Dr Patel on Findings From the TRUST-II Trial in ROS1+ NSCLC

Jyoti Patel, MD, professor medicine (hematology and oncology), associate vice chair, Clinical Research, Department of Medicine, Northwestern University; medical director, Thoracic Oncology, assistant director, Clinical Research, Lurie Cancer Center, Feinberg School of Medicine, Northwestern Medicine, discusses the findings and clinical implications of the phase 2 TRUST-II trial (NCT04919811) in patients with locally advanced or metastatic ROS1-positive non–small cell lung cancer (NSCLC), regardless of prior TKI exposure.

At the 2024 IASLC World Conference on Lung Cancer, investigators presented data from the global, single-arm, open-label, multicenter TRUST-II trial, which evaluated the taletrectinib (AB-106) in this patient within this population. At a median follow-up of 15.8 months (range, 3.6-29.8), the next-generation ROS1 TKI demonstrated a confirmed overall response rate (cORR) of 85.2% (95% CI, 72.88%-93.38%) in patients without prior exposure to a ROS1 TKI (n = 54). Conversely, for patients previously treated with a ROS1 TKI (n = 47), the cORR with taletrectinib was 61.7% (95% CI, 46.38%-75.49%) at a median follow-up of 15.7 months (range, 3.9-29.8).

The TRUST-II study demonstrated high overall and intracranial response rates across 2 patient groups: TKI-naive patients and those previously treated with TKIs, Patel begins. In the pretreated cohort, most of the patients had received prior treatment with crizotinib (Xalkori) or entrectinib (Rozlytrek), she reports, adding that during the trial, patients in both cohorts received taletrectinib at a dose of 600 mg once daily. Notably, the intracranial response rates among patients who were TKI naive (n = 9) and TKI pretreated (n = 16) were 66.7% (95% CI, 29.93%-92.51%) and 56.3% (95% CI, 29.88%-80.25%), respectively, Patel explains.

The treatment was generally well tolerated, although dose reductions were required in 37.1% of patients, 16.4% of which were due to elevated liver enzymes, she explains. Notably, taletrectinib has shown efficacy in patients with ROS1 translocations, which are notoriously difficult to treat, Patel emphasizes.