Identification of CCDC6-RET Fusion in the Human Lung Adenocarcinoma Cell Line, LC- 2/ad Daisuke Matsubara, MD, PhD, Yoshihiko Kanai, Shumpei Ishikawa,

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Identification of CCDC6-RET Fusion in the Human Lung Adenocarcinoma Cell Line, LC- 2/ad Daisuke Matsubara, MD, PhD, Yoshihiko Kanai, Shumpei Ishikawa, MD, PhD, Shiori Ohara, BSc, Taichiro Yoshimoto, MD, PhD, Takashi Sakatani, MD, PhD, Sachiko Oguni, Tomoko Tamura, Hiroaki Kataoka, Shunsuke Endo, MD, PhD, Yoshinori Murakami, MD, PhD, Hiroyuki Aburatani, MD, PhD, Masashi Fukayama, MD, PhD, Toshiro Niki, MD, PhD Journal of Thoracic Oncology Volume 7, Issue 12, Pages 1872-1876 (December 2012) DOI: 10.1097/JTO.0b013e3182721ed1 Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Dose-response curves of three cell lines, LC-2/ad, HCC827, and H1993. HCC827 harbors EGFR Exon 19 deletion (746–750) and H1993 expresses wild-type EGFR. The x axis indicates the log10 (concentration of vandetanib [A] and gefitinib [B]), and the y axis indicates the % of cell viability = (mean absorbance in test wells)/(mean absorbance in control well) × 100. A, LC-2/ad and HCC827 were sensitive to vandetanib (IC50 values were 2.9E-08 and 6.9E-09, respectively), but H1993 was resistant to vandetanib (IC50 value was 5.1E-04). B, HCC827 was sensitive to gefitinib (inhibitory concentration 50 value was 1.8E-10), but LC-2/ad and H1993 were resistant to gefitinib (inhibitory concentration 50 values were 1.8E-05 and 4.0E-06, respectively). EGFR, epidermal growth factor receptor. Journal of Thoracic Oncology 2012 7, 1872-1876DOI: (10.1097/JTO.0b013e3182721ed1) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Effects of vandetanib and gefitinib on the phosphorylation levels of EGFR, ERK, and AKT in LC-2/ad, HCC827, and H1993. Gefitinib efficiently led to dephosphorylation of EGFR, ERK, and AKT in HCC827, but not in LC-2/ad and H1993. Vandetanib efficiently led to dephosphorylation of ERK and AKT in LC-2/ad and HCC827, but not in H1993.EGFR, EGFR, epidermal growth factor receptor; ERK, extracellular signal-regulated kinase; AKT, v-akt murine thymoma viral oncogene homolog 1. Journal of Thoracic Oncology 2012 7, 1872-1876DOI: (10.1097/JTO.0b013e3182721ed1) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Identification of CCDC6-RET fusion in LC-2/ad by fusion-specific RT-PCR. A, Bar graphs of gene-level expressions of RET in the 39 cell lines. B, Results for fusion-specific RT-PCR of LC-2/ad: with the forward primer CCDC6-197F and reverse primer RET-2381R (Lane 1), with the forward primer KIF5B-867F and reverse primer RET-2381R (Lane 2), and with the forward primer KIF5B-2265F and reverse primer RET-2381R (Lane 3). A PCR product of an expected size (352 base pair) was amplified in Lane 1, but not in Lane 2 or Lane 3. Molecular weight marker: ϕX174-HAE digest. C, RET-CCDC6 fusion was captured only in LC-2/ad and was not captured in any of the other cell lines tested. The results for eight cell lines are shown: Lane 1, A549; Lane 2, ABC1; Lane 3, Calu-3; Lane 4, PC3; Lane 5, RERF-LC-KJ; Lane 6, HLC-1; Lane 7, L27; Lane 8, LC-2/ad; and Lane 9, VMRC-LCD). Molecular weight marker: ϕX174-HAE digest. D, Direct sequencing of the PCR product containing RET-CCDC6 fusion. PCR, polymerase chain reaction; RT-PCR, reverse-transcriptase polymerase chain reaction. Journal of Thoracic Oncology 2012 7, 1872-1876DOI: (10.1097/JTO.0b013e3182721ed1) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Histopathologic characteristics of an established xenograft tumor of LC-2/ad. A, The main histopathologic diagnosis of the tumor was acinar-predominant adenocarcinoma showing a cribriform pattern (hematoxylin and eosin staining, ×200). B, The tumor was positive for RET (RET immunostaining, ×200). C, The tumor was positive for Napsin A (Napsin A immunostaining, ×200). D, The tumor was negative for thyroglobulin (Thyroglobulin immunostaining, ×200). Journal of Thoracic Oncology 2012 7, 1872-1876DOI: (10.1097/JTO.0b013e3182721ed1) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions