Jochen H. Lorch, MD, MS

A 71-Year-Old Woman With NTRK Gene Fusion Thyroid Cancer

NTRK Gene Fusion Thyroid Cancer: Incidence and Prognosis 

Preferred Testing Methods and Treatment Options 

LOXO-101 Trial Regimen Overview

A 71-year-old woman presents with a painless “ball on his neck”

PMH: hypercholesterolemia, medically controlled

PE: palpable, non-tender solitary left-of-the midline neck mass; otherwise unremarkable

Labs: including TSH, anti-Tg antibodies WNL

Ultrasound of the neck revealed a 3.8 cm suspicious mass arising from the left thyroid; 4 suspicious submandibular lymph nodes, largest 2.2 cm in size

Ultrasound-guided FNAB of the thyroid mass and the largest lymph node confirmed undifferentiated papillary thyroid carcinoma

Chest/abdominal/pelvic CT showed no evidence of distant metastases

Patient underwent total thyroidectomy with therapeutic central compartment and left selective neck dissection

Pathology: 3.8 cm undifferentiated papillary thyroid cancer arising in left lobe of thyroid, 2 of 7 positive central compartment lymph nodes, largest 1.3 cm, no extra nodal extension

She was treated with radioactive iodine 150 millicuries

Whole body scan showed uptake in neck only consistent with thyroid remnant

Follow-up at 2 months TSH 0.2 mU/L; thyroglobulin 26 ng/mL

MRI of the brain revealed multiple small lesions

Initiated treatment with larotrectinib 100 mg PO BID

Videos

A key opinion leader reviews the case of a 71-year-old woman with NTRK gene fusion thyroid cancer and considers novel therapies available for the management of her disease. 

Jochen H. Lorch, MD, MS | Authors

Articles

A 71-Year-Old Woman with NTRK Gene Fusion Thyroid Cancer