Taletrectinib Phase 2 Global Study in ROS1 Positive NSCLC
NCT ID: NCT04919811
Last Updated: 2026-01-07
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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ACTIVE_NOT_RECRUITING
PHASE2
217 participants
INTERVENTIONAL
2021-09-01
2027-12-31
Brief Summary
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Detailed Description
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About 214 patients will be enrolled and divided into 5 cohorts, depending on past history of ROS1 TKI treatment.
Taletrectinib is administered once daily in 21-day cycles. Patients will continue with the treatment on taletrectinib until progression of disease as determined by the investigator.
The tumor response evaluation will be conducted on a regular basis until progression of disease. Long-term survival follow-up will also be conducted.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Taletrectinib
Single-arm trial whereby all consented, enrolled, eligible patients receive taletrectinib
Taletrectinib
400mg or 600mg QD
Interventions
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Taletrectinib
400mg or 600mg QD
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Histologically or cytologically confirmed diagnosis of locally advanced (including inoperable Stage IIIA or IIIB NSCLC) or metastatic NSCLC (Cohorts 1-3, 5) or other solid tumors including NSCLC patients ineligible for other cohorts (Cohort 4).
3. Evidence of ROS1 fusion by a validated assay as performed in Clinical Laboratory Improvement Amendments (CLIA)-certified or locally equivalent diagnostic laboratories. The molecular assays (i.e., Reverse Transcription Polymerase Chain Reaction \[RT-PCR\], Next-generation Sequencing \[NGS\]) are highly recommended.
4. Sufficient tumor tissue is required for patients in Cohort 1 and for TKI-naïve patients in Cohort 5 in order to perform confirmatory ROS1 fusion testing at the designated central laboratories. For patients in Cohort 1 and for TKI-naïve patients in Cohort 5, an archival tumor tissue specimen should be available and collected prior to enrollment. If archival tumor tissue is unavailable, then a fresh biopsy must be performed. Tumor tissue for patients in other cohorts is highly recommended, and tumor tissue obtained after progression on the most recent prior ROS1 TKI therapy in these cohorts is preferred. Cytology samples (e.g., pleural effusion cell pellets) may be acceptable for patients in Cohorts 2-4, and patients in Cohort 5 that received prior treatment with TKI(s) having ROS1 activity.
5. Patients with central nervous system (CNS) involvement, including leptomeningeal carcinomatosis, must be stable (either asymptomatic or previously treated and controlled are allowed:
* Seizure prophylaxis is permitted with non-enzyme inducing anti-epileptic drugs (non-EIAEDs).
* Corticosteroid treatment at a stable or decreasing dose within 7 days prior to the first dose of taletrectinib.
* Whole brain radiation therapy (WBRT) must be completed at least 14 days and stereotactic radiotherapy, stereotactic radiosurgery, or gamma knife radiotherapy at least 7 days prior to enrollment; the patient must be clinically stable for 7 days according to investigator judgement prior to first dose of taletrectinib.
6. The patient can be either ROS1 TKI treatment naïve or treated with prior ROS1 TKI(s):
o Cohort 1: Patients with locally advanced or metastatic ROS1-positive NSCLC. Systemic chemotherapy naïve or pretreated with 1 prior line of chemotherapy but never treated with any ROS1 TKI.
o Cohort 2: Patients with locally advanced or metastatic ROS1-positive NSCLC. Prior treatment with 1 approved ROS1 TKI (crizotinib or entrectinib) and disease progression. The patient can be either chemotherapy naïve or has received 1 line of systemic chemotherapy for locally advanced or metastatic ROS1-positive NSCLC.
* Cohort 3: Patients with locally advanced or metastatic ROS1-positive NSCLC. Prior treatment with ≥2 TKIs with ROS1 activity and disease progression. The patient can be either chemotherapy naïve or has received 1 line of systemic chemotherapy for locally advanced or metastatic ROS1-positive NSCLC, patients with known ROS1 resistant mutations are preferred.
* Cohort 4: Patients with other ROS1-positive solid tumors, or NSCLC patients ineligible for Cohorts 1-3. Prior treatment with ≤3 TKIs with ROS1 activity. The patient can be either chemotherapy naïve or has received ≤2 lines of systemic chemotherapy for locally advanced or metastatic solid tumors.
