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ROS1-rearranged pulmonary carcinoma
Friday 15 March 2013
ROS1-rearranged Lung Cancer; ROS1-associated pulmonary adenocarcinoma
Recent discovery of ROS1 gene fusion in a subset of lung cancers has raised clinical interest, because ROS1 fusion-positive cancers are reportedly sensitive to kinase inhibitors.
2.5% of adenocarcinomas harbor ROS1 fusion transcripts.
The most frequent fusion partner is CD74 followed by EZR.
The affected patients are often younger non-smoking female individuals, and they had overall survival rates similar to those of the ROS1 fusion-negative cancer patients.
All the ROS1 fusion-positive tumors are adenocarcinomas except rare adenosquamous carcinomas.
Histologic examination identified an at least focal presence of either solid growth with signet-ring cells or cribriform architecture with abundant extracellular mucus in 53% of the cases.
These 2 patterns are reportedly also characteristic of anaplastic lymphoma kinase (ALK)-rearranged lung cancers, and our data suggest a phenotypic resemblance between the ROS1-rearranged and ALK-rearranged tumors.
Nearly all tumors are immunoreactive to thyroid transcription factor-1.
Fluorescence in situ hybridization using ROS1 break-apart probes reveals positive rearrangement signals in 23% to 93% of the tumor cells in ROS1 fusion-positive cancers.
All ROS1 fusion-positive tumors lack alteration of EGFR, KRAS, HER2, ALK, and RET genes.
Conditions for ROS1 FISH
metastatic pulmonary adenocarcinoma non-smoking patient others biomarkers negative: EGFR, KRAS, BRAF, HER2, ALK
References
ROS1-Rearranged Lung Cancer: A Clinicopathologic and Molecular Study of 15 Surgical Cases. Yoshida A, Kohno T, Tsuta K, Wakai S, Arai Y, Shimada Y, Asamura H, Furuta K, Shibata T, Tsuda H. Am J Surg Pathol. 2013 Apr;37(4):554-62. doi: 10.1097/PAS.0b013e3182758fe6 . PMID: #23426121#
