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Background   ROS1  rearrangements are validated drivers in lung cancer, which have been identified in a small subset (1–2%) of patients with non-small cell lung cancer (NSCLC). To date, 18 fusion genes of  ROS1  have been identified in NSCLC. The ALK inhibitor (crizotinib) exhibits therapeutic effect against  ROS1 -rearranged NSCLC. Next-generation sequencing (NGS) technology represents a novel tool for  ROS1  detection that covers many fusion genes.    Case presentation  A 55-year-old female with  EGFR  mutation (L858R) was diagnosed with lung adenocarcinoma, who was responsive to first-generation EGFR-tyrosine kinase inhibitor (TKI). Afterwards, she developed acquired resistance accompanied with a  ROS1  rearrangement. A NGS assay showed that the tumor had a novel  ROS1-ADGRG6  rearrangement generated by the fusion of exons of 1–33 of  ROS1  on chr6: q22.1 to exons of 2–26 of  ADGRG6  on chr6: q24.2. The patient was obviously responsive to crizotinib.    Conclusion  We firstly identified  ROS1-ADGRG6  fusion variant in NSCLC by NGS, which should be considered in further ROS1 detecting assays.

ROS1-ADGRG6: a case report of a novel ROS1 oncogenic fusion variant in lung adenocarcinoma and the response to crizotinib