On April 21, 2026 Nuvation Bio Inc. (NYSE: NUVB), a global oncology company focused on tackling some of the toughest challenges in cancer treatment, reported results from a pooled analysis of long-term follow-up data from the pivotal TRUST-I and TRUST-II trials for IBTROZI (taletrectinib) in patients with advanced ROS1-positive (ROS1+) non-small cell lung cancer (NSCLC). The updated efficacy and safety results for both TKI-naïve and TKI-pretreated patients were presented at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting 2026 in oral and poster presentations. The long-term pooled results in TKI-naïve patients demonstrated a confirmed objective response rate (cORR) of 89.8%, a median duration of response (mDOR) of 49.7 months and a median progression-free survival (mPFS) of 46.1 months. Updated results from the TRUST-I study were also simultaneously published in the Journal of Clinical Oncology, demonstrating robust ORR, mDOR and mPFS in TKI-naïve patients, with a median follow up of 51 months.
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"Achieving durable responses is a primary goal in treating ROS1-positive lung cancer. These extensive follow-up data with this next-generation ROS1 inhibitor show high rates of responses that last more than four years for many patients, and a median progression-free survival that’s nearly just as long," stated Lyudmila Bazhenova, M.D., Medical Oncologist at UC San Diego Health, Professor of Medicine at University of California San Diego School of Medicine and investigator for the TRUST-II study. "Critically, the data demonstrated robust intracranial activity without the significant central nervous system toxicities that often limit the long-term use of other brain-penetrant therapies, and a favorable safety profile that allowed patients to stay on treatment and continue to benefit."
The new pooled analysis presented at AACR (Free AACR Whitepaper) demonstrated robust efficacy with IBTROZI for both TKI-naïve and TKI-pretreated patients in TRUST-I and TRUST-II.
For TKI-naïve patients (n=157): the analysis showed a cORR of 89.8%, a median DOR of 49.7 months, a median PFS of 46.1 months and an intracranial response rate of 76.5% in patients with brain metastases (n=17). Median OS was not yet reached.
For TKI-pretreated patients (n=113): the analysis showed a cORR of 55.8%, a median DOR of 16.6 months, a median PFS of 9.7 months and an intracranial response rate of 65.6% in patients with brain metastases (n=32). Median OS was 29.8 months. Notably, 98% of TKI-pretreated patients (111/113) enrolled following progressive disease on entrectinib or crizotinib. The remaining two patients were enrolled following intolerance to a prior TKI.
A pooled safety analysis demonstrated a favorable and manageable safety profile for IBTROZI, consistent with its prescribing information. Adverse events (AEs) of clinical interest (diarrhea, nausea, vomiting and dizziness) were generally low-grade and resolved quickly. Treatment discontinuations due to treatment-emergent AEs (TEAEs) were low (8.5%). No new safety signals were identified with the longer follow-up.
In another poster session at AACR (Free AACR Whitepaper), new preclinical data showed that taletrectinib inhibited the migration of lung cancer cells, suggesting the ability of taletrectinib to reduce the invasive capacity of lung cancer cells based on its tropomyosin receptor kinase B (TRKB) inhibition profile. In mechanistic studies, taletrectinib reduced the expression of key markers associated with the epithelial to mesenchymal transition pathway. The data also suggested that TRKB-sparing agents may not reduce the migration of TRKB expressing lung cancer cells and may lack the potential CNS-protective effects of TRKB inhibition.
"Our objective was to redefine the standard of care for advanced ROS1-positive NSCLC, and we believe IBTROZI is delivering on that promise," said David Hung, M.D., Founder, President and Chief Executive Officer of Nuvation Bio. "In these updated long-term clinical data presented at AACR (Free AACR Whitepaper) and published in the prestigious Journal of Clinical Oncology, IBTROZI demonstrated remarkable durability, underscored by the long mDOR and mPFS seen in ROS1+ TKI-naïve patients. And new preclinical data suggest that taletrectinib inhibits critical pathways that can lead to metastasis. When you combine these benefits with its favorable safety profile, you have a treatment that we believe addresses the disease from all angles."
