Fusion proteins in lung cancer: addressing diagnostic problems for deciding therapy. Issue 8 (3rd August 2021)

• Record Type: Journal Article
• Authors: Zito Marino, Federica; Alì, Greta; Facchinetti, Francesco; Righi, Luisella; Fontanini, Gabriella; Rossi, Giulio; Franco, Renato
• Is Part Of: Expert review of anticancer therapy. Volume 21:Issue 8(2021)
• Page Start: 887
• Page End: 900
• Publication Date: 2021-08-03
• Subjects: ALK-rearrangements -- fluorescence in situ hybridization (FISH) -- immunohistochemistry (IHC) -- next generation sequencing (NGS) -- NTRK-rearrangements -- RET-rearrangements -- ROS1-rearrangements -- tyrosine kinase inhibitors; Cancer -- Treatment -- Periodicals; 616.99406
• DOI: 10.1080/14737140.2021.1903875
• Languages: English
• ISSNs: 1473-7140

Abstract

ABSTRACT: Introduction : Gene fusions are frequent chromosomal aberrations in solid tumors. In Lung cancer (LC) several druggable-fusions involving tyrosine kinase receptor genes have been described, including ALK, ROS1, RET and NTRK. In non-small cell lung cancer, testing for targetable fusions has become a part of routine clinical practice, greatly impacting therapeutic choice for patients with these aberrations. Although substantial technologies for gene fusion detection have been implemented over time including; cytogenetic, Fluorescence in situ hybridization (FISH), Immunohistochemistry (IHC), Retro-transcription Real-Time PCR (RT-qPCR), to Next Generation Sequencing (NGS), nCounter system (Nanostring technology), several critical issues remain. To date, only the companion diagnostic tests FISH and IHC for ALK-rearrangements and NGS for ROS1-rearrangments were approved. Other fusion approved tests are currently unavailable. Areas covered : In this review, we explore current diagnostic problems of gene fusion detection relative to the technologies available, in order to clarify future standardization of analyses which determine therapeutic choices. Expert opinion : The establishment of a gold standard, an effective diagnostic algorithm, and a standardized interpretation for the analysis of each druggable-fusions in lung cancer is essential for adequate therapeutic management.