A 68-Year-Old Woman with Metastatic NTRK Fusion-Positive Colon Cancer
Cathy Eng, MD, FACP, FASCO, reviews the case of a 68-year-old diagnosed with metastatic NTRK fusion-positive colon cancer and shares treatments options.
Case: A 68-Year-Old Woman With Metastatic NTRK Fusion-Positive Colon Cancer
Initial presentation
- A 68-year-old woman presented with a 3-month history of intermittent abdominal pain, and alternating constipation/diarrhea
- PMH/SH: hypertension and hypercholesterolemia, medically managed; colonoscopy at age 50 was unremarkable; never smoker; no family history of cancer
- PE: abdomen tender on deep palpation in the right lower quadrant
Clinical workup
- Labs: Hb 11.9, Hct 32%, MCV 75 fL, CEA 12.8 ng/mL
- Chest/abdominal/pelvic CT showed a 5-cm right sided bowl mass and multiple hepatic lesions, and regional lymphadenopathy
- Colonoscopy revealed a 5-cm mass in the ascending colon, biopsy was taken
- Pathology: grade 3 poorly differentiated adenocarcinoma, with invasion of the submucosa
- Biomarkers: KRAS-wt, NRAS-wt, BRAF-, NTRK+; MSI-H
- Stage TXNXM1; ECOG PS 1
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