Difference between revisions of "Larotrectinib (Vitrakvi)"

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<br>Extravasation: n/a
 
<br>Extravasation: n/a
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.
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For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.
  
==Preliminary data==
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==Diseases for which it is used==
<!--
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*[[Malignant solid neoplasm, NTRK-mutated|Solid malignancies with NTRK fusions]]
# '''Abstract:''' Hyman DM, Laetsch TW, Kummar S, DuBois SG, Farago AF, Pappo AS, Demetri GD, El-Deiry WS, Lassen UN, Dowlati A, Brose MS. The efficacy of larotrectinib (LOXO-101), a selective tropomyosin receptor kinase (TRK) inhibitor, in adult and pediatric TRK fusion cancers. [http://ascopubs.org/doi/full/10.1200/JCO.2017.35.18_suppl.LBA2501 link to abstract] -->
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# Drilon A, Laetsch TW, Kummar S, DuBois SG, Lassen UN, Demetri GD, Nathenson M, Doebele RC, Farago AF, Pappo AS, Turpin B, Dowlati A, Brose MS, Mascarenhas L, Federman N, Berlin J, El-Deiry WS, Baik C, Deeken J, Boni V, Nagasubramanian R, Taylor M, Rudzinski ER, Meric-Bernstam F, Sohal DPS, Ma PC, Raez LE, Hechtman JF, Benayed R, Ladanyi M, Tuch BB, Ebata K, Cruickshank S, Ku NC, Cox MC, Hawkins DS, Hong DS, Hyman DM. Efficacy of larotrectinib in TRK fusion-positive cancers in adults and children. N Engl J Med. 2018 Feb 22;378(8):731-739. [http://www.nejm.org/doi/full/10.1056/NEJMoa1714448 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/29466156 PubMed]
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==History of changes in FDA indication==
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*2018-11-26: Granted accelerated approval for adult and pediatric patients with [[:Category:Malignant solid neoplasm|solid tumors]] that have a [[Biomarkers#NTRK|neurotrophic tyrosine receptor kinase (NTRK) gene]] [[Biomarkers#Rearrangement|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. ''(Based on LOXO-TRK-14001, SCOUT, and NAVIGATE)''
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==History of changes in EMA indication==
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*2019-09-19: Initial conditional authorisation as Vitrakvi. Vitrakvi as monotherapy is indicated for the treatment of adult and paediatric patients with [[:Category:Malignant solid neoplasm|solid tumours]] that display a [[Biomarkers#NTRK|Neurotrophic Tyrosine Receptor Kinase (NTRK) gene]] [[Biomarkers#Rearrangement|fusion]], who have a disease that is locally advanced, metastatic or where surgical resection is likely to result in severe morbidity, and who have no satisfactory treatment options.
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==History of changes in Health Canada indication==
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*2019-07-10: Initial notice of compliance with conditions for the treatment of adult and pediatric patients with [[:Category:Malignant solid neoplasm|solid tumours]] that have a Neurotrophic Tyrosine Receptor Kinase (NTRK) gene fusion without a known acquired resistance mutation, are metastatic, or where surgical resection is likely to result in severe morbidity, and have no satisfactory treatment options.
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==History of changes in PMDA indication==
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*2021-03-23: Newly indicated for the treatment of NTRK fusion gene-positive advanced or recurrent [[:Category:Malignant solid neoplasm|solid tumours]].
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==Patient Drug Information==
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*[https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/211710s000lbl.pdf Larotrectinib (Vitrakvi) Package Insert]<ref>[https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/211710s000lbl.pdf Larotrectinib (Vitrakvi) Package Insert]</ref>
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==Also known as==
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*'''Code name:''' LOXO-101
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*'''Brand name:''' Vitrakvi
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==References==
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[[Category:Drugs]]
  
[[Category:Drug index]]
 
[[Category:Chemotherapy]]
 
 
[[Category:Oral medications]]
 
[[Category:Oral medications]]
  
[[Category:Kinase inhibitors]]
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[[Category:TRK inhibitors]]
 
[[Category:TRK inhibitors]]
  
[[Category:Site-agnostic medications]]
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[[Category:Mutation-specific medications]]
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[[Category:Malignant solid neoplasm, NTRK-mutated medications]]
  
[[Category:Investigational]]
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[[Category:FDA approved in 2018]]
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[[Category:EMA approved in 2019]]
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[[Category:Health Canada approved in 2019]]
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[[Category:PMDA approved in 2021]]

Latest revision as of 01:01, 29 June 2024

General information

Class/mechanism from the NCI Drug Dictionary: An orally available, tropomyosin receptor kinase (Trk) inhibitor, with potential antineoplastic activity. Upon administration, larotrectinib binds to Trk, thereby preventing neurotrophin-Trk interaction and Trk activation, which results in both the induction of cellular apoptosis and the inhibition of cell growth in tumors that overexpress Trk.
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.

Diseases for which it is used

History of changes in FDA indication

  • 2018-11-26: Granted accelerated approval for adult and pediatric patients with solid tumors that have a neurotrophic tyrosine receptor 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. (Based on LOXO-TRK-14001, SCOUT, and NAVIGATE)

History of changes in EMA indication

  • 2019-09-19: Initial conditional authorisation as Vitrakvi. Vitrakvi as monotherapy is indicated for the treatment of adult and paediatric patients with solid tumours that display a Neurotrophic Tyrosine Receptor Kinase (NTRK) gene fusion, who have a disease that is locally advanced, metastatic or where surgical resection is likely to result in severe morbidity, and who have no satisfactory treatment options.

History of changes in Health Canada indication

  • 2019-07-10: Initial notice of compliance with conditions for the treatment of adult and pediatric patients with solid tumours that have a Neurotrophic Tyrosine Receptor Kinase (NTRK) gene fusion without a known acquired resistance mutation, are metastatic, or where surgical resection is likely to result in severe morbidity, and have no satisfactory treatment options.

History of changes in PMDA indication

  • 2021-03-23: Newly indicated for the treatment of NTRK fusion gene-positive advanced or recurrent solid tumours.

Patient Drug Information

Also known as

  • Code name: LOXO-101
  • Brand name: Vitrakvi

References