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

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机构: [1]Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, People’s Republic of China [2]Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China [3]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital andInstitute, Beijing, People’s Republic of China [4]Department of Chemotherapy, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou, People’s Republic of China [5]Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China [6]Department of Respiratory Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, People’s Republicof China [7]Senior Department of Pathology, The 7th Medical Center of PLA General Hospital, Beijing, People’s Republic of China [8]Cancer Molecular Diagnostics Core, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People’s Republic of China [9]Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for CancerMedicine, Guangzhou, People’s Republic of China [10]Guangdong Lung Cancer Institute, Guangdong Provincial Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People’s Hospital, Guangdong Academyof Medical Sciences, School of Medicine, Guangzhou, People’s Republic of China [11]State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, ChineseAcademy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China [12]Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central SouthUniversity, Changsha, People’s Republic of China [13]Department of Thoracic Cancer, Jilin Cancer Hospital, Changchun, People’s Republic of China [14]Translational Medicine Research Center, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People’sHospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China [15]Department of VIP Inpatient, Sun Yet-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine,Guangzhou, People’s Republic of China [16]Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China [17]Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School ofMedicine, Cancer Center, Zhejiang University, Hangzhou, People’s Republic of China [18]Department of Respiratory Medicine, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China [19]Department of Respiratory Medicine, Clinical Medical School of Yangzhou University, Subei People’s Hospital of Jiangsu Province, Yangzhou, People’s Republic of China [20]Department of Medical Oncology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuzhou, People’s Republic of China [21]Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China [22]Department of Internal Medicine, Cancer Center of PLA, Qinhuai Medical Area, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic ofChina [23]Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People’s Republic of China [24]Department of Medical Oncology, Lung Cancer and Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha,People’s Republic of China [25]Department of Orthopaedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Peking University, Beijing, People’s Republic of China [26]Department of Radiotherapy and Chemotherapy, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, People’s Republic of China [27]Department of Pulmonary Medicine, Taizhou Hospital of Wenzhou Medical University, Taizhou, People’s Republic of China [28]Department of Respiratory Medicine, The 900th Hospital of the Joint Logistics Team (The Former Fuzhou General Hospital), Fujian Medical University, Fuzhou, People’sRepublic of China [29]Department of Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China [30]Department of Medical Oncology, Peking University International Hospital, Beijing, People’s Republic of China [31]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospitalof Guangzhou Medical University (The First Affiliated Hospital of Guangzhou Medical University), Guangzhou, People’s Republic of China [32]Department of Thoracic Oncology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, People’s Republic of China [33]Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China [34]Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China [35]Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China [36]Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China [37]Department of Medical Oncology, The First Affiliated Hospital of Medicine, Xiamen University, Xiamen, People’s Republic of China [38]Department of Medical Oncology, Cancer Hospital of China Medical University, Shenyang, People’s Republic of China [39]Zhejiang Key Laboratory of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, People’s Republic of China [40]Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology,Chengdu, People’s Republic of China [41]Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China [42]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital andInstitute, Beijing, People’s Republic of China [43]State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University,Xi’an, People’s Republic of China [44]Department of Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China [45]Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China [46]Department of Oncology and Hematology, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China [47]Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China [48]Department of Cell Biology, College of Medicine, Jiaxing University, Jiaxing, People’s Republic of China [49]Aiyi Technology Co., Ltd, Beijing, People’s Republic of China [50]Department of Pathology, Shanghai OrigiMed Co, Ltd, Shanghai, People’s Republic of China [51]Department of Oncology, Baotou Cancer Hospital, Baotou, People’s Republic of China [52]Department of Thoracic Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic ofChina [53]Department of Oncology, Lishui Municipal Central Hospital, Lishui, People’s Republic of China [54]Department of the Comprehensive Cancer Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China [55]Department of Pathology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, People’s Republic of China [56]Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China [57]Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China [58]Department of Respiratory Medicine, Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, People’s Republic of China [59]Department of Oncology, The Second Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, People’s Republic of China [60]Department of Pathology, The Second Hospital of Jilin University, Changchun, People’s Republic of China [61]Senior Department of Oncology, The 5th Medical Center of PLA General Hospital, Beijing, People’s Republic of China [62]Department of Respiratory Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, People’s Republic of China [63]Department of Clinical Oncology, The 901 Hospital of Joint Logistics Support Force of People Liberation Army, Hefei, People’s Republic of China [64]Department of Radiation Oncology, Zhebei Mingzhou Hospital, Huzhou, People’s Republic of China [65]Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic ofChina [66]Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China [67]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute,Beijing, People’s Republic of China [68]Department of Oncology, Ruijin Hospital, Shanghai Jiao tong University School of Medicine, Shanghai, People’s Republic of China [69]Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China [70]Department of Bone and Soft-Tissue Surgery, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou, People’s Republic of China [71]Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou MedicalCollege, Hangzhou, People’s Republic of China [72]Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, People’s Republic of China [73]Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, People’s Republic of China [74]Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China [75]Department of Oncology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology, Research of Zhejiang Province, Affiliated Hangzhou Cancer Hospital, Cancer Center,Zhejiang University School of Medicine, Hangzhou, People’s Republic of China [76]Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, FudanUnviersity, Shanghai, People’s Republic of China [77]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital andInstitute, Beijing, People’s Republic of China [78]Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China
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关键词: fusion precision medicine solid tumor targeted therapy tyrosine receptor kinase

摘要:
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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大类 | 3 区 医学
小类 | 3 区 肿瘤学 3 区 呼吸系统
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大类 | 3 区 医学
小类 | 4 区 肿瘤学 4 区 呼吸系统
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Q3 ONCOLOGY Q3 RESPIRATORY SYSTEM
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Q2 RESPIRATORY SYSTEM Q3 ONCOLOGY

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第一作者:
第一作者机构: [1]Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, People’s Republic of China [2]Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
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通讯作者:
通讯机构: [2]Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China [77]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital andInstitute, Beijing, People’s Republic of China [78]Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China [*1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China. [*2]Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, People’s Republic of China. [*3]Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, People’s Republic of China.
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