Why is larotrectinib not recommended for lung cancer?

Larotrectinib is a targeted anti-cancer drug mainly suitable for cancer patients with TRK (neuroprimitive ectodermal tumor) gene fusion. However, in some cases, particularly in patients with lung cancer, larotrectinib is not always recommended for the following reasons:

Low frequencyTRK gene fusion: The frequency of TRK gene fusion in lung cancer is relatively low, which means that only a small number of lung cancer patients will show TRK gene fusion in genetic testing. For patients in whom this gene fusion is not detected, the use of larotrectinib may not result in significant efficacy.

Other more common treatment options: For patients with lung cancer, there are other more common and proven treatment options, such as radiotherapy, chemotherapy, targeted drugs (EGFRinhibitors, ALKinhibitors, etc.). These treatment modalities have been widely used in the management of lung cancer and have achieved good results in some cases.

Indications of larotrectinib: At present, the indications of larotrectinib mainly include children's soft tissue sarcoma, thyroid cancer, etc., while lung cancer is not one of its main indications. Therefore, when considering treatment options for patients with lung cancer, doctors may be more inclined to choose treatments that target specific subtypes of lung cancer.

Overall anti-cancer treatment strategy: For patients with lung cancer, doctors usually formulate an overall anti-cancer treatment strategy, taking into account multiple factors such as tumor subtype, stage, and patient's health status. Larotrectinib may be useful in certain circumstances but is not the first choice for all patients with lung cancer.

Larotrectinib has been launched in China and has not yet been included in medical insurance. Since it has not been launched in China for a long time, it may be difficult to purchase it in hospitals. For specific conditions, it is recommended to consult the local hospital pharmacy. In foreign markets, larotinib has two options: original drug and generic drug. Original drugs include the German version, the American version, the European version and the Hong Kong version, and the price is about 10,000 to 20,000 yuan. In comparison, generic drugs are much cheaper. There are Lao and Bangladeshi versions of generic drugs, and the price is around two to three thousand. It is worth noting that the ingredients of original drugs and generic drugs are basically the same.