ROS1

Chr 6

ROS proto-oncogene 1, receptor tyrosine kinase

Also known as: MCF3, ROS, c-ros-1

The ROS1 protein is a receptor tyrosine kinase that regulates cell differentiation, proliferation, and survival through multiple downstream signaling pathways including PI3K-mTOR and STAT3. Mutations in ROS1 cause autosomal dominant gingival fibromatosis, a condition characterized by progressive enlargement of the gums. This gene is not highly constrained against loss-of-function mutations, suggesting the pathogenic variants may act through other mechanisms.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismLOEUF 1.12
Clinical SummaryROS1
Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
1.12LOEUF
pLI 0.000
Z-score 0.46
OE 0.95 (0.821.12)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
-0.50Z-score
OE missense 1.04 (0.991.09)
1243 obs / 1194.3 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios
LoF OE0.95 (0.821.12)
00.351.4
Missense OE1.04 (0.991.09)
00.61.4
Synonymous OE1.12
01.21.6
LoF obs/exp: 113 / 118.3Missense obs/exp: 1243 / 1194.3Syn Z: -1.93
DN
0.6744th %ile
GOF
0.73top 25%
LOF
0.3745th %ile

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function and dominant-negative). Both the Badonyi & Marsh prediction and the broader genomic evidence point to gain-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

GOFprediction above median
DNprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

ROS1 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Breast CancerCholangiocarcinomaColorectal Cancer

Basket Study of Entrectinib (RXDX-101) for the Treatment of Patients With Solid Tumors Harboring NTRK 1/2/3 (Trk A/B/C), ROS1, or ALK Gene Rearrangements (Fusions)

ACTIVE NOT RECRUITING
NCT02568267Phase PHASE2Hoffmann-La RocheStarted 2015-11-19
Entrectinib
Lymphoma, Non-HodgkinMultiple MyelomaAdvanced Solid Tumors

Canadian Profiling and Targeted Agent Utilization Trial (CAPTUR)

RECRUITING
NCT03297606Phase PHASE2Canadian Cancer Trials GroupStarted 2018-03-23
OlaparibDasatinibNivolumab plus Ipilimumab
Solid TumorAdvanced Solid TumorMetastatic Cancer

KPMNG Study of MOlecular Profiling Guided Therapy Based on Genomic Alterations in Advanced Solid Tumors II

RECRUITING
NCT05525858Seoul National University Bundang HospitalStarted 2022-09-28
AlectinibAtezolizumabErlotinib
Non-small Cell Lung CancerBrain MetastasesEGFR Gene Mutation

Nitroglycerin Plus Radiotherapy Versus Conventional Radiotherapy in Patients With Lung Cancer.

RECRUITING
NCT06238882Phase NAInstituto Nacional de Cancerologia de MexicoStarted 2023-02-23
Nitroglycerin
Locally Advanced or Metastatic Solid TumorsLocally Advanced or Metastatic Non-small Cell Lung Cancer

A Study of XZP-5955 Tablets in Patients With NTRK or ROS1 Fusion Positive Locally Advanced or Metastatic Solid Tumors

RECRUITING
NCT04996121Phase PHASE1, PHASE2Xuanzhu Biopharmaceutical Co., Ltd.Started 2021-12-06
XZP-5955 tablets
Non-Small Cell Carcinoma of Lung, TNM Stage 4Non-Small Cell Lung CancerEGFR Gene Mutation

Early Rebiopsy to Identify Biomarkers of Tumor Cell Survival Following EGFR, ALK, ROS1 or BRAF TKI Therapy

RECRUITING
NCT03042221University of Colorado, DenverStarted 2016-05-10
Non Small Cell Lung Cancer

Efficacy and Safety Analysis of First-Line ABCP Therapy in Advanced SMARCA4-Mutated NSCLC

NOT YET RECRUITING
NCT07093762Fuzhou General HospitalStarted 2025-08-20
Atezolizumab+Bevacizumab+Carboplatin+Paclitaxel
Non-small Cell Lung Cancer (NSCLC)

Sacituzumab Tirumotecan (MK-2870) Versus Chemotherapy in Previously Treated Advanced or Metastatic Nonsquamous Non-small Cell Lung Cancer (NSCLC) With EGFR Mutations or Other Genomic Alterations (MK-2870-004)

RECRUITING
NCT06074588Phase PHASE3Merck Sharp & Dohme LLCStarted 2023-11-12
Sacituzumab tirumotecanDocetaxelPemetrexed
Lung Cancer

Feasibility of Targeted Bronchial Washing for Molecular Testing by Next Generation Sequencing in Early-stage Lung Cancer

ACTIVE NOT RECRUITING
NCT06301295Phase NAPusan National University HospitalStarted 2024-05-29
Ultarthin bronchoscopy with intratumoral washing
Carcinoma, Non-Small-Cell Lung

LIquid BIopsies in Patients Presenting Non-small Cell Lung Cancer

RECRUITING
NCT02511288Centre Leon BerardStarted 2015-07
ROS1 Fusion PositiveNon Small Cell Lung Cancer

Study on the Mechanism of Acquired Resistance of Entrectinib

RECRUITING
NCT07199959Fudan UniversityStarted 2025-01-15
venipuncyureEntrectinib
Lung CancerNon Small Cell Lung Cancer

Amivantamab With Tyrosine Kinase Inhibitors (TKI) for Advanced NSCLC With ALK, ROS1, or RET Alterations

ACTIVE NOT RECRUITING
NCT05845671Phase PHASE1, PHASE2University of Colorado, DenverStarted 2023-07-17
Amivantamab 1050mgAmivantamab 1400mgAmivantamab (to be determined)
Clinical Literature
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