Repotrectinib in NTRK fusion-positive advanced solid tumors: a phase 1/2 trial.
Benjamin Besse, Jessica J Lin, Lyudmila Bazhenova...
https://pubmed.ncbi.nlm.nih.gov/41639379/Actively Recruiting
Led by Turning Point Therapeutics, Inc. · Updated on 2026-05-27
500
Participants Needed
165
Research Sites
N/A
Total Duration
Researchers are studying repotrectinib TPX-0005 in adults and adolescents with advanced solid tumors that have specific gene rearrangements in ALK, ROS1, or NTRK1-3. The trial aims to find the safest and most effective dose in Phase 1, and then evaluate how well the drug works in Phase 2 across different patient groups with these gene changes. This includes patients with tumors that have spread and those with brain involvement, focusing on response rates and survival outcomes. The study involves oral doses of repotrectinib. Phase 1 includes dose escalation to determine dose-limiting toxicities, maximum tolerated dose, and recommended dose for Phase 2. A sub-study also examines drug interactions with midazolam. In Phase 2, participants are assigned to one of six groups based on their tumor type and prior treatments, including different lines of targeted therapy and chemotherapy. Treatments continue according to protocol with regular monitoring. Participants will have measurable tumors confirmed by imaging reviewed centrally. They undergo physical exams, lab tests, and safety assessments throughout the study. Researchers measure response rates, duration of response, progression-free survival, overall survival, and clinical benefit over several years. The study monitors drug levels in blood and evaluates safety closely. Participation may last years with follow-up to assess long-term outcomes and effects on brain metastases.
CONDITIONS
A Study of Repotrectinib (TPX-0005) in Patients With Advanced Solid Tumors Harboring ALK, ROS1, or NTRK1-3 Rearrangements
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Turning Point Therapeutics, Inc.
Lead Sponsor
Zai Lab (Shanghai) Co., Ltd.
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Repotrectinib (investigational) | Standard targeted therapy |
|---|---|---|
| What it is | An investigational oral tyrosine kinase inhibitor targeting ALK, ROS1, and NTRK gene rearrangements, evaluated in a single‑arm phase 1/2 study | Approved oral kinase inhibitors such as crizotinib or entrectinib are standard therapies for ALK‑, ROS1‑, or NTRK‑rearranged advanced solid tumors |
| Primary use | Tested as treatment for patients with advanced solid tumors harboring ALK, ROS1, or NTRK rearrangements | Used as standard targeted therapy based on molecular alteration in routine care outside clinical trials |
| Evidence status | In patients with ROS1‑fusion positive NSCLC, repotrectinib achieved objective response rates of ~79 % in TKI‑naive and ~38 % in TKI‑pretreated cohorts; median PFS around 35.7 months in naive group | First‑generation TKIs such as crizotinib and entrectinib yield objective response rates over 60‑70 % in ROS1‑rearranged NSCLC with shorter durability due to resistance and limited CNS penetration |
| Important risks | Safety profile includes treatment‑emergent adverse events (e.g., dizziness, anemia, neurologic AEs) and dose reductions; full risk profile under ongoing evaluation | Known AEs include vision disorders, nausea, weight gain, and depending on agent, CNS‑related toxicities and transaminase elevations |
| Important limitations | Single‑arm trial without randomized comparator; unknown long‑term outcomes and comparative effectiveness | First‑generation TKIs often develop resistance and have limited central nervous system penetration; newer agents may overcome these limits but require access |
| Patient impact | Durable responses in many patients, including intracranial disease control in ROS1 fusion–positive NSCLC | Improved tumor shrinkage and symptom control initially, but limited duration and less brain activity may affect long‑term outcomes |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Until disease progression or intolerable toxicity
Participants receive oral repotrectinib (TPX-0005) capsules as treatment for advanced solid tumors harboring ALK, ROS1, or NTRK1-3 rearrangements.
Regular visits during treatment to monitor safety and response
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/30093503/Turning Point Therapeutics, Inc.
Lead Sponsor
Zai Lab (Shanghai) Co., Ltd.
Collaborating Sponsor