Fusions

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Introduction

Chimeric gene fusions involving the ALK (anaplastic lymphoma kinase) gene are now recognised as oncogenic driver mutations in about 5% of all NSCLC. The most common genomic rearrangement involving the ALK gene is an inv(2)(p21p23), resulting in the creation of an EML4-ALK chimeric gene, although over 20 other partner genes have been described. Tumours with ALK genomic rearrangements are now considered as a new molecular subgroup of lung carcinomas. Tumours with ALK rearrangements show excellent response rates to inhibitors of ALK tyrosine kinase activity e.g. Crizotinib. Testing for ALK rearrangements can be by several methods e.g. ALK1 IHC, FISH analysis or reverse transcriptase PCR. ALK FISH analysis is regarded as the ‘gold standard’ method. The laboratory can also offer testing for other NSCLC-associated rearrangements such as ROS1.

Please refer to the National Genomic Test Directory for Cancer here.

Reporting times

ALK FISH 14 calendar days

ROS1 FISH 14 calendar days

Fusion panel 21 calendar days

Please refer to our Sample Requirements section before sending any samples to us for testing.