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ELCC 2025 | How do you sequence ROS1 inhibitors for ROS1+ NSCLC in the clinic?
Misako Nagasaka, MD, UCI Health Chao Family Comprehensive Cancer Center, Orange, CA, comments on the sequencing of ROS1 inhibitors for patients with ROS1-positive non-small cell lung cancer (NSCLC) in the clinic. Repotrectinib is a preferred option over crizotinib and entrectinib due to its better brain penetration and ability to tackle resistant mechanisms, making it a valuable addition to the standard of care treatment for patients who do not qualify for clinical trials. This interview took place at the European Lung Cancer Congress (ELCC) 2025 in Paris, France.
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Transcript
Sure. So at this time, at least in the United States, the FDA approved ROS1 inhibitors include the first generation crizotinib and entrectinib, as well as the next generation repotrectinib. So if I were to have a patient who would not qualify for clinical trials and would like to have standard of care treatment, I would probably start the treatment with repotrectinib just because of better brain penetration compared to the earlier generation of ROS inhibitors, as well as the ability to tackle resistant mechanisms up front...
Sure. So at this time, at least in the United States, the FDA approved ROS1 inhibitors include the first generation crizotinib and entrectinib, as well as the next generation repotrectinib. So if I were to have a patient who would not qualify for clinical trials and would like to have standard of care treatment, I would probably start the treatment with repotrectinib just because of better brain penetration compared to the earlier generation of ROS inhibitors, as well as the ability to tackle resistant mechanisms up front. That being said, I think repotrectinib, when it does come out, would be a very beautiful option because of the lack of TRK related side effects.
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