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ROS1 G2032R resistance mutation

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDBIO-ROS1-G2032R
TypeBiomarker
Aliases
ROS1 G2032R — мутація резистентностіROS1 p.G2032RROS1 solvent-front mutation
Statusreviewed 2026-04-27 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 SRC-TRIDENT1-DRILON-2024

Biomarker Facts

Biomarker typegene_mutation
Mutation details{"exon": "38", "functional_impact": "resistance to crizotinib, ceritinib, entrectinib, lorlatinib; sensitive to repotrectinib (TRIDENT-1)", "gene": "ROS1", "hgvs_protein": "p.G2032R", "variant_type": "missense"}
Measurement
MethodctDNA NGS preferred at TKI progression; tumor re-biopsy NGS acceptable
Unitscategorical (positive | negative); VAF % when reported
Sensitivity requirementSubclonal emergence is common — VAF ≥0.5% (cfDNA) actionable
Actionability lookup{"gene": "ROS1", "variant": "G2032R"}
Related biomarkersBIO-ROS1-FUSION

Notes

Most common acquired resistance mutation in ROS1-rearranged NSCLC treated with crizotinib (~40% of resistance cases). Solvent-front position structurally analogous to ALK G1202R; confers cross- resistance to crizotinib, ceritinib, entrectinib, and lorlatinib. Repotrectinib (TPX-0005), a next-generation macrocyclic ROS1/TRK inhibitor, demonstrates activity in G2032R-positive patients per TRIDENT-1 (Drilon 2024, NEJM): ORR ~38-58% in TKI-pretreated cohort including G2032R-positive subset. FDA-approved 2023 for ROS1+ NSCLC (TKI-naive and post-TKI). Standard recommendation when G2032R detected on prior ROS1-TKI failure.

Used By

No reverse references found in the YAML corpus.