Dr. Levy on Entrectinib in Oncogene-Driven NSCLC

Benjamin P. Levy, MD, assistant professor of oncology, clinical director of Medical Oncology, Sidney Kimmel Cancer Center and Johns Hopkins Medicine, discusses the use of entrectinib in patients with oncogene-driven non—small cell lung cancer (NSCLC).

Entrectinib is yet another targeted agent that’s making its way into the NSCLC space. It’s use is currently being evaluated in patients with advanced-stage disease who harbor NTRK fusions or ROS1 rearrangements, Levy says. In the NTRK space, recent studies show an approximate 55% response rate and a progression-free survival benefit ranging from 10 to 12 months with entrectinib. However, larotrectinib (Vitrakvi) has already received FDA approved for the treatment of all solid tumors that harbor these rare mutations, so where entrectinib will fit into this complex space remains to be seen.

In ROS1-rearranged tumors, the STARTRK trials have demonstrated a response rate of about 70% to 75% with entrectinib, Levy adds. Although the agent does not appear to have benefit in patients who were previously treated with crizotinib (Xalkori), it does induce benefit in targeted therapy-naïve patients.

In February 2019, the FDA granted a priority review designation to a new drug application for entrectinib for the treatment of select adult and pediatric patients with NTRK fusion-positive locally advanced or metastatic solid tumors, as well as patients with metastatic ROS1-positive NSCLC.