RET Fusion Testing in Patients With NSCLC: The RETING Study

Introduction: RET inhibitors with impressive overall response rates are now available for patients with NSCLC, yet the identi fication of RET fusions remains a dif ficult challenge. Most guidelines encourage the upfront use of next -generation sequencing (NGS), or alternatively, fluorescence in situ...

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Autores: Conde, Esther, Hernández, Susana, Rodríguez Carrillo, Jose Luis, Martínez, Rebeca, Alonso, Marta, Curto, Daniel, Jiménez, Beatriz, Caminoa, Alejandra, Benito, Amparo, Garrido, Pilar, Clave, Sergi, Arriola, Edurne, Esteban Rodríguez, Isabel, Castro, Javier de, Sansano, Irene, Felip, Enriqueta, Rojo, Federico, Dómine, Manuel, Abdulkader, Ihab, García González, Jorge, Teixidó Febrero, Cristina, Reguart, Noemí, Compañ, Desamparados, Insa, Amelia, Mancheño, Nuria, Palanca, Sarai, Juan Vidal, Oscar, Baixeras, Nuria, Nadal, Ernest, Cebollero, Maria, Calles Blanco, Antonio, Martín, Paloma, Salas, Clara, Provencio, Mariano, Aranda, Ignacio, Massuti, Bartomeu, López Vilaro, Laura, Majem, Margarita, Paz-Ares, Luis, López Rios, Fernando
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/214201
Acceso en línea:https://hdl.handle.net/2445/214201
Access Level:acceso abierto
Palabra clave:Càncer de pulmó
Creatina quinasa
Lung cancer
Creatine kinase
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spelling RET Fusion Testing in Patients With NSCLC: The RETING StudyConde, EstherHernández, SusanaRodríguez Carrillo, Jose LuisMartínez, RebecaAlonso, MartaCurto, DanielJiménez, BeatrizCaminoa, AlejandraBenito, AmparoGarrido, PilarClave, SergiArriola, EdurneEsteban Rodríguez, IsabelCastro, Javier deSansano, IreneFelip, EnriquetaRojo, FedericoDómine, ManuelAbdulkader, IhabGarcía González, JorgeTeixidó Febrero, CristinaReguart, NoemíCompañ, DesamparadosInsa, AmeliaMancheño, NuriaPalanca, SaraiJuan Vidal, OscarBaixeras, NuriaNadal, ErnestCebollero, MariaCalles Blanco, AntonioMartín, PalomaSalas, ClaraProvencio, MarianoAranda, IgnacioMassuti, BartomeuLópez Vilaro, LauraMajem, MargaritaPaz-Ares, LuisLópez Rios, FernandoCàncer de pulmóCreatina quinasaLung cancerCreatine kinaseIntroduction: RET inhibitors with impressive overall response rates are now available for patients with NSCLC, yet the identi fication of RET fusions remains a dif ficult challenge. Most guidelines encourage the upfront use of next -generation sequencing (NGS), or alternatively, fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR) when NGS is not possible or available. Taken together, the suboptimal performance of single-analyte assays to detect RET fusions, although consistent with the notion of encouraging universal NGS, is currently widening some of the clinical practice gaps in the implementation of predictive biomarkers in patients with advanced NSCLC. Methods: This situation prompted us to evaluate several RET assays in a large multicenter cohort of RET fusion -positive NSCLC (n 1 / 4 38) to obtain real -world data. In addition to RNA -based NGS (the criterion standard method), all positive specimens underwent break -apart RET FISH with two different assays and were also tested by an RT-PCR assay. Results: The most common RET partners were KIF5B (78.9%), followed by CCDC6 (15.8%). The two RET NGSpositive but FISH -negative samples contained a KIF5B(15)RET(12) fusion. The three RET fusions not identi fied with RT-PCR were AKAP13(35)-RET(12) , KIF5B(24)-RET(9) and KIF5B(24)-RET(11) . All three false -negative RT-PCR cases were FISH -positive, exhibited a typical break -apart pattern, and contained a very high number of positive tumor cells with both FISH assays. Signet ring cells, psammoma bodies, and pleomorphic features were frequently observed (in 34.2%, 39.5%, and 39.5% of tumors, respectively). Conclusions: In-depth knowledge of the advantages and disadvantages of the different RET testing methodologies could help clinical and molecular tumor boards implement and maintain sensible algorithms for the rapid and effective detection of RET fusions in patients with NSCLC. The likelihood of RET false -negative results with both FISH and RT-PCR reinforces the need for upfront NGS in patients with NSCLC. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Elsevier BV2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/214201Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.jtocrr.2024.100653JTO Clinical and Research Reports, 2024, vol. 5, num. 4https://doi.org/10.1016/j.jtocrr.2024.100653cc by (c) Conde, Esther et al, 2024http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2142012026-05-27T06:46:51Z
dc.title.none.fl_str_mv RET Fusion Testing in Patients With NSCLC: The RETING Study
title RET Fusion Testing in Patients With NSCLC: The RETING Study
spellingShingle RET Fusion Testing in Patients With NSCLC: The RETING Study
Conde, Esther
Càncer de pulmó
Creatina quinasa
Lung cancer
Creatine kinase
title_short RET Fusion Testing in Patients With NSCLC: The RETING Study
title_full RET Fusion Testing in Patients With NSCLC: The RETING Study
