The Lung NGS Fusion Panel (Complete or Limited) is an RNA-based next-generation sequencing panel that detects translocations and fusions of the genes ALK, MET Exon 14 skipping, NTRK1, NTRK2, NTRK3, NRG1, RET and ROS1 with known and novel fusion partners. Examples of some of the published fusions detectable in this test include EML4-ALK, KIF5B-ALK, NPM1-ALK, CD74-NTRK1, MPRIP-NTRK1, TPM3-NTRK1, TRIM24-NTRK2, PAN3-NTRK2, ETV6-NTRK3, CCD6-RET (aka RET-PTC1), KIF5B-RET, NCOA4-RET (aka RET-PTC3), CD74-ROS1, SLC34A2-ROS1, and TPM3-ROS1.
Lung Complete NGS Fusion Panel includes all genes listed above. Clients can opt out of ALK and ROS1 testing to receive the Lung Limited NGS Fusion Panel report.
This test may be used to select patients for the following FDA-approved therapies:
- ALK- ALECENSA® (alectinib), XALKORI® (crizotinib), ZYKADIA™ (ceritinib), ALUNBRIG® (brigatinib), LORBRENA® (lorlatinib)
- MET Exon 14- TABRECTA™ (capmatinib)
- NTRK- ROZLYTREK® (entrectinib), VITRAKVI® (larotrectinib)
- RET- GAVRETO™ (pralsetinib), RETEVMO™ (selpercatinib)
- ROS- XALKORI® (crizotinib), ROZLYTREK® (entrectinib)
Fusions of the ALK, NTRK1, NTRK2, NTRK3, RET and ROS1 kinase genes with various partner genes have been reported as oncogenic drivers in multiple cancer types including lung adenocarcinoma. Chimeric proteins resulting from the gene fusions may be overexpressed or constitutively activated and lead to progression of cancer. Patients whose tumors have such gene fusions may respond to various kinase inhibitors. In non-small cell lung carcinoma (NSCLC), these gene fusions are detected with the following approximate frequencies: ALK (4-6%), NTRK (1%), RET (1-2%), and ROS1 (1-2%).
- FFPE tissue: Paraffin block is preferred. Alternatively, send 1 H&E slide plus 5-10 unstained slides cut at 5 or more microns. Please use positively-charged slides and 10% NBF fixative. Do not use zinc fixatives.
Use cold pack for transport. Make sure cold pack is not in direct contact with specimen.