Lung cancer
ICD-10 C34 · ICD-11 2C25.Z

Treatment of Advanced or Metastatic Non-Small Cell Lung Cancer with ROS1 Gene Fusion

Clinical Scenario

This protocol applies to patients with advanced or metastatic non-small cell lung cancer (NSCLC) in whom molecular testing has identified a ROS1 gene fusion. ROS1 fusions occur in approximately 1–2% of NSCLC patients and are associated with responsiveness to oral ROS1 tyrosine kinase inhibitors (TKIs).

First-Line Treatment Approach

The recommended approach for this population is first-line targeted therapy with an oral ROS1 TKI. Several preferred agents are recognized, with selection informed in part by whether the patient has brain metastases.

Full agent selection, sequencing, and considerations are available in the complete protocol →
Instant Access to Structured Evidence-Based Regimens

References

  1. It is estimated that ROS1 gene fusions occur in about 1% to 2% of patients with NSCLC.
  2. The presence of a ROS1 gene fusion is associated with responsiveness to oral ROS1 TKIs.
  3. The Panel recommends crizotinib, entrectinib, repotrectinib, or taletrectinib as preferred first-line treatment options for patients with ROS1 gene fusion-positive advanced or metastatic NSCLC.
  4. Entrectinib, repotrectinib, or taletrectinib may be better for patients with brain metastases.
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