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Japanese Society of Medical Oncology/Japan Society of Clinical Oncology/Japanese Society of Pediatric Hematology/Oncology-led clinical recommendations on the diagnosis and use of tropomyosin receptor kinase inhibitors in adult and pediatric patients with neurotrophic receptor tyrosine kinase fusion-positive advanced solid tumors |
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| Authors: | Naito Yoichi Mishima Saori Akagi Kiwamu Hayashi Naomi Hirasawa Akira Hishiki Tomoro Igarashi Ataru Ikeda Masafumi Kadowaki Shigenori Kajiyama Hiroaki Kato Motohiro Kenmotsu Hirotsugu Kodera Yasuhiro Komine Keigo Koyama Takafumi Maeda Osamu Miyachi Mitsuru Nishihara Hiroshi Nishiyama Hiroyuki Ohga Shouichi Okamoto Wataru Oki Eiji Ono Shigeru Sanada Masashi Sekine Ikuo Takano Tadao Tao Kayoko Terashima Keita Tsuchihara Katsuya Yatabe Yasushi Yoshino Takayuki Baba Eishi |
| Affiliation: | 1.National Cancer Center Hospital East, Kashiwa, Japan ;2.Saitama Cancer Center, Saitama, Japan ;3.The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan ;4.Okayama University, Okayama, Japan ;5.Chiba University, Chiba, Japan ;6.Yokohama City University School of Medicine, Yokohama, Japan ;7.Aichi Cancer Center, Aichi, Japan ;8.Nagoya University, Aichi, Japan ;9.The University of Tokyo, Tokyo, Japan ;10.Shizuoka Cancer Center, Shizuoka, Japan ;11.Nagoya University Hospital, Aichi, Japan ;12.Tohoku University, Miyagi, Japan ;13.National Cancer Center Hospital, Tokyo, Japan ;14.Kyoto Prefectural University of Medicine, Kyoto, Japan ;15.Keio University, Tokyo, Japan ;16.Tsukuba University, Ibaraki, Japan ;17.Kyushu University, Fukuoka, Japan ;18.Hiroshima University Hospital, Hiroshima, Japan ;19.Jichi Medical University, Tochigi, Japan ;20.National Hospital Organization Nagoya Medical Center, Aichi, Japan ;21.National Center for Child Health and Development, Tokyo, Japan ;22.Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; |
| Abstract: | Background Clinical trials have reported the efficacy of tropomyosin receptor kinase (TRK) inhibitors against neurotrophic receptor tyrosine kinase (NTRK) fusion gene-positive advanced solid tumors. The accumulated evidence of tumor-agnostic agent has made since TRK inhibitors were approved and used in clinical practice. Therefore, we have revised the ‘Japan Society of Clinical Oncology (JSCO)/Japanese Society of Medical Oncology (JSMO)-led clinical recommendations on the diagnosis and use of tropomyosin receptor kinase inhibitors in adult and pediatric patients with neurotrophic receptor tyrosine kinase fusion-positive advanced solid tumors, cooperated by the Japanese Society of Pediatric Hematology/Oncology (JSPHO)’. MethodsClinical questions regarding medical care were formulated for patients with NTRK fusion-positive advanced solid tumors. Relevant publications were searched by PubMed and Cochrane Database. Critical publications and conference reports were added manually. Systematic reviews were performed for each clinical question for the purpose of developing clinical recommendations. The committee members identified by JSCO, JSMO, and JSPHO voted to determine the level of each recommendation considering the strength of evidence, expected risks and benefits to patients, and other related factors. Thereafter, a peer review by experts nominated from JSCO, JSMO, and JSPHO, and the public comments among all societies' members was done. ResultsThe current guideline describes 3 clinical questions and 14 recommendations for whom, when, and how NTRK fusion should be tested, and what is recommended for patients with NTRK fusion-positive advanced solid tumors. ConclusionThe committee proposed 14 recommendations for performing NTRK testing properly to select patients who are likely to benefit from TRK inhibitors. |
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