Identification of a novel KIF13A-RET fusion in lung adenocarcinoma by next-generation sequencing
Xuefei Zhang1, Yanlin Li2, Changhong Liu3
1Department of Thoracic Surgery, Qilu Hospital of Shandong University, Ji'nan City, Shandong Province 250012, China; Department of Thoracic Surgery, The Second Hospital of Dalian Medical University, Dalian City, Liaoning Province 116023, China.
Objectives:
RET fusions have been reported in 1-2% of lung adenocarcinomas, and represent an actionable target. Patients whose tumors possess RET fusion are associated with clinical benefit from the treatment with multi-kinase inhibitors such as cabozantinib and vandetanib. Further molecular screening for RET fusions is warranted. Novel KIF13A-RET fusion containing an intact RET kinase domain involving exons 1-18 of KIF13A and exons 12-20 of RET was identified in a lung cancer specimen from an 74-year-old Asian never smoker by next-generation sequencing (NGS) during clinical care. The patient was negative for EGFR, ALK, ROS1 and other putative driver alterations. Fusion analysis is consistent with other described RET fusions and is predicted to result in aberrant constitutive activation caused by dimerization and sensitivity to RET-directed therapies. We describe a novel RET-fusion with molecular characteristics consistent with RET-driven non-small cell lung cancer. Our case expands the spectrum of RET fusion partners and supports broad molecular profiling in non-small cell lung cancer optimizing patient therapeutic options. The new RET fusion has immediate clinical implications for cancer patients.
Insights
A novel KIF13A-RET fusion was identified in lung adenocarcinoma. This RET fusion is actionable, offering new therapeutic options for non-small cell lung cancer patients.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- RET fusions are actionable targets in 1-2% of lung adenocarcinomas.
- Patients with RET fusions benefit from multi-kinase inhibitors like cabozantinib and vandetanib.
- Molecular screening for RET fusions is crucial for identifying treatment opportunities.
Observation:
- A novel KIF13A-RET fusion was identified in a 74-year-old Asian never-smoker with lung cancer.
- Next-generation sequencing (NGS) revealed the fusion involved KIF13A exons 1-18 and RET exons 12-20.
- The patient tested negative for common driver mutations like EGFR, ALK, and ROS1.
Findings:
- The identified KIF13A-RET fusion retains an intact RET kinase domain.
- Fusion analysis suggests constitutive activation due to dimerization, predicting sensitivity to RET-targeted therapies.
- This novel fusion expands the known repertoire of RET fusion partners in lung cancer.
Implications:
- This case highlights the importance of broad molecular profiling in non-small cell lung cancer.
- The discovery of new RET fusions provides additional therapeutic targets for lung cancer patients.
- Identifying actionable RET fusions can optimize treatment strategies and improve patient outcomes.
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