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Detection of ROS1 rearrangement in non-small cell lung cancer: current and future perspectives

Authors Rossi G, Jocollé G, Conti A, Tiseo M, Zito Marino F, Donati G, Franco R, Bono F, Barbisan F, Facchinetti F

Received 6 March 2017

Accepted for publication 9 May 2017

Published 7 July 2017 Volume 2017:8 Pages 45—55


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Pan-Chyr Yang

Giulio Rossi,1 Genny Jocollé,2 Antonia Conti,3 Marcello Tiseo,4 Federica Zito Marino,5,6 Giovanni Donati,7 Renato Franco,5,6 Francesca Bono,8 Francesca Barbisan,9 Francesco Facchinetti4,10

1Pathology Unit, 2Oncology Unit, Azienda USL Valle d’Aosta, Regional Hospital “Parini”, Aosta, 3Medical Illustrator, Riccione, 4Medical Oncology Unit, University Hospital of Parma, Parma, 5Pathology Unit, Istituto Nazionale Tumori Fondazione G. Pascale, 6Pathology Unit, Luigi Vanvitelli University of Campania, Naples, 7Unit of Thoracic and Senology Surgery, Azienda USL Valle d’Aosta, Regional Hospital “Parini”, Aosta, 8Unit of Pathologic Anatomy, San Gerardo Hospital, IRCCS, Monza, 9Pathology Unit, University Hospital, Azienda Ospedali Riuniti, Ancona, Italy; 10INSERM, U981, Gustave Roussy Cancer Campus, Villejuif, France

ROS1 rearrangement characterizes a small subset (1%–2%) of non-small cell lung cancer and is associated with slight/never smoking patients and adenocarcinoma histology. Identification of ROS1 rearrangement is mandatory to permit targeted therapy with specific inhibitors, demonstrating a significantly better survival when compared with conventional chemotherapy. Detection of ROS1 rearrangement is based on in situ (immunohistochemistry, fluorescence in situ hybridization) and extractive non-in situ assays. While fluorescence in situ hybridization still represents the gold standard in clinical trials, this technique may fail to recognize rearrangements of ROS1 with some gene fusion partner. On the other hand, immunohistochemistry is the most cost-effective screening technique, but it seems to be characterized by low specificity. Extractive molecular assays are expensive and laborious methods, but they specifically recognize almost all ROS1 fusions using a limited amount of mRNA even from formalin-fixed, paraffin-embedded tumor tissues. This review is a discussion on the present and futuristic diagnostic scenario of ROS1 identification in lung cancer.

Keywords: lung, adenocarcinoma, ROS1, FISH, immunohistochemistry, NGS, rearrangement

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