4.6 Review

NTRK fusions in thyroid cancer: Pathology and clinical aspects

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2023.103957

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NTRK; Thyroid cancer; NTRK fusion; Clinicopathological feature; TRK inhibitor

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Thyroid cancer is commonly associated with NTRK fusions, which are oncogenic drivers in various solid tumors. Current detection methods rely on RNA-based next-generation sequencing, and targeted therapy with tropomyosin receptor kinase inhibitors has shown promise. Overcoming drug resistance is a current research focus. However, there is a lack of standardized procedures for diagnosing and treating NTRK fusions in thyroid cancer. This review provides an overview of the current research progress, clinicopathological features, and detection and therapeutic options for NTRK fusion-positive thyroid cancer.
Thyroid cancer is the most common endocrine cancer. Neurotrophic tyrosine receptor kinase (NTRK) fusions are oncogenic drivers in multiple solid tumors, including thyroid cancer. NTRK fusion thyroid cancer has unique pathological features such as mixed structure, multiple nodes, lymph node metastasis, and a background of chronic lymphocytic thyroiditis. Currently, RNA-based next-generation sequencing is the gold standard for the detection of NTRK fusions. Tropomyosin receptor kinase inhibitors have shown promising efficacy in patients with NTRK fusion-positive thyroid cancer. Efforts to overcome acquired drug resistance are the focus of research concerning next-generation TRK inhibitors. However, there are no authoritative recommendations or stan-dardized procedures for the diagnosis and treatment of NTRK fusions in thyroid cancer. This review discusses current research progress regarding NTRK fusion-positive thyroid cancer, summarizes the clinicopathological features of the disease, and outlines the current statuses of NTRK fusion detection and targeted therapeutic agents.

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