2023JSMOJSCOJSPH临床建议：原肌球蛋白受体激酶抑制剂在成人和儿童神经营养受体酪氨酸激酶融合阳性晚期实体瘤患者中的诊断和应用

International Journal of Clinical Oncologyhttps:/doi.og/10.1007/s10147-023-02345-7SPECIAL ARTICLEJapanese Society of Medical Oncology/Japan Society of ClinicalOncology/Japanese Society of Pediatric Hematology/Oncology-ledclinical recommendations on the diagnosis and use of tropomyosinreceptor kinase inhibitors in adult and pediatric patientswith neurotrophic receptor tyrosine kinase fusion-positive advancedsolid tumorsYoichi Naito.Saori Mishima.Kiwamu Akagi2.Naomi Hayashi3.Akira Hirasawa4.Tomoro Hishiki5.Ataru lgarashi.Masafumi lkeda'.Shigenori Kadowaki.Hiroaki Kajiyama.Motohiro Kato.Hirotsugu Kenmotsu10.Yasuhiro Kodera1.Keigo Komine12.Takafumi Koyama13.Osamu Maeda11.Mitsuru Miyachi14.Hiroshi Nishihara15.Hiroyuki Nishiyama16.Shouichi Ohga17.Wataru Okamoto18.EijiOki7.Shigeru Ono19.Masashi Sanada20.lkuo Sekine16.Tadao Takano12.Kayoko Tao13.Keita Terashima21.Katsuya Tsuchihara'.Yasushi Yatabe13.Takayuki Yoshino'.Eishi Baba22Received:13 March 2023/Accepted:13 April 2023©The Author(s)2023AbstractBackground Clinical trials have reported the efficacy of tropomyosin receptor kinase (TRK)inhibitors against neurotrophicreceptor tyrosine kinase (NTRK)fusion gene-positive advanced solid tumors.The accumulated evidence of tumor-agnosticagent has made since TRK inhibitors were approved and used in clinical practice.Therefore,we have revised the 'JapanSociety of Clinical Oncology (JSCO)/Japanese Society of Medical Oncology (JSMO)-led clinical recommendations onthe diagnosis and use of tropomyosin receptor kinase inhibitors in adult and pediatric patients with neurotrophic receptortyrosine kinase fusion-positive advanced solid tumors,cooperated by the Japanese Society of Pediatric Hematology/Oncol-ogy (JSPHO)'.Methods Clinical questions regarding medical care were formulated for patients with NTRK fusion-positive advancedsolid tumors.Relevant publications were searched by PubMed and Cochrane Database.Critical publications and conferencereports were added manually.Systematic reviews were performed for each clinical question for the purpose of developingclinical recommendations.The committee members identified by JSCO,JSMO,and JSPHO voted to determine the level ofeach recommendation considering the strength of evidence,expected risks and benefits to patients,and other related fac-tors.Thereafter,a peer review by experts nominated from JSCO,JSMO,and JSPHO,and the public comments among allsocieties'members was done.Results The current guideline describes 3 clinical questions and 14 recommendations for whom,when,and how NTRKfusion should be tested,and what is recommended for patients with NTRK fusion-positive advanced solid tumors.Conclusion The committee proposed 14 recommendations for performing NTRK testing properly to select patients who arelikely to benefit from TRK inhibitorsKeywords Advanced solid tumor.Clinical practice guideline.Neurotrophic receptor tyrosine kinase (NTRK)fusion.Tropomyosin receptor kinase (TRK)inhibitor.Tumor-agnostic treatmentExtended auth