{"entity":{"id":"paper-oreilly-hechtman-ntrk-fusion-pancreatic-larotrectinib-ann-oncol-2019","kind":"paper","name":"Tumour response to TRK inhibition in a patient with pancreatic adenocarcinoma harbouring an NTRK gene fusion","aka":[],"tldr":"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.","asOf":"2026-09-24","links":[{"label":"O'Reilly and Hechtman, Ann Oncol 2019: CTRC-NTRK1 fusion pancreatic cancer treated with larotrectinib","url":"https://doi.org/10.1093/annonc/mdz385"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31605106/"}],"tags":[],"related":["ntrk-fusion"],"cancers":["pancreatic","kras-wild-type-pdac"],"sections":[],"technologies":[],"targets":["ntrk"],"drugs":["larotrectinib"],"companies":[],"institutions":["mskcc"],"pathways":[],"terms":["tumour-agnostic"],"trials":[],"people":["eileen-oreilly"],"bottlenecks":[],"keyPapers":[],"journals":["annals-of-oncology"],"dependsOn":[],"notes":[],"journal":"Annals of Oncology","year":2019,"doi":"10.1093/annonc/mdz385","pmid":"31605106","authors":"O'Reilly EM, Hechtman JF.","paperType":"observational","findings":["CTRC-NTRK1 fusion pancreatic cancer: partial response to larotrectinib, progression at 6 months.","Acquired resistance and a BRAF V600E clone followed."],"whatItMeans":"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."],"changedPractice":false,"participants":1},"route":"/key-papers/paper-oreilly-hechtman-ntrk-fusion-pancreatic-larotrectinib-ann-oncol-2019/","neighbours":{"biomarker":[{"id":"ntrk-fusion","kind":"biomarker","name":"NTRK1/2/3 gene fusion","route":"/biomarkers/ntrk-fusion/"}],"cancer":[{"id":"kras-wild-type-pdac","kind":"cancer","name":"KRAS wild-type pancreatic ductal adenocarcinoma","route":"/cancers/kras-wild-type-pdac/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"target":[{"id":"ntrk","kind":"target","name":"NTRK","route":"/targets/ntrk/"}],"drug":[{"id":"larotrectinib","kind":"drug","name":"Larotrectinib","route":"/drugs/larotrectinib/"}],"institution":[{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"}],"term":[{"id":"tumour-agnostic","kind":"term","name":"Tumour-agnostic (tissue-agnostic) approval","route":"/terms/tumour-agnostic/"}],"person":[{"id":"eileen-oreilly","kind":"person","name":"Eileen M. O'Reilly","route":"/people/eileen-oreilly/"}],"journal":[{"id":"annals-of-oncology","kind":"journal","name":"Annals of Oncology","route":"/journals/annals-of-oncology/"}]}}