Australian consensus statement for best practice ROS1 testing in advanced non-small cell lung cancer

Lung cancer is the most commonly diagnosed malignancy and the leading cause of death from cancer globally. Diagnosis of advanced non-small cell lung cancer (NSCLC) is associated with 5-year relative survival of 3.2%. ROS proto-oncogene 1 (ROS1) is an oncogenic driver of NSCLC occurring in up to 2% o...

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Veröffentlicht in:Pathology 2019-12, Vol.51 (7), p.673-680
Hauptverfasser: Pavlakis, Nick, Cooper, Caroline, John, Thomas, Kao, Steven, Klebe, Sonja, Lee, Chee Khoon, Leong, Trishe, Millward, Michael, O'Byrne, Ken, Russell, Prudence A., Solomon, Benjamin, Cooper, Wendy A., Fox, Stephen
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container_end_page 680
container_issue 7
container_start_page 673
container_title Pathology
container_volume 51
creator Pavlakis, Nick
Cooper, Caroline
John, Thomas
Kao, Steven
Klebe, Sonja
Lee, Chee Khoon
Leong, Trishe
Millward, Michael
O'Byrne, Ken
Russell, Prudence A.
Solomon, Benjamin
Cooper, Wendy A.
Fox, Stephen
description Lung cancer is the most commonly diagnosed malignancy and the leading cause of death from cancer globally. Diagnosis of advanced non-small cell lung cancer (NSCLC) is associated with 5-year relative survival of 3.2%. ROS proto-oncogene 1 (ROS1) is an oncogenic driver of NSCLC occurring in up to 2% of cases and commonly associated with younger age and a history of never or light smoking. Results of an early trial with the tyrosine kinase inhibitor (TKI) crizotinib that inhibits tumours that harbour ROS1 rearrangements have shown an objective response rate (ORR) of 72% (95% CI 58–83%), median progression free survival (PFS) of 19.3 months (95% CI 15.2–39.1 months) and median overall survival (OS) of 51.4 months (95% CI 29.3 months to not reached). Therefore, with the availability of highly effective ROS1-targeted TKI therapy, upfront molecular testing for ROS1 status alongside EGFR and ALK testing is recommended for all patients with NSCLC. We review the tissue requirements for ROS1 testing by immunohistochemistry (IHC) and fluorescent in situ hybridisation (FISH) and we present a testing algorithm for advanced NSCLC and consider how the future of pathology testing for ROS1 may evolve.
doi_str_mv 10.1016/j.pathol.2019.08.006
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Diagnosis of advanced non-small cell lung cancer (NSCLC) is associated with 5-year relative survival of 3.2%. ROS proto-oncogene 1 (ROS1) is an oncogenic driver of NSCLC occurring in up to 2% of cases and commonly associated with younger age and a history of never or light smoking. Results of an early trial with the tyrosine kinase inhibitor (TKI) crizotinib that inhibits tumours that harbour ROS1 rearrangements have shown an objective response rate (ORR) of 72% (95% CI 58–83%), median progression free survival (PFS) of 19.3 months (95% CI 15.2–39.1 months) and median overall survival (OS) of 51.4 months (95% CI 29.3 months to not reached). Therefore, with the availability of highly effective ROS1-targeted TKI therapy, upfront molecular testing for ROS1 status alongside EGFR and ALK testing is recommended for all patients with NSCLC. 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subjects Australia
biomarker testing
Biomarkers - analysis
Carcinoma, Non-Small-Cell Lung - diagnosis
Carcinoma, Non-Small-Cell Lung - genetics
Carcinoma, Non-Small-Cell Lung - pathology
consensus
Crizotinib - pharmacology
Gene Rearrangement
Humans
Immunohistochemistry
In Situ Hybridization, Fluorescence
Lung Neoplasms - diagnosis
Lung Neoplasms - genetics
Lung Neoplasms - pathology
Non-small cell lung cancer
Protein Kinase Inhibitors - pharmacology
Protein-Tyrosine Kinases - antagonists & inhibitors
Protein-Tyrosine Kinases - genetics
Protein-Tyrosine Kinases - metabolism
Proto-Oncogene Proteins - antagonists & inhibitors
Proto-Oncogene Proteins - genetics
Proto-Oncogene Proteins - metabolism
ROS1
title Australian consensus statement for best practice ROS1 testing in advanced non-small cell lung cancer
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