Treatment Considerations for TRK Fusion-Positive NSCLC


Dr David S. Hong reacts to updated survival data associated with the use of larotrectinib as treatment for TRK fusion–positive non–small cell lung cancer.

David S. Hong, MD: Increasing evidence in the last several years shows that lung cancer in particular is a molecular disease. As we’re increasingly being able to parse out the details of lung cancer, whether it’s ALK, ROS1, EGFR, or NTRK, we’re seeing that defining these tumors is important in our patients with NTRK1 fusion. In our data set, we’ve identified close to 14 patients. The overall response rate is very similar to the overall data set that we’ve seen in the larotrectinib cohort, and that is 71%. Interestingly, the majority of these patients, close to 50%, will present with CNS [central nervous system] metastasis. For those patients who have CNS metastasis, their response rate with a brain metastases is close to 60% or 57%. Overall, the duration we’ve seen is approximately 12.9 months; follow-up has not yet been reached. The median follow-up with 14.6 months with median progression-free survival has not been reached. The median overall survival also has not been reached for the medium fallout of about 12.6 months; 91% of these patients were alive at 12 months. These were patients who were refractory to standard platinum and immunotherapy, many of whom were in the data set that my colleague Dr [Alexander] Drilon presented with greater than 3 lines of therapy.

Transcript edited for clarity.

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