Title : A novel ROS1 G2032 K missense mutation mediates lorlatinib resistance in a patient with ROS1-rearranged lung adenocarcinoma but responds to nab-paclitaxel plus pembrolizumab.

Pub. Date : 2020 May

PMID : 32208297






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1 A novel ROS1 G2032 K missense mutation mediates lorlatinib resistance in a patient with ROS1-rearranged lung adenocarcinoma but responds to nab-paclitaxel plus pembrolizumab. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
2 INTRODUCTION: ROS1-rearranged non-small cell lung cancer (NSCLC) has demonstrated promising response to lorlatinib; however, no targeted therapy is available after failure of lorlatinib and information on acquired resistance mechanisms mediating lorlatinib resistance among ROS1-rearranged NSCLC patients is limited. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
3 INTRODUCTION: ROS1-rearranged non-small cell lung cancer (NSCLC) has demonstrated promising response to lorlatinib; however, no targeted therapy is available after failure of lorlatinib and information on acquired resistance mechanisms mediating lorlatinib resistance among ROS1-rearranged NSCLC patients is limited. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
4 INTRODUCTION: ROS1-rearranged non-small cell lung cancer (NSCLC) has demonstrated promising response to lorlatinib; however, no targeted therapy is available after failure of lorlatinib and information on acquired resistance mechanisms mediating lorlatinib resistance among ROS1-rearranged NSCLC patients is limited. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
5 We report a ROS1-rearranged NSCLC patient who responded to immunochemotherapy after acquisition of ROS1 G2032K-mediated lorlatinib resistance. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
6 We report a ROS1-rearranged NSCLC patient who responded to immunochemotherapy after acquisition of ROS1 G2032K-mediated lorlatinib resistance. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
7 RESULTS: NGS analysis revealed the detection of an acquired ROS1 G2032 K after failure from lorlatinib. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
8 Homology modeling revealed the conformational change in the inhibitor binding site induced by the ROS1 G2032 K that disrupted lorlatinib binding. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
9 In vitro experiments using patient-derived cells bearing concurrent CD74-ROS1-rearrangement and ROS1 G2032 K demonstrated half-maximal inhibitory concentration IC50 of 730.2 nM for lorlatinib, 812.1 nM for entrectinib, and 1546 nM for crizotinib, indicating resistance to these inhibitors. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
10 In vitro experiments using patient-derived cells bearing concurrent CD74-ROS1-rearrangement and ROS1 G2032 K demonstrated half-maximal inhibitory concentration IC50 of 730.2 nM for lorlatinib, 812.1 nM for entrectinib, and 1546 nM for crizotinib, indicating resistance to these inhibitors. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens
11 CONCLUSION: ROS1 G2032 K is a novel mutation that mediates resistance to lorlatinib. lorlatinib ROS proto-oncogene 1, receptor tyrosine kinase Homo sapiens