MedPath
EMA Approval

Vitrakvi

L01XE53

xl 01 xe 53

Antineoplastic agents

larotrectinib

Abdominal Neoplasms

Basic Information

L01XE53

xl 01 xe 53

Antineoplastic agents

Therapeutic indication

Vitrakvi as monotherapy is indicated for the treatment of adult and paediatric patients with solid tumours that display a Neurotrophic Tyrosine Receptor Kinase (NTRK) gene fusion,

  • who have a disease that is locally advanced, metastatic or where surgical resection is likely to result in severe morbidity, and
  • who have no satisfactory treatment options.

Overview Summary

Vitrakvi is a cancer medicine for treating solid tumours with NTRK gene fusion. NTRK gene fusion is a rare genetic abnormality that can occur in tumours from different parts of the body such as the lungs, thyroid glands and intestines.

Vitrakvi is used in patients whose tumours are advanced, have spread to other parts of the body or are not amenable to surgery, and who have no satisfactory alternative treatments.

It contains the active substance larotrectinib.

Authorisations (1)

EMEA/H/C/004919

Bayer AG,51368 Leverkusen,Germany

Authorised

September 19, 2019

Conditional Approval

Active Substances (2)

larotrectinib sulfate

larotrectinib sulfate

Documents (12)

Vitrakvi : Orphan designation withdrawal assessment report (initial authorisation)

October 24, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

Vitrakvi : EPAR - Public assessment report

October 24, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Vitrakvi

July 26, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

Vitrakvi : EPAR - Risk-management-plan summary

October 24, 2019

RISK_MANAGEMENT_PLAN_SUMMARY

Vitrakvi : Orphan designation withdrawal assessment report (initial authorisation)

October 24, 2019

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Vitrakvi : EPAR - Public assessment report

October 24, 2019

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

CHMP summary of positive opinion for Vitrakvi

July 26, 2019

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Vitrakvi : EPAR - Procedural steps taken and scientific information after authorisation

July 31, 2020

CHANGES_SINCE_INITIAL_AUTHORISATION

Vitrakvi-H-C-004919-P46-008 : EPAR - Assessment report

April 5, 2023

CHANGES_SINCE_INITIAL_AUTHORISATION

Vitrakvi : EPAR - Product information

October 24, 2019

DRUG_PRODUCT_INFORMATION

Vitrakvi : EPAR - Medicine overview

October 24, 2019

OVERVIEW_DOCUMENT

Vitrakvi : EPAR - All authorised presentations

August 21, 2020

AUTHORISED_PRESENTATIONS

Overview Q&A (8)

Question

What are the risks associated with Vitrakvi?

Answer

The most common side effects with Vitrakvi (which may affect more than 1 in 5 people) are tiredness, dizziness, constipation, nausea, vomiting, anaemia (low red blood cell counts) and high blood levels of alanine aminotransferase and aspartate aminotransferase (a sign of liver problems).

Most side effects are mild to moderate. For the full list of side effects and restrictions, see the package leaflet.

Question

What measures are being taken to ensure the safe and effective use of Vitrakvi?

Answer

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Vitrakvi have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Vitrakvi are continuously monitored. Side effects reported with Vitrakvi are carefully evaluated and any necessary action taken to protect patients.

Question

Other information about Vitrakvi

Answer

Vitrakvi received a conditional marketing authorisation valid throughout the EU on 19 September 2019.

Question

Why is Vitrakvi authorised in the EU?

Answer

Vitrakvi differs from many other cancer medicines by targeting certain tumours with a specific gene arrangement wherever they occur in the body. Although studies are still underway, the results released so far show that it is effective at reducing the size of patients’ tumours. In addition, the short time taken to shrink the tumours is important in relieving patients’ symptoms.

As for its safety, the side effects of Vitrakvi appear manageable. The European Medicines Agency therefore concluded that its benefits are greater than its risks and that it can be authorised for use in the EU.

Vitrakvi has been given ‘conditional authorisation’. This means that there is more evidence to come about the medicine, which the company is required to provide. Every year, the Agency will review any new information that becomes available and this overview will be updated as necessary.

Question

How is Vitrakvi used?

Answer

Vitrakvi is available as a liquid (20 mg per ml) and capsules (25 and 100 mg) and is taken by mouth. Adult patients should take 100 mg twice a day for as long as the cancer is stable and the side effects are acceptable. The dose for children is based on their body surface area (weight and height).

Vitrakvi should be started by a doctor experienced in using cancer medicines and can only be obtained with a prescription. For more information about using Vitrakvi, see the package leaflet or contact your doctor or pharmacist.

Question

How does Vitrakvi work?

Answer

Tumours with NTRK gene fusion produce an abnormal protein (TRK fusion protein), which causes the uncontrolled growth of cancer cells. The active substance in Vitrakvi, larotrectinib, blocks the action of this protein, preventing the excessive growth of cancer cells and thereby slowing down the worsening of the cancer.

Question

What benefits of Vitrakvi have been shown in studies?

Answer

Three ongoing studies in 102 patients with solid tumours with NTRK gene fusion showed that Vitrakvi is effective at reducing the size of patients’ tumours. In these studies, 67% of patients who took Vitrakvi had a reduction in the size of their tumours, and the tumours on average shrank to less than half their original size. In addition, the tumours shrank quickly (within 2 months).

Question

What information is still awaited for Vitrakvi?

Answer

Since Vitrakvi has been given conditional authorisation, the company that markets Vitrakvi will provide further data on its effects. This data will come from the three ongoing studies which aim to confirm the benefits and safety of Vitrakvi and its longer term effect in children.

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