PURPOSE: Tropomyosin receptor kinase (TRK) fusions are detected in less than 2% of central nervous system tumors. There are limited data on the clinical course of affected patients. EXPERIMENTAL DESIGN: We conducted an international retrospective cohort study of patients with TRK fusion-driven central nervous system tumors. RESULTS: A total of 119 patients were identified. The median age at the time of diagnosis was 4.5 years. The majority were reported to have a histology consistent with a diagnosis of high-grade glioma (HGG; 57.1%) followed by low-grade glioma (LGG; 27.7%). Pediatric patients had a better prognosis, with a median overall survival of 185.5 months compared with 24.8 months in adults (P < 0.0001). Patients with LGG also had a better outcome when compared with HGG (P = 0.0012). The objective response was 68.8% with larotrectinib compared with 38.1% for nontargeted treatment. CONCLUSIONS: Children with LGG had a favorable outcome compared with adult glioma and HGG. TRK inhibitors seem to improve tumor control.

Aga Khan University Hospital Karachi Pakistan

American University of Beirut Medical Center Beirut Lebanon

Arnold Palmer Hospital Orlando Florida

B C Children's Hospital Vancouver British Columbia Canada

Brain Tumour Research Programme Telethon Kids Cancer Centre Telethon Kids Institute University of Western Australia Perth Perth Western Australia Australia

Cancer Immunology Program Peter MacCallum Cancer Centre Melbourne Victoria Australia

Children's Cancer Centre Royal Children's Hospital Parkville Victoria Australia

Children's Cancer Institute Lowy Cancer Centre UNSW Sydney Sydney New South Wales Australia

Children's Health Care of Atlanta Emory University School of Medicine Atlanta Georgia

Children's Hospital Los Angeles Los Angeles California

Children's Hospital of Orange County Orange California

Children's Minnesota Minneapolis Minnesota

Children's National Hospital Washington District of Columbia

CHRU de Brest Brest France

CHU Hôpital Saint André Bordeaux France

Cliniques Universitaires Saint Luc Brussels Belgium

Department of Neurosciences University of Montreal CHU Sainte Justine Montreal Quebec Canada

Department of Oncology DCCC Brain Tumor Center Rigshospitalet Copenhagen Denmark

Department of Oncology University Children's Hospital Zurich Switzerland

Department of Paediatric Haematology and Oncology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Paediatrics School of Medicine University of Western Australia Perth Western Australia Australia

Department of Pathology and Molecular Medicine 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Pediatric Hematology Oncology and BMT Wroclaw Medical University Wroclaw Poland

Department of Pediatric Oncology and Hematology Perth Children's Hospital Perth Western Australia Australia

Department of Pediatrics Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia

Department of Pediatrics St Anna Children's Hospital Medical University of Vienna Vienna Austria

Department of Pediatrics University of Cincinnati Medical School Cincinnati Children's Hospital Medical Center Cincinnati Ohio

Department of Pediatrics University of Minnesota Minneapolis Minnesota

Division of Hematology Oncology Department of Pediatrics London Health Sciences Centre and Western University London Ontario Canada

Division of Neurosurgery Children's Hospital of Philadelphia Philadelphia Pennsylvania

Division of Oncology Children's Hospital of Philadelphia Philadelphia Pennsylvania

Division of Pediatric Glioma Research Hopp Children's Cancer Center Heidelberg Germany

Division of Pediatric Hematology and Oncology University Medical Center Göttingen Göttingen Germany

Division of Pediatric Hematology Oncology University of Montreal CHU Sainte Justine Montreal Quebec Canada

Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy

German Cancer Research Center Heidelberg Germany

Ghent University Hospital Ghent Belgium

Gustave Roussy Cancer Center Université Paris Saclay Villejuif France

Hematology Department Faculty of Medicine King Abdulaziz University Jeddah Saudia Arabia

Hospices Civils de Lyon Lyon France

Hospital for Sick Children Toronto Ontario Canada

Hospital Infantil Universitario Niño Jesús Madrid Spain

Hygeia Hospital Athens Greece

Institut Bergonié Bordeaux France

Institut d'Hématologie et d'Oncologie Pédiatrique and Pluridisciplinar Research in Pediatric Oncology for Perspectives in Evaluation Care and Therapy Centre Leon Berard Lyon France

IOP GRAACC UNIFESP Sao Paulo Brasil

IWK Health Centre Halifax Nova Scotia Canada

Kanagawa Children's Medical Center Yokohama Japan

Karolinska University Hospital Stockholm Sweden

Kids Cancer Centre Sydney Children's Hospital Randwick New South Wales Australia

Lund University Lund Sweden

Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College New York New York

Michael Rice Centre for Hematology and Oncology Adelaide South Australia Australia

Monash Children's Hospital Clayton Victoria Australia

Monash University Clayton Victoria Australia

Montreal Children's Hospital Montréal Quebec Canada

Murdoch Children's Research Institute Melbourne Victoria Australia

National Center for Tumor Diseases NCT Heidelberg A Partnership between DKFZ and Heidelberg University Hospital Heidelberg Germany

Nemour Alfred 1 du Pont Hospital for Children Wilmington Delaware

Phoenix Children's Hospital Phoenix Arizona

School of Clinical Medicine UNSW Medicine and Health UNSW Sydney Sydney New South Wales Australia

SIREDO Oncology Center PSL Research University Institut Curie Paris France

South Australia Health and Medical Research Institute Adelaide South Australia Australia

South Australia ImmunoGENomics Cancer Institute University of Adelaide Adelaide South Australia Australia

St Anna Children's Cancer Research Institute Vienna Austria

Taipei Medical University Taipei Taiwan

Texas Children's Hospital Houston Texas

The Hudson Institute of Medical Research Clayton Victoria Australia

The Institute of Cancer Research London United Kingdom

University of California San Francisco San Francisco California

University of Michigan Ann Arbor Michigan

University Paris Cité Paris France

Vall d'Hebron Children's Hospital Barcelona Spain

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