Entrectinib in ROS1-positive advanced non-small cell lung cancer: the phase 2/3 BFAST trial

Document Type

Article

Publication Date

7-1-2024

Publication Title

Nature medicine

Abstract

Although comprehensive biomarker testing is recommended for all patients with advanced/metastatic non-small cell lung cancer (NSCLC) before initiation of first-line treatment, tissue availability can limit testing. Genomic testing in liquid biopsies can be utilized to overcome the inherent limitations of tissue sampling and identify the most appropriate biomarker-informed treatment option for patients. The Blood First Assay Screening Trial is a global, open-label, multicohort trial that evaluates the efficacy and safety of multiple therapies in patients with advanced/metastatic NSCLC and targetable alterations identified by liquid biopsy. We present data from Cohort D (ROS1-positive). Patients ≥18 years of age with stage IIIB/IV, ROS1-positive NSCLC detected by liquid biopsies received entrectinib 600 mg daily. At data cutoff (November 2021), 55 patients were enrolled and 54 had measurable disease. Cohort D met its primary endpoint: the confirmed objective response rate (ORR) by investigator was 81.5%, which was consistent with the ORR from the integrated analysis of entrectinib (investigator-assessed ORR, 73.4%; data cutoff May 2019, ≥12 months of follow-up). The safety profile of entrectinib was consistent with previous reports. These results demonstrate consistency with those from the integrated analysis of entrectinib in patients with ROS1-positive NSCLC identified by tissue-based testing, and support the clinical value of liquid biopsies to inform clinical decision-making. The integration of liquid biopsies into clinical practice provides patients with a less invasive diagnostic method than tissue-based testing and has faster turnaround times that may expedite the reaching of clinical decisions in the advanced/metastatic NSCLC setting. ClinicalTrials.gov registration: NCT03178552 .

Medical Subject Headings

Humans; Carcinoma, Non-Small-Cell Lung; Indazoles; Benzamides; Lung Neoplasms; Female; Male; Middle Aged; Aged; Proto-Oncogene Proteins; Protein-Tyrosine Kinases; Adult; Aged, 80 and over; Liquid Biopsy; Biomarkers, Tumor; Protein Kinase Inhibitors

PubMed ID

38898120

ePublication

ePub ahead of print

Volume

30

Issue

7

First Page

1923

Last Page

1932

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