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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Thursday, February 1, 2024
Treatment with the ROS1 tyrosine kinase inhibitor repotrectinib may improve clinical outcomes in patients with ROS1 fusion–positive non–small cell lung cancer (NSCLC), according to a study published in The New England Journal of Medicine. This durable clinical activity was achieved regardless of whether patients received previous treatment with an ROS1 inhibitor. These findings, in conjunction with the favorable safety profile, suggest its potential as a therapeutic alternative for this patient population, according to Alexander Drilon, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, and colleagues.
From 2017 to 2022, a total of 519 patients with ROS1 fusion–positive NSCLC were enrolled in the study. A total of 416 patients were analyzed in phase II of the study. All patients were administered repotrectinib until evidence of disease progression or unacceptable toxic effects.
Patients were stratified into four cohorts based on previous exposure to ROS1 inhibitors and chemotherapy. In addition, an efficacy analysis was performed in a small subset of patients who had started treatment with repotrectinib and could attend regular clinical follow-up appointments for at least 14 months (n = 127). These patients were stratified based on whether they received previous ROS1 inhibitor therapy (n = 71) or not (n= 56).
Of the patients who had never received previous ROS1 inhibitor therapy within the efficacy analysis cohort, 79% of patients demonstrated a clinical response to treatment, with a median duration of response of 34.1 months and a median progression-free survival of 35.7 months. In addition, among patients with a history of treatment with an ROS1 inhibitor, clinical response to therapy was observed in 38%, with a median duration of response of 14.8 months and a median progression-free survival of 9.0 months. Furthermore, common treatment-related adverse events included dizziness (58%), dysgeusia (50%), and paresthesia (30%).
Disclosure: For full disclosures of the study authors, visit nejm.org.
The New England Journal of Medicine
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