Repotrectinib Explained

Tradename:Augtyro
Dailymedid:Repotrectinib
Routes Of Administration:By mouth
Class:Tyrosine kinase inhibitor
Atc Prefix:None
Legal Us:Rx-only
Legal Us Comment:[1]
Cas Number:1802220-02-5
Pubchem:135565923
Drugbank:DB16826
Chemspiderid:64853849
Unii:08O3FQ4UNP
Kegg:D11454
Chebi:229220
Chembl:4298138
Pdb Ligand:7GI
Synonyms:TPX-0005
C:18
H:18
F:1
N:5
O:2
Smiles:C[C@H]1CNC(=O)C2=C3N=C(N[C@H](C)C4=CC(F)=CC=C4O1)C=CN3N=C2
Stdinchi:1S/C18H18FN5O2/c1-10-8-20-18(25)14-9-21-24-6-5-16(23-17(14)24)22-11(2)13-7-12(19)3-4-15(13)26-10/h3-7,9-11H,8H2,1-2H3,(H,20,25)(H,22,23)/t10-,11+/m0/s1
Stdinchikey:FIKPXCOQUIZNHB-WDEREUQCSA-N

Repotrectinib, sold under the brand name Augtyro, is an anti-cancer medication used for the treatment of non-small cell lung cancer. It is taken by mouth. Repotrectinib is an inhibitor of proto-oncogene tyrosine-protein kinase ROS1 (ROS1) and of the tropomyosin receptor tyrosine kinases (TRKs) TRKA, TRKB, and TRKC.

The most common adverse reactions include dizziness, dysgeusia, peripheral neuropathy, constipation, dyspnea, ataxia, fatigue, cognitive disorders, and muscular weakness.

Repotrectinib was approved for medical use in the United States in November 2023.[2] [3]

Medical uses

Repotrectinib is indicated for the treatment of adults with locally advanced or metastatic ROS1-positive non-small cell lung cancer.

In June 2024, the US Food and Drug Administration (FDA) expanded the indication to include the treatment of people twelve years of age and older with solid tumors that have a neurotrophic tyrosine receptor kinase (NTRK) gene fusion, are locally advanced or metastatic or where surgical resection is likely to result in severe morbidity, and that have progressed following treatment or have no satisfactory alternative therapy.

History

Approval by the US FDA was based on TRIDENT-1, a global, multicenter, single-arm, open-label, multi-cohort clinical trial (NCT03093116) which included participants with ROS1-positive locally advanced or metastatic non-small cell lung cancer. Efficacy was evaluated in 71 ROS1 tyrosine kinase inhibitor-naïve participants who received up to one prior line of platinum-based chemotherapy and/or immunotherapy and 56 participants who received one prior ROS1 tyrosine kinase inhibitor with no prior platinum-based chemotherapy or immunotherapy.

The FDA granted the application for repotrectinib priority review, breakthrough therapy, and fast track designations.

Clinical trials

TRIDENT-1

Efficacy was evaluated in TRIDENT-1 (NCT03093116), a multicenter, single-arm, open-label, multi-cohort trial in 88 adult patients with locally advanced or metastatic NTRK gene fusion-positive solid tumors who had either received a prior TRK tyrosine kinase inhibitor (TKI) (n=48) or were TKI-naïve (n=40). [4] [5] All patients were assessed for central nervous (CNS) lesions at baseline, and patients with symptomatic brain metastases were excluded. Tumor assessments were performed every 8 weeks.

The most common (>20%) adverse reactions were dizziness, dysgeusia, peripheral neuropathy, constipation, dyspnea, fatigue, ataxia, cognitive impairment, muscular weakness, and nausea.

Further reading

External links

Notes and References

  1. Web site: Augtyro- repotrectinib capsule . DailyMed . 15 November 2023 . 12 December 2023 . 12 December 2023 . https://web.archive.org/web/20231212070951/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fb526827-40ba-4462-94cf-179ae3b0cb8a . live .
  2. Web site: FDA approves repotrectinib for ROS1-positive non-small cell lung cancer . U.S. Food and Drug Administration (FDA) . 15 November 2023 . 17 November 2023 . 16 November 2023 . https://web.archive.org/web/20231116191134/https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-repotrectinib-ros1-positive-non-small-cell-lung-cancer . live .
  3. U.S. Food and Drug Administration Approves Augtyro (repotrectinib), a Next-Generation Tyrosine Kinase Inhibitor (TKI), for the Treatment of Locally Advanced or Metastatic ROS1-Positive Non-Small Cell Lung Cancer (NSCLC) . Bristol Myers Squibb . Business Wire . 16 November 2023 . 17 November 2023 . 16 November 2023 . https://web.archive.org/web/20231116192414/https://www.businesswire.com/news/home/20231115632242/en . live .
  4. Web site: 13 June 2024 . FDA grants accelerated approval to repotrectinib for adult and pediatric patients with NTRK gene fusion-positive solid tumors . 13 June 2024 . U.S. Food and Drug Administration . 13 June 2024 . https://web.archive.org/web/20240613185259/https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-repotrectinib-adult-and-pediatric-patients-ntrk-gene-fusion-positive . live .
  5. A Phase 1/2, Open-Label, Multi-Center, First-in-Human Study of the Safety, Tolerability, Pharmacokinetics, and Anti-Tumor Activity of TPX-0005 in Patients With Advanced Solid Tumors Harboring ALK, ROS1, or NTRK1-3 Rearrangements (TRIDENT-1) . Turning Point Therapeutics, Inc. . 5 February 2024 . clinicaltrials.gov . NCT03093116 . 18 June 2024 . 18 June 2024 . https://web.archive.org/web/20240618080337/https://clinicaltrials.gov/study/NCT03093116 . live .