ROS1-mutated NSCLC with an Uncommon Fusion Partner Treated with Crizotinib - From an Initial Good Response to Acquired Resistance and Rapid Progression

Chien-Yu Lin ； Chia-Hao Hu ； Che-Wei Hsu ； Chien-Chung Lin

《胸腔醫學》 37卷4期 (2022/12) Pp. 288-294

摘要

ROS1+ non-small cell lung cancer (NSCLC) is a heterogeneous disease with at least 24 distinct fusion partners and five fusion partners (CD74, SLC34A2, SDC4, ERZ, and TPM3) primarily made up of the ROS1+ patients with NSCLC. A recent study proposed that ROS1 fusion partners may be classified as CD74-ROS1 and non-CD74-ROS1, since these 2 groups have different responses to crizotinib, and a predilection for central nervous system metastasis. Intergenic-breakpoint fusions are defined as 1 or both genomic breakpoints localizing to the intergenic regions; however, whether these intergenic-breakpoint fusions can be activated or not remains unresolved. Here, we reported a case of advanced ROS1 fusion gene rearrangement lung adenocarcinoma, which initially responded to crizotinib, but then recurred within 3 months. The DNA next-generation sequencing for liquid biopsy showed G2032R and L2026M mutations, and an uncommon ROS1 fusion with an intron (ROS1-LOC100505984 rearrangement); however, the patient did not respond to cabozantinib, and instead experienced disease progression.

關鍵字

Crizotinib ； Cabozantinib ； uncommon fusion partner ； intergenic-breakpoint fusion ； intron