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fusão genética NTRK1/2/3 — controlador acionável pan-tumor; < 1% no NSCLC. Larotrectinib (NAVIGAT...

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IDRF-NSCLC-NTRK-FUSION-ACTIONABLE
TipoSinal de alerta
Estadoreviewed 2026-04-27 | pending_clinical_signoff
DoençasDIS-NSCLC
FontesSRC-ESMO-NSCLC-METASTATIC-2024 SRC-NAVIGATE-DRILON-2018 SRC-NCCN-NSCLC-2025 SRC-STARTRK2-DRILON-2020

Origem da bandeira vermelha

DefiniçãoNTRK1/2/3 gene fusion — pan-tumor actionable driver; <1% in NSCLC. Larotrectinib (NAVIGATE — ORR 75% pan-tumor) and entrectinib (STARTRK-2) are FDA tissue-agnostic TRK inhibitors. Treatment-defining if detected.
Direcção clínicaintensificar
Categoriahigh-risk-biology
Algoritmo de deslocamentosALGO-NSCLC-METASTATIC-1L, ALGO-NSCLC-METASTATIC-2L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "ntrk_fusion",
      "value": true
    },
    {
      "finding": "ntrk_status",
      "value": "fusion_positive"
    },
    {
      "finding": "ntrk1_fusion",
      "value": true
    },
    {
      "finding": "ntrk2_fusion",
      "value": true
    },
    {
      "finding": "ntrk3_fusion",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notas

Detection: pan-TRK IHC screen → confirm by RNA-NGS or FISH (IHC less sensitive for NTRK3). Acquired-resistance solvent-front mutations (NTRK1 G595R, NTRK3 G623R) addressed by next-gen TRK-TKI repotrectinib / selitrectinib. Class neurologic toxicity (dizziness, paresthesias, weight gain) — tropomyosin-receptor-mediated.

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