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Xingliang Li
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EP1.14 - Targeted Therapy (ID 204)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 2
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.14-45 - ROS1-ADGRG6: A Novel ROS1 Oncogenic Fusion Variant in Lung Adenocarcinoma and the Response to Crizotinib (ID 96)
08:00 - 18:00 | Author(s): Xingliang Li
- Abstract
Background
ROS1 rearrangements are validated driver genes in non-small cell lung cancer (NSCLC) and have been identified in a small subset (1%-2%) of patients with NSCLC. To date, 18 different fusion genes of ROS1 in NSCLC have been identified. The ALK inhibitor, crizotinib, exhibits therapeutic efficacy against ROS1-rearranged NSCLC. In addition to immunohistochemistry, real-time PCR, and fluorescence in situ hybridization, next-generation sequencing (NGS) technology represents a novel tool for ROS1 detection that covers a wide range of fusion genes.
Method
A 55-year-old female with stage IV was detected with a novel ROS1 fusion afther treated with gefitinib due to detection of an EGFR mutation (L858R). Histological examination was consistent with lung adenocarcinoma.
Result
A NGS assay showed that the tumor had a novel ROS1-ADGRG6 rearrangement generated by the fusion of exons of 1-33 of ROS1 on chr6: q22.1 to exons of 2-26 of ADGRG6 on chr6: q24.2. The predicted ROS1-ADGRG6 protein product contained 3075 amino acids comprising the N-terminal amino acids 1-1853 of ROS1 and C-terminal amino acid 1-1222 of ADGRG6. The patient had a favorable tumor response to crizotinib.
Conclusion
ROS1-ADGRG6 is a novel ROS1 fusion gene in NSCLC detected by NGS and should be considered in ROS1 detection assays.
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EP1.14-47 - Lung Adenocarcinoma with Concurrent KRAS Mutation and ALK Rearrangement Responding to Crizotinib (ID 108)
08:00 - 18:00 | Author(s): Xingliang Li
- Abstract
Background
Chromosomal translocation resulting in the fusion between the echinoderm microtubule-associated protein-like 4 (EML4) gene and the anaplastic lymphoma kinase (ALK) gene has been considered as a novel oncogenic fusion in a subset of non-small cell lung cancer (NSCLC), mostly in non-smokers with adenocarcinoma. EML4-ALK translocations are commonly reported to be mutually exclusive with EGFR or KRAS mutations.
Method
We reported a rare case of 47-year-old female was diagnosed with lung adenocarcinoma and treated with three cycles of chemotherapy. A biopsy acquired after disease progression revealed concurrent KRAS mutation and ALK translocation by a NGS assay.
Result
Based on molecular findings, treatment was initiated with crizotinib in September, 2016. After 2 months of therapy, the patient achieved a partial response. Afterwards, the patient was further administrated with crizotinib for 9 months with a stable disease before tumor progression.
Conclusion
A further understanding of the molecular biology with multiple oncogenic drivers will promote the optimal treatment for NSCLC.