ALK/ROS1 TKI (1st generation) · small molecule

crizotinib

17 active trials across 12 of our biomarkers, targeting ALK/ROS1/MET. 9 active approvals for a biomarker on marked.bio.

Also known as PF-02341066, Xalkori.

Counts only trials that select patients by one of the biomarkers on marked.bio, not every trial of this drug.

Approvals and pivotal results

Biomarker-selected approvals in the United States and the European Union, with the pivotal trial's results and side effects where we have them. Results from different trials are not directly comparable.

TherapyBiomarkerTumourUnited StatesEuropean Union
crizotinib
FDA, 2011
metastatic, ALK-positive AA 26/08/2011, converted to regular approval 20/11/2013 (FDA Verified clinical benefit list). Current label 1.1 covers ALK- or ROS1-positive metastatic NSCLC. Source
EU (EMA), 2012
previously treated ALK-positive advanced NSCLC Conditional MA 23/10/2012 (previously treated). Switched to an MA not subject to specific obligations by II/0044 (EC decision 11/11/2016). First-line indication added 23/11/2015 (II/0024), now its own row. Source
EU (EMA), 2015
first line, ALK-positive advanced NSCLC II/0024, EC decision 23/11/2015 (MA still conditional then; not conditional since 11/11/2016). Source
Xalkori
ALK fusion NSCLC Approved 2011 Approved 2012

In the US label

PROFILE 1014 vs pemetrexed + platinum, 171 vs 169 patients
PFS 10.9 months vs 7.0 months, HR 0.45 (0.35-0.60)Response 74% vs 45%OS HR 0.76 (0.55-1.05), not significant

Serious side effects 34%Stopped for side effects 8%Fatal 2.3%

Trial details and side effects
Patients
first-line ALK-positive NSCLC (NCT01154140)
Most common side effects
vision disorder 71%, diarrhoea 61%, nausea 56%, oedema 49%, vomiting 46%, constipation 43% (340 (both arms) patients)
Notes
Xalkori US label (Study 1); side effects from the label rev. 09/2023.
Source
US label

In the EU product information

PROFILE 1007 vs pemetrexed or docetaxel, 173 vs 174 patients
PFS 7.7 months vs 3.0 months, HR 0.49 (0.37-0.64)Response 65% vs 20%OS HR 0.85 (0.66-1.10)

Trial details and side effects
Patients
ALK-positive NSCLC after platinum chemotherapy (NCT00932893)
Notes
EU SmPC section 5.1 (PROFILE 1007).
Source
EU product information

In the EU product information

PROFILE 1014 vs pemetrexed + platinum, 172 vs 171 patients
PFS 10.9 months vs 7.0 months, HR 0.45 (0.35-0.60)Response 74% vs 45%OS HR 0.76 (0.55-1.05), not significant

Trial details and side effects
Patients
first-line ALK-positive NSCLC (NCT01154140)
Most common side effects
vision disorder 71%, diarrhoea 61%, nausea 56%, oedema 49%, vomiting 46%, constipation 43% (340 (both arms) patients)
Notes
EU SmPC section 5.1 (PROFILE 1014). Side effects from the US label.
Source
EU product information
crizotinib
FDA, 2021
relapsed or refractory systemic ALK-positive ALCL, age >=1 and young adults Label 1.2: paediatric >=1 year and young adults, relapsed/refractory systemic ALK+ ALCL. Year confirmed: FDA approval announced 14/01/2021. Source
EU (EMA), 2022
paediatric (1 to <18 years), relapsed or refractory systemic ALK-positive ALCL II/0072, EC decision 28/10/2022 (first approved for age 6 to <18; now 1 to <18). Source
Xalkori
ALK fusion anaplastic large cell lymphoma Approved 2021 Approved 2022

ADVL0912 single-arm, 26 patients
Response 88% (71-96)Lasting 39% still responding at 6 months

Serious side effects 35%Stopped for side effects 8%

Trial details and side effects
Patients
relapsed or refractory ALK-positive ALCL, children and young adults (NCT00939770)
Most common side effects
diarrhoea, vomiting, nausea, vision disorder, headache, musculoskeletal pain (each 35% or more)
Notes
Xalkori US label.
Source
US label
crizotinib
FDA, 2022
unresectable, recurrent or refractory ALK-positive IMT, adults and children >=1 year Label 1.3. Year confirmed: FDA approval announced 14/07/2022. Source
EU (EMA), 2022
paediatric (1 to <18 years), recurrent or refractory ALK-positive unresectable IMT II/0072, EC decision 28/10/2022. Unlike the FDA label, the EU IMT indication covers children only. Source
Xalkori
ALK fusion inflammatory myofibroblastic tumour Approved 2022 Approved 2022

