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NCT02576431

A Study to Test the Effect of the Drug Larotrectinib in Adults and Children With NTRK-fusion Positive Solid Tumors

Version 19 to 20 · Bayer

Patch inspector

Version 19 to 20

49 operations 8 path groups ctgov_internal_history
ClinicalTrials.gov
Severity is deterministic uncalibrated triage metadata, not validated review priority. Operation-level severity is inferred from deterministic path rules. Rule matches shown per operation are approximate previews (they skip the pipeline's suppression passes); the authoritative classification is the stored event record.
Plain-language summary

Manual review pending.

Rules fired
arms_or_interventions_changeeligibility_criteria_changeenrollment_count_changeprimary_outcome_any_changesecondary_outcome_any_change
Value signals
[
  {
    "path": "/protocolSection/statusModule/primaryCompletionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "medium",
    "direction": "later",
    "new_value": "2019-12",
    "old_value": "2018-04",
    "delta_days": 609,
    "date_struct": "primaryCompletionDateStruct",
    "new_precision": "month",
    "old_precision": "month"
  }
]
Provenance
Source
ctgov_internal_history
Fetched
2026-06-18 19:12:18+00
Raw hash
e3560207e0b18524c8d535a21274f022f694c7c0747940f760f51ae4fb01a919
Payload
Source URL
Primary outcomes Outcome measures that define the trial's primary evidence target. Triage: Critical 1 ops
replace /protocolSection/outcomesModule/primaryOutcomes/0/measure
Triage: Critical
Primary Outcome Change Operation 28
Matched rules
  • primary_outcome_any_change Any add/remove/replace under primary outcome measures is critical review priority.
Before
Overall Response Rate of confirmed CR or PR as determined by an Independent Radiology Committee using RECIST 1.1 or RANO criteria
After
Overall Response Rate as determined by an independent radiology review committee and measured by the proportion of subjects with best overall confirmed response of complete response (CR) or partial response (PR) by RECISTv1.1 or RANO criteria
Design Trial model, phase, allocation, masking, arms, or interventions. Triage: High 21 ops
replace /protocolSection/designModule/enrollmentInfo/count
Triage: High
Enrollment Change Operation 7
Matched rules
  • enrollment_count_change Enrollment count changes can signal scope or feasibility shifts.
Before
151
After
176
replace /protocolSection/armsInterventionsModule/armGroups/0/description
Triage: High
Arm Intervention Change Operation 8
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/0/interventionNames/0
Triage: High
Arm Intervention Change Operation 9
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/1/description
Triage: High
Arm Intervention Change Operation 10
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/1/interventionNames/0
Triage: High
Arm Intervention Change Operation 11
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/2/description
Triage: High
Arm Intervention Change Operation 12
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/2/interventionNames/0
Triage: High
Arm Intervention Change Operation 13
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/3/description
Triage: High
Arm Intervention Change Operation 14
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/3/interventionNames/0
Triage: High
Arm Intervention Change Operation 15
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/4/description
Triage: High
Arm Intervention Change Operation 16
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/4/interventionNames/0
Triage: High
Arm Intervention Change Operation 17
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/5/description
Triage: High
Arm Intervention Change Operation 18
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral LOXO-101
After
Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/5/interventionNames/0
Triage: High
Arm Intervention Change Operation 19
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/6/description
Triage: High
Arm Intervention Change Operation 20
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Brain Tumor Measurable by RANO Oral LOXO-101
After
Brain Tumor Measurable by RANO Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/6/interventionNames/0
Triage: High
Arm Intervention Change Operation 21
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/armGroups/7/description
Triage: High
Arm Intervention Change Operation 22
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Tumor Histology not in Cohorts 1-7 Evaluable but not Measurable Disease Oral LOXO-101
After
Tumor Histology not in Cohorts 1-7 Evaluable but not Measurable Disease Oral larotrectinib (LOXO-101)
replace /protocolSection/armsInterventionsModule/armGroups/7/interventionNames/0
Triage: High
Arm Intervention Change Operation 23
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: LOXO-101
After
Drug: Larotrectinib LOXO-101
add /protocolSection/armsInterventionsModule/armGroups/8
Triage: High
Arm Intervention Change Operation 24
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
After
{
  "type": "OTHER",
  "label": "Eligible for cohorts 1-8 but lab certification not confirmed",
  "description": "Subjects eligible for Cohorts 1-8, but lab CLIA- or equivalent certification cannot be confirmed at time of Subjects eligible for Cohorts 1-8, but lab CLIA- or equivalent certification cannot be confirmed at time of consent Oral larotrectinib (LOXO-101)",
  "interventionNames": [
    "Drug: Larotrectinib LOXO-101"
  ]
}
replace /protocolSection/armsInterventionsModule/interventions/0/name
Triage: High
Arm Intervention Change Operation 25
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
LOXO-101
After
Larotrectinib LOXO-101
replace /protocolSection/armsInterventionsModule/interventions/0/description
Triage: High
Arm Intervention Change Operation 26
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Oral capsule of LOXO-101 - 100mg BID
After
Oral capsule of larotrectinib (LOXO-101) - 100mg BID
add /protocolSection/armsInterventionsModule/interventions/0/armGroupLabels/3
Triage: High
Arm Intervention Change Operation 27
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
After
Eligible for cohorts 1-8 but lab certification not confirmed
Eligibility Criteria and population definition changes. Triage: High 1 ops
replace /protocolSection/eligibilityModule/eligibilityCriteria
Triage: High
Eligibility Change Operation 46
Matched rules
  • eligibility_criteria_change Eligibility criteria changes can alter the studied population.
