Dr. Spira on the Challenges of Developing NRG1 Fusion–Directed Therapies in NSCLC

Alexander Spira, MD, PhD, FACP, a medical oncologist and director of the Virginia Cancer Specialists Research Institute and the Phase 1 Trial Program, discusses the challenges of developing targeted therapies for patients with NRG1 fusion–positive non–small cell lung cancer (NSCLC).

The potential to target NRG1 fusions has generated a lot of clinical excitement in NSCLC with ongoing studies such as the phase 2 CRESTONE trial (NCT04383210) evaluating seribantumab and the phase 2 RAIN trial (NCT03805841) evaluating tarloxotinib.

However, NRG1 fusions are exceedingly rare and occur in about 1% of patients with NSCLC, says Spira, who says he has not identified a patient who harbors an NRG1 fusion in clinical practice. Because of their rarity, identifying patients who harbor NRG1 fusions and enrolling them onto clinical trials is challenging, Spira explains. However, preliminary data from the CRESTONE trial appear promising for patients with solid tumors that harbor NRG1 fusions, Spira concludes.