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Only specific tests can uncover TRK fusion cancer

  • While NTRK gene fusions were one of the first oncogenes identified, they are not routinely tested for and/or included on all test platforms1,2
  • TRK fusion cancers can be detected through a number of testing methodologies; however, only sensitive and specific tests can reliably detect NTRK gene fusions1,2

Next-generation sequencing (NGS) provides the most comprehensive view of a large number of genes and may identify NTRK gene fusions as well as other actionable alterations.3,4 However, it is important to know whether the NGS assay used has the capacity to detect NTRK gene fusions.3,5

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Immunohistochemistry (IHC) Pan-TRK IHC antibodies detect TRK proteins A,B,C, which may be expressed in both wild-type and fusion proteins. Protein expression may not be the result of a gene fusion event.6

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DNA fluorescence in situ hybridization (FISH) testing may have limited utility in uncovering NTRK gene fusions because it is not designed for multiplexing. In order to detect fusions at multiple locations, such as the 3 NTRK genes, multiple FISH tests would need to be run. Additionally, it can require a highly specialized pathology analysis.3,5,8

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Reverse transcription polymerase chain reaction (RT-PCR) is designed to identify only known translocation partners and breakpoints and cannot identify novel breakpoints or novel fusion partners.9

Collaboration between oncologists and pathology lab partners can help determine which tests are appropriate to detect TRK fusion cancer.