EGFR Fusions as Novel Therapeutic Targets in Lung Cancer

Kartik Konduri, Jean-Nicolas Gallant, Young Kwang Chae, Francis J. Giles, Barbara J. Gitlitz, Kyle Gowen, Eiki Ichihara, Taofeek K. Owonikoko, Vijay Peddareddigari, Suresh S. Ramalingam, Satyanarayan K. Reddy, Beth Eaby-Sandy, Tiziana Vavalà, Andrew Whiteley, Heidi Chen, Yingjun Yan, Jonathan H. Sheehan, Jens Meiler, Deborah Morosini, Jeffrey S. Ross, Philip J. Stephens, Vincent A. Miller, Siraj M. Ali, Christine M. Lovly

Here, we report that novel epidermal growth factor receptor (EGFR) gene fusions comprising the N-terminal of EGFR linked to various fusion partners, most commonly RAD51, are recurrent in lung cancer. We describe five patients with metastatic lung cancer whose tumors harbored EGFR fusions, four of whom were treated with EGFR tyrosine kinase inhibitors (TKIs) with documented anti-tumor responses. In vitro, EGFR-RAD51 fusions are oncogenic and can be therapeutically targeted with available EGFR TKIs and therapeutic antibodies. These results support the dependence of EGFR-rearranged tumors on EGFR-mediated signaling and suggest several therapeutic strategies for patients whose tumors harbor this novel alteration.