Professor Han Baohui: His Rentinini brings ROS1 -positive NSCLC treatment new choices, and the era of "slow disease" treatment of lung cancer is coming.

*For medical professionals for reference

ROS1 positive late NSCLC patients add new choices.

In recent years, with the development and popularization of gene detection technology, (NSCLC) has become more and more targetsPoints were found and successfully permeated, bringing high -efficiency and low -toxic treatment new choices to countless patients.Regarding the patient with ROS1 positive NSCLC patients, Cizidinib was approved by the US Food and Drug Administration (FDA) in 2016, becoming the first targeted therapeutic drug for ROS1 to integrate positive NSCLC.Nigeri and Reipininib has also been approved to be listed one after another, which has enriched patients treatment choices.

Recently, based on the efficacy and safety results of Trust-I research, the China National Drug Administration (NMPA) accepted the next generation of ROS1-TKIs new drug application ( NDA), which is used in the advanced NSCLC for first-line therapy ROS1-positive and has not been treated with ROS1-tyrosine kinase inhibitors (TKI), which undoubtedly brings great evidence of evidence-based medical evidence to the targeted therapy of ROS1 positive patients in my country New choice. Professor Han Baohui, Affiliated Chest Hospital has been deeply cultivated in the clinical diagnosis and treatment of lung cancer, and has accumulated extremely rich experience in clinical research and practice.On this opportunity, [Medical Community] invites Professor Han Baohui to share around the "clinical diagnosis and treatment of patients with late NSCLC patients" and talk about academic views in order to bring professional thinking to clinicians.

Analyze the status quo of ROS1 -positive NSCLC diagnosis and treatment, There are still unsatisfactory treatment needs

ROS1 fusion mutation in NSCLC is lower. Only about 1%to 2%, but in view of my countrys huge population base and numerous patients with lung cancer, the number of patients with this rare mutation in actual mutation is still considerable.In the current clinical practice, the fusion of ROS1 is already a "requiring" gene for patients with advanced NSCLC, which accurately detects the accurate treatment of ROS1 fusion to help patients and extend the time of survival. Professor Han Baohui pointed out that the second-generation sequencing (NGS) based on DNA and RNA can be used for ROS1 fusion gene detection, but DNA-NGS testing has the risk of missed inspection.Combining DNA detection with RNA detection can make up for the possible missed inspections of conventional detection methods and effectively improve the rate of detection rates in the fusion gene.

In terms of treatment, ALK inhibitory clubininib was found to have good effects among ROS1 -positive NSCLC patients, thereby opening the era of ROS1 targeted therapy.However, Professor Han Baohui said that most patients who receive targeted therapy will face the dilemma of disease progress due to drug -resistant or central nervous system (CNS) transfer.A generation of ROS1-TKI has obvious limitations in intracranial efficacy, and has more adverse reactions for long-term use.Therefore, the new generation of ROS1-TKI, which is more effective and safer, and has higher cerebral permeability to meet the urgent needs of clinical applications, has become an important task of current ROS1 positive late NSCLC clinical diagnosis and treatment.

The new generation of ROS1-TKI shows the hard power of the brain, the curative effect and security data are encouraged

His Rentinib is a new generation of ROS1-TKI with CNS activity. Professor Han Baohui emphasized that the advent of his Rentinib not only solves the problem of poor TKIs poor cerebral permeability in the past,It also reduces the incidence of adverse reactions in CNS, and is expected to become a preferred preferred treatment of brain metastases.

Trust-I Study is a stage II, multi-center, and single-arm research.ORR evaluated by researchers, no progressive survival (PFS), disease control rate (DCR), reaction duration (DOR), etc. (DOR).At the annual meeting of the American Clinical Oncology Society (ASCO) in 2024, Trust-I research announced the latest results: Among the patients with TKI initial administration, 2 years of follow-up, his CORR of Ritininib is as high as 91%, and the median PFS is stillWithout reaching (NR), the 2 -year PFS rate is 71%, the intracranial ORR is 88%, and the intracranial DCR is 100%. Among the TKI after treatment, the median follow -up is 9.7 months, the CORR is 52%, the MPFS is 7.6 is 7.6In a month, the intracranial ORR was 73%, the intracranial DCR was 93.3%, and the ORR of the G2032R drug -resistant mutations was 67%[1].

Figure 1: Trus-I Research relief results

Figure 2: Trus-I Study PFS Analysis Results

In termsThe exposure time is 12.2 months, and the most common treatment related adverse events (Teaes) is elevation, diarrhea, rising diarrhea, elevated glutamic aminotransferase, and vomiting. Most Traes are 1-2.Because his Rentinib reduced his ability to suppress TRKB, thereby reducing the neurotoxicity caused by the NTRK pathway. The patients CNS AE has a low frequency. Common CNS AE includes dizziness, disorder, headache, etc. Most of them are 1.class.

In short, whether in TKIs initial treatment or patients who have been treated with clipininib in the past, he Ritidinib shows the excellent body and intracranial efficacy, while safetygood.In addition, for the G2032R secondary drug tolerance mutation, he also showed the effectiveness of therapeutic, which further highlights the role of the drug in overcoming drug resistance.In June 2024, "Journal of Clinical Oncology" published the full text of Trust-I research, which not only marked that he has made a major breakthrough in the field of ROS1 positive NSCLC treatment.Come to the hope of new treatment.

Share Ros1 positive NSCLC full management experience , Multiple measures and help ROS1 positive NSCLC Realize "slow disease"