ADVL0912 and A8081013 (IMT) single-arm, 14 children, 7 adults
Response 86% (children); 5 of 7 adults (57-98 (children))

Serious side effects 7% (children)

Trial details and side effects
Patients
unresectable recurrent or refractory ALK-positive inflammatory myofibroblastic tumour (NCT00939770)
Notes
Xalkori US label.
Source
US label
crizotinib
FDA, 2016
metastatic, ROS1-positive Label 1.1 (ALK- or ROS1-positive metastatic NSCLC). Year confirmed: FDA approval announced 11/03/2016. Source
EU (EMA), 2016
ROS1-positive advanced NSCLC II/0039, EC decision 25/08/2016. Xalkori MA no longer conditional since 11/11/2016. Source
Xalkori
ROS1 fusion NSCLC Approved 2016 Approved 2016

In the US label

PROFILE 1001 (ROS1 cohort) single-arm, 50 patients
Response 66% (51-79)Lasting 18.3 months

Trial details and side effects
Patients
ROS1-positive NSCLC (NCT00585195)
Most common side effects
vision disorder 92%
Notes
Xalkori US label (Study 3).
Source
US label

In the EU product information

PROFILE 1001 (ROS1 cohort) single-arm, 53 patients
Response 72% (58-83)Lasting 24.7 months

Trial details and side effects
Patients
ROS1-positive NSCLC (NCT00585195)
Most common side effects
vision disorder 92%
Notes
EU SmPC section 5.1 (PROFILE 1001, later data cut than the US label).
Source
EU product information

Biomarkers

BiomarkerActive trialsAll trialsFurthest active phase
ALK fusion 10 40 Phase 3
ROS1 fusion 7 14 Phase 3
BRAF V600E 2 4 Phase 2
BRCA1/2 mutation 1 1 Phase 2
EGFR exon 19 deletion / L858R 1 4 Phase 2
EGFR exon 20 insertion 1 1 Phase 2
KRAS G12C 1 2 Phase 2
MET exon 14 skipping 1 3 Phase 2
MSI-H / dMMR 1 1 Phase 2
NTRK1/2/3 fusion 1 1 Phase 2
RET fusion or mutation 1 2 Phase 2
KRAS G12D 0 1 –

Sponsors

Industry sponsors leading active biomarker-selected trials of crizotinib.

  1. Shenzhen TargetRx 1
  2. Pfizer 1
  3. Xcovery Holdings 1
  4. Guangzhou JOYO Pharma 1
  5. Nuvation Bio 1
  6. Bristol Myers Squibb 1
  7. Roche 1

Trials

Status

17 of 55 trials shown

  1. A Phase III Study to Evaluate the Efficacy and Safety of JYP0322 in Previously Untreated ROS1-Positive Locally Advanced or Metastatic Non-Small Cell Lung Cancer

    Not yet recruiting Phase 3 Guangzhou JOYO Pharma Started 2026Primary completion 2028-12 NCT07816380

    JYP0322crizotinib FDA EU

    …dition stage IIIB or IIIC not amenable to multimodality therapy) or metastatic (stage IV) ROS1-positive non-small cell lung cancer (NSCLC).

    ROS1 fusionNSCLC (Advanced Non-small Cell Lung Cancer)

  2. A Study Of SY-3505 Versus Crizotinib In First Line Treatment Of Patients With ALK-Positive NSCLC

    Not yet recruiting Phase 3 Shouyao Holdings Started 2024Primary completion 2026-05 NCT06254599

    SY-3505 Capsulescrizotinib FDA EU

    …s much as possible after signing the ICF and before the first dose for central laboratory ALK fusion positive reconfirmation based on study progression needs). b.

