NRG1 and Lung Cancer

What is an NRG1-positive cancer?

Errors in the NRG1 gene are one type of lung cancer biomarker. NRG1, or neuregulin 1, gene fusions cause two parts of a cell’s DNA to join together, or fuse. This sends signals to the cells to grow abnormally. 

How do you know if you have NRG1-positive lung cancer?

NRG1 fusions are identified by testing the DNA in the tumor. This is done through a process called next-generation sequencing (NGS). NGS (also called comprehensive biomarker testing) is when tissue from a patient’s tumor (gathered from a biopsy) is placed in a machine that looks for many possible biomarkers at one time. Researchers have found that sometimes NGS testing is not very sensitive to the presence of NRG1 fusions. Physicians may also use special laboratory tests to look at the RNA of the cells to gather more information and be sure no treatable biomarkers are missed. 

Learn more about the different types of biomarker tests.

Who is most likely to have NRG1-positive lung cancer?

NRG1 gene fusions have been described in a variety of cancer types, including pancreatic cancer and now lung cancer. NRG1 gene fusions are often found in the invasive mucinous subtype of non-small cell lung cancer (NSCLC) adenocarcinoma. 

What are the treatment options for someone with NRG1-positive cancer?

Knowing if you have an NRG1 gene fusion is important no matter your stage of lung cancer. However, it has the most treatment implications for patients with stage four lung cancer. Patients with advanced-stage NSCLC whose cancer has continued to grow after other treatments, may be eligible for a targeted medication called zenocutuzumab-zbco (Bizengri). This medication is given through an IV. Other treatments for NRG1 fusions are being studied in clinical trials. 

Work with your doctor to discuss your goals and options each time you have to make a treatment decision. The three big questions to ask are:

1. What is the goal of this treatment?
2. What are the potential side effects?
3. What other options do I have?

Research is happening at a rapid pace and your doctor should be up to date on the recommendations for your specific type of lung cancer. If you don’t feel comfortable with the answers you are receiving, do not hesitate to seek out a second opinion.