Dr. Falchook on TRK Alterations in Lung Cancer

Gerald S. Falchook, MD, director, Drug Development, Sarah Cannon Research Institute, discusses TRK alterations in lung cancer.

In the United States, TRK is seen in approximately 5,000 patients annually across all cancer types. It is pathognomonic in some rare cancers and uncommonly seen in lung cancer. Approximately 3% of patients with lung cancer have this mutation, explains Falchook, but it remains a strong oncogenic driver. Recent clinical trials have examined the use of TRK inhibitors.

At the 2017 ASCO Annual Meeting, data on larotrectinib were presented in an oral session. Earlier this year, these data were published in the New England Journal of Medicine. Upwards of 70% of patients with TRK alterations across all cancer types show responses, many of which are durable, explains Falchook.

There are 3 types of TRK alterations that physicians look for using next-generation sequencing including NTRK1, NTRK2, and NTRK3. Any patient with an alteration in one of these genes should be considered for a TRK inhibitor on a clinical trial, states Falchook.