There are many ways a gene can be altered and there are many genes that, when altered, can cause cancer. Testing individually for each possible alteration in every cancer–related gene is not feasible as it would require hundreds of individual tests and many, many thousands of dollars. A University of Colorado Cancer Center case study published in the journal JCO Precision Oncology highlights an alternative: Use testing that can look for gene alterations in many genes simultaneously. The technique results in the first published report describing successful targeting of MET fusion in a lung cancer patient.

In this study, researchers examined the tumor sample from a late–stage lung cancer patient using an assay that detects gene fusions in dozens of genes. The test identified a rare fusion involving the gene MET, leading researchers to treat the cancer with the targeted therapy crizotinib, which inhibits MET signaling (among other kinds of signaling). Now more than 8 months after the start of the targeted treatment, the patient who was diagnosed with stage IV lung cancer continues to show an almost complete response.

“The way we approach the workup and treatment of stage IV lung cancer patients includes broad molecular profiling, so that’s what we did,” said the patient’s oncologist, Terry Ng, MD, senior fellow in clinical and translational research in thoracic oncology at CU Cancer Center and the CU School of Medicine.

Among the tests used for this molecular profiling was a relatively new assay called Archer FusionPlex, developed by a Boulder–based biotechnology company ArcherDX, and validated for clinical testing by the Colorado Molecular Correlates Laboratory (CMOCO), an advanced molecular diagnostics laboratory which is part of the Department of Pathology at the University of Colorado. Instead of testing for alterations in individual genes – for example, testing separately for changes to known oncogenes ALK, ROS1 or EGFR – the test explored an entire class of genetic changes, testing simultaneously for “gene fusions” in 53 cancer–related genes.