# Tumour response to TRK inhibition in a patient with pancreatic adenocarcinoma harbouring an NTRK gene fusion

Source: https://onco.cc/key-papers/paper-oreilly-hechtman-ntrk-fusion-pancreatic-larotrectinib-ann-oncol-2019/  
OnCo record `paper-oreilly-hechtman-ntrk-fusion-pancreatic-larotrectinib-ann-oncol-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A woman whose pancreatic cancer carried a CTRC-NTRK1 fusion responded to larotrectinib for six months after chemotherapy failed, then developed resistance, showing both the promise and the limits of TRK inhibitors in this disease.

## Summary

A 61-year-old with metastatic pancreatic ductal adenocarcinoma received gemcitabine, nab-paclitaxel and ADI-PEG 20 for 12 months (partial response), then modified FOLFIRINOX, before somatic profiling revealed a CTRC-NTRK1 fusion. Larotrectinib 100 mg twice daily gave a partial response at 2 months; progression at 6 months led to re-biopsy and the next-generation TRK inhibitor selitrectinib, then dabrafenib and trametinib for a BRAF V600E mutation; the patient died two months later.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Annals of Oncology
- Year: 2019
- DOI: 10.1093/annonc/mdz385
- Authors: O'Reilly EM, Hechtman JF.
- Findings: CTRC-NTRK1 fusion pancreatic cancer: partial response to larotrectinib, progression at 6 months.; Acquired resistance and a BRAF V600E clone followed.
- What it means: NTRK fusions are under 0.5% of pancreatic cancers but carry a tumour-agnostic approval; this case is the published proof that the label applies here.
- Caveats: Single case.; Resistance mechanisms were not fully characterised in the abstract.

## Sources

- O'Reilly and Hechtman, Ann Oncol 2019: CTRC-NTRK1 fusion pancreatic cancer treated with larotrectinib: https://doi.org/10.1093/annonc/mdz385
- PubMed: https://pubmed.ncbi.nlm.nih.gov/31605106/

## Connected records

- biomarkers: [NTRK1/2/3 gene fusion](https://onco.cc/biomarkers/ntrk-fusion/)
- cancers: [KRAS wild-type pancreatic ductal adenocarcinoma](https://onco.cc/cancers/kras-wild-type-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- targets: [NTRK](https://onco.cc/targets/ntrk/)
- drugs: [Larotrectinib](https://onco.cc/drugs/larotrectinib/)
- institutions: [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/)
- terms: [Tumour-agnostic (tissue-agnostic) approval](https://onco.cc/terms/tumour-agnostic/)
- people: [Eileen M. O'Reilly](https://onco.cc/people/eileen-oreilly/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)

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