NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer

37 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 ROS1 . Like ALK , the ROS1 fusion gene makes an overactive ROS1 surface receptor that helps lung cancer cells grow. ROS1 testing is advised for metastatic lung adenocarcinomas, large-cell lung carcinomas, and unknown subtypes. It may be considered for people with squamous cell carcinoma. An ROS1 rearrangement does not usually occur with EGFR , ALK , and KRAS mutations. BRAF V600E mutation A BRAF V600E mutation occurs in 1 to 2 out of every 100 lung adenocarcinomas (1%–2%). Commonly, people with this mutation smoke or have smoked. Mutations in the BRAF gene causes the BRAF protein (kinase) to be overactive. BRAF overactivity causes new cancer cells to form quickly. BRAF testing is advised for metastatic lung adenocarcinomas, large-cell lung carcinomas, and unknown subtypes. It may be considered for people with squamous cell carcinoma. BRAF mutations typically do not occur with EGFR and ALK mutations. 4 Treatment planning Cancer lab tests Figure 12 Surface receptor Some lung cancers consist of cells with abnormal surface receptors. A surface receptor is a protein in the outer membrane of cells that starts changes within a cell when turned on. Receptors that may be abnormal and help lung cancer grow include EGFR, ALK, and ROS1. cancer cell surface receptor Copyright © 2017 National Comprehensive Cancer Network ® (NCCN ® ). www.nccn.org When my biopsy was performed, the tissue was sent off for testing. I have a mutation that allows for targeted therapy. My treatment team is superb! – Shirley Lung cancer survivor “

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