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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.
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.
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.
Shares NTRK1/2/3 gene fusion, Larotrectinib, NTRK, Pancreatic ductal adenocarcinoma.
Shares Eileen M. O'Reilly, KRAS wild-type pancreatic ductal adenocarcinoma, Tumour-agnostic (tissue-agnostic) approval, Pancreatic ductal adenocarcinoma.
Shares Eileen M. O'Reilly, Memorial Sloan Kettering Cancer Center, Pancreatic ductal adenocarcinoma.
Shares NTRK1/2/3 gene fusion, NTRK, Memorial Sloan Kettering Cancer Center.
Shares Eileen M. O'Reilly, Pancreatic ductal adenocarcinoma.
Shares Eileen M. O'Reilly, Annals of Oncology, Pancreatic ductal adenocarcinoma.