* Cohort 5: Patients with locally advanced or metastatic ROS1-positive NSCLC. The patient can be either chemotherapy naïve or has received ≤2 lines of systemic chemotherapy line of systemic chemotherapy for locally advanced or metastatic ROS1-positive NSCLC. ROS1-TKI-naïve or pretreated with TKI(s) having ROS1 activity.
7. At least 1 measurable disease per RECIST 1.1 as assessed by the investigator.
8. Eastern Cooperative Oncology Group Performance Status: 0 or 1.
9. Patient with a life expectancy ≥12 weeks based on the judgement of investigator.
10. Patients with adequate organ function meeting the following criteria:
1. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT): ≤3.0 × upper limit of normal (ULN) (or ≤5.0 × ULN, for patients with concurrent liver metastases)
2. Serum total bilirubin: ≤1.5 × ULN (≤3.0 × ULN for patients with Gilbert syndrome or if liver function abnormalities are due to underlying malignancy)
3. Absolute neutrophil count: ≥1,500/μL
4. Platelet count: ≥100,000/μL
5. Hemoglobin: ≥9.0 g/dL
6. Serum creatinine ≤1.5 × ULN and estimated creatinine clearance (CLcr) ≥45 mL/min as calculated using the method standard for the institution (e.g., Cockcroft - Gault Equation)
11. Males and/or females who meet any of the following criteria:
a. For males (irrespective of surgical sterilization \[vasectomy\]): agree to use effective contraception methods during the study intervention period and for at least 90 days after the last dose of investigational drug or agree with complete abstinence.
b. Females without menses for at least 1 year prior to screening or documented to be surgically sterilized. Women of childbearing potential (WOCBP) must agree to use two concurrent highly effective methods of contraception or agree with complete abstinence from sexual intercourse since the informed consent until 45 days after the last dose of investigational drug. Usage of hormonotherapy for contraception should be recorded as well.
12. For all females of childbearing potential, a negative pregnancy test must be obtained within 7 days before starting study treatment. Female patients of non childbearing potential must meet at least 1 of the following criteria:
○ Achieved postmenopausal status, defined as follows: cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause; status may be confirmed with a serum follicle stimulating hormone (FSH) level confirming the postmenopausal state.
○ Have undergone a documented hysterectomy and/or bilateral oophorectomy.
○ Have medically confirmed ovarian failure. All other female patients (including female patients with tubal ligations) are considered to be of childbearing potential.
13. The patient is willing and capable to give written informed consent.
14. The patient is willing and capable to comply with the study scheduled visits, treatment plans, laboratory tests and other procedures.
15. The patient is willing and capable to comply with study site's COVID-19 policies.
Exclusion Criteria
2. Major surgical procedure, open biopsy, or significant traumatic injury ≤4 weeks before the first dose of taletrectinib.
Note: Placement of vascular access device is not considered major surgery. Other minor surgical procedures, such as catheter placement or minimally invasive biopsy, are allowed.
3. Radiation outside the chest and brain \<7 days prior to C1D1.
4. Have been diagnosed with another primary malignancy other than NSCLC except for adequately treated non-melanoma skin cancer or cervical cancer in situ; definitively treated non-metastatic prostate cancer; or patients with another primary malignancy who are definitively relapse-free with at least 3 years elapsed since the diagnosis of the other primary malignancy.
5. Adverse events due to prior therapy are unresolved to ≤ CTCAE Grade 1 or has not returned to baseline, by the first dose of taletrectinib except for AEs not constituting a safety risk to the patient based on the judgment of investigators.
6. Patients with untreated spinal cord compression caused by tumor and/or cancerous meningitis.
7. History or evidence of interstitial fibrosis, interstitial lung disease or drug-induced pneumonitis (Excluding clinically insignificant or asymptomatic post radiation pneumonitis).
8. Any gastrointestinal disorders that may affect absorption of oral medications.
1\. 9. Active and clinically significant bacterial, fungal, or viral infection including hepatitis B virus (HBV), hepatitis C virus (HCV), or severe acute respiratory syndrome coronavirus 2 (SARS CoV 2), known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) related illness. Note that the following are permitted:
○ Patients treated for hepatitis C (HCV) or HIV with no detectable viral load; for at least 1 month prior to the first dose of taletrectinib.
