medwireNews: An international expert panel has made a series of tumor-agnostic recommendations on the management of patients with solid tumors positive for microsatellite instability (MSI) or deficient mismatch repair (dMMR) biomarkers, and those with neurotrophic tyrosine receptor kinase (NTRK) gene fusions.
The advice follows a meeting hosted in October 2019 by the Japan Society of Clinical Oncology that was also attended by oncologists representing the European Society of Medical Oncology, the American Society of Clinical Oncology, and the Taiwan Oncology Society.
As reported in the Annals of Oncology, the guidelines detail which patients with unresectable or metastatic solid tumors should undergo or be considered for MSI/dMMR testing or for NTRK fusion testing, as well as the optimal laboratory tests, specimens, and timing of these investigations.
In the absence of other satisfactory treatment options, the panel “strongly” recommends that clinicians should give PD-1 inhibitor therapy, such as pembrolizumab, to patients who test positive for MSI/dMMR, and the TRK inhibitors larotrectinib or entrectinib to those with NTRK fusions.
“Genomic profiling of tumors to identify other potentially targetable alterations (such as ALK, BRAF, BRCAness, FGFR, HER2, HER3, homologous recombination deficiency […], KRAS, RET, ROS1 and TMB-high), which can be used in tumour-agnostic treatment approaches, is ongoing,” note Takayuki Yoshino, from the National Cancer Center Hospital East in Kashiwa, Japan, and co-authors.
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