKI treatment, with good negative predictive value, faster turnaround time, and cost effectiveness. Positive and indeterminate cases can be confirmed by FISH or NGS.

CYTOPATHOLOGY (2021)

Article Immunology

Efficacy of immune checkpoint inhibitor therapy in patients with RET fusion-positive non-small-cell lung cancer

Naleen Raj Bhandari et al.

Summary: This study investigated outcomes of RET fusion-positive NSCLC patients receiving ICI-based treatments in the US, finding them consistent with unselected populations. Despite limitations in sample size, it provides insights into survival outcomes of this specific patient subgroup.

IMMUNOTHERAPY (2021)

Article Oncology

Clinicopathologic Features and Response to Therapy of NRG1 Fusion-Driven Lung Cancers: The eNRGy1 Global Multicenter Registry

Alexander Drilon et al.

Summary: The study found that NRG1 fusion-positive lung cancers are more heterogeneous in molecular, pathological, and clinical aspects than previously recognized, with disappointing responses to cytotoxic, immune, and targeted therapies, indicating a need for further research in developing new therapeutic strategies targeting NRG1-rearranged tumors.

JOURNAL OF CLINICAL ONCOLOGY (2021)

Article Pathology

Diagnostic Utility of Gene Fusion Panel to Detect Gene Fusions in Fresh and Formalin-Fixed, Paraffin-Embedded Cancer Specimens

Lisa Haley et al.

Summary: The study demonstrates the high sensitivity and specificity of NanoString fusion assays in a clinical diagnostics laboratory, which is crucial for diagnosing leukemias/lymphomas and solid tumors.

JOURNAL OF MOLECULAR DIAGNOSTICS (2021)

Article Oncology

SMARCA4 and Other SWItch/Sucrose NonFermentable Family Genomic Alterations in NSCLC: Clinicopathologic Characteristics and Outcomes to Immune Checkpoint Inhibition

Joao V. Alessi et al.

Summary: Mutations in SWI/SNF chromatin remodeling complex genes are closely related to clinical characteristics and prognosis of NSCLC patients, especially in relation to the efficacy of immune checkpoint inhibitors. Among these mutations, SMARCA4 alterations may affect the immunotherapy outcomes in KRAS-mutant NSCLC patients.

JOURNAL OF THORACIC ONCOLOGY (2021)

Article Medicine, Research & Experimental

Molecular characteristics and clinical outcomes of complex ALK rearrangements identified by next-generation sequencing in non-small cell lung cancers

Peiyi Xia et al.

Summary: This study identified complex ALK rearrangements in NSCLC, with 14 cases classified into three types. All cases expressed canonical EML4-ALK fusion transcripts confirmed by RNA-based NGS. Patients with complex ALK rearrangements treated with ALK inhibitors showed no difference in progression-free survival compared to those with canonical ALK fusions.

JOURNAL OF TRANSLATIONAL MEDICINE (2021)

Article Oncology

Pralsetinib for RET fusion-positive non-small-cell lung cancer (ARROW): a multi-cohort, open-label, phase 1/2 study

Justin F. Gainor et al.

Summary: The study demonstrated that pralsetinib is a new, well-tolerated, promising, once-daily oral treatment option for patients with RET fusion-positive NSCLC.

LANCET ONCOLOGY (2021)

Article Oncology

Going beneath the tip of the iceberg. Identifying and understanding EML4-ALK variants and TP53 mutations to optimize treatment of ALK fusion positive (ALK plus ) NSCLC

Shannon S. Zhang et al.

Summary: This study discusses the impact of EML4-ALK variants on NSCLC and response to ALK TKIs. EML4-ALK 1 and 3 are the most common variants, dominant in ALK+ NSCLC. Short (v3 and v5) and long (v1, v2, v5', v7, and v8) EML4-ALK variants show differential response to TKIs.

LUNG CANCER (2021)

Review Medical Laboratory Technology

NUT carcinoma of the lung

Sylvie Lantuejoul et al.

Summary: Thoracic NUT carcinoma is a rare and highly aggressive tumor defined by the fusion of the NUTM1 gene with partners from the bromodomain-containing proteins gene family. Diagnosis is based on detecting NUT protein expression, with poor prognosis and limited response to conventional chemotherapy.

SEMINARS IN DIAGNOSTIC PATHOLOGY (2021)

Article Pathology

Status quo of ALK testing in lung cancer: results of an EQA scheme based on in-situ hybridization, immunohistochemistry, and RNA/DNA sequencing

Philipp Jurmeister et al.

