TABLE I.
Targeted therapies approved by Health Canada that require testing for molecular biomarkers
| Gene | Nature of aberration | Cancer type | Targeted therapy |
|---|---|---|---|
| Solid tumours | |||
|
| |||
| ALK1 | Fusion | Lung cancer | Alectinib, brigatinib, ceritinib, crizotinib |
|
| |||
| BRAF | Variant | Melanoma | Cobimetinib–vemurafenib, dabrafenib with or without trametinib, trametinib monotherapy, vemurafenib monotherapy |
| Variant | Lung cancer | Dabrafenib with trametinib | |
|
| |||
| BRCA1/2 | Variant, copy number | Ovarian, fallopian tube, primary peritoneal cancer | Olaparib |
| Germline and HER2-negative | Variant, copy number | Breast cancer | Olaparib |
|
| |||
| EGFR | Variant, insertion or deletion | Lung cancer | Afatinib, erlotinib, gefitinib, osimertinib |
| KRAS wild type | Variant | Colon cancer | Cetuximab |
| RAS wild type | Variant | Colon cancer | Panitumumab |
|
| |||
| Kit (CD117) | Variant | Gastrointestinal stromal tumours | Imatinib |
|
| |||
| ROS1 | Fusion | Lung cancer | Crizotinib |
|
| |||
| HER2 | |||
| Overexpression | Copy number | Breast cancer | Lapatinib, pertuzumab, trastuzumab, trastuzumab emtansine |
| Negative | Copy number | Breast cancer | Everolimus |
|
| |||
| PD-L1 | Protein expression | Lung cancer | Pembrolizumab |
| Hematologic cancers | |||
|
| |||
| 17p deletion | Copy number | CLL | Venetoclax |
|
| |||
| BCR–ABL1 | Fusion | CML | Bosutinib, dasatinib, imatinib, nilotinib, ponatinib |
|
| |||
| FIP1L1–PDGFRA | Fusion | CEL | Imatinib |
|
| |||
| PDGFR | Variant | Myelodysplastic disease | Imatinib |
|
| |||
| PML/RAR | Fusion | APL | Arsenic trioxide |
CLL = chronic lymphocytic leukemia; CML = chronic myeloid leukemia; CEL = chronic eosinophilic leukemia; APL = acute promyelocytic leukemia.