Note: caution with drug drug interactions of concomitant anti HIV agents and CYP3A substrates.
○ Patients with known hepatitis B (HBV) infections:
* With past or resolved HBV infection (defined as the presence of hepatitis B core antibody \[HBcAb\] and absence of hepatitis B surface antigen \[HBsAg\]); or
* With inactive HBV carrier state (defined as HBsAg positive, with normal ALT, and HBV DNA \<2,000 IU/mL or \<10,000 copies/mL).
Note: Please consider that, for patients in an inactive HBV carrier state or with a resolved HBV infection, there may be a risk of HBV reactivation, and anti HBV prophylaxis should be considered.
10\. Clinically significant cardiovascular diseases within 3 months prior to the first dose of taletrectinib: myocardial infarction, severe/unstable angina, coronary/peripheral endovascular treatment, heart failure or cerebrovascular disorder including transient ischemic attack.
11\. Ongoing cardiac dysrhythmias of ≥ CTCAE Grade 2, uncontrolled atrial fibrillation of any grade, or QT interval corrected for heart rate by Fredericia's formula (QTcF) \>470 milliseconds, or symptomatic bradycardia \<45 beats per minute; patient has family or medical history of long QT syndrome.
12\. Pregnancy or lactation/breastfeeding. 13. Use of food or drugs that are known potent cytochrome P450 3A4/5 (CYP3A4/5) inhibitors or inducers or P-glycoprotein inhibitors or inducers within 14 days prior to the first dose of study treatment and while on treatment.
14\. Administration of agents with potential QT interval prolonging effect within 14 days prior to first dose of study treatment and while on treatment.
15\. Patients with other severe medical or mental diseases in whom the risk is increased by participation to the study or treatment with study treatment in the opinion of the investigator.
18 Years
ALL
Yes
Sponsors
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Nuvation Bio Inc.
INDUSTRY
Responsible Party
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Principal Investigators
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Wei Wang, MD, PhD
Role: STUDY_DIRECTOR
Nuvation Bio Inc.
Locations
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Beverly Hills Cancer Center
Beverly Hills, California, United States
The Oncology Institute of Hope and Innovation
Glendale, California, United States
Moores Cancer Center at UC San Diego
La Jolla, California, United States
Keck Medicine of University of Southern California
Los Angeles, California, United States
UCI Medical Center
Orange, California, United States
Ventura County Hematology-Oncology Specialists
Oxnard, California, United States
SCRI - Florida Cancer Specialists South
Fort Meyers, Florida, United States
Memorial Cancer Institute at Memorial Hospital East
Hollywood, Florida, United States
Cancer Specialists of North Florida
Jacksonville, Florida, United States
Memorial Cancer Institute at Memorial Hospital West
Pembroke Pines, Florida, United States
SCRI - Hematology Oncology Clinic
Baton Rouge, Louisiana, United States
Mayo Clinic
Rochester, Minnesota, United States
Center for Cancer Research
Brick, New Jersey, United States
Cleveland Clinic Foundation
Cleveland, Ohio, United States
SCRI - Tennessee Oncology
Nashville, Tennessee, United States
Texas Oncology, P.A.