Summary: This study aimed to investigate the diagnostic performance of different methods for detecting ALK alterations in non-small cell lung cancer on a national scale. The results showed that RNA/DNA sequencing had the highest sensitivity and concordance among the methods tested.

VIRCHOWS ARCHIV (2021)

Article Biotechnology & Applied Microbiology

A Novel KIF5B-EGFR Fusion Variant in Non-Small-Cell Lung Cancer and Response to Afatinib: A Case Report

Xia Wang et al.

Summary: EGFR fusions are rare genomic events in NSCLC with no standard treatment options, but TKIs have shown promising results in patients with rare fusions like KIF5B-EGFR, leading to partial responses and extended PFS. Utilizing NGS for the identification of uncommon EGFR mutations in NSCLC patients is crucial for personalized treatment strategies.

ONCOTARGETS AND THERAPY (2021)

Review Cell Biology

Perspectives and Issues in the Assessment of SMARCA4 Deficiency in the Management of Lung Cancer Patients

Subasri Armon et al.

Summary: In France in 2020, lung cancers, particularly adenocarcinomas, ranked third in cancer incidence, with a focus on the tumor suppressor gene SMARCA4, impacting younger male smokers. These SMARCA4-deficient adenocarcinomas display aggressive behavior, leading to poor clinical outcomes despite early detection.

CELLS (2021)

Article Oncology

Peripheral Lung Squamous Carcinoma With ROS1 Rearrangement Sensitive to Crizotinib: A Case Report

Guangdie Yang et al.

Summary: ROS1 rearrangements are rare in lung squamous cell carcinoma, but can be effectively targeted with crizotinib. Clinicians should consider testing for ROS1 rearrangements and using crizotinib in the treatment of lung squamous cell carcinoma.

FRONTIERS IN ONCOLOGY (2021)

Review Oncology

Targeted Therapy for RET Fusion Lung Cancer: Breakthrough and Unresolved Issue

Shinkichi Takamori et al.

Summary: This article summarizes the use of molecular drugs targeting mutated or rearranged oncogenes in patients with non-small cell lung cancer, focusing on the efficacy and adverse events of multikinase inhibitors and selective RET inhibitors for RET gene fusion, as well as various diagnostic techniques for detecting RET gene fusion.

FRONTIERS IN ONCOLOGY (2021)

Article Oncology

Detection of ALK fusion transcripts in plasma of non-small cell lung cancer patients using a novel RT-PCR based assay

Simon Heeke et al.

Summary: The study evaluated a novel RT-PCR-based detection method for ALK rearrangements in plasma of NSCLC patients, demonstrating limited sensitivity but high specificity at baseline and disease progression. Therefore, this detection method could potentially be considered for selecting patients for ALK-targeted therapy when tissue samples are lacking.

ANNALS OF TRANSLATIONAL MEDICINE (2021)

Review Medical Laboratory Technology

Pan-TRK Immunohistochemistry An Example-Based Practical Approach to Efficiently Identify Patients With NTRK Fusion Cancer

Esther Conde et al.

Summary: Identification of NTRK fusions remains a challenge, with highly recurrent alterations in rare malignancies. The use of pan-TRK IHC can assist pathologists in detecting these fusions across various histologies.

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE (2021)

Article Oncology

Earlier extracranial progression and shorter survival in ALK-rearranged lung cancer with positive liquid rebiopsies

Petros Christopoulos et al.

Summary: Positive liquid rebiopsies in ALK(+) NSCLC characterize biologically more aggressive disease, commonly associated with extracranial progression, but rare with CNS-only progression or benign changes. Liquid rebiopsies can guide therapy, affecting patient survival and progression-free survival on subsequent treatments.

TRANSLATIONAL LUNG CANCER RESEARCH (2021)

Article Oncology

Out-of-Pocket Costs for Tyrosine Kinase Inhibitors and Patient Outcomes in EGFR- and ALK-Positive Advanced Non-Small-Cell Lung Cancer

Bernardo H. L. Goulart et al.

Summary: The study aimed to investigate the association between TKI out-of-pocket costs and overall survival in EGFR- and ALK-positive NSCLC patient, and the results showed higher TKI out-of-pocket costs are associated with decreased TKI adherence, increased likelihood of TKI discontinuation, and inferior survival.

JCO ONCOLOGY PRACTICE (2021)

Review Oncology

The Road Less Traveled: A Guide to Metastatic ROS1-Rearranged Non-Small-Cell Lung Cancer

Daniel Almquist et al.

