Jul 30, 2026 · 17 min · 8 segments
A new drug is approved for ROS1 NSCLC after a prior TKI (with some data in patients after 2 TKIs). Zidesamtinib...easy for you to say. Also, a post hoc analysis of PACIFIC provides some of the best…
John BazarHost
So this drug, zidusamantinib, is approved for non-small cell lung cancer, advanced non-small cell lung cancer.
in a second-line setting, and not second-line after chemo, but second-line after a prior ROS1 inhibitor.
Repotrectinib and Taltrectinib are probably the best drugs we have in the advanced ROS1 mutated lung cancer after progression on a ROS1 inhibitor.
And this data is seven years old and has not garnered FDA approval either from, for whatever reason, not sure if it was ever submitted.
And then there's some, a little bit of data within treknib, but taltreknib and repotreknib are probably the other drugs this would be competing with.
Taltrectinib has response rates of 52% and 62% in two different studies in the setting.
Now, talotrectinib also does not have any warning precaution state about CNS dysfunction, which is pretty common.
Rapotrectinib is a 3 or 4 inducer, so it has some interaction with drugs like apixaban that would be worrisome.
And Zadacimab is kind of in between these as far as its side effect profile and apparent efficacy, which we'll get into.
ECG because there's a risk of QT prolongation, but also you need a baseline lipase and amylase because of a fairly significant risk of pancreatitis.
So this drug, zidusamantinib, is approved for non-small cell lung cancer, advanced non-small cell lung cancer.
in a second-line setting, and not second-line after chemo, but second-line after a prior ROS1 inhibitor.
Repotrectinib and Taltrectinib are probably the best drugs we have in the advanced ROS1 mutated lung cancer after progression on a ROS1 inhibitor.
And this data is seven years old and has not garnered FDA approval either from, for whatever reason, not sure if it was ever submitted.
And then there's some, a little bit of data within treknib, but taltreknib and repotreknib are probably the other drugs this would be competing with.
Taltrectinib has response rates of 52% and 62% in two different studies in the setting.
Now, talotrectinib also does not have any warning precaution state about CNS dysfunction, which is pretty common.
Rapotrectinib is a 3 or 4 inducer, so it has some interaction with drugs like apixaban that would be worrisome.
And Zadacimab is kind of in between these as far as its side effect profile and apparent efficacy, which we'll get into.
ECG because there's a risk of QT prolongation, but also you need a baseline lipase and amylase because of a fairly significant risk of pancreatitis.
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