Real-world characteristics, testing patterns, and outcomes in patients with tropomyosin receptor kinase fusion cancer from a large pooled clinicogenomic database

Background Tropomyosin receptor kinase (TRK) inhibitors are highly active in neurotrophic tyrosine receptor kinase ( NTRK ) gene fusion cancers. The registrational datasets of the three approved TRK inhibitors are well described in the literature but real-world data remain limited. To address this gap, we conducted the Real wOrld treAtment anD outcoMes Among Patients with TRK fusion cancer study. Patients and methods This pooled analysis of five large, international clinicogenomic databases assessed patient characteristics, biomarker testing patterns, co-occurring genomic alterations, and clinical outcomes of patients with TRK fusion cancers. Results A total of 451 patients with advanced/metastatic TRK fusion cancer were identified. NTRK gene fusions were mainly identified by next-generation sequencing [363 (81%) patients]. The median time from diagnosis of advanced/metastatic cancer to the date of the first NTRK gene fusion test was 25 days [interquartile range (IQR) 0-459]. Of the 172 (38%) patients who received a TRK inhibitor, the median time from NTRK gene fusion testing to first TRK inhibitor administration was 118 days (IQR 31-335). The median real-world overall survival was 28 months [95% confidence interval (CI) 21-32] for any first-line systemic therapy and it varied widely across tumor types, from 11 months (95% CI 8-17) for pancreatic cancer to 41 months (95% CI 25-50) for breast cancer. Conclusions This is the largest integrated real-world cohort describing patients with TRK fusion cancer to date, providing a comprehensive picture of TRK fusion cancer treatment in the age of TRK-targeted therapy.