Lung cancer
ICD-10 C34 · ICD-11 2C25.Z

Treatment of Advanced or Metastatic Non-Small Cell Lung Cancer with NTRK1/2/3 Gene Fusion

Advanced or metastatic non-small cell lung cancer (NSCLC) harbouring an NTRK1, NTRK2, or NTRK3 gene fusion is a distinct, actionable molecular subtype. Confirming the fusion by molecular testing is the critical step that defines first-line treatment selection for this population.

Clinical scenario

NTRK1/2/3 gene fusions are rare in NSCLC, estimated to occur in fewer than 1% of patients, and do not typically co-occur with other known oncogenic drivers. This low prevalence makes systematic molecular testing essential to identify eligible patients.

First-line approach (summary only)

For patients with confirmed NTRK gene fusion-positive advanced or metastatic NSCLC, current evidence supports a first-line targeted therapy strategy. Preferred agents and the criteria governing their selection are detailed in the full protocol.

The complete list of preferred options and applicable clinical criteria are available in the full regimen — see below.

Instant Access to Structured Evidence-Based Regimens

References

It is estimated that NTRK1/2/3 gene fusions occur in <1% of patients with NSCLC and do not typically overlap with other known oncogenic drivers.

The Panel recommends entrectinib, larotrectinib, or repotrectinib as preferred first-line therapy options for patients with NTRK1/2/3 gene fusion-positive advanced or metastatic NSCLC (PS 0–4).

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