Nuvation Bio announced in June 2025 that the U.S. Food and Drug Administration (FDA) approved IBTROZI for the treatment of adult patients with locally advanced or metastatic ROS1+ NSCLC. IBTROZI is also approved for patients with advanced ROS1+ NSCLC in Japan, where it is marketed by Nippon Kayaku, and in China, where it is marketed by Innovent Biologics under the brand name DOVBLERON. Additionally, Nuvation Bio, along with its partner Eisai, announced in March 2026 that the Marketing Authorisation Application (MAA) for taletrectinib was validated by the European Medicines Agency and accepted for full approval consideration with a standard review timeline.
To review the publications, visit the Publications page of the Nuvation Bio website.
About ROS1+ NSCLC
Each year, more than one million people globally are diagnosed with non-small cell lung cancer (NSCLC), the most common form of lung cancer. It is estimated that approximately 2% of patients with NSCLC have ROS1+ disease. About 35% of patients newly diagnosed with metastatic ROS1+ NSCLC have tumors that have spread to their brain. The brain is also the most common site of disease progression, with about 50% of previously treated patients developing central nervous system (CNS) metastases.
About IBTROZI
IBTROZI is an oral, potent, CNS-active, selective, next-generation ROS1 inhibitor therapy. On June 11, 2025, following Priority Review and Breakthrough Therapy designations for both TKI-naive and TKI-pretreated disease, the U.S. Food and Drug Administration (FDA) approved taletrectinib for the treatment of adult patients with locally advanced or metastatic ROS1+ NSCLC. Learn more about taletrectinib in the U.S. at IBTROZI.com.
About the TRUST Clinical Program
The TRUST clinical program comprises three registrational studies evaluating the safety and efficacy of IBTROZI. TRUST-I (NCT04395677) and TRUST-II (NCT04919811) are Phase 2 single-arm studies evaluating IBTROZI for the treatment of adults with advanced ROS1+ NSCLC in China (N=173) and globally (N=189), respectively. The primary endpoint of both studies is confirmed objective response rate (cORR) as assessed by an independent review committee. TRUST-IV (NCT07154706) is a Phase 3 placebo-controlled study evaluating IBTROZI for the adjuvant treatment of adults with resected early-stage ROS1+ NSCLC. The study will enroll approximately 180 patients in the U.S., Canada, Europe, Japan and China. The primary endpoint is disease-free survival as determined by investigator, and the primary completion date is estimated to be in 2030. Nuvation Bio is also sponsoring TRUST-III (NCT06564324), a confirmatory randomized Phase 3 study evaluating IBTROZI versus crizotinib in 194 patients in China with advanced ROS1+ NSCLC who have not previously received ROS1 TKIs.
U.S. Indication
IBTROZI is indicated for the treatment of adult patients with locally advanced or metastatic ROS1+ non-small cell lung cancer (NSCLC).
IMPORTANT SAFETY INFORMATION FOR IBTROZI (taletrectinib)
WARNINGS AND PRECAUTIONS
Hepatotoxicity: Hepatotoxicity, including drug-induced liver injury and fatal adverse reactions, can occur. 88% of patients experienced increased AST, including 10% Grade 3/4. 85% of patients experienced increased ALT, including 13% Grade 3/4. Fatal liver events occurred in 0.6% of patients. Median time to first onset of AST or ALT elevation was 15 days (range: 3 days to 20.8 months).
Increased AST or ALT each led to dose interruption in 7% of patients and dose reduction in 5% and 9% of patients, respectively. Permanent discontinuation was caused by increased AST, ALT, or bilirubin each in 0.3% and by hepatotoxicity in 0.6% of patients.
Concurrent elevations in AST or ALT ≥3 times the ULN and total bilirubin ≥2 times the ULN, with normal alkaline phosphatase, occurred in 0.6% of patients.
Interstitial Lung Disease (ILD)/Pneumonitis: Severe, life-threatening, or fatal ILD or pneumonitis can occur. ILD/pneumonitis occurred in 2.3% of patients, including 1.1% Grade 3/4. One fatal ILD case occurred at the 400 mg daily dose. Median time to first onset of ILD/pneumonitis was 3.8 months (range: 12 days to 11.8 months).
