Taletrectinib Phase 2 Global Study in ROS1 Positive NSCLC

NCT ID: NCT04919811

Last Updated: 2026-01-07

Study Results

Results pending

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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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

217 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-01

Study Completion Date

2027-12-31

Brief Summary

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The main purpose of the study is to evaluate safety and efficacy of taletrectinib (also known as AB-106 or DS-6051b) monotherapy in the treatment of advanced NSCLC.

Detailed Description

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This is a global Phase 2, multicenter, single-arm, open label study of taletrectinib in patients of NSCLC harboring with ROS1 fusion gene.

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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Non Small Cell Lung Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Taletrectinib

Single-arm trial whereby all consented, enrolled, eligible patients receive taletrectinib

Group Type EXPERIMENTAL

Taletrectinib

Intervention Type DRUG

400mg or 600mg QD

Interventions

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Taletrectinib

400mg or 600mg QD

Intervention Type DRUG

Other Intervention Names

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DS-6051b AB-106

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years (or ≥20 years as required by local regulations).
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

1. Treatment with small molecule anticancer therapy including other investigational agents or cytotoxic systemic anticancer therapy within 2 weeks (or 5 half-lives of the compound, whichever is shorter) prior to the first dose of taletrectinib; or treatment with monoclonal antibodies, including immune checkpoint inhibitors within 4 weeks before the first dose of taletrectinib.
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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Nuvation Bio Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

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

Site Status

The Oncology Institute of Hope and Innovation

Glendale, California, United States

Site Status

Moores Cancer Center at UC San Diego

La Jolla, California, United States

Site Status

Keck Medicine of University of Southern California

Los Angeles, California, United States

Site Status

UCI Medical Center

Orange, California, United States

Site Status

Ventura County Hematology-Oncology Specialists

Oxnard, California, United States

Site Status

SCRI - Florida Cancer Specialists South

Fort Meyers, Florida, United States

Site Status

Memorial Cancer Institute at Memorial Hospital East

Hollywood, Florida, United States

Site Status

Cancer Specialists of North Florida

Jacksonville, Florida, United States

Site Status

Memorial Cancer Institute at Memorial Hospital West

Pembroke Pines, Florida, United States

Site Status

SCRI - Hematology Oncology Clinic

Baton Rouge, Louisiana, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Center for Cancer Research

Brick, New Jersey, United States

Site Status

Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status

SCRI - Tennessee Oncology

Nashville, Tennessee, United States

Site Status

Texas Oncology, P.A.

Dallas, Texas, United States

Site Status

Renovatio Clinical

El Paso, Texas, United States

Site Status

MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Renovatio Clinical

The Woodlands, Texas, United States

Site Status

Northwest Medical Specialties, PLLC

Tacoma, Washington, United States

Site Status

Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status

McGill University Health Centre Research Institute

Montreal, Quebec, Canada

Site Status

Beijing Cancer Hospital

Beijing, Beijing Municipality, China

Site Status

The First Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status

Shanghai Pulmonary Hospital

Shanghai, Shanghai Municipality, China

Site Status

Hunan Cancer Hospital

Changsha, , China

Site Status

West China Hospital

Chengdu, , China

Site Status

Shandong Cancer Hospital

Jinan, , China

Site Status

Wuhan Union Hospital

Wuhan, , China

Site Status

Henan Cancer Hospital

Zhengzhou, , China

Site Status

CHU Lyon - Hôpital Cardio-Vasculaire et Pneumologique Louis Pradel

Bron, , France

Site Status

CHU Grenoble Alpes- Hospital Michallon

La Tronche, , France

Site Status

Centre Léon Bérard

Lyon 08, , France

Site Status

Centre d'Essais Précoces de Cancerologie de Marseille

Marseille, , France

Site Status

APHP- Hôpital Europeen Georges Pompidou (HEGP)

Paris, , France

Site Status

CHU de Poitiers Pole regional

Poitiers, , France

Site Status

Institut Jean Godinot

Reims, , France

Site Status

CHU Rennes - Hospital Pontchaillou

Rennes, , France

Site Status

Institut De Cancérologie De L'ouest

Saint-Herblain, , France

Site Status

Institut Gustave Roussy

Saint-Herblain, , France

Site Status

Istituto Tumori Giovanni Paolo II IRCCS Ospedale Oncologico

Bari, , Italy

Site Status

Humanitas Istituto Clinico Catanese, Misterbinanoco

Catania, , Italy

Site Status

Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico

Milan, , Italy

Site Status

Ospedale San Raffaele

Milan, , Italy

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

IEO Istituto Europeo di Oncologia

Milan, , Italy

Site Status

AOU Cagliari- P.O. Policlinico Universitario Duilio Casula

Monserrato, , Italy

Site Status

Azienda Ospedaliera Universitaria- Università degli Studi della Campania

Napoli, , Italy

Site Status

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, , Italy

Site Status

National Hospital Organization Kyushu Cancer Center

Fukuoka, , Japan

Site Status

National Cancer Center Hospital East

Kashiwa, , Japan

Site Status

Sendai Kousei Hospital

Miyagi, , Japan

Site Status

Aichi Cancer Center Hospital

Nagoya, , Japan

Site Status

Kindai University Hospital

Osaka, , Japan

Site Status

Shizuoka Cancer Center

Shizuoka, , Japan

Site Status

National Cancer Center Hospital

Tokyo, , Japan

Site Status

The Cancer Institute Hospital of JFCR

Tokyo, , Japan

Site Status

Instytut Centrum Zdrowia Matki Polki

Lodz, , Poland

Site Status

Med-Polonia Sp. z o.o.

Poznan, , Poland

Site Status

MICS Centrum Medyczne Toruńa

Torun, , Poland

Site Status

Pusan National University Hospital

Busan, , South Korea

Site Status

Pusan National University Yangsan Hospital

Gyeongsang, , South Korea

Site Status

Chonnam National University Hwasun Hospital

Hwasun, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Korea University Guro Hospital

Seoul, , South Korea

Site Status

Clinica Mi Tres Torres

Barcelona, , Spain

Site Status

Hospital Quironsalud Barcelona

Barcelona, , Spain

Site Status

Hospital Universitari Vall d'Hebron

Barcelona, , Spain

Site Status

ICO l'Hospitalet - Hospital Duran i Reynals L'Hospitalet de Llobregat

Barcelona, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Universitario Clinico San Carlos

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital Regional Universitario de Malaga

Málaga, , Spain

Site Status

Hospital Universitario Virgen Macarena

Seville, , Spain

Site Status

Instituto Valenciano de Oncologia IVO

Valencia, , Spain

Site Status

Hospital Clinico Universitario de Valencia

Valencia, , Spain

Site Status

Countries

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United States Canada China France Italy Japan Poland South Korea Spain

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.

Reference Type DERIVED
PMID: 40179330 (View on PubMed)

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.

Reference Type DERIVED
PMID: 36877099 (View on PubMed)

Other Identifiers

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AB-106-G208

Identifier Type: -

Identifier Source: org_study_id

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