Reference Detail

Ref Type

Journal Article

PMID

(30446652)

Authors

Paratala BS, Chung JH, Williams CB, Yilmazel B, Petrosky W, Williams K, Schrock AB, Gay LM, Lee E, Dolfi SC, Pham K, Lin S, Yao M, Kulkarni A, DiClemente F, Liu C, Rodriguez-Rodriguez L, Ganesan S, Ross JS, Ali SM, Leyland-Jones B, Hirshfield KM

Title

RET rearrangements are actionable alterations in breast cancer.

Journal	Vol	Issue	Date	Pages	Journal Short Title
Nature communications	9	1	2018 11 16	4821	Nat Commun

URL

Abstract Text

Fusions involving the oncogenic gene RET have been observed in thyroid and lung cancers. Here we report RET gene alterations, including amplification, missense mutations, known fusions, novel fusions, and rearrangements in breast cancer. Their frequency, oncogenic potential, and actionability in breast cancer are described. Two out of eight RET fusions (NCOA4-RET and a novel RASGEF1A-RET fusion) and RET amplification were functionally characterized and shown to activate RET kinase and drive signaling through MAPK and PI3K pathways. These fusions and RET amplification can induce transformation of non-tumorigenic cells, support xenograft tumor formation, and render sensitivity to RET inhibition. An index case of metastatic breast cancer progressing on HER2-targeted therapy was found to have the NCOA4-RET fusion. Subsequent treatment with the RET inhibitor cabozantinib led to a rapid clinical and radiographic response. RET alterations, identified by genomic profiling, are promising therapeutic targets and are present in a subset of breast cancers.

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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description
RET	C611R	missense	unknown	RET C611R lies within the extracellular domain of the Ret protein (UniProt.org). C611R has been identified in the scientific literature (PMID: 22747440, PMID: 30446652, PMID: 25163725), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Feb 2024).
RET	D925H	missense	unknown	RET D925H lies within the protein kinase domain of the Ret protein (UniProt.org). D925H has been identified in sequencing studies (PMID: 8825918, PMID: 30446652), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Jan 2024).
RET	E232K	missense	unknown	RET E232K lies within the cadherin domain of the Ret protein (UniProt.org). E232K has been identified in sequencing studies (PMID: 30446652), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Jan 2024).
RET	L633V	missense	unknown	RET L633V lies within the extracellular domain of the Ret protein (UniProt.org). L633V has been identified in sequencing studies (PMID: 30446652), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Jan 2024).
RET	S462L	missense	unknown	RET S462L lies within the extracellular domain of the Ret protein (UniProt.org). S462L has been identified in sequencing studies (PMID: 30446652), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Jan 2024).
RET	V706M	missense	unknown	RET V706M lies within the cytoplasmic domain of the Ret protein (UniProt.org). V706M has been identified in sequencing studies (PMID: 27683183, PMID: 30446652, PMID: 34741450), but has not been biochemically characterized and therefore, its effect on Ret protein function is unknown (PubMed, Jan 2024).

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
RET over exp	Advanced Solid Tumor	predicted - sensitive	Cabozantinib	Preclinical - Cell line xenograft	Actionable	In a preclinical study, Cometriq (Cabometyx, cabozantinib) treatment resulted in moderate tumor volume reduction in a cell line xenograft model of transformed cells overexpressing RET (PMID: 30446652).	30446652