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Andrea Forschner1, Stephan Forchhammer2, Irina Bonzheim3

  • 1Zentrum für Dermatoonkologie, Universitäts-Hautklinik Tübingen.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|December 29, 2020
PubMed
Summary
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Neurotrophic tyrosine receptor kinase (NTRK) fusions are oncogenic drivers. This study found NTRK fusions are relatively common in Spitzoid melanoma, suggesting TRK inhibitors may benefit these patients.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Context:

  • Neurotrophic tyrosine receptor kinase (NTRK) gene fusions are established oncogenic drivers in various cancers, including rare instances in melanoma.
  • High incidences of NTRK fusions are reported in infantile fibrosarcoma and secretory breast carcinoma.
  • The recent approval of Larotrectinib, a Tropomyosin receptor kinase (TRK) inhibitor, prompts investigation into their relevance for melanoma patients.

Purpose:

  • To investigate the prevalence and clinical relevance of NTRK gene fusions in different melanoma subtypes.
  • To explore the potential of TRK inhibitors as a therapeutic strategy for melanoma patients with NTRK fusions.

Summary:

  • NTRK fusions occur in 21-29% of Spitzoid melanomas, significantly higher than in cutaneous (<1%), mucosal (<1%), or acral (2.5%) melanomas.

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  • NTRK fusions appear to be mutually exclusive with other common drivers like BRAF and NRAS.
  • Low tumor mutational burden may indicate a higher likelihood of NTRK-positive tumors.
  • Impact:

    • Identifies a potential therapeutic target and patient population for TRK inhibitors in melanoma.
    • Highlights the need for integrating NTRK fusion screening into clinical practice for melanoma management.
    • Suggests screening BRAF, NRAS, and KIT wild-type melanoma patients with Next-Generation Sequencing upon requiring systemic therapy or upon lack of response to checkpoint inhibitors.