Repotrectinib is now an FDA-approved option for patients with ROS1- positive advanced non–small cell lung cancer.
The FDA has granted approval to repotrectinib, a tyrosine kinase inhibitor (TKI), for the treatment of patients with ROS1-positive locally advanced or metastatic NSCLC.1
Data from the phase 1/2 TRIDENT-1 study showed that patients who were TKI-naïve and TKI-pretreated, including patients who had ROS1 resistance mutations treated with repotrectinib, had a high response rate and a clinically meaningful duration of response (DOR).2,3
After a median follow-up of 18.1 months for the TKI-naive patients, the overall response rate (ORR) was 78.9% (95% CI, 67.6-87.7) and the 12-month landmark DOR was 86.1%. For patients who were previously treated with 1 prior ROS1 TKI and no prior chemotherapy, the ORR was 37.5% (95% CI, 24.9-51.5) with a 6-month landmark DOR of 79.5% after 15.5 months median follow up.2
“New treatment options continue to be needed for patients with ROS1 fusion-positive NSCLC that support important clinical goals, including achieving durable therapeutic responses,” said Jessica J. Lin, MD, TRIDENT-1 primary investigator and attending physician at the Center for Thoracic Cancers at Massachusetts General Hospital and Assistant Professor of Medicine at Harvard Medical School, in a press release “Based on the data we have seen in the TRIDENT-1 trial, repotrectinib has the potential to become a new standard of care option for patients with locally advanced or metastatic ROS1 fusion-positive lung cancer.”1
The median DOR was 13.3 months (range, 0.80-60.6+) in all patients treated with repotrectinib (n = 71). Among the 56 patients who achieved a complete response, the median duration of treatment was 15.5 months (range, 3.1-60.6+). Activity was also observed in pretreated patients with ROS1 G032R resistance mutation, according to investigators (ORR, 58.5%; 95% CI, 32.9-81.6).1
For safety, repotrectinib had a tolerable safety profile. The most common treatment-emergent adverse events being low-grade dizziness (61.3%), which was grade 1 in 73.2% of patients. Additionally, 19.6% of patients had ataxia, with 20 patients (4.5%) reporting ataxia in the absence of dizziness, and 45% of patients had TEAEs leading to drug interruption, 34% had TEAEs leading to dose reductions, and 9.7% had TEAEs leading to drug discontinuation.