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10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
NTRK fusion lung cancer is very rare and is treated with the same TRK-blocking pills approved for any cancer with the fusion: larotrectinib, entrectinib or repotrectinib shrink most tumours, including in the brain, so the point is to test broadly enough to find it.
NTRK1, NTRK2 and NTRK3 fusions drive a small share of many cancers, common in a few rare tumours (infantile fibrosarcoma, secretory carcinoma) and rare in common ones such as lung cancer. Larotrectinib was approved in November 2018 for any solid tumour with an NTRK fusion, the second tumour-agnostic approval after pembrolizumab for mismatch-repair deficiency, on a pooled response rate of 75 percent across tumour types in its phase 1 and 2 studies (NAVIGATE among them); entrectinib followed in August 2019 with a 57 percent pooled response rate and intracranial activity, and repotrectinib received a tumour-agnostic accelerated approval in June 2024, with activity against the solvent-front mutations that arise on the first two drugs.
In lung cancer specifically the numbers are small: lung cohorts within the larotrectinib and entrectinib programmes reported response rates of about 70 percent with responses in brain metastases, and the drugs are recommended first line or after chemotherapy. Dizziness, weight gain and paraesthesia from on-target TRK inhibition in the nervous system are the characteristic side effects. Checkpoint inhibitors and chemotherapy are used as for driver-negative disease when TRK inhibitors are exhausted.
| Setting | Approach | Guideline |
|---|---|---|
| Advanced, first line or after chemotherapy | Larotrectinib or entrectinib under their tumour-agnostic approvals; repotrectinib after resistance to either; chemoimmunotherapy as for driver-negative disease before or after. | not mapped |