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Poster Display session 3

5366 - Co-occurrence of NTRK fusions with other genomic biomarkers in cancer patients


30 Sep 2019


Poster Display session 3


Translational Research

Tumour Site


Xiaolong Jiao


Annals of Oncology (2019) 30 (suppl_5): v25-v54. 10.1093/annonc/mdz239


X. Jiao1, A. Lokker2, J. Snider2, E. Castellanos3, S. Nanda4, V. Fisher5, J. Zong4, K. Keating6, M. Fellous7

Author affiliations

  • 1 Biostatistics, Bayer HealthCare Pharmaceuticals, Inc., NJ07981 - Whippany/US
  • 2 Research Oncology, Flatiron Health, Inc., New York/US
  • 3 Research Oncology, Flatiron Health, Inc., 10013 - New York/US
  • 4 Biostatistics, Bayer HealthCare Pharmaceuticals, Inc., Whippany/US
  • 5 Biostatistics, Foundation Medicine, Inc., Cambridge/US
  • 6 Heor, Bayer HealthCare Pharmaceuticals, Inc., Whippany/US
  • 7 Global Medical Affairs, Bayer HealthCare Pharmaceuticals, Inc., Whippany/US


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Abstract 5366


Larotrectinib is the first therapy approved in the U.S. for locally advanced or metastatic solid tumors with neurotropic tyrosine receptor kinase (NTRK) gene fusions. NTRK gene fusions have been documented with variable frequency across numerous tumor types; limited data exist regarding the relationship of NTRK gene fusions with other targetable biomarkers. This study evaluated the co-occurrence of NTRK gene fusions with other therapy molecular markers in cancer patients.


This retrospective study included cancer patients from a de-identified Flatiron Health-Foundation Medicine Clinico-Genomic Database (CGDB) who had next-generation sequencing (NGS) between Jan 2011 and July 2018. The co-occurrence frequencies of NTRK gene fusions with the following markers was determined using NGS assays including FoundationOne and FoundationOne Heme: tumor mutation burden (TMB), microsatellite instability (MSI), ALK, BRAF, ERBB2, EGFR, ROS1, and KRAS.


An evaluable sample of 15,971 of 33,398 patients in the CGDB had one of 18 histologies where at least one NTRK fusion patient was identified. NTRK gene fusions were identified in 29 patients: 55% (16/29) were female; 69% (20/29) were Caucasians. The median age was 60 years (Q1-Q3: 49.0-65.0). Fifteen different fusion partners were identified; the most frequent were ETV6-NTRK3 (n = 8), TPM3-NTRK1 (n = 6), and TPR-NTRK1 (n = 3). Co-occurring genomic alterations are shown in the table.Table: 102P

Co-occurring biomarkers*Patients with NTRK gene fusions (N = 29), % (n)
TMB High (>20 mut/mB) TMB Medium (<20, >5 mut/mB)20.7 (6/29) 10.3 (3/29)
MSI (high)17.6 (3/17)**
ALK rearrangement0.0 (0/29)
BRAF alteration3.5 (1/29)
ERBB2 amplification0.0 (0/29)
EGFR alteration3.5 (1/29)
ROS1 alteration0.0 (0/29)
KRAS alteration10.3 (3/29)

Variants of “known” or “likely” functional status were included


MSI status missing for 12 patients


The study confirmed the rarity of NTRK gene fusions in cancer patients. Co-occurrence of the biomarkers ALK, BRAF, ERBB2, EGFR, ROS1, or KRAS was uncommon. These results highlight the importance of identifying patients with NTRK gene fusion-driven cancers, through molecular testing, who will benefit from the use of selective TRK kinase inhibitors across different solid tumors.

Clinical trial identification

Editorial acknowledgement

Michael Sheldon, PhD, of Scion, London, UK, funded by Bayer.

Legal entity responsible for the study





X. Jiao: Full / Part-time employment: Bayer. A. Lokker: Full / Part-time employment: Flatiron Health; Shareholder / Stockholder / Stock options: CVS Health, Roche, Medtronic, Sangamo Therapeutics. J. Snider: Full / Part-time employment: Flatiron Health; Shareholder / Stockholder / Stock options: Roche. E. Castellanos: Full / Part-time employment: Flatiron Health. S. Nanda: Full / Part-time employment: Bayer. V. Fisher: Full / Part-time employment: Foundation Medicine. J. Zong: Full / Part-time employment: Bayer. K. Keating: Full / Part-time employment: Bayer. M. Fellous: Full / Part-time employment: Bayer.

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