Before
<p>Key Inclusion Criteria:</p><ol><li>Locally-advanced or metastatic malignancy with an NTRK1, NTRK2 or NTRK3 gene fusion, identified through molecular assays as routinely performed at CLIA or other similarly-certified laboratories.</li><li>Subjects must have received prior standard therapy appropriate for their tumor type and stage of disease, or in the opinion of the Investigator, would be unlikely to tolerate or derive clinical benefit from appropriate standard of care therapy.</li><li><p>Adequate organ function as defined by the following criteria:</p><ul><li>Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) &lt; 2.5 upper limit of normal (ULN), or AST and ALT &lt; 5 ULN if liver function abnormalities are due to underlying malignancy.</li><li>Total bilirubin &lt; 2.5 ULN.
Subjects with a known history of Gilberts Disease and an isolated elevation of indirect bilirubin are eligible.</li><li>Serum creatinine &lt; 2.0 ULN OR an estimated glomerular filtration rate ≥ 30 mL&#x2F;minute using the Cockroft-Gault formula.</li></ul></li></ol><p>Key Exclusion Criteria:</p><p>1. Pregnancy or lactation.</p>
After
<p>Key Inclusion Criteria:</p><ol><li>Locally-advanced or metastatic malignancy with an NTRK1, NTRK2, or NTRK3 gene fusion, identified through molecular assays as routinely performed at CLIA or other similarly-certified laboratories.
Subjects who have NTRK gene fusion identified in a lab where certification of the lab cannot be confirmed by the Sponsor at the time of consent may enroll to Cohort 9.</li><li>Subjects must have received prior standard therapy appropriate for their tumor type and stage of disease, or in the opinion of the Investigator, would be unlikely to tolerate or derive clinical benefit from appropriate standard of care therapy.</li><li><p>Adequate organ function as defined by the following criteria:</p><ul><li>Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) &lt; 2.5 upper limit of normal (ULN), or AST and ALT &lt; 5 ULN if liver function abnormalities are due to underlying malignancy.</li><li>Total bilirubin &lt; 2.5 x ULN, except in the setting of biliary obstruction.
Subjects with a known history of Gilberts Disease and an isolated elevation of indirect bilirubin are eligible</li><li>Serum creatinine &lt; 2.0 x ULN OR an estimated glomerular filtration rate ≥ 30 mL&#x2F;minute using the Cockcroft-Gault formula</li><li>ECOG score &lt; 3 (age &gt;16 years) or Lansky Performance Score (LPS) &gt;40% (age &lt;16 years).
If enrolled with primary CNS tumor to be assessed by RANO, Karnofsky Performance Score (KPS) (age &gt;16 years) or LPS (age &lt;16 years) &gt;50%</li><li>Archived tumor tissue.
If archival tissue is known to not be available, then an on-study tumor biopsy should be attempted if it can be safely performed.</li></ul></li></ol><p>Key Exclusion Criteria:</p><ol><li>Symptomatic or unstable brain metastases.
(Note: Subjects with asymptomatic brain metastases are eligible to participate in the study).