    ALK fusionStatus may be outdated, last updated 2024-02-12Non-small Cell Lung Cancer

  3. A Phase III Study Comparing Taletrectinib With Standard Therapy in ROS1 Positive Locally Advanced or Metastatic Non-small Cell Lung Cancer Patients

    Recruiting Phase 3 Nuvation Bio Started 2024Primary completion 2029-01 NCT06564324

    taletrectinib FDAcrizotinib FDA EU

    Have documentation of ROS1 rearrangement by a positive result

    ROS1 fusionNon Small Cell Lung Cancer

  4. TGRX-326 Chinese Phase III for Advanced Non-small Cell Lung Cancer (NSCLC)

    Active, not recruiting Phase 3 Shenzhen TargetRx Started 2023Primary completion 2026-04 NCT06082635

    deulorlatinibcrizotinib FDA EU

    Diagnosed as incurable stage IIIB - IV ALK-positive NSCLC;

    ALK fusionNon Small Cell Lung Cancer

  5. A Study of Repotrectinib Versus Crizotinib in Participants With Locally Advanced or Metastatic Tyrosine Kinase Inhibitor (TKI)-naïve ROS1-positive Non-Small Cell Lung Cancer (NSCLC) (TRIDENT-3)

    Active, not recruiting Phase 3 Bristol Myers Squibb Started 2023Primary completion 2027-02 NCT06140836

    repotrectinib FDA EUcrizotinib FDA EU

    Participant has a ROS1 gene rearrangement/fusion as detected by a local test.

    ROS1 fusionCarcinoma, Non-Small-Cell Lung

  6. A Study to Compare the Efficacy and Safety of Entrectinib and Crizotinib in Participants With Advanced or Metastatic ROS1 Non-small Cell Lung Cancer (NSCLC) With and Without Central Nervous System (CNS) Metastases

    Active, not recruiting Phase 3 Roche Started 2021Primary completion 2026-09 NCT04603807

    entrectinib FDA EUcrizotinib FDA EU

    … amenable for radical treatment) or metastatic (Stage IV) NSCLC that harbors a documented ROS1 gene rearrangement.

    ROS1 fusionCarcinoma, Non-Small-Cell Lung

  7. A Study Of Lorlatinib Versus Crizotinib In First Line Treatment Of Patients With ALK-Positive NSCLC

    Active, not recruiting Phase 3 Pfizer Started 2017Primary completion 2020-03 NCT03052608

    lorlatinib FDA EUcrizotinib FDA EU

    Histologically or cytologically confirmed diagnosis of locally advanced or metastatic ALK-positive NSCLC

    ALK fusionCarcinoma, Non-Small-Cell Lung

  8. eXalt3: Study Comparing X-396 (Ensartinib) to Crizotinib in ALK Positive Non-Small Cell Lung Cancer (NSCLC) Patients

    Active, not recruiting Phase 3 Xcovery Holdings Started 2016Primary completion 2025-12 NCT02767804

    ensartinib FDAcrizotinib FDA EU

    …age IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC that is ALK-positive by an FDA-approved assay performed centrally.

    ALK fusionNon-small Cell Lung Cancer

  9. Crizotinib in Treating Patients With Stage IB-IIIA Non-small Cell Lung Cancer That Has Been Removed by Surgery and ALK Fusion Mutations (An ALCHEMIST Treatment Trial)

    Active, not recruiting Phase 3 ECOG-ACRIN Cancer Research Group Started 2015Primary completion 2036-05 NCT02201992

    crizotinib FDA EU

    …K gene locus (e.g. resulting in echinoderm microtubule associated protein like 4 \[EML4\]-ALK fusion) as determined by the Vysis Break Point fluorescence in situ hybridization (FISH) assay a…

    ALK fusionALK Gene Rearrangement, ALK Gene Translocation, ALK Positive, Stage IB Non-Small Cell Lung Carcinoma AJCC v7

  10. Neoadjuvant Umbrella Trial for Patients With Unresectable Stage III NSCLC Harboring Rare Mutations.

    Recruiting Phase 2 Sun Yat-sen University Started 2024Primary completion 2027-11 NCT06563999

    sunvozertinib FDAcrizotinibpralsetiniblarotrectinibsavolitinibpyrotinibdabrafenibtrametinibglecirasibensartinib

    Subjects should have a rare mutation based on NGS, including mutations of EGFR exon20ins, ROS1 fusion, RET fusion, NTRK fusion, MET 14 exon, HER2, BRAF V600E, KRAS G12C, and ALK …

    EGFR exon 20 insertionKRAS G12CBRAF V600EALK fusionROS1 fusionRET fusion or mutationNTRK1/2/3 fusionLung Cancer Stage III, Mutation

  11. ALK Tyrosine Kinase Inhibitors in ALK-rearranged Advanced Squamous Cell Carcinoma

    Recruiting Phase 2 Hunan Province Tumor Hospital Started 2021Primary completion 2026-06 NCT05014464

    crizotinib FDA EUalectinib FDA EUbrigatinib FDA EUlorlatinib FDA EUpemetrexedcarboplatinpaclitaxel

    ALK fusion positive evaluated by IHC (ventana), NGS or FISH.

