Clinical Characteristics and Outcomes of Central Nervous System Tumors Harboring NTRK Gene Fusions

Clin Cancer Res. 2025 Feb 3;31(3):561-572. doi: 10.1158/1078-0432.CCR-24-0581.

Abstract

Purpose: Tropomyosin receptor kinase (TRK) fusions are detected in less than 2% of central nervous system tumors. There are limited data on the clinical course of affected patients.

Experimental design: We conducted an international retrospective cohort study of patients with TRK fusion-driven central nervous system tumors.

Results: A total of 119 patients were identified. The median age at the time of diagnosis was 4.5 years. The majority were reported to have a histology consistent with a diagnosis of high-grade glioma (HGG; 57.1%) followed by low-grade glioma (LGG; 27.7%). Pediatric patients had a better prognosis, with a median overall survival of 185.5 months compared with 24.8 months in adults (P < 0.0001). Patients with LGG also had a better outcome when compared with HGG (P = 0.0012). The objective response was 68.8% with larotrectinib compared with 38.1% for nontargeted treatment.

Conclusions: Children with LGG had a favorable outcome compared with adult glioma and HGG. TRK inhibitors seem to improve tumor control.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Central Nervous System Neoplasms* / diagnosis
  • Central Nervous System Neoplasms* / drug therapy
  • Central Nervous System Neoplasms* / genetics
  • Central Nervous System Neoplasms* / mortality
  • Central Nervous System Neoplasms* / pathology
  • Child
  • Child, Preschool
  • Female
  • Gene Fusion*
  • Glioma* / drug therapy
  • Glioma* / genetics
  • Glioma* / mortality
  • Glioma* / pathology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Oncogene Proteins, Fusion* / genetics
  • Prognosis
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use
  • Receptor, trkA* / genetics
  • Receptor, trkB / genetics
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Receptor, trkA
  • larotrectinib
  • Oncogene Proteins, Fusion
  • Pyrazoles
  • Pyrimidines
  • Receptor, trkB
  • Protein Kinase Inhibitors