ROS1 positive lung cancer is an aggressive form of lung cancer that often spreads quickly.

This genetic mutation occurs in about 1% to 2% of people diagnosed with NSCLC.

Causes

Cell genes act as a blueprint for proteins that regulate the growth and division of cells.

The ROS1 gene is one in a subfamily of tyrosine-kinase insulin-receptor genes.

The ROS1 gene mutation seen in NSCLC is really a fusion between ROS1 and another gene.

This fusion produces a defective gene that acts as a chance driver, causing cancer cells to multiply excessively.

Genetic testingis usually done on a tissue sample from alung biopsyor from tissue removed during lung cancer surgery.

Increasingly, healthcare providers are usingliquid biopsyto help diagnose ROS1 rearrangement.

Testing methods include usingimmunohistochemistryandfluorescence in situ hybridization(FISH) to analyze the samples and determine genetic abnormalities.

Part of the testing involves ruling out other genetic abnormalities includingKRAS mutations,EGFR mutations, andALK rearrangements.

These include treatments that work on cancer tumors that are still small and located in one place.

Instead, healthcare providers are now using targeted medications, which offer many advantages.

Some chemotherapy agents are also effective in ROS1-positive tumors.

ROS1-positive lung cancer appears to respond well to the chemotherapy drug Alimta (pemetrexed), for instance.

Never stop any medication without first consulting your healthcare provider.

Studies suggest that a component of vitamin E called a-tocopherol may greatly reduce the effectiveness of crizotinib.

Xalkori doesnt work very well for brain metastases because it does notcross the blood-brain barrierwell.

Rozlytrek appears to have better brain penetration and has shown success in small trials.

Radiation therapy may also offer some hope for ROS1-positive lung cancer that has spread to the brain.

Stereotactic radiotherapysince it only treats a small portion of the brainhas fewer side effects.

But whole-brain radiotherapy may offer better outcomes.

Drug Resistance

Most cancers eventually become resistant to targeted therapy medications.

Your healthcare provider will prescribe a new treatment once your cancer show signs of resistance.

But that treatment, too, might become ineffective.

Prognosis

ROS1-positive lung cancer tends to be aggressive, growing, and spreading fairly rapidly.

But it does respond to targeted therapy.

Look into local and national groups that focus on ROS1 issues, be them in person or online.

For example, check out theROS1 group hosted by Smart Patients.

Consider learning about current treatments and geting involved inclinical trials, if possible.

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