ILD/pneumonitis led to dose interruption in 1.1% of patients, dose reduction in 0.6% of patients, and permanent discontinuation in 0.6% of patients.
QTc Interval Prolongation: QTc interval prolongation can occur, which can increase the risk for ventricular tachyarrhythmias (e.g., torsades de pointes) or sudden death. IBTROZI prolongs the QTc interval in a concentration-dependent manner.
In patients who received IBTROZI and underwent at least one post baseline ECG, QTcF increase of >60 msec compared to baseline and QTcF >500 msec occurred in 13% and 2.6% of patients, respectively. 3.4% of patients experienced Grade ≥3. Median time from first dose of IBTROZI to onset of ECG QT prolongation was 22 days (range: 1 day to 38.7 months). Dose interruption and dose reduction each occurred in 2.8% of patients.
Significant QTc interval prolongation may occur when IBTROZI is taken with food, strong and moderate CYP3A inhibitors, and/or drugs with a known potential to prolong QTc. Administer IBTROZI on an empty stomach. Avoid concomitant use with strong and moderate CYP3A inhibitors and/or drugs with a known potential to prolong QTc.
Hyperuricemia: Hyperuricemia can occur and was reported in 14% of patients, with 16% of these requiring urate-lowering medication without pre-existing gout or hyperuricemia. 0.3% of patients experienced Grade ≥3. Median time to first onset was 2.1 months (range: 7 days to 35.8 months). Dose interruption occurred in 0.3% of patients.
Myalgia with Creatine Phosphokinase (CPK) Elevation: Myalgia with or without CPK elevation can occur. Myalgia occurred in 10% of patients. Median time to first onset was 11 days (range: 2 days to 10 months).
Concurrent myalgia with increased CPK within a 7-day time period occurred in 0.9% of patients. Dose interruption occurred in 0.3% of patients with myalgia and concurrent CPK elevation.
Skeletal Fractures: IBTROZI can increase the risk of fractures. ROS1 inhibitors as a class have been associated with skeletal fractures. 3.4% of patients experienced fractures, including 1.4% Grade 3. Some fractures occurred in the setting of a fall or other predisposing factors. Median time to first onset of fracture was 10.7 months (range: 26 days to 29.1 months). Dose interruption occurred in 0.3% of patients.
Embryo-Fetal Toxicity: Based on literature, animal studies, and its mechanism of action, IBTROZI can cause fetal harm when administered to a pregnant woman.
ADVERSE REACTIONS
Among patients who received IBTROZI, the most frequently reported adverse reactions (≥20%) were diarrhea (64%), nausea (47%), vomiting (43%), dizziness (22%), rash (22%), constipation (21%), and fatigue (20%).
The most frequently reported Grade 3/4 laboratory abnormalities (≥5%) were increased ALT (13%), increased AST (10%), decreased neutrophils (5%), and increased creatine phosphokinase (5%).
DRUG INTERACTIONS
Strong and Moderate CYP3A Inhibitors/CYP3A Inducers and Drugs that Prolong the QTc Interval: Avoid concomitant use.
Gastric Acid Reducing Agents: Avoid concomitant use with PPIs and H2 receptor antagonists. If an acid-reducing agent cannot be avoided, administer locally acting antacids at least 2 hours before or 2 hours after taking IBTROZI.
OTHER CONSIDERATIONS
Pregnancy: Please see important information in Warnings and Precautions under Embryo-Fetal Toxicity.
Lactation: Advise women not to breastfeed during treatment and for 3 weeks after the last dose.
Effect on Fertility: Based on findings in animals, IBTROZI may impair fertility in males and females. The effects on animal fertility were reversible.
Pediatric Use: The safety and effectiveness of IBTROZI in pediatric patients has not been established.
Photosensitivity: IBTROZI can cause photosensitivity. Advise patients to minimize sun exposure and to use sun protection, including broad-spectrum sunscreen, during treatment and for at least 5 days after discontinuation.
(Press release, Nuvation Bio, APR 21, 2026, View Source [SID1234664633])