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Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study.

ABSTRACT: BACKGROUND:NTRK1, NTRK2 and NTRK3 gene fusions (NTRK gene fusions) occur in a range of adult cancers. Larotrectinib is a potent and highly selective ATP-competitive inhibitor of TRK kinases and has demonstrated activity in patients with tumours harbouring NTRK gene fusions. PATIENTS AND METHODS:This multi-centre, phase I dose escalation study enrolled adults with metastatic solid tumours, regardless of NTRK gene fusion status. Key inclusion criteria included evaluable and/or measurable disease, Eastern Cooperative Oncology Group performance status 0-2, and adequate organ function. Larotrectinib was administered orally once or twice daily, on a continuous 28-day schedule, in increasing dose levels according to a standard 3?+?3 dose escalation scheme. The primary end point was the safety of larotrectinib, including dose-limiting toxicity. RESULTS:Seventy patients (8 with tumours with NTRK gene fusions; 62 with tumours without a documented NTRK gene fusion) were enrolled to 6 dose cohorts. There were four dose-limiting toxicities; none led to study drug discontinuation. The maximum tolerated dose was not reached. Larotrectinib-related adverse events were predominantly grade 1; none were grade 4 or 5. The most common grade 3 larotrectinib-related adverse event was anaemia [4 (6%) of 70 patients]. A dose of 100?mg twice daily was recommended for phase II studies based on tolerability and antitumour activity. In patients with evaluable TRK fusion cancer, the objective response rate by independent review was 100% (eight of the eight patients). Eight (12%) of the 67 assessable patients overall had an objective response by investigator assessment. Median duration of response was not reached. Larotrectinib had limited activity in tumours with NTRK mutations or amplifications. Pharmacokinetic analysis showed exposure was generally proportional to administered dose. CONCLUSIONS:Larotrectinib was well tolerated, demonstrated activity in all patients with tumours harbouring NTRK gene fusions, and represents a new treatment option for such patients. CLINCALTRIALS.GOV NUMBER:NCT02122913.

SUBMITTER: Hong DS

PROVIDER: S-EPMC6386027 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study.

Hong D S DS Bauer T M TM Lee J J JJ Dowlati A A Brose M S MS Farago A F AF Taylor M M Shaw A T AT Montez S S Meric-Bernstam F F Smith S S Tuch B B BB Ebata K K Cruickshank S S Cox M C MC Burris H A HA Doebele R C RC

Annals of oncology : official journal of the European Society for Medical Oncology 20190201 2

<h4>Background</h4>NTRK1, NTRK2 and NTRK3 gene fusions (NTRK gene fusions) occur in a range of adult cancers. Larotrectinib is a potent and highly selective ATP-competitive inhibitor of TRK kinases and has demonstrated activity in patients with tumours harbouring NTRK gene fusions.<h4>Patients and methods</h4>This multi-centre, phase I dose escalation study enrolled adults with metastatic solid tumours, regardless of NTRK gene fusion status. Key inclusion criteria included evaluable and/or measu ...[more]

PMID: 30624546

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Dataset Information

Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study.

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Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study.

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