    ALK fusionStatus may be outdated, last updated 2024-09-20Non-small Cell Lung Cancer

  12. PLATFORM Study of Precision Medicine for Rare Tumors

    Recruiting Phase 2 Cancer Institute and Hospital, Chinese Academy of Medical Sciences Started 2020Primary completion 2026-07 NCT04423185

    aumolertinibdacomitinib FDA EUalectinibcrizotinibpyrotinibimatinibniraparibpalbociclibvemurafenibsintilimabatezolizumab

    when obtaining EGFR mutation, ALK fusion, ROS-1 fusion, C-MET amplification, C-MET mutation, BRAF mutation, BRCA1/2 mu…

    EGFR exon 19 deletion / L858RBRAF V600EBRCA1/2 mutationALK fusionROS1 fusionRare Tumor

  13. Testing Crizotinib as Potentially Targeted Treatment in Cancers With MET Exon 14 Deletion Genetic Changes (MATCH - Subprotocol C2)

    Active, not recruiting Phase 2 National Cancer Institute (NCI) Started 2016Primary completion 2022-11 NCT06360575

    crizotinib

    Patient must have MET exon 14 skipping as defined via the MATCH Master Protocol and described or other mutations that d…

    MET exon 14 skippingAdvanced Lymphoma, Advanced Malignant Solid Neoplasm, Refractory Lymphoma, Refractory Malignant Solid Neoplasm

  14. Testing Crizotinib as a Potential Targeted Treatment in Cancers With ALK Genetic Changes (MATCH-Subprotocol F)

    Active, not recruiting Phase 2 National Cancer Institute (NCI) Started 2015Primary completion 2020-03 NCT04439266

    crizotinib FDA EU

    Patients must have an ALK rearrangement as defined via the MATCH Master Protocol

    ALK fusionAdvanced Lymphoma, Advanced Malignant Solid Neoplasm, Hematopoietic and Lymphoid Cell Neoplasm, Refractory Lymphoma

  15. Testing Crizotinib as a Potential Targeted Treatment in Cancers With ROS1 Genetic Changes (MATCH-Subprotocol G)

    Active, not recruiting Phase 2 National Cancer Institute (NCI) Started 2015Primary completion 2020-03 NCT04439253

    crizotinib FDA EU

    Patients must be positive for translocation or inversion events involving the ROS1 gene via the MATCH Master Protocol

    ROS1 fusionAdvanced Lymphoma, Advanced Malignant Solid Neoplasm, Hematopoietic and Lymphoid Cell Neoplasm, Refractory Lymphoma

  16. Targeted Therapy Directed by Genetic Testing in Treating Patients With Advanced Refractory Solid Tumors, Lymphomas, or Multiple Myeloma (The MATCH Screening Trial)

    Active, not recruiting Phase 2 National Cancer Institute (NCI) Started 2015Primary completion 2027-12 NCT02465060

    adavosertibafatinibbinimetinibcapivasertibcopanlisibcrizotinibdabrafenibDasatinibdefactiniberdafitinibfexagratinibipatasertib

    …candidate for Z1M based on local Clinical Laboratory Improvement Act (CLIA) assessment of mismatch repair deficiency (MMRd) by immunohistochemistry (IHC) or microsatellite instability (MSI) status by polyme…

    MSI-H / dMMRAdvanced Lymphoma, Advanced Malignant Solid Neoplasm, Bladder Carcinoma, Breast Carcinoma

  17. Genetic Testing in Screening Patients With Stage IB-IIIA Non-small Cell Lung Cancer That Has Been or Will Be Removed by Surgery (The ALCHEMIST Screening Trial)

    Active, not recruiting No phase National Cancer Institute (NCI) Started 2014Primary completion 2025-12 NCT02194738

    carboplatincisplatincrizotinib FDA EUerlotinibgemcitabinenivolumabpaclitaxelpembrolizumabpemetrexed

    No prior treatment with agents targeting EGFR mutation, ALK rearrangement, and PD-1/PD-L1/CTLA-4

    ALK fusionStage IB Lung Non-Small Cell Carcinoma AJCC v7, Stage II Lung Non-Small Cell Cancer AJCC v7, Stage IIA Lung Cancer AJCC v8, Stage IIB Lung Cancer AJCC v8