Subjects with primary CNS tumors are eligible.</li><li>Investigational agent or anticancer therapy within 2 weeks prior to the planned start of larotrectinib (LOXO-101) or 5 half-lives, whichever is shorter, and without recovery of clinically significant toxicities from that therapy.</li><li>Pregnancy or lactation.</li></ol>
Secondary outcomes Additional endpoints and outcome descriptions. Triage: High 17 ops
replace /protocolSection/outcomesModule/secondaryOutcomes/0/measure
Triage: High
Secondary Outcome Change Operation 29
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Overall Response Rate of confirmed CR or PR as determined by the treating investigator using RECIST 1.1 or RANO criteria
After
Overall Response Rate of confirmed CR or PR as determined by the treating investigator Overall Response Rate based on the treating Investigator&#x27;s response assessment using RECISTv1.1 or RANO criteria, as appropriate to tumor type.
replace /protocolSection/outcomesModule/secondaryOutcomes/3/measure
Triage: High
Secondary Outcome Change Operation 30
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Progression Free Survival
After
To estimate the proportion of subjects that has any tumor regression as a best response.
remove /protocolSection/outcomesModule/secondaryOutcomes/3/description
Triage: High
Secondary Outcome Change Operation 31
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Number of moths from initiation of Loxo-101 to the earlier of diease progression or death due to any cause
replace /protocolSection/outcomesModule/secondaryOutcomes/4/measure
Triage: High
Secondary Outcome Change Operation 32
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Overall Survival (OS)
After
Duration of Progression Free Survival following initiation of larotrectinib (LOXO-101)
replace /protocolSection/outcomesModule/secondaryOutcomes/4/description
Triage: High
Secondary Outcome Change Operation 33
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Number of months from the initiation of LOXO-101 to the date of death due to any cause.
After
Number of months from initiation of larotrectinib (LOXO-101) to the earlier of disease progression or death due to any cause.
replace /protocolSection/outcomesModule/secondaryOutcomes/4/timeFrame
Triage: High
Secondary Outcome Change Operation 34
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Through study completion up to 42 months
After
Up to 30 months
replace /protocolSection/outcomesModule/secondaryOutcomes/5/measure
Triage: High
Secondary Outcome Change Operation 35
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Comparison of Progression Free Survival following initiation of Loxo-101 to that following the line of therapy immediately preceding Loxo-101
After
Duration of overall survival (OS) following initiation of larotrectinib (LOXO-101)
replace /protocolSection/outcomesModule/secondaryOutcomes/5/description
Triage: High
Secondary Outcome Change Operation 36
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
In each subject who has received prior therapy
After
Number of months from the initiation of larotrectinib (LOXO-101) to the date of death due to any cause.
replace /protocolSection/outcomesModule/secondaryOutcomes/5/timeFrame
Triage: High
Secondary Outcome Change Operation 37
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
UP to 30 months
After
Through study completion up to 42 months
replace /protocolSection/outcomesModule/secondaryOutcomes/6/measure
Triage: High
Secondary Outcome Change Operation 38
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Incidence of Adverse Events
After
To assess the safety profile and tolerability of larotrectinib (LOXO-101).
replace /protocolSection/outcomesModule/secondaryOutcomes/6/timeFrame
Triage: High
Secondary Outcome Change Operation 39
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Up to 30 months
After
Through study completion up to 42 months
add /protocolSection/outcomesModule/secondaryOutcomes/6/description
Triage: High
Secondary Outcome Change Operation 40
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
After
Incidence, duration, and severity of adverse events
replace /protocolSection/outcomesModule/secondaryOutcomes/7/measure
Triage: High
Secondary Outcome Change Operation 41
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Severity of Adverse Events
After
Comparison of Progression Free Survival following initiation of larotrectinib (LOXO-101) to that following the line of therapy immediately preceding larotrectinib (LOXO-101) in each subject who has received prior therapy.
add /protocolSection/outcomesModule/secondaryOutcomes/7/description
Triage: High
Secondary Outcome Change Operation 42
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
After
Number of months from initiation of larotrectinib (LOXO-101) to the earlier of disease progression or death due to any cause
replace /protocolSection/outcomesModule/secondaryOutcomes/8/measure
Triage: High
Secondary Outcome Change Operation 43
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Duration of Adverse Events
After
Evaluate the clinical benefit rate (CBR) based on the proportion of subjects with best overall response of CR, PR, or stable disease lasting 16 or more weeks following initiation of larotrectinib (LOXO-101)
replace /protocolSection/outcomesModule/secondaryOutcomes/9/measure
Triage: High
Secondary Outcome Change Operation 44
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Changes from baseline in clinical safety laboratory values
After
&quot;Evaluate the concordance of prior molecular profiling that detected an NTRK fusion within the subject&#x27;s tumor with the diagnostic test being evaluated by the Sponsor&quot;
remove /protocolSection/outcomesModule/secondaryOutcomes/10
Triage: High
Secondary Outcome Change Operation 45
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
{
  "measure": "Changes from baseline in vital signs",
  "timeFrame": "Up to 30 months"
}
Timeline Start, primary completion, and completion date movement. Triage: Medium 1 ops
replace /protocolSection/statusModule/primaryCompletionDateStruct/date
Triage: Medium
Timeline Shift Operation 2
Matched rules
  • primary_completion_timeline_change Primary completion date changes are operational timeline signals.