Dallas, Texas, United States
Renovatio Clinical
El Paso, Texas, United States
MD Anderson Cancer Center
Houston, Texas, United States
Renovatio Clinical
The Woodlands, Texas, United States
Northwest Medical Specialties, PLLC
Tacoma, Washington, United States
Princess Margaret Cancer Centre
Toronto, Ontario, Canada
McGill University Health Centre Research Institute
Montreal, Quebec, Canada
Beijing Cancer Hospital
Beijing, Beijing Municipality, China
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, China
Shanghai Pulmonary Hospital
Shanghai, Shanghai Municipality, China
Hunan Cancer Hospital
Changsha, , China
West China Hospital
Chengdu, , China
Shandong Cancer Hospital
Jinan, , China
Wuhan Union Hospital
Wuhan, , China
Henan Cancer Hospital
Zhengzhou, , China
CHU Lyon - Hôpital Cardio-Vasculaire et Pneumologique Louis Pradel
Bron, , France
CHU Grenoble Alpes- Hospital Michallon
La Tronche, , France
Centre Léon Bérard
Lyon 08, , France
Centre d'Essais Précoces de Cancerologie de Marseille
Marseille, , France
APHP- Hôpital Europeen Georges Pompidou (HEGP)
Paris, , France
CHU de Poitiers Pole regional
Poitiers, , France
Institut Jean Godinot
Reims, , France
CHU Rennes - Hospital Pontchaillou
Rennes, , France
Institut De Cancérologie De L'ouest
Saint-Herblain, , France
Institut Gustave Roussy
Saint-Herblain, , France
Istituto Tumori Giovanni Paolo II IRCCS Ospedale Oncologico
Bari, , Italy
Humanitas Istituto Clinico Catanese, Misterbinanoco
Catania, , Italy
Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico
Milan, , Italy
Ospedale San Raffaele
Milan, , Italy
Fondazione IRCCS Istituto Nazionale dei Tumori
Milan, , Italy
IEO Istituto Europeo di Oncologia
Milan, , Italy
AOU Cagliari- P.O. Policlinico Universitario Duilio Casula
Monserrato, , Italy
Azienda Ospedaliera Universitaria- Università degli Studi della Campania
Napoli, , Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Roma, , Italy
National Hospital Organization Kyushu Cancer Center
Fukuoka, , Japan
National Cancer Center Hospital East
Kashiwa, , Japan
Sendai Kousei Hospital
Miyagi, , Japan
Aichi Cancer Center Hospital
Nagoya, , Japan
Kindai University Hospital
Osaka, , Japan
Shizuoka Cancer Center
Shizuoka, , Japan
National Cancer Center Hospital
Tokyo, , Japan
The Cancer Institute Hospital of JFCR
Tokyo, , Japan
Instytut Centrum Zdrowia Matki Polki
Lodz, , Poland
Med-Polonia Sp. z o.o.
Poznan, , Poland
MICS Centrum Medyczne Toruńa
Torun, , Poland
Pusan National University Hospital
Busan, , South Korea
Pusan National University Yangsan Hospital
Gyeongsang, , South Korea
Chonnam National University Hwasun Hospital
Hwasun, , South Korea
Asan Medical Center
Seoul, , South Korea
Korea University Guro Hospital
Seoul, , South Korea
Clinica Mi Tres Torres
Barcelona, , Spain
Hospital Quironsalud Barcelona
Barcelona, , Spain
Hospital Universitari Vall d'Hebron
Barcelona, , Spain
ICO l'Hospitalet - Hospital Duran i Reynals L'Hospitalet de Llobregat
Barcelona, , Spain
Hospital Universitario Ramon y Cajal
Madrid, , Spain
Hospital Universitario Clinico San Carlos
Madrid, , Spain
Hospital Universitario 12 de Octubre
Madrid, , Spain
Hospital Universitario La Paz
Madrid, , Spain
Hospital Regional Universitario de Malaga
Málaga, , Spain
Hospital Universitario Virgen Macarena
Seville, , Spain
Instituto Valenciano de Oncologia IVO
Valencia, , Spain
Hospital Clinico Universitario de Valencia
Valencia, , Spain
Countries
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References
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Perol M, Li W, Pennell NA, Liu G, Ohe Y, De Braud F, Nagasaka M, Felip E, Xiong A, Zhang Y, Fan H, Wang X, Li S, Lai RK, Ran F, Zhang X, Chen W, Bazhenova L, Zhou C. Taletrectinib in ROS1+ Non-Small Cell Lung Cancer: TRUST. J Clin Oncol. 2025 Jun;43(16):1920-1929. doi: 10.1200/JCO-25-00275. Epub 2025 Apr 3.
Nagasaka M, Ohe Y, Zhou C, Choi CM, Yang N, Liu G, Felip E, Perol M, Besse B, Nieva J, Raez L, Pennell NA, Dimou A, Marinis F, Ciardiello F, Seto T, Hu Z, Pan M, Wang W, Li S, Ou SI. TRUST-II: a global phase II study of taletrectinib in ROS1-positive non-small-cell lung cancer and other solid tumors. Future Oncol. 2023 Jan;19(2):123-135. doi: 10.2217/fon-2022-1059. Epub 2023 Mar 6.
Other Identifiers
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AB-106-G208
Identifier Type: -
Identifier Source: org_study_id
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