Looking at the Future of Larotrectinib in NTRK Fusion+ Lung Cancer


David S. Hong, MD, discusses what he sees for the future of the NTRK inhibitor 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 what he sees for the future of the NTRK inhibitor larotrectinib (Vitrakvi).

Larotrectiniib was originally approved by the FDA for patients with NTRK fusion-positive lung cancer based off the findings of the phase 2 NAVIGATE (NCT02576431), phase 1 LOXO-TRK-14001 trial (NCT02122913), and phase 1/2 SCOUT trials (NCT02637687), that looked at this disease in various settings.

According to Hong, a pooled analysis of these 3 studies showed the remarkable durability of the drug, showing a median duration of response at 32.9 months, progression-free survival at 29.4 months, and in the most recent analysis, an overall survival rate around 70%. Studies are ongoing with this treatment, which is why Hong believes Larotrectinib will continue to find new roles in this, and other, patient populations.


0:07 | Just like a lot of other drugs, I think larotrectiniib will be often used in the refractory setting, patients who fail chemotherapy. However, there's data that we also presented on different efficacy and different lines of therapy that suggests that patients who get this drug, even in tumor types like NSCLC, who have standard of care options in the frontline setting, do benefit from it and will have a benefit for long periods of time.

0:39 | I think if you talk with a lot of [lung cancer speciclatis], for example, if you identify a patient with NTRK fusion, it's reasonable to give these patients larotrectinib even in the frontline setting. Ultimately down the line, if you think about how a lot of drugs are kind of go from refractory to frontline, [or how] eventually they will go into the adjuvant or even neoadjuvant setting, we don't have enough patients and those trials have yet to really kind of read out. But I think eventually that's what we'll move towards to.

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