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NTRK1-TPM3 Gene Rearrangement in Recurrent Ovarian Cancer: Case Report

By: Joseph Fanelli
Posted: Thursday, September 23, 2021

A case study presented in Research Square (a preprint platform of preliminary reports that have not undergone peer review) described a rare instance of recurrent ovarian cancer with NTRK1-TPM3 gene fusion. According to Keiya Fujimori, MD, PhD, of the Fukushima Medical University, Japan, and colleagues, the targeted kinase inhibitor entrectinib was not effective in this particular patient.

“Physicians should be aware of the discrepancy of DNA rearrangement and protein expression, and immunohistochemistry should be performed for confirmation of NTRK protein expression before entrectinib administration,” the authors said.

In this study, the authors described the clinical scenario of a 56-year old woman who was diagnosed with stage IV ovarian cancer reportedly due to pleural effusion. The woman received neoadjuvant chemotherapy and interval debulking surgery followed by chemotherapy. At 10 months after surgery, the ovarian cancer recurred, and she was treated with multimodal therapy.

Next, DNA-based next-generation sequencing found a NTRK1-TPM3 rearrangement, and the patient started receiving treatment with entrectinib. After 6 weeks of treatment, entrectinib was discontinued, and 1 month later, the patient died. Immunohistochemistry with a pan-Trk monoclonal antibody was performed to determine the expression of NTRK, but the immunohistochemistry result returned negative.

“The present case demonstrates the discrepancy between gene rearrangement detected by next-generation sequencing and protein expression,” the authors said.

Disclosure: For full disclosure of the study authors, visit researchsquare.com.



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