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Title: Australian consensus statement for best practice ROS1 testing in advanced non-small cell lung cancer.
Austin Authors: Pavlakis, Nick;Cooper, Caroline;John, Thomas ;Kao, Steven;Klebe, Sonja;Lee, Chee Khoon;Leong, Trishe Y-M;Millward, Michael;O'Byrne, Ken;Russell, Prudence A;Solomon, Benjamin;Cooper, Wendy A;Fox, Stephen
Affiliation: School of Medicine, Western Sydney University, Sydney, NSW, Australia
Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Sydney Medical School, University of Sydney, Sydney, NSW, Australia
Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
St Vincent's Hospital, University of Melbourne, Melbourne, Vic, Australia
Princess Alexandra Hospital, Woolloongabba, Qld, Australia
University of Western Australia, Perth, WA, Australia
Austin Health, Heidelberg, Victoria, Australia
St George Hospital, Kogarah, NSW, Australia
SA Pathology, and Flinders University at Flinders Medical Centre, Bedford Park, SA, Australia
Chris O'Brien Lifehouse, Camperdown, NSW, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Pathology Queensland, Princess Alexandra Hospital, Woolloongabba, Qld, Australia
Royal North Shore Hospital, St Leonards, and Sydney University, Camperdown, NSW, Australia
Issue Date: Dec-2019
Date: 2019-10-23
Publication information: Pathology 2019; 51(7): 673-680
Abstract: 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: 10.1016/j.pathol.2019.08.006
Journal: Pathology
PubMed URL: 31668406
Type: Journal Article
Subjects: Non-small cell lung cancer
biomarker testing
Appears in Collections:Journal articles

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