Dr Patel on Findings From the TRUST-II Trial in ROS1+ NSCLC

Jyoti Patel, MD, professor medicine (hematology and oncology), associate vice chair, Clinical Research, Department of Medicine, Northwestern University; medical director, Thoracic Oncology, assistant director, Clinical Research, Lurie Cancer Center, Feinberg School of Medicine, Northwestern Medicine, discusses the findings and clinical implications of the phase 2 TRUST-II trial (NCT04919811) in patients with locally advanced or metastatic 

-positive non–small cell lung cancer (NSCLC), regardless of prior TKI exposure.

At the 2024 IASLC World Conference on Lung Cancer, investigators presented data from the global, single-arm, open-label, multicenter TRUST-II trial, which evaluated the taletrectinib (AB-106) in this patient within this population. At a median follow-up of 15.8 months (range, 3.6-29.8), the next-generation ROS1 TKI demonstrated a confirmed overall response rate (cORR) of 85.2% (95% CI, 72.88%-93.38%) in patients without prior exposure to a ROS1 TKI (n = 54). Conversely, for patients previously treated with a ROS1 TKI (n = 47), the cORR with taletrectinib was 61.7% (95% CI, 46.38%-75.49%) at a median follow-up of 15.7 months (range, 3.9-29.8).

The TRUST-II study demonstrated high overall and intracranial response rates across 2 patient groups: TKI-naive patients and those previously treated with TKIs, Patel begins. In the pretreated cohort, most of the patients had received prior treatment with crizotinib (Xalkori) or entrectinib (Rozlytrek), she reports, adding that during the trial, patients in both cohorts received taletrectinib at a dose of 600 mg once daily. Notably, the intracranial response rates among patients who were TKI naive (n = 9) and TKI pretreated (n = 16) were 66.7% (95% CI, 29.93%-92.51%) and 56.3% (95% CI, 29.88%-80.25%), respectively, Patel explains.

The treatment was generally well tolerated, although dose reductions were required in 37.1% of patients, 16.4% of which were due to elevated liver enzymes, she explains. Notably, taletrectinib has shown efficacy in patients with 

 translocations, which are notoriously difficult to treat, Patel emphasizes.

Videos

Jyoti Patel, MD, discusses the implications of the TRUST-II trial in locally advanced or metastatic ROS1-positive NSCLC, regardless of prior TKI exposure.

Jyoti Patel, MD, professor of medicine, director, Thoracic Oncology, University of Chicago School of Medicine, discusses checkpoint blockade in non—small cell lung cancer (NSCLC).

There have been significant responses to checkpoint blockades, but only about 20% of patients demonstrate response.

The goal now is to bring the right immunotherapy agents to a broader population, says Patel, giving more patients a chance at response.

Jyoti Patel, MD, professor of medicine, director, Thoracic Oncology, University of Chicago School of Medicine, discusses checkpoint blockade in non–small cell lung cancer.

Dr. Patel Discusses Checkpoint Blockade in NSCLC

Jyoti Patel, MD, professor of medicine, director, Thoracic Oncology, University of Chicago School of Medicine, discusses combination chemotherapy and immunotherapy in patients with lung cancer.

There are a number of promising ongoing clinical trials combining chemotherapy and immunotherapy in lung cancer, says Patel.

In a phase III trial, the combination of pembrolizumab (Keytruda) with carboplatin and pemetrexed demonstrated a significantly higher response rate than chemotherapy alone, as well as an overall survival benefit. This combination led to the May 2017 FDA approval for patients as a frontline treatment.

Jyoti Patel, MD

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