Background
- NRG1 gene fusions are rare but actionable genomic drivers that occur across a growing number of tumor types.
- NRG1 has an EGF-like domain that serves as a ligand for ErbB (HER3) receptors, thereby inducing heterodimerization, usually with HER2, and subsequent activation of relevant downstream signaling pathways.
- Agents targeting the HER2/HER3 pathway have shown early clinical promise in NRG1 fusion-positive cancers.
- The HER2/HER3 bispecific antibody zenocutuzumab has FDA Fast Track Designation for tumors with NRG1 fusions.
Conclusions
- NRG1 fusions are rare but actionable genomic events that occur across many tumor types.
- There are a wide variety of fusion partners within and across tumor types.
- The clinical implications of the heterogeneity among fusion partners warrants further investigation.