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Case Reports
. 2018 Aug 2:2:PO.18.00101.
doi: 10.1200/PO.18.00101. eCollection 2018.

Durable Clinical Response to Larotrectinib in an Adolescent Patient With an Undifferentiated Sarcoma Harboring an STRN- NTRK2 Fusion

Affiliations
Case Reports

Durable Clinical Response to Larotrectinib in an Adolescent Patient With an Undifferentiated Sarcoma Harboring an STRN- NTRK2 Fusion

Lawrence W Wu et al. JCO Precis Oncol. .
No abstract available

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/po/author-center. Lawrence W. WuNo relationship to discloseTara PavlockNo relationship to discloseAlison PattersonNo relationship to discloseAnne PostNo relationship to discloseCaitlyn AmbroseNo relationship to discloseVeena RajaramNo relationship to discloseDean C. PavlickEmployment: Foundation Medicine Stock and Other Ownership Interests: Foundation MedicineMatthew CookeEmployment: Foundation Medicine Stock and Other Ownership Interests: Foundation Medicine Travel, Accommodations, Expenses: Foundation MedicineVincent A. MillerEmployment: Foundation Medicine Leadership: Foundation Medicine Stock and Other Ownership Interests: Foundation Medicine Patents, Royalties, Other Intellectual Property: Periodic royalties related to T790M patent awarded to Memorial Sloan Kettering Cancer CenterLee A. AlbackerEmployment: Foundation Medicine Stock and Other Ownership Interests: Foundation MedicineSiraj M. AliEmployment: Foundation Medicine Leadership: Incyte Stock and Other Ownership Interests: Exelixis, Blueprint Medicines, Agios Pharmaceuticals, Genocea Biosciences Patents, Royalties, Other Intellectual Property: Patents through Foundation Medicine, patents through Seres Therapeutics on microbiome in non-neoplastic disease (I)Steven SmithConsulting or Advisory Role: Loxo OncologyMichael C. CoxEmployment: Bayer AG, Loxo Oncology, Merck, Amgen Stock and Other Ownership Interests: Loxo Oncology, Bayer AG, Merck, Amgen Patents, Royalties, Other Intellectual Property: US patent 62/318,041 issued to Loxo Oncology (Inst)Andrew MartinNo relationship to discloseSteve MegisonNo relationship to discloseTheodore W. LaetschConsulting or Advisory Role: Novartis, Loxo Oncology, Eli Lilly, Bayer AG Research Funding: Pfizer (Inst)

Figures

Fig 1.
Fig 1.
Computed tomography imaging of patient’s abdominal tumor over time. (A) Initial imaging. (B) Development of aortic pseudo-aneurysm. (C) Baseline before enrollment, postsurgery. (D) After 1.6 months of larotrectinib treatment. (E) After 14 months of larotrectinib treatment.
Fig 2.
Fig 2.
Surgical resection of retroperitoneal sarcoma. (A) Retroperitoneal tumor before resection. (B) Tumor bed after resection, with residual tumor invading the vertebral bodies. (C) Status postreconstruction of the aorta. (D) Excised tumor specimen, including the aortic bifurcation.
Fig 3.
Fig 3.
Pathology of patient’s tumor from resection. (A) Transverse section of the mass with aneurysmal cavity around the aorta. (B) Hematoxylin and eosin stain that shows epithelioid/rhabdoid cells with eccentric, pleomorphic nuclei; occasional nucleoli and abundant eosinophilic cytoplasm; and a single mitosis. (C) Immunohistochemistry for INI-1 that shows retained nuclear positivity in the neoplastic cells. (D) Immunohistochemistry for pan-Trk that shows membranous and cytoplasmic positivity in the neoplastic cells. (E) STRN-NTRK2 fusion identified in tumor sample by next generation sequencing. (F) RNA sequencing reads that support the STRN-NTRK2 fusion.
Fig 4.
Fig 4.
Timeline. IE, ifosfamide and etoposide; NGS, next-generation sequencing; NRSTS, nonrhabdomyosarcoma soft tissue sarcoma; PET, positron emission tomography; RECIST, Response Evaluation Criteria in Solid Tumors; VAdriaC, vincristine, doxorubicin, and cyclophosphamide.

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