Posted: Monday, June 20, 2022
According to Alexander E. Drilon, MD, of the Memorial Sloan Kettering Cancer Center, New York, and colleagues, the TRK inhibitor larotrectinib demonstrated rapid and durable responses, extended survival, and a favorable long-term safety profile in an expanded cohort of patients with NTRK fusion–positive advanced lung cancer from two clinical trials. These findings, which were presented during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9024), also appeared to hold true in those with central nervous system (CNS) metastases.
The investigators focused on 26 patients with NTRK fusion–positive (NTRK1: 81%; NTRK3: 19%) lung cancer (non–small cell: n = 24; atypical carcinoid: n = 1; neuroendocrine: n = 1) who were administered 100 mg of larotrectinib twice daily. Of this population, 10 presented with CNS metastases at baseline.
The objective response rate was 83% in the 23 response-evaluable patients, with 2 complete responses, 17 partial responses, and 4 cases of stable disease. The median duration of the time to response was 1.8 months. The objective response rate was 80% in patients with CNS metastases; this included eight partial responses and two cases of stable disease. The median durations of response and progression-free survival were not reached. The 24-month rates of duration of response and progression-free survival were 72% and 67%, respectively. At 24 and 36 months, the rate of overall survival was 72%. Among the patients with CNS metastases, the 12-month duration of response, progression-free survival, and overall survival rates were 26%, 22%, and 78%, respectively.
Most treatment-related adverse events were grade 1 or 2. A total of five patients experienced treatment-related adverse events of grade 3 or 4. No treatment discontinuations due to treatment-related adverse events were reported.
“These results support testing for NTRK gene fusions in patients with lung cancer,” the investigators concluded.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.