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Gastrointestinal cancers, new data of efficacy for targeted therapy
BY congress on gastrointestinal cancer of the American Society of Clinical Oncology (ASCO GI) in San Francisco come new data on the progress of the oncology precision. For patients who have a particular mutation - the gene fusion TRK - targeted drug larotrectinib showed a response rate of 43% in general, rising to 50% for the subgroup with colon cancer. In this case, all patients except one showed, as expected, also another feature of the genome: the high level of instability microsatellitare.
tumors with fusion TRK mergers TRK are of the chromosomal anomalies are rare and occur when one of the genes NTRK (receptor tyrosine kinase neurotrofica) is fused with another gene, giving rise to the production of abnormal protein. These fusion proteins TRK promote proliferation and cell survival, resulting in tumors with a fusion TRK (29 different types) that may form in many parts of the body. Larotrectinib is the first drug in the class of the inhibitors oral of TRK approved in Europe last September for all the cancers that have the merger, and without a specific indication of the organ.

Approved the first cancer drug with no indication of organ
The new data, The new analysis has regarded in all 14 patients with the mutation, of which 8 with colon cancer and the other 6 with cholangiocarcinoma, cancer of the pancreas, appendix and liver. In general, the progression-free survival median, after 19 months of follow-up was 5.3 months and the median time to response of 1.9 months.

“The responses we have observed with larotrectinib in gastrointestinal cancers are in line with the strong efficacy seen in lots of types different of cancer,” explains Salvatore Siena, full Professor of Medical Oncology at the University of Milan and Director of Oncology, Niguarda Cancer Center, Milano: “More than half of these patients had a tumor of the colon, most with high instability microsatellitare, further confirming that the fusion gene NTRK are more common in this subgroup. These data and the powerful responses that we observe with larotrectinib should encourage a wider application of genomic tests to identify gene mutations, especially in patients with colon cancer with high instability microsatellitare”.

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Larotrectinib is already approved in various Countries, including those of the European Union, for patients with solid tumors that have a fusion gene NTRK, metastatic, or in which surgical resection is likely to cause a severe morbidity and that have no satisfactory alternative treatment or in progression after therapy. This indication is approved under accelerated procedure on the basis of overall response rate and duration of response.

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