Summary: Significant advances have been made in the diagnostic testing, treatment, and prognosis of advanced non-small-cell lung cancer (NSCLC) over the past decade, particularly in identifying specific gene alterations that define subsets of NSCLC. Current therapies for advanced ROS1-rearranged NSCLC, such as crizotinib and entrectinib, have shown promising results, while next-generation inhibitors are being developed to overcome resistance mutations and improve efficacy, especially in CNS metastases cases.

JCO ONCOLOGY PRACTICE (2021)

Article Oncology

Lorlatinib in pretreated ALK- or ROS1-positive lung cancer and impact of TP53 co-mutations: results from the German early access program

Nikolaj Frost et al.

Summary: The study reports the results of the German early access program with the third-generation ALK- and ROS1-inhibitor lorlatinib, demonstrating its efficacy in heavily pretreated patients and providing a meaningful option for those with resistance mutations not covered by other targeted therapies or with brain metastases or leptomeningeal carcinomatosis. TP53 mutations were associated with reduced progression-free survival and identified as a strong prognostic biomarker, while prior treatments and brain metastases had no significant influence on outcomes.

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY (2021)

Article Oncology

Targeted Next-Generation Sequencing Analysis for Recurrence in Early-Stage Lung Adenocarcinoma

In Ae Kim et al.

Summary: Targeted NGS was used to identify genetic alterations predicting recurrence in early-stage lung adenocarcinoma. CTNNB1 mutation and fusion genes (ALK, ROS1, RET) were negative prognostic factors, while EGFR mutation was favorable. TP53 mutation was a negative predictor compared to EGFR mutation for recurrence.

ANNALS OF SURGICAL ONCOLOGY (2021)

Article Medical Laboratory Technology

Correlation of ROS1 Immunohistochemistry With ROS1 Fusion Status Determined by Fluorescence In Situ Hybridization

Richard S. P. Huang et al.

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE (2020)

Review Biochemical Research Methods

The pre-analytical phase of the liquid biopsy

Francesca Salvianti et al.

NEW BIOTECHNOLOGY (2020)

Article Oncology

State-of-the-Art Strategies for Targeting RET-Dependent Cancers

Vivek Subbiah et al.

JOURNAL OF CLINICAL ONCOLOGY (2020)

Review Medicine, General & Internal

Artificial intelligence as the next step towards precision pathology

B. Acs et al.

JOURNAL OF INTERNAL MEDICINE (2020)

Article Oncology

Clinicopathologic Characteristics of BRG1-De fi cient NSCLC

Ibiayi Dagogo-Jack et al.

JOURNAL OF THORACIC ONCOLOGY (2020)

Article Genetics & Heredity

Specialized Blood Collection Tubes for Liquid Biopsy: Improving the Pre-analytical Conditions

Laure Sorber et al.

MOLECULAR DIAGNOSIS & THERAPY (2020)

Article Biochemistry & Molecular Biology

Sequencing Strategies for Fusion Gene Detection

Erin E. Heyer et al.

BIOESSAYS (2020)

Review Pathology

Artificial Intelligence in Pathology: A Simple and Practical Guide

Keluo Yao et al.

ADVANCES IN ANATOMIC PATHOLOGY (2020)

Letter Oncology

Challenges in the Diagnosis of NTRK Fusion-Positive Cancers

Oliver Gautschi et al.

JOURNAL OF THORACIC ONCOLOGY (2020)

Article Medicine, General & Internal

Osimertinib in Resected EGFR-Mutated Non-Small-Cell Lung Cancer

Yi-Long Wu et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

Article Biotechnology & Applied Microbiology

KIF5B-EGFR Fusion: A Novel EGFR Mutation in Lung Adenocarcinoma

Hui Xu et al.

ONCOTARGETS AND THERAPY (2020)

Review Oncology

Decade in review: a new era for RET-rearranged lung cancers

Noura J. Choudhury et al.

TRANSLATIONAL LUNG CANCER RESEARCH (2020)

Review Oncology

How selecting best upfront therapy for metastatic disease?-Focus on ROS1-rearranged disease

Lorenza Landi et al.

TRANSLATIONAL LUNG CANCER RESEARCH (2020)

Article Oncology

Identification of a highly lethal V3+TP53+ subset in ALK+ lung adenocarcinoma

P. Christopoulos et al.

INTERNATIONAL JOURNAL OF CANCER (2019)

Review Biochemical Research Methods

Pre-analytical processes in medical diagnostics: New regulatory requirements and standards

Georges Dagher et al.

