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ROS1 fusão (CD74-ROS1, EZR-ROS1 outros) — ~1-2% de NSCLC adenocarcinoma; nunca fumante e...

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IDRF-NSCLC-ROS1-FUSION-ACTIONABLE
TipoSinal de alerta
Estadoreviewed 2026-04-27 | pending_clinical_signoff
DoençasDIS-NSCLC
FontesSRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 SRC-STARTRK2-DRILON-2020 SRC-TRIDENT1-DRILON-2024

Origem da bandeira vermelha

DefiniçãoROS1 fusion (CD74-ROS1, EZR-ROS1, others) — ~1-2% of NSCLC adenocarcinoma; never-smoker enriched. Treatment-defining: entrectinib (CNS-active) or repotrectinib (TRIDENT-1, including post-crizotinib resistance) preferred 1L; crizotinib historic option.
Direcção clínicaintensificar
Categoriahigh-risk-biology
Algoritmo de deslocamentosALGO-NSCLC-METASTATIC-1L, ALGO-NSCLC-METASTATIC-2L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "ros1_fusion",
      "value": true
    },
    {
      "finding": "ros1_rearrangement",
      "value": "positive"
    },
    {
      "finding": "ros1_status",
      "value": "positive"
    }
  ],
  "type": "biomarker"
}

Notas

Detection: RNA-NGS preferred for fusion partner; IHC screen with ROS1 antibody (D4D6) acceptable. Repotrectinib next-gen TKI active vs solvent-front G2032R resistance mutation; preferred 1L+ in guidelines updated post-TRIDENT-1. Brain metastases — entrectinib and repotrectinib have CNS activity; crizotinib does not.

Usado por

Algoritmos