Before
2018-04
After
2019-12
Contacts and locations Site, contact, and location updates that are usually operational. Triage: Uncategorized 3 ops
remove /protocolSection/contactsLocationsModule/locations/7
Triage: Uncategorized
Uncategorized Operation 47
Before
{
  "zip": "03756",
  "city": "Lebanon",
  "state": "New Hampshire",
  "status": "RECRUITING",
  "country": "United States",
  "contacts": [
    {
      "name": "Mary Chamberlin, MD",
      "role": "CONTACT"
    }
  ],
  "facility": "Dartmouth Hitchcock Medical Center",
  "geoPoint": {
    "lat": 43.64229,
    "lon": -72.25176
  }
}
remove /protocolSection/contactsLocationsModule/locations/7
Triage: Uncategorized
Uncategorized Operation 48
Before
{
  "zip": "07601",
  "city": "Hackensack",
  "state": "New Jersey",
  "status": "RECRUITING",
  "country": "United States",
  "contacts": [
    {
      "name": "Martin Gutierrez, MD",
      "role": "CONTACT"
    }
  ],
  "facility": "John Theurer Cancer Center at Hackensack",
  "geoPoint": {
    "lat": 40.88593,
    "lon": -74.04347
  }
}
add /protocolSection/contactsLocationsModule/locations/23
Triage: Uncategorized
Uncategorized Operation 49
After
{
  "zip": "277-8577",
  "city": "Kashiwa",
  "state": "Chiba",
  "status": "RECRUITING",
  "country": "Japan",
  "contacts": [
    {
      "name": "Makoto Tahara",
      "role": "CONTACT"
    }
  ],
  "facility": "National Cancer Center Hospital East",
  "geoPoint": {
    "lat": 35.86224,
    "lon": 139.97732
  }
}
Other registry fields Changes outside the current high-signal rule families. Triage: Uncategorized 4 ops
replace /protocolSection/statusModule/statusVerifiedDate
Triage: Uncategorized
Uncategorized Operation 1
Before
2017-07
After
2018-08
replace /protocolSection/statusModule/lastUpdateSubmitDate
Triage: Uncategorized
Uncategorized Operation 3
Before
2017-09-05
After
2018-08-31
replace /protocolSection/statusModule/lastUpdatePostDateStruct/date
Triage: Uncategorized
Uncategorized Operation 4
Before
2017-09-07
After
2018-09-05
replace /protocolSection/descriptionModule/detailedDescription
Triage: Uncategorized
Uncategorized Operation 6
Before
<p>This is a Phase II, multi-center, open-label study of patients with advanced solid tumors harboring a fusion of NTRK1, NTRK2 or NTRK3.
Patients with NTRK1, NTRK2 or NTRK3 fusion-positive cancers will be identified through molecular assay.</p><p>LOXO-101 will be administered orally at 100mg twice daily (BID), with each cycle consisting of 28 days of dosing administered on a continuous basis.</p><p>The study will analyze 8 cohorts of patients with tumors bearing NTRK fusions, including non small cell lung cancer, thyroid cancer, sarcoma, colorectal cancer, salivary gland cancer, biliary cancer and primary CNS tumor, as well as a cohort that will enroll patients not included in the histologies listed above.</p>
After
<p>This is a Phase II, multi-center, open-label study of patients with advanced solid tumors harboring a fusion of NTRK1, NTRK2 or NTRK3.
Patients with NTRK1, NTRK2 or NTRK3 fusion-positive cancers will be identified through molecular assay.</p><p>Larotrectinib (LOXO-101) will be administered orally at 100mg twice daily (BID), with each cycle consisting of 28 days of dosing administered on a continuous basis.</p><p>The study will analyze 9 cohorts of patients with tumors bearing NTRK fusions, including non small cell lung cancer, thyroid cancer, sarcoma, colorectal cancer, salivary gland cancer, biliary cancer and primary CNS tumor, as well as a cohort that will enroll patients not included in the histologies listed above.
