Oncogenic TRK fusions are amenable to inhibition in hematologic malignancies

Justin Taylor, Dean Pavlick, Akihide Yoshimi, Christina Marcelus, Stephen S. Chung, Jaclyn F. Hechtman, Ryma Benayed, Emiliano Cocco, Benjamin H. Durham, Lillian Bitner, Daichi Inoue, Young Rock Chung, Kerry Mullaney, Justin M. Watts, Eli L. Diamond, Lee A. Albacker, Tariq I. Mughal, Kevin Ebata, Brian B. Tuch, Nora KuMaurizio Scaltriti, Mikhail Roshal, Maria Arcila, Siraj Ali, David M. Hyman, Jae H. Park, Omar Abdel-Wahab

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Rearrangements involving the neurotrophic receptor kinase genes (NTRK1, NTRK2, and NTRK3; hereafter referred to as TRK) produce oncogenic fusions in a wide variety of cancers in adults and children. Although TRK fusions occur in fewer than 1% of all solid tumors, inhibition of TRK results in profound therapeutic responses, resulting in Breakthrough Therapy FDA approval of the TRK inhibitor larotrectinib for adult and pediatric patients with solid tumors, regardless of histology. In contrast to solid tumors, the frequency of TRK fusions and the clinical effects of targeting TRK in hematologic malignancies are unknown. Here, through an evaluation for TRK fusions across more than 7,000 patients with hematologic malignancies, we identified TRK fusions in acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), histiocytosis, multiple myeloma, and dendritic cell neoplasms. Although TRK fusions occurred in only 0.1% of patients (8 of 7,311 patients), they conferred responsiveness to TRK inhibition in vitro and in vivo in a patient-derived xenograft and a corresponding AML patient with ETV6-NTRK2 fusion. These data identify that despite their individual rarity, collectively, TRK fusions are present in a wide variety of hematologic malignancies and predict clinically significant therapeutic responses to TRK inhibition.

Original languageEnglish (US)
Pages (from-to)3819-3825
Number of pages7
JournalJournal of Clinical Investigation
Volume128
Issue number9
DOIs
StatePublished - Aug 31 2018
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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    Taylor, J., Pavlick, D., Yoshimi, A., Marcelus, C., Chung, S. S., Hechtman, J. F., Benayed, R., Cocco, E., Durham, B. H., Bitner, L., Inoue, D., Chung, Y. R., Mullaney, K., Watts, J. M., Diamond, E. L., Albacker, L. A., Mughal, T. I., Ebata, K., Tuch, B. B., ... Abdel-Wahab, O. (2018). Oncogenic TRK fusions are amenable to inhibition in hematologic malignancies. Journal of Clinical Investigation, 128(9), 3819-3825. https://doi.org/10.1172/JCI120787