Diagnostic algorithm for identification of tropomyosin receptor kinase (TRK) fusions in solid tumors

NGS: next-generation sequencing; IHC: immunohistochemistry.
* Tumor types with a >20% rate of TRK fusion positivity include congenital mesoblastic nephroma (CMN), infantile fibrosarcoma (IFS), mammary analogue secretory carcinoma (MASC) of the salivary gland, and secretory breast cancer (SBC).
¶ Tissue-relevant driver alterations include mutations in epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), c-ROS oncogene 1 (ROS1), KRAS, NRAS, and BRAF.
Δ Tumor types include non-small cell lung cancer, thyroid cancer, pancreatic cancer, cholangiocarcinoma, and sarcomas.