Oncogenic Mutations/Gene Rearrangements in Patients with Advanced Adenocarcinoma Lung
Primary Objective: To determine the frequency of oncogenic mutation/gene rearrangements in tumors from patients with advanced adenocarcinoma of the lung. The mutations of interest include those seen in EGFR, HER2, BRAF, MET, MEK1, EGFR and Ross1 and rearrangement of the EML4-ALK fusion gene. Secondary Objectives: -To correlate the presence of the oncogenic mutation/gene rearrangements with clinical outcome. The clinical features associated with these mutations are not well characterized as the testing for these abnormalities has not been done in the current clinical setting. As some of these mutations/rearrangements are drugable, the ultimate goal will be to develop effective therapies with better understanding of the biology of lung cancer. -To enumerate circulating tumor cells (EpCAM+CD45) from the same patients with adenocarcinoma of the lung and correlate with clinical outcome and detect the presence of the oncogenic mutations/gene rearrangements (e.g. ALK fusions) as outlined above. The tumor cell heterogeneity in the CTC population will be examined and compared with that seen in primary tumor samples. -To evaluate the tumor from these patients with adenocarcinoma of the lung for additional gene mutations of interest seen by NEXT GENERATION SEQUENCING (NGS).