NSCLC: An Update of Driver Mutations, Their Role in Pathogenesis and Clinical Significance.

Lung cancer is the most common malignancy in the US and causes the most cancer-related deaths. Non-small-cell lung carcinoma (NSCLC) accounts for the majority of cases. NSCLC historically was considered one entity, reflected by platinum-based therapy as the standard of care; however, with the discovery of EGFR mutations and ALK rearrangements, the landscape of treatment has become more personalized reflecting genomic heterogeneity. The molecular basis for tumor genesis was recognized and became a new method of classification. The availability of tumor sequencing and testing for these mutations is also becoming more accessible outside of major academic institutions. Targeted therapies offer alternatives to dangerous cytotoxic chemotherapy with equal or better efficacy. With these changes, driver mutations will play an increasing role in the diagnosis and treatment of NSCLC. In this review we will examine the characteristics of several NSCLC driver mutations and gene rearrangements and emerging data on therapies directed against them.

Relationship between FRA11F and 11q13 gene amplification in oral cancer.

Common fragile sites (CFS) are nonstaining gaps or breaks in chromosomes that are expressed under conditions inducing replicative stress. CFS have been suggested to play a role in epithelial cancers by their association with loss of heterozygosity, loss of gene expression, and/or gene amplification in the form of homogeneously staining regions (hsrs). In oral squamous-cell carcinomas (OSCC), amplification of chromosomal band 11q13 occurs in the form of an hsr. We suggested previously that CFS flanking 11q13 may be susceptible to breakage induced by tobacco or other carcinogens and/or human papillomavirus, promoting formation of the 11q13 amplicon. Examination of OSCC cell lines with 11q13 amplification using fluorescence in situ hybridization showed loss of FRA11F sequences, whereas cell lines without 11q13 amplification displayed an intact FRA11F site. Cell lines with more complex 11q rearrangements expressed FRA11F in the form of an inverted duplication, characteristic of breakage-fusion-bridge cycles. Our findings suggest that gene amplification involving chromosomal band 11q13 in OSCC may be initiated by breakage at FRA11F.