Augtyro (repotrectinib)

The patient received treatment with crizotinib and entrectinib successively. No new severe drug-related adverse events were observed. This case suggests that in patients with ROS1 fusion-positive nonsmall cell lung cancer who have experienced prior ROS1-tyrosine kinase inhibitor treatment failure and concomitant severe renal insufficiency, repotrectinib may represent a potential and tolerable treatment option when fully assessing clinical risks and ensuring close monitoring.

P1, N=30, Completed, Bristol-Myers Squibb | Recruiting --> Completed

Peripheral monocyte profiling of the patient post-Repotrectinib and localized radiotherapy showed 75% CD8+/CD3 + T cells, 14.2% CD4+/CD3 + T cells, 3.95% regulatory T cells (Tregs), and 38% PD-1 + CD3 + T cells...Furthermore, we also provide a comprehensive review of recent clinical advancements in ALK/ROS1-TKI for NSCLC, including mechanistic insights into TKI resistance development. This case underscores the therapeutic potential of molecular-targeted agents in LUSC and highlights the essential role of NGS-guided precision oncology.

Tumors harboring these fusions respond dramatically to TRK inhibitors (e.g., larotrectinib, entrectinib, and repotrectinib), which selectively target the constitutively active fusion protein. Conclusively, this first report of three novel NTRK2 fusion transcript variants co-occurrence in an MTC patient expands the known spectrum of translocation partners in NTRK2 rearrangements. Prospective validation of their impact on TRK-targeted therapy efficacy and disease prognosis requires long-term follow-up.

Inhibitors such as larotrectinib, entrectinib and repotrectinib are used when cancer cells harbor NTRK1, NTRK2 or NTRK3 fusion...Short courses of prednisone for the former and dexamethasone for the latter were initiated after failure of standard analgesia... For patients experiencing TRK inhibitor withdrawal pain, especially when tapering down the inhibitor is not an available strategy, a short course of corticosteroids can provide lasting relief. These cases emphasize the importance of better understanding the mechanism underlying the relationship between NRTK, NGF and nociception.

Multiple ROS1 tyrosine kinase inhibitors (TKIs)-from crizotinib to newer agents such as entrectinib, lorlatinib, repotrectinib, taletrectinib, and the highly selective zidesamtinib-have improved systemic and intracranial outcomes, although resistance remains inevitable and biologically diverse, involving both on-target kinase mutations and off-target mechanisms...Pemetrexed-based chemotherapy remains an effective option, whereas immune checkpoint inhibitors provide limited benefit...Looking ahead, priorities include optimizing sequencing strategies, evaluating perioperative targeted approaches, and incorporating genomic monitoring to anticipate resistance. These advances are reshaping the natural history of ROS1-rearranged NSCLC and supporting a more durable, precision-driven treatment paradigm.

These results support the use of repotrectinib to treat patients with NTRK+ solid tumors. ClinicalTrials.gov identifier: NCT03093116 .

P1, N=32, Recruiting, Bristol-Myers Squibb | Not yet recruiting --> Recruiting

This first NSCLC-focused FAERS comparison integrating four-method signal detection with network analysis delineates reproducible class effects superimposed by drug-specific toxicities. Findings support tailored monitoring (e.g., dermatologic care for EGFR-TKIs; ECG/electrolytes for osimertinib; lipid/CK surveillance for ALK-TKIs; blood pressure/liver testing for RET-TKIs) to inform risk-aware first-line decisions.

Repotrectinib is not cost-effective at current prices, but first-line use is consistently more economically favorable than second-line therapy. Price reductions or shorter treatment durations could improve its cost-effectiveness.