Biomarker NTRK Coverage from Every Angle

NTRK Gene Fusion Testing and Treatment Modifications: Survey of Medical Oncologists

By: Julia Fiederlein
Posted: Sunday, August 1, 2021

Neurotrophic tyrosine receptor kinase (NTRK) gene fusions are present across various tumor types; tropomyosin receptor kinase (TRK) inhibitors are often administered as first-line or subsequent treatment options. Landon Z. Marshall, PharmD, PhD, of Cardinal Health Specialty Solutions, Dublin, Ohio, and colleagues sought to assess the timing of NTRK gene fusion testing and treatment modifications for patients with NTRK-positive disease. Their findings were presented during the NCCN 2021 Virtual Annual Conference (Abstract BPI21-006) and published in JNCCN–Journal of the National Comprehensive Cancer Network.

“Among [patients with NTRK-positive disease], medical oncologists reported testing for NTRK fusions at diagnosis or prior to [first-line therapy],” the investigators commented. “Future research should elucidate why less than half of oncologists surveyed would not use TRK inhibitors…and assess actual clinical practices…as well as characterize treatment patterns and clinical outcomes among [these patients] in the real-world setting.”

A total of 28 medical oncologists from the Oncology Provider Extended Network who had treated patients with NTRK-positive advanced or metastatic solid tumors completed a questionnaire. Between January 1, 2016, and December 31, 2019, participating physicians managed or treated 148 patients with this gene fusion.

Tumors of the lungs (27%), thyroid (18%), and salivary gland (14%) were most commonly tested. More than half of physicians (68%) reported testing NTRK status at diagnosis; testing after disease progression on the first- (36%), second- (25%), and third- (21%) lines of therapy was also frequently performed. A total of 96% of physicians did not have difficulty interpreting NTRK reports. Most physicians (96%) reported the use of next-generation sequencing for determining NTRK status. According to 57% of physicians, age, tumor type, and performance status did not impact NTRK testing decisions. Less than half of physicians (46%) reported using TRK inhibitors after the confirmation of NTRK-positive disease. A total of 89% of physicians frequently reviewed the NTRK testing guidelines.

Disclosure: Dr. Marshall and two coauthors are employees of Cardinal Health and may own stock in the company. Three other coauthors are employees of Bayer U.S. LLC.

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