David S. Hong, MD, discusses which disease subgroups may benefit from treatment with larotrectinib.
David S. Hong, MD, deputy chair, Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses which disease subgroups may benefit from treatment with larotrectinib (Vitrakvi).
Previously in 2018, the FDA granted an accelerated approval to larotrectinib for the treatment of adult and pediatric patients with solid tumors that have an NTRK gene fusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have no satisfactory alternative treatments or that have progressed following treatment. The other FDA approved TRK inhibitor is entrectinib (Rozlytrek).
Results from multiple studies, including the phase 2 NAVIGATE (NCT02576431), phase 1 LOXO-TRK-14001 trial (NCT02122913), and phase 1/2 SCOUT trial (NCT02637687), sought to evaluate larotrectinib as an NTRK inhibitor and have confirmed the long-term response and efficacy of larotrectinib in patients with lung cancer who harbor NTRK fusions.
Here, Hong notes that patients who have either primary central nervous system (CNS) or brain are benefiting from larotrectinib, and highlights other subgroups that may as well.
0:10 | The CNS is a component of it. We didn't present the data at ASCO [last] year, but there are clearly patients who have either primary CNS, or who also have brain metastases who are benefiting from larotrectinib. A highlight of entrectinib is that it seems to be brain penetrating, but we know that both molecules can penetrate the brain.
0:40 | Some of these patients, particularly the pediatric patients with infantile fibrosarcoma, who got the drug had significant tumor shrinkage and they were able to go in and resect the tumor out in a way, NGS [next generation sequencing] like in a neoadjuvant setting. Primarily, as more patients are becoming or getting NGS earlier in the staging, I think we will identify these patients that may benefit from these drugs earlier, as soon as they're identified within transfusion.