CROS1 eyed.

The growing number of predictive mutations across all cancers is dizzying. In this latest comprehensive review on ROS1-rearranged non-small cell lung cancer (NSCLC), you’ll learn there is currently a surprising amount of nuance to treating this population comprising only 1-2% of all NSCLC. First, ROS1-fusions should be evaluated via screening IHC and confirmatory FISH or next-gen sequencing for all advanced adenos—verdict is still out on its utility for squams among non-smokers. Once you identify a ROS1-fusion, though, you’ve only just begun. For those contemplating their second or third round of boards studying, Figure 1 provides a detailed treatment algorithm that should provide a fun addition to your slideset. Most important to know is that crizotinib is first-line without brain mets, while entrectinib is first-line with brain mets. If you make it to second-line treatment for ROS1-rearranged NSCLC, all we can say is, you passed. TBL: ROS1 evaluation is an important component to the initial work-up of advanced adenocarcinoma of the lung because there are numerous effective TKIs already approved as well as in-the-works. | Almquist, JCO Oncol Pract 2020

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