title_fullStr RET Fusion Testing in Patients With NSCLC: The RETING Study
title_full_unstemmed RET Fusion Testing in Patients With NSCLC: The RETING Study
title_sort RET Fusion Testing in Patients With NSCLC: The RETING Study
dc.creator.none.fl_str_mv Conde, Esther
Hernández, Susana
Rodríguez Carrillo, Jose Luis
Martínez, Rebeca
Alonso, Marta
Curto, Daniel
Jiménez, Beatriz
Caminoa, Alejandra
Benito, Amparo
Garrido, Pilar
Clave, Sergi
Arriola, Edurne
Esteban Rodríguez, Isabel
Castro, Javier de
Sansano, Irene
Felip, Enriqueta
Rojo, Federico
Dómine, Manuel
Abdulkader, Ihab
García González, Jorge
Teixidó Febrero, Cristina
Reguart, Noemí
Compañ, Desamparados
Insa, Amelia
Mancheño, Nuria
Palanca, Sarai
Juan Vidal, Oscar
Baixeras, Nuria
Nadal, Ernest
Cebollero, Maria
Calles Blanco, Antonio
Martín, Paloma
Salas, Clara
Provencio, Mariano
Aranda, Ignacio
Massuti, Bartomeu
López Vilaro, Laura
Majem, Margarita
Paz-Ares, Luis
López Rios, Fernando
author Conde, Esther
author_facet Conde, Esther
Hernández, Susana
Rodríguez Carrillo, Jose Luis
Martínez, Rebeca
Alonso, Marta
Curto, Daniel
Jiménez, Beatriz
Caminoa, Alejandra
Benito, Amparo
Garrido, Pilar
Clave, Sergi
Arriola, Edurne
Esteban Rodríguez, Isabel
Castro, Javier de
Sansano, Irene
Felip, Enriqueta
Rojo, Federico
Dómine, Manuel
Abdulkader, Ihab
García González, Jorge
Teixidó Febrero, Cristina
Reguart, Noemí
Compañ, Desamparados
Insa, Amelia
Mancheño, Nuria
Palanca, Sarai
Juan Vidal, Oscar
Baixeras, Nuria
Nadal, Ernest
Cebollero, Maria
Calles Blanco, Antonio
Martín, Paloma
Salas, Clara
Provencio, Mariano
Aranda, Ignacio
Massuti, Bartomeu
López Vilaro, Laura
Majem, Margarita
Paz-Ares, Luis
López Rios, Fernando
author_role author
author2 Hernández, Susana
Rodríguez Carrillo, Jose Luis
Martínez, Rebeca
Alonso, Marta
Curto, Daniel
Jiménez, Beatriz
Caminoa, Alejandra
Benito, Amparo
Garrido, Pilar
Clave, Sergi
Arriola, Edurne
Esteban Rodríguez, Isabel
Castro, Javier de
Sansano, Irene
Felip, Enriqueta
Rojo, Federico
Dómine, Manuel
Abdulkader, Ihab
García González, Jorge
Teixidó Febrero, Cristina
Reguart, Noemí
Compañ, Desamparados
Insa, Amelia
Mancheño, Nuria
Palanca, Sarai
Juan Vidal, Oscar
Baixeras, Nuria
Nadal, Ernest
Cebollero, Maria
Calles Blanco, Antonio
Martín, Paloma
Salas, Clara
Provencio, Mariano
Aranda, Ignacio
Massuti, Bartomeu
López Vilaro, Laura
Majem, Margarita
Paz-Ares, Luis
López Rios, Fernando
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer de pulmó
Creatina quinasa
Lung cancer
Creatine kinase
topic Càncer de pulmó
Creatina quinasa
Lung cancer
Creatine kinase
description Introduction: RET inhibitors with impressive overall response rates are now available for patients with NSCLC, yet the identi fication of RET fusions remains a dif ficult challenge. Most guidelines encourage the upfront use of next -generation sequencing (NGS), or alternatively, fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR) when NGS is not possible or available. Taken together, the suboptimal performance of single-analyte assays to detect RET fusions, although consistent with the notion of encouraging universal NGS, is currently widening some of the clinical practice gaps in the implementation of predictive biomarkers in patients with advanced NSCLC. Methods: This situation prompted us to evaluate several RET assays in a large multicenter cohort of RET fusion -positive NSCLC (n 1 / 4 38) to obtain real -world data. In addition to RNA -based NGS (the criterion standard method), all positive specimens underwent break -apart RET FISH with two different assays and were also tested by an RT-PCR assay. Results: The most common RET partners were KIF5B (78.9%), followed by CCDC6 (15.8%). The two RET NGSpositive but FISH -negative samples contained a KIF5B(15)RET(12) fusion. The three RET fusions not identi fied with RT-PCR were AKAP13(35)-RET(12) , KIF5B(24)-RET(9) and KIF5B(24)-RET(11) . All three false -negative RT-PCR cases were FISH -positive, exhibited a typical break -apart pattern, and contained a very high number of positive tumor cells with both FISH assays. Signet ring cells, psammoma bodies, and pleomorphic features were frequently observed (in 34.2%, 39.5%, and 39.5% of tumors, respectively). Conclusions: In-depth knowledge of the advantages and disadvantages of the different RET testing methodologies could help clinical and molecular tumor boards implement and maintain sensible algorithms for the rapid and effective detection of RET fusions in patients with NSCLC. The likelihood of RET false -negative results with both FISH and RT-PCR reinforces the need for upfront NGS in patients with NSCLC. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/214201
url https://hdl.handle.net/2445/214201
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.jtocrr.2024.100653
JTO Clinical and Research Reports, 2024, vol. 5, num. 4
https://doi.org/10.1016/j.jtocrr.2024.100653
dc.rights.none.fl_str_mv cc by (c) Conde, Esther et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Conde, Esther et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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