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Trade namesVitrakvi
Other namesLOXO-101, ARRY-470
  • (3S)-N-{5-[(2R)-2-(2,5-difluorophenyl)pyrrolidin-1-yl]pyrazolo[1,5-a]pyrimidin-3-yl}-3-hydroxypyrrolidine-1-carboxamide
Clinical data
Drug classTyrosine kinase inhibitor[1]
Main usesCancer[2]
Side effectsLiver problems, low red blood cells, muscle pain, tiredness, low white blood cells, diarrhea, nausea, fever[3]
  • AU: D
Routes of
By mouth
Typical dose100 mg BID[4]
External links
US NLMLarotrectinib
License data
Legal status
  • AU: S4 (Prescription only)
  • US: ℞-only
  • EU: Rx-only
Chemical and physical data
Molar mass428.444 g·mol−1
3D model (JSmol)
  • O[C@H]1CCN(C1)C(=O)Nc2cnn3ccc(nc23)N4CCC[C@@H]4c5cc(F)ccc5F
  • InChI=1S/C21H22F2N6O2/c22-13-3-4-16(23)15(10-13)18-2-1-7-28(18)19-6-9-29-20(26-19)17(11-24-29)25-21(31)27-8-5-14(30)12-27/h3-4,6,9-11,14,18,30H,1-2,5,7-8,12H2,(H,25,31)/t14-,18+/m0/s1

Larotrectinib, sold under the brand name Vitrakvi, is a medication used to treat cancer.[2][3] Specifically it is used for cases that have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion.[3] It is taken by mouth.[1]

Common side effects include liver problems, low red blood cells, muscle pain, tiredness, low white blood cells, diarrhea, nausea, and fever.[3] Other side effects may include numbness, tremor, and delirium.[1] Use in pregnancy may harm the baby.[3] It is a tyrosine kinase inhibitor of TrkA, TrkB, and TrkC.[1]

Larotrectinib was approved for medical use in the United States in 2018, Europe in 2019, and Australia in 2020.[1][5][2] In the United Kingdom it costs the NHS about £15,000 a month as of 2021.[4] In the United States this amount is about 34,000 USD.[6]

Medical uses

In two thirds of people it decreased the size of their cancer to less than half.[5]


It is generally taken at a dose of 100 mg twice per day.[4]


It was discovered by Array BioPharma and licensed to Loxo Oncology in 2013. Larotrectinib was initially awarded orphan drug status in 2015, for soft tissue sarcoma, and breakthrough therapy designation in 2016 for the treatment of metastatic solid tumors with NTRK fusion.[7] Some clinical trial results were announced in 2017.[8]

Larotrectinib was the first drug to be specifically developed and approved to treat any cancer containing certain mutations, as opposed to cancers of specific tissues (i.e., the approval is "tissue agnostic"). Several earlier drugs, including pembrolizumab, were eventually approved by the FDA for treatment of specific mutations independent of the type of cancer, but those drugs had been initially developed for specific cancer types.[9] The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.[10]


  1. 1.0 1.1 1.2 1.3 1.4 "Larotrectinib Monograph for Professionals". Retrieved 21 November 2021.
  2. 2.0 2.1 2.2 "Vitrakvi". Therapeutic Goods Administration (TGA). 16 September 2020. Retrieved 22 September 2020.
  3. 3.0 3.1 3.2 3.3 3.4 "Vitrakvi- larotrectinib capsule Vitrakvi- larotrectinib solution, concentrate". DailyMed. 26 July 2019. Retrieved 22 September 2020.
  4. 4.0 4.1 4.2 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 1031. ISBN 978-0857114105.
  5. 5.0 5.1 "Vitrakvi EPAR". European Medicines Agency (EMA). 23 July 2019. Retrieved 22 September 2020.
  6. "Vitrakvi Prices, Coupons & Patient Assistance Programs". Retrieved 21 November 2021.
  7. "Larotrectinib". AdisInsight. Retrieved 31 January 2017.
  8. Novel Agent Shows Antitumor Activity in TRK-Fusion Cancers. June 2017
  9. Dun L (27 November 2018). "FDA approves a new cancer drug targeted to genetic mutation, not cancer type". NBC. Retrieved 3 Dec 2018.
  10. New Drug Therapy Approvals 2018 (PDF). U.S. Food and Drug Administration (FDA) (Report). January 2019. Retrieved 16 September 2020.

External links

External sites: