Undifferentiated and Unresectable Sarcoma With NTRK3-Fusion in a Pediatric Patient Treated With Larotrectinib and Proton Beam Radiotherapy

J Pediatr Hematol Oncol. 2022 Apr 1;44(3):e770-e774. doi: 10.1097/MPH.0000000000002358.

Abstract

A 6-year-old female presenting with an abdominal mass was found to have an unresectable undifferentiated sarcoma. The tumor did not respond to multiagent chemotherapy. However, molecular testing identified an NTRK3-fusion, and treatment was changed to larotrectinib monotherapy. Following 6 months of therapy, the patient achieved a very good partial response with 96% reduction in tumor size. She underwent proton beam radiation therapy with continued larotrectinib therapy and achieved a complete response. This case report shows that an NTRK fusion positive undifferentiated sarcoma can be safely treated with larotrectinib and radiation therapy and highlights the importance of early molecular testing.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Female
  • Humans
  • Neuroblastoma* / drug therapy
  • Oncogene Proteins, Fusion / genetics
  • Protons
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Sarcoma* / drug therapy
  • Sarcoma* / genetics
  • Sarcoma* / radiotherapy
  • Soft Tissue Neoplasms* / pathology

Substances

  • Oncogene Proteins, Fusion
  • Protons
  • Pyrazoles
  • Pyrimidines
  • larotrectinib