中文報導
http://www.wenxuecity.com/news/2018/11/27/7857215.html
https://mp.weixin.qq.com/s/34vIrozubBtMnqOzAHxBkw
美國上市時間：2018年11月26日
批準單位：美國食品和藥物管理局（FDA）
藥物名稱：Vitrakvi（又名Larotrectinib）
藥物功效：有效對抗由單一罕見基因突變驅動的各種癌症
針對群體：患有實體腫瘤的成人和兒童患者
製造商：Bayer（拜耳）和Loxo Oncology共同研發
可有效治療的類型：
肺癌、甲狀腺癌、黑色素瘤
胃腸癌、結腸癌、軟組織肉瘤
唾液腺、嬰兒纖維肉瘤、闌尾癌
乳腺癌、膽管癌、胰腺癌等17種
中文版：美FDA批準首個TRK抑製劑治療NTRK基因融合晚期實體瘤
http://med.sina.cn/article_detail_103_2_56652.html#
FDA官方公布：FDA approves larotrectinib for solid tumors with NTRK gene fusions
https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm626720.htm
On November 26, 2018, the Food and Drug Administration granted accelerated approval to larotrectinib (VITRAKVI, Loxo Oncology Inc. and Bayer) for adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion without a known acquired resistance mutation, that are either metastatic or where surgical resection is likely to result in severe morbidity, and who have no satisfactory alternative treatments or whose cancer has progressed following treatment.
This is the second tissue-agnostic FDA approval for the treatment of cancer.
Approval was based on data from three multicenter, open-label, single-arm clinical trials: LOXO-TRK-14001 (NCT02122913), SCOUT (NCT02637687), and NAVIGATE (NCT02576431). Identification of positive NTRK gene fusion status was prospectively determined in local laboratories using next generation sequencing (NGS) or fluorescence in situ hybridization (FISH). NTRK gene fusions were inferred in three pediatric patients with infantile fibrosarcoma who had a documented ETV6 translocation by FISH. The major efficacy outcome measures were overall response rate (ORR) and response duration, as determined by a blinded independent review committee according to RECIST 1.1.
Efficacy was evaluated in the first 55 patients with unresectable or metastatic solid tumors harboring an NTRK gene fusion enrolled across the three trials. All patients were required to have progressed following systemic therapy for their disease, if available, or would have required surgery with significant morbidity for locally advanced disease. Twelve patients were less than 18 years of age. A total of 12 cancer types were represented, with the most common being salivary gland tumors (22%), soft tissue sarcoma (20%), infantile fibrosarcoma (13%), and thyroid cancer (9%).
ORR was 75% (95% CI: 61%, 85%), including 22% complete responses and 53% partial responses. At the time of database lock, median duration of response had not been reached. Response duration was 6 months or longer for 73%, 9 months or longer for 63%, and 12 months or longer for 39% of patients.
The safety of larotrectinib was evaluated in 176 patients enrolled across the three clinical trials, including 44 pediatric patients. The most common adverse reactions (≥20%) with larotrectinib were fatigue, nausea, dizziness, vomiting, increased AST, cough, increased ALT, constipation, and diarrhea.
The recommended larotrectinib doses are 100 mg orally twice daily for adults and 100 mg/m2 orally twice daily (maximum of 100 mg per dose) for pediatric patients.
View full prescribing information for VITRAKVI.
This indication is approved under accelerated approval and continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. FDA granted this application priority review, breakthrough therapy designation and orphan product designation. A description of FDA expedited programs is in the Guidance for Industry: Expedited Programs for Serious Conditions-Drugs and Biologics.
Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDA’s MedWatch Reporting System or by calling 1-800-FDA-1088.
