Discover and read the best of Twitter Threads about #ntrk

Most recents (7)

Bird’s-eye view 👁 on what to look out for @WCGIC #WorldGI2020.
Opening remarks on important data 📺 @myESMO - by Dr. Eric Van Cutsem @UZLeuven.
🟩Good to see more #PrecisionMedicine🧬
🟥#Immunotherapy #Immuno-#oncology
🟦TNT & other chemo strategies
@Annals_Oncology #OncoAlert
🆕#ctDNA #liquidbiopsies 🩸🧬
👀 👇🏾at the number of #clinicaltrials cropping up in this space‼️
🇦🇺DYNAMIC-II
🇦🇺DYNAMIC-III
🇺🇸COBRA @NRGonc
🇺🇸BESPOKE
🇺🇸@SU2C
🇯🇵 CIRCULATE
🌎COLUMBIA
🇮🇹🇪🇸PEGASYS
🇬🇧TRACC
🇩🇪CIRCULATE
🇫🇷crEATE
🇩🇰IMPROVE-IT
We have 2🇺🇸studies open. #CRCSM #WorldGI2020
#WORLDGI2020 This is 🆒 ☢️ 32-P EUS-guided implantation in #pancreascancer #PANCSM @myESMO @WCGIC @Annals_Oncology.

Still miles to go. OS median of 16 months pointing again to the systemic nature of disease. Need to piggyback these local approaches to better systemic. #OncoAlert
Read 55 tweets
Precision therapies for #cancer are underutilized for a variety of reasons: lack of sensitive diagnostic tools, lack of clinician awareness, et cetera.

This is changing one step at a time.

(A Thread)
Conceptually, precision drugs exploit genetic defects in a patient's tumor. Using comprehensive next-gen #sequencing (NGS), clinicians can surface mutations that indicate the use of a precision drug.

If we don't catch mutations, we underutilize therapies.
One notoriously difficult variant class is an #NTRK Fusion, which is common in certain pediatric cancers and sometimes present in common adult cancers.

While precision therapies targeting NTRK-fusions exist, only recently have we improved our ability to detect them in tumors.
Read 11 tweets
#OncoAlert Very helpful report of on-target adverse events with #NTRK inhibitors in @Annals_Oncology by @alexdrilon @AliSchram @jhaveri_komal group. Important to understand the physiologic role of the receptors we target so we can monitor appropriately.

annalsofoncology.org/article/S0923-…
#OncoAlert TRK is involved in nervous system development. Decreasing TRK signaling can lead to hyperphagia, weight gain, dizziness. These are often underreported or underrecognized so important to ask patients as symptoms can be severe and respond well to dose reduction. Image
#OncoAlert Also involved in pain sensation (decreased nociception). Stopping NTRK inhibitors can lead to a pain withdrawal syndrome - something I've noticed in my own patients. Image
Read 3 tweets
🚨Tweetorial: NTRK 101 🚨Given the data discussed at @asco #ASCO2019 & @sno #SNO2019 on #NTRK fusions in primary brain tumors & brain mets, I thought we could review the background of these fusions, how to find them, and then look at potential options for tx. #btsm
<Disclaimer: I’m a speaker for Bayer (larotrectinib) and a subI for the STARTRK trial using entrectinib. I also have ongoing research work w @carisls > I’m keeping this as bias-free as possible though. Ok, next...
With the increase in tumor profiling & expanded options using #RNAseq, it seems like it is getting easier to find an #NTRK fusion. It can easily feel like Christmas when you do! 🎄 Just remember that an #NTRK MUTATION is not 🚫 fusion. They aren’t = & treatments aren’t the same.
Read 26 tweets
#DCLUNG19 Daunting task of all non-EGFR/ALK drivers in #NSCLC handled easily by @alexdrilon - in #ROS1, note that not all ALK inhibitors are ROS1 inhibitors. Variation in CNS activity. Many active drugs to consider. #LCSM #LCAM ImageImageImage
#DCLUNG19 Highly active, CNS penetrant and well tolerated TKIs for #RET and #NTRK fusion positive cancers, outlined by expert @alexdrilon ImageImageImageImage
#DCLUNG19 Dabrafenib and trametinib active in #BRAF but be sure it’s V600E! Three drugs with breakthrough designation for #METex14. HER2 is a target but not copy number for #NSCLC, its mutations (usually ex20). #LCSM #LCAM ImageImageImageImage
Read 5 tweets
#WCLC19 @rdoebele kicks off the plenary with a discussion of tumor agnostic therapy. Really refers to biology driven. Our current siloed approach to oncology is a bit of a barrier to this strategy. Timing favored lung cancer as the field where this became mainstream. #OncoAlert ImageImageImage
#NTRK is a great example where we see efficacy across tumors and no indication of a specific tumor type resistant to inhibition. But we see similar themes in #ALK and #ROS1 - will there be a regulatory path forward? #OncoAlert #WCLC19 ImageImage
Importantly, resistance also seems to be tumor agnostic. Similar mutations seen mediating resistance across tumor types. Predicting #NRG1 as next important target across tumor types. Biology is more dependent on the genomics than the histology! #WCLC19 #OncoAlert ImageImage
Read 3 tweets
#OncoAlert Important work by @RymaBenayed @MLadanyi in @CCR_AACR online now reviewing why RNA testing is critical for patients with #NSCLC in the important search for actionable driver alterations to guide proper therapy #LCSM

clincancerres.aacrjournals.org/content/early/…
@RymaBenayed @MLadanyi @CCR_AACR #OncoAlert The authors analyzed 254 patients with lung adenocarcinoma who were driver negative by MSK-IMPACT (DNA based NGS) and had enough tissue for RNA sequencing with ARCHER. 232 successfully sequenced and they identified 36 driver events or 15.5% of these patients! #LCSM
@RymaBenayed @MLadanyi @CCR_AACR The most common were #ROS1 (28%), #NRG1 (14%), #ALK (11%), #RET (8%) and #NTRK (8%). Patients able to receive targeted therapy had the expected good outcomes. @ros1cancer @EGFRResisters @ALKLungCancer Image
Read 7 tweets

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