Patterns of Metastatic Spread and Mechanisms of Resistance to Crizotinib in <i>ROS1</i>-Positive Non–Small-Cell Lung Cancer

Abstract

Compared to <i>ALK</i> rearrangements, <i>ROS1</i> rearrangements are associated with lower rates of extrathoracic metastases, including fewer brain metastases, at initial metastatic diagnosis. <i>ROS1</i> resistance mutations, particularly G2032R, appear to be the predominant mechanism of resistance to crizotinib, underscoring the need to develop novel ROS1 inhibitors with activity against these resistant mutants.