Adenoma detection rate and risk of colorectal cancer and death.

By M. Dawwas. New England Journal of Medicine, 2014

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n engl j med 370;26 nejm.org june 26, 2014 2539 tyrosine kinase related to ALK. In fact, previous work established that ceritinib targets both ALK and ROS1 at clinically relevant concentrations, although ceritinib has more potency against ALK.1,2 In ROS1-rearranged NSCLC, resistance to crizotinib may develop owing to the acquisition of a secondary mutation, such as ROS1 G2032R.3 On the basis of the crystal structure of the nonmutant ROS1 kinase domain bound to crizotinib, the substitution of glycine with the bulkier arginine at position 2032 is predicted to cause steric interference with crizotinib binding.3 We speculate that this arginine would also clash sterically with ceritinib, preventing effective binding and inhibition of the kinase. Consistent with this notion, the analogous mutation in ALK (G1202R) causes resistance to ceritinib,4 and in cell-based assays performed in our laboratory, ceritinib is 5 to 10 times less active against ROS1 G2032R than against nonmutant ROS1. Thus, although ceritinib could have activity in ROS1-rearranged NSCLC, we believe that its efficacy would be impaired by the ROS1 G2032R mutation.

Subfields: Oncology, Pathology and Forensic Medicine, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/2820336f622ba706a5ce56448c56ad1b03df838b

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In Oncology

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In Pulmonary and Respiratory Medicine

  1. Douglas Rex

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