Treatment of Advanced or Metastatic Non-Small Cell Lung Cancer with NTRK1/2/3 Gene Fusion
This protocol addresses a molecularly defined subgroup of non-small cell lung cancer (NSCLC): patients with advanced or metastatic disease whose tumours carry an NTRK1, NTRK2, or NTRK3 gene fusion — a rare but actionable oncogenic alteration.
NTRK1/2/3 gene fusions are detected in fewer than 1% of NSCLC cases and are generally mutually exclusive with other established oncogenic drivers. Molecular testing to identify this fusion is central to appropriate patient selection for this pathway.
The protocol involves targeted therapy directed at this fusion. For disease that has progressed following earlier NTRK-directed treatment, a distinct targeted agent is used as a subsequent option — the full sequence and regimen are in the complete protocol.
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.
Repotrectinib can be used as a subsequent therapy if entrectinib or larotrectinib were given previously.
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