APRIL 2014CANCER DISCOVERY  |  OF1 CD74–NRG1 Fusions in Lung

ABSTRACT We discovered a novel somatic gene fusion, CD74–NRG1, by transcriptome sequenc-ing of 25 lung adenocarcinomas of never smokers. By screening 102 lung adenocar-cinomas negative for known oncogenic alterations, we found four additional fusion-positive tumors, all of which were of the invasive mucinous subtype. Mechanistically, CD74–NRG1 leads to extracellular expression of the EGF-like domain of NRG1 III-β3, thereby providing the ligand for ERBB2–ERBB3 receptor complexes. Accordingly, ERBB2 and ERBB3 expression was high in the index case, and expres-sion of phospho-ERBB3 was specifi cally found in tumors bearing the fusion ( P < 0.0001). Ectopic expression of CD74–NRG1 in lung cancer cell lines expressing ERBB2 and ERBB3 activated ERBB3 and the PI3K–AKT pathway, and led to increased colony formation in soft agar. Thus, CD74–NRG1 gene fusions are activating genomic alterations in invasive mucinous adenocarcinomas and may offer a therapeutic opportunity for a lung tumor subtype with, so far, no effective treatment. SIGNIFICANCE: CD74–NRG1 fusions may represent a therapeutic opportunity for invasive mucinou