Thoracic Cancer (Nov 2022)

Expert consensus on the diagnosis and treatment of NTRK gene fusion solid tumors in China

  • Chunwei Xu,
  • Lu Si,
  • Wenxian Wang,
  • Ziming Li,
  • Zhengbo Song,
  • Qian Wang,
  • Aijun Liu,
  • Jinpu Yu,
  • Wenfeng Fang,
  • Wenzhao Zhong,
  • Zhijie Wang,
  • Yongchang Zhang,
  • Jingjing Liu,
  • Shirong Zhang,
  • Xiuyu Cai,
  • Anwen Liu,
  • Wen Li,
  • Ping Zhan,
  • Hongbing Liu,
  • Tangfeng Lv,
  • Liyun Miao,
  • Lingfeng Min,
  • Yu Chen,
  • Jingping Yuan,
  • Feng Wang,
  • Zhansheng Jiang,
  • Gen Lin,
  • Xingxiang Pu,
  • Rongbo Lin,
  • Weifeng Liu,
  • Chuangzhou Rao,
  • Dongqing Lv,
  • Zongyang Yu,
  • Lei Lei,
  • Xiaoyan Li,
  • Chuanhao Tang,
  • Chengzhi Zhou,
  • Junping Zhang,
  • Junli Xue,
  • Hui Guo,
  • Qian Chu,
  • Rui Meng,
  • Jingxun Wu,
  • Rui Zhang,
  • Xiao Hu,
  • Jin Zhou,
  • Zhengfei Zhu,
  • Yongheng Li,
  • Hong Qiu,
  • Fan Xia,
  • Yuanyuan Lu,
  • Xiaofeng Chen,
  • Rui Ge,
  • Enyong Dai,
  • Yu Han,
  • Weiwei Pan,
  • Jiancheng Luo,
  • Hongtao Jia,
  • Xiaowei Dong,
  • Fei Pang,
  • Kai Wang,
  • Liping Wang,
  • Youcai Zhu,
  • Yanru Xie,
  • Xinqin Lin,
  • Jing Cai,
  • Jia Wei,
  • Fen Lan,
  • Huijing Feng,
  • Lin Wang,
  • Yingying Du,
  • Wang Yao,
  • Xuefei Shi,
  • Xiaomin Niu,
  • Dongmei Yuan,
  • Yanwen Yao,
  • Jianhui Huang,
  • Yinbin Zhang,
  • Pingli Sun,
  • Hong Wang,
  • Mingxiang Ye,
  • Dong Wang,
  • Zhaofeng Wang,
  • Bing Wan,
  • Donglai Lv,
  • Qing Wei,
  • Jin Kang,
  • Jiatao Zhang,
  • Chao Zhang,
  • Genhua Yu,
  • Juanjuan Ou,
  • Lin Shi,
  • Zhongwu Li,
  • Zhefeng Liu,
  • Jing Liu,
  • Nong Yang,
  • Lin Wu,
  • Huijuan Wang,
  • Gu Jin,
  • Liu Yang,
  • Guansong Wang,
  • Meiyu Fang,
  • Yong Fang,
  • Yuan Li,
  • Xiaojia Wang,
  • Yiping Zhang,
  • Shenglin Ma,
  • Biyun Wang,
  • Xiaotian Zhang,
  • Yong Song,
  • Yuanzhi Lu

DOI
https://doi.org/10.1111/1759-7714.14644
Journal volume & issue
Vol. 13, no. 21
pp. 3084 – 3097

Abstract

Read online

Abstract Gene fusions can drive tumor development for multiple types of cancer. Currently, many drugs targeting gene fusions are being approved for clinical application. At present, tyrosine receptor kinase (TRK) inhibitors targeting neurotrophic tyrosine receptor kinase (NTRK) gene fusions are among the first “tumor agnostic” drugs approved for pan‐cancer use. Representative TRK inhibitors, including larotrectinib and entrectinib, have shown high efficacy for many types of cancer. At the same time, several second‐generation drugs designed to overcome first‐generation drug resistance are undergoing clinical development. Due to the rarity of NTRK gene fusions in common cancer types and technical issues regarding the complexity of fusion patterns, effectively screening patients for TRK inhibitor treatment in routine clinical practice is challenging. Different detection methods including immunohistochemistry, fluorescence in situ hybridization, reverse transcription‐polymerase chain reaction, and (DNA and/or RNA‐based) next‐generation sequencing have pros and cons. As such, recommending suitable tests for individual patients and ensuring the quality of tests is essential. Moreover, at present, there is a lack of systematic review for the clinical efficacy and development status of first‐ and second‐generation TRK inhibitors. To resolve the above issues, our expert group has reached a consensus regarding the diagnosis and treatment of NTRK gene fusion solid tumors, aiming to standardize clinical practice with the goal of benefiting patients with NTRK gene fusions treated with TRK inhibitors.

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