NEW BIOTECHNOLOGY (2019)

Article

Defining molecular risk in ALK+ NSCLC

Petros Christopoulos et al.

Oncotarget (2019)

Article Medical Laboratory Technology

Preanalytics and Precision Pathology Pathology Practices to Ensure Molecular Integrity of Cancer Patient Biospecimens for Precision Medicine

Carolyn C. Compton et al.

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE (2019)

Article Medicine, General & Internal

Blood sample quality

Giuseppe Lippi et al.

DIAGNOSIS (2019)

Article Medicine, Research & Experimental

Serial liquid biopsies for detection of treatment failure and profiling of resistance mechanisms in KLC1-ALK-rearranged lung cancer

Steffen Dietz et al.

COLD SPRING HARBOR MOLECULAR CASE STUDIES (2019)

Article Oncology

Rediagnosis of Lung Cancer as NUT Midline Carcinoma Based on Clues From Tumor Genomic Profiling

Alexander S. Baras et al.

JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK (2018)

Letter Oncology

EGFR-RAD51 Fusion: A Targetable Partnership Originated from the Tumor Evolution?

Luis E. Raez et al.

JOURNAL OF THORACIC ONCOLOGY (2018)

Review Oncology

Clinical and Translational Implications of RET Rearrangements in Non-Small Cell Lung Cancer

Roberto Ferrara et al.

JOURNAL OF THORACIC ONCOLOGY (2018)

Editorial Material Respiratory System

EML4-ALK V3, treatment resistance, and survival: refining the diagnosis of ALK+ NSCLC

Petros Christopoulos et al.

JOURNAL OF THORACIC DISEASE (2018)

Article Oncology

Clinicopathologic Features of Non-Small-Cell Lung Cancer Harboring an NTRK Gene Fusion

Anna F. Farago et al.

JCO PRECISION ONCOLOGY (2018)

Article Biochemistry & Molecular Biology

Mutational landscape of metastatic cancer revealed from prospective clinical sequencing of 10,000 patients

Ahmet Zehir et al.

NATURE MEDICINE (2017)

Article Pathology

Pan-Trk Immunohistochemistry Is an Efficient and Reliable Screen for the Detection of NTRK Fusions

Jaclyn F. Hechtman et al.

AMERICAN JOURNAL OF SURGICAL PATHOLOGY (2017)

Review Oncology

Beyond ALK and ROS1: RET, NTRK, EGFR and BRAF gene rearrangements in non-small cell lung cancer

Anna F. Farago et al.

TRANSLATIONAL LUNG CANCER RESEARCH (2017)

Article Oncology

High-Throughput Diagnostic Profiling of Clinically Actionable Gene Fusions in Lung Cancer

Nicole Pfarr et al.

GENES CHROMOSOMES & CANCER (2016)

Article Oncology

The distribution of BRAF gene fusions in solid tumors and response to targeted therapy

Jeffrey S. Ross et al.

INTERNATIONAL JOURNAL OF CANCER (2016)

Article Oncology

EGFR Fusions as Novel Therapeutic Targets in Lung Cancer

Kartik Konduri et al.

CANCER DISCOVERY (2016)

Review Oncology

FGFR3-TACC3 fusion in solid tumors: mini review

Ricardo Costa et al.

ONCOTARGET (2016)

Article Oncology

NRG1 fusion in a French cohort of invasive mucinous lung adenocarcinoma

Michael Duruisseaux et al.

CANCER MEDICINE (2016)

Article Oncology

Intratumoral Heterogeneity of ALK-Rearranged and ALK/EGFR Coaltered Lung Adenocarcinoma

Weijing Cai et al.

JOURNAL OF CLINICAL ONCOLOGY (2015)

Article Oncology

Molecular Mechanisms Underlying Oncogenic RET Fusion in Lung Adenocarcinoma

Tatsuji Mizukami et al.

JOURNAL OF THORACIC ONCOLOGY (2014)

Article Oncology

Identification of Targetable FGFR Gene Fusions in Diverse Cancers

Yi-Mi Wu et al.

CANCER DISCOVERY (2013)

Article Biochemistry & Molecular Biology

The transcriptional landscape and mutational profile of lung adenocarcinoma

Jeong-Sun Seo et al.

GENOME RESEARCH (2012)

Article Oncology

Long-Term Survival of a Patient with Squamous Cell Carcinoma Harboring NUT Gene Rearrangement

Naomi Fujioka et al.

JOURNAL OF THORACIC ONCOLOGY (2010)