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Augtyro

repotrectinib
ROS1/TRK Tyrosine Kinase Inhibitor FDA Approved 2023 Bristol-Myers Squibb
Route
Oral
Half-Life
~35 hrs
FDA Approved
2023
Manufacturer
Bristol-Myers Squibb
1. Indications and Usage

ROS1-positive NSCLC: Adult patients with locally advanced or metastatic ROS1-positive non-small cell lung cancer. NTRK gene fusion-positive solid tumors: Adult patients with locally advanced or metastatic solid tumors with a neurotrophic tyrosine receptor kinase (NTRK) gene fusion without a known acquired resistance mutation, who have no satisfactory alternative treatments or whose cancer has progressed following treatment.

2. Dosage and Administration

Weeks 1–2: 160 mg orally once daily. Week 3 onwards: 160 mg orally twice daily. Take with or without food. Swallow capsules whole.
Dose reduction: First reduction to 160 mg once daily; second to 120 mg once daily. Discontinue if unable to tolerate 120 mg once daily.

3. Dosage Forms and Strengths

Capsules: 40 mg, 160 mg

4. Contraindications

None established in prescribing information.

5. Warnings and Precautions
  • Interstitial Lung Disease (ILD)/Pneumonitis: Occurred in 5.4% of patients. Withhold and investigate; permanently discontinue if confirmed Grade 3–4.
  • Dizziness/Cognitive Effects: Dizziness (45%) and cognitive impairment (33%) reported, including Grade ≥3. Avoid hazardous activities (driving) until effects are known.
  • Peripheral Neuropathy: Occurred in 38% of patients. Monitor for new or worsening symptoms.
  • Myalgia/Arthralgia/CPK Elevation: Myalgia and CPK elevation reported. Monitor CPK.
  • Embryo-Fetal Toxicity: Can cause fetal harm. Advise effective contraception.
6. Adverse Reactions
Most Common Adverse Reactions

Dizziness (45%), Dysgeusia (43%), Peripheral Neuropathy (38%), Constipation (33%), Cognitive Impairment (33%), Fatigue (31%), Dyspnea (27%), Ataxia (26%)

Dizziness
45%
Dysgeusia
43%
Peripheral Neuropathy
38%
Constipation
33%
Cognitive Impairment
33%
Fatigue
31%
Dyspnea
27%
Ataxia
26%

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

7. Drug Interactions

Strong CYP3A4 inhibitors: Avoid; if unavoidable, reduce repotrectinib dose.
Strong CYP3A4 inducers: Avoid concomitant use.
Sensitive CYP3A4 substrates with narrow therapeutic index: Avoid concomitant use.

8. Use in Specific Populations
Pregnancy

Can cause fetal harm. Advise females of reproductive potential to use effective contraception. Consult the full prescribing information for pregnancy risk details.

Lactation

Advise women not to breastfeed during treatment and for a period after the last dose. Refer to prescribing information for duration guidance.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established unless otherwise noted in the full prescribing information.

Hepatic/Renal Impairment

Dose modifications for organ impairment are specified in the complete prescribing information.

12. Clinical Pharmacology
Mechanism of Action

Repotrectinib is a next-generation ROS1 and TRK (TRKA/B/C) tyrosine kinase inhibitor engineered with a compact macrocyclic structure to address acquired resistance mutations (e.g., ROS1 G2032R, NTRK XDFG mutations) that limit earlier-generation TKIs. It competitively inhibits ATP binding in the kinase domain, blocking downstream proliferative signaling.

Pharmacokinetics

Tmax: ~4 hours. Protein binding: ~98%. Hepatic metabolism via CYP3A4. Half-life: ~35 hours. Elimination: feces (83%), urine (7%). Steady state: ~14 days.

14. Clinical Studies

Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.

Pivotal Clinical Trials
Additional Resources
FDA-Approved Tumor Types

Augtyro has FDA-approved indications across the following cancer types covered on CancerDrugEvidence:

External Resources
Important Notice: This page is intended as a navigational reference to the FDA-approved prescribing information for Augtyro. It does not replace the full prescribing information. Healthcare professionals should consult the complete package insert available at DailyMed before making prescribing decisions. Patient-specific factors should always guide clinical decision-making.

Frequently Asked Questions

What is Augtyro (repotrectinib) approved for?

Augtyro (repotrectinib) is an FDA-approved oncology agent. Refer to the full prescribing information for complete indication details.

How is Augtyro (repotrectinib) administered?

Refer to the full prescribing information for dosing schedules, administration instructions, and dose modifications.

How does Augtyro (repotrectinib) work?

Repotrectinib is a next-generation ROS1 and TRK (TRKA/B/C) tyrosine kinase inhibitor engineered with a compact macrocyclic structure to address acquired resistance mutations (e.g., ROS1 G2032R, NTRK XDFG mutations) that limit earlier-generation TKIs. It competitively inhibits ATP binding in the kina

What are the most common side effects?

Dizziness (45%), Dysgeusia (43%), Peripheral Neuropathy (38%), Constipation (33%), Cognitive Impairment (33%), Fatigue (31%), Dyspnea (27%), Ataxia (26%)