Novel CAD-ALK gene rearrangement is drugable by entrectinib in colorectal cancer.

Abstract:

BACKGROUND:Activated anaplastic lymphoma kinase (ALK) gene fusions are recurrent events in a small fraction of colorectal cancers (CRCs), although these events have not yet been exploited as in other malignancies. METHODS:We detected ALK protein expression by immunohistochemistry and gene rearrangements by fluorescence in situ hybridisation in the ALKA-372-001 phase I study of the pan-Trk, ROS1, and ALK inhibitor entrectinib. One out of 487 CRCs showed ALK positivity with a peculiar pattern that prompted further characterisation by targeted sequencing using anchored multiplex PCR. RESULTS:A novel ALK fusion with the carbamoyl-phosphate synthetase 2, aspartate transcarbamylase, and dihydroorotase (CAD) gene (CAD-ALK fusion gene) was identified. It resulted from inversion within chromosome 2 and the fusion of exons 1-35 of CAD with exons 20-29 of ALK. After failure of previous standard therapies, treatment of this patient with the ALK inhibitor entrectinib resulted in a durable objective tumour response. CONCLUSIONS:We describe the novel CAD-ALK rearrangement as an oncogene and provide the first evidence of its drugability as a new molecular target in CRC.

journal_name

Br J Cancer

authors

Amatu A,Somaschini A,Cerea G,Bosotti R,Valtorta E,Buonandi P,Marrapese G,Veronese S,Luo D,Hornby Z,Multani P,Murphy D,Shoemaker R,Lauricella C,Giannetta L,Maiolani M,Vanzulli A,Ardini E,Galvani A,Isacchi A,Sartore

doi

10.1038/bjc.2015.401

subject

Has Abstract

pub_date

2015-12-22 00:00:00

pages

1730-4

issue

12

eissn

0007-0920

issn

1532-1827

pii

bjc2015401

journal_volume

113

pub_type

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