ROS1 as a 'druggable' receptor tyrosine kinase: lessons learned from inhibiting the ALK pathway

Sai-Hong Ignatius Ou1, Jackie Tan, Yun Yen

  • 1Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA 92868, USA. ignatius.ou@uci.edu

Insights

ROS1 rearrangements are found in various cancers, including non-small-cell lung cancer (NSCLC). Existing ALK inhibitors show promise for treating ROS1-rearranged tumors, particularly NSCLC.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • ROS1 is an orphan receptor tyrosine kinase, evolutionarily related to ALK.
  • ROS1 rearrangements have been identified in glioblastoma, non-small-cell lung cancer (NSCLC), and cholangiocarcinoma.
  • Clinicopathologic features of ROS1-rearranged NSCLC are increasingly understood, while those in other cancers require further definition.

Purpose of the Study:

  • To review the current understanding of ROS1 rearrangements in cancer.
  • To explore the potential of ALK inhibitors for treating ROS1-rearranged malignancies.
  • To highlight the emerging clinical research landscape for ROS1-driven cancers.

Main Methods:

  • Literature review of ROS1 rearrangements and their clinical implications.
  • Analysis of existing data on ALK inhibitors' efficacy against ROS1.
  • Synthesis of information on clinicopathologic characteristics of ROS1-rearranged cancers.

Main Results:

  • ROS1 rearrangements occur in glioblastoma, NSCLC, and cholangiocarcinoma.
  • Despite limited homology, ALK inhibitors demonstrate in vitro activity against ROS1.
  • Crizotinib, an approved ALK/MET inhibitor, offers a potential therapeutic avenue for ROS1-rearranged NSCLC.

Conclusions:

  • ROS1-rearranged NSCLC is a distinct clinicopathologic entity.
  • Available ALK inhibitors represent a promising therapeutic strategy for ROS1-driven tumors.
  • Accelerated clinical research is anticipated for ROS1-rearranged cancers using existing ALK inhibitors.

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