Adjuvant Larotrectinib in a Resected Secretory Carcinoma-Like Lung Adenocarcinoma Harboring EML4-NTRK3 Fusion: Case Report

IF 3.6 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI:10.1016/j.jtocrr.2025.100946

Vladmir Cláudio Cordeiro de Lima MD, PhD , Breno Jeha Araújo MD , Felipe D' Almeida Costa MD, PhD , Beatriz Fuga Rossi Teixeira MD , André Luiz Cicilini MD , Carolina de Bustamante Fernandes PhD , Juliana Folador Morellato MD, MsC , Rodrigo Dienstmann MD, MBA , Mariana Tosello Laloni MD, PhD

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Abstract

Secretory carcinoma of the lung is an exceptionally rare salivary gland-type malignancy, typically associated with NTRK fusions. We report a 71-year-old woman with pulmonary stage IIIA adenocarcinoma having salivary gland differentiation and solid-cribriform architecture, confirmed by S100 and Pan-TRK immunohistochemistry. Broad DNA and RNA next-generation sequencing identified an EML4-NTRK3 fusion. After adjuvant chemotherapy, maintenance larotrectinib was initiated based on proven TRK inhibitor efficacy in metastatic NTRK-fusion tumors and emerging evidence for targeted therapy benefit in driver-positive early stage lung adenocarcinoma. Our findings demonstrate the value of molecular pathology in the diagnostic journey of pulmonary malignancies, guiding rare fusion detection and supporting therapeutic decisions based on rare fusions in early stage disease.

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larorectinib佐剂治疗伴有EML4-NTRK3融合的分泌性癌样肺腺癌一例

分泌性肺癌是一种罕见的涎腺型恶性肿瘤，通常与NTRK融合有关。我们报告一例71岁女性肺IIIA期腺癌患者，经S100和Pan-TRK免疫组织化学证实，其涎腺分化和固体筛网状结构。下一代宽DNA和RNA测序鉴定出EML4-NTRK3融合。在辅助化疗后，基于TRK抑制剂在转移性ntrk融合肿瘤中的有效性，以及在驱动阳性早期肺腺癌中靶向治疗获益的新证据，开始维持larorectinib。我们的研究结果证明了分子病理学在肺部恶性肿瘤诊断过程中的价值，指导罕见融合检测，并支持基于早期疾病罕见融合的治疗决策。

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