Cohort 9 will include patients who meet criteria for Cohorts 1 to 8, but with documented NTRK fusion from a laboratory where CLIA or equivalent certification cannot be confirmed by the Sponsor at the time of consent.</p>
Sponsor and administrative fields Sponsor, collaborator, oversight, or registry maintenance changes. Triage: Uncategorized 1 ops
add /protocolSection/sponsorCollaboratorsModule/collaborators
Triage: Uncategorized
Uncategorized Operation 5
After
[
  {
    "name": "Bayer",
    "class": "INDUSTRY"
  }
]
Raw JSON Patch
[
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/statusVerifiedDate",
    "value": "2018-08"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/primaryCompletionDateStruct/date",
    "value": "2019-12"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdateSubmitDate",
    "value": "2018-08-31"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdatePostDateStruct/date",
    "value": "2018-09-05"
  },
  {
    "op": "add",
    "path": "/protocolSection/sponsorCollaboratorsModule/collaborators",
    "value": [
      {
        "name": "Bayer",
        "class": "INDUSTRY"
      }
    ]
  },
  {
    "op": "replace",
    "path": "/protocolSection/descriptionModule/detailedDescription",
    "value": "<p>This is a Phase II, multi-center, open-label study of patients with advanced solid tumors harboring a fusion of NTRK1, NTRK2 or NTRK3.\nPatients with NTRK1, NTRK2 or NTRK3 fusion-positive cancers will be identified through molecular assay.</p><p>Larotrectinib (LOXO-101) will be administered orally at 100mg twice daily (BID), with each cycle consisting of 28 days of dosing administered on a continuous basis.</p><p>The study will analyze 9 cohorts of patients with tumors bearing NTRK fusions, including non small cell lung cancer, thyroid cancer, sarcoma, colorectal cancer, salivary gland cancer, biliary cancer and primary CNS tumor, as well as a cohort that will enroll patients not included in the histologies listed above.\nCohort 9 will include patients who meet criteria for Cohorts 1 to 8, but with documented NTRK fusion from a laboratory where CLIA or equivalent certification cannot be confirmed by the Sponsor at the time of consent.</p>"
  },
  {
    "op": "replace",
    "path": "/protocolSection/designModule/enrollmentInfo/count",
    "value": 176
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/0/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/0/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/1/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/1/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/2/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/2/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/3/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/3/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/4/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/4/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/5/description",
    "value": "Adult Solid Tumors Measurable Disease by RECIST 1.1 Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/5/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/6/description",
    "value": "Brain Tumor Measurable by RANO Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/6/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/7/description",
    "value": "Tumor Histology not in Cohorts 1-7 Evaluable but not Measurable Disease Oral larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/7/interventionNames/0",
    "value": "Drug: Larotrectinib LOXO-101"
  },
  {
    "op": "add",
    "path": "/protocolSection/armsInterventionsModule/armGroups/8",
    "value": {
      "type": "OTHER",
      "label": "Eligible for cohorts 1-8 but lab certification not confirmed",
      "description": "Subjects eligible for Cohorts 1-8, but lab CLIA- or equivalent certification cannot be confirmed at time of Subjects eligible for Cohorts 1-8, but lab CLIA- or equivalent certification cannot be confirmed at time of consent Oral larotrectinib (LOXO-101)",
      "interventionNames": [
        "Drug: Larotrectinib LOXO-101"
      ]
    }
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/interventions/0/name",
    "value": "Larotrectinib LOXO-101"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/interventions/0/description",
    "value": "Oral capsule of larotrectinib (LOXO-101) - 100mg BID"
  },
  {
    "op": "add",
    "path": "/protocolSection/armsInterventionsModule/interventions/0/armGroupLabels/3",
    "value": "Eligible for cohorts 1-8 but lab certification not confirmed"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/primaryOutcomes/0/measure",
    "value": "Overall Response Rate as determined by an independent radiology review committee and measured by the proportion of subjects with best overall confirmed response of complete response (CR) or partial response (PR) by RECISTv1.1 or RANO criteria"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/0/measure",
    "value": "Overall Response Rate of confirmed CR or PR as determined by the treating investigator Overall Response Rate based on the treating Investigator&#x27;s response assessment using RECISTv1.1 or RANO criteria, as appropriate to tumor type."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/3/measure",
    "value": "To estimate the proportion of subjects that has any tumor regression as a best response."
  },
  {
    "op": "remove",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/3/description"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/4/measure",
    "value": "Duration of Progression Free Survival following initiation of larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/4/description",
    "value": "Number of months from initiation of larotrectinib (LOXO-101) to the earlier of disease progression or death due to any cause."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/4/timeFrame",
    "value": "Up to 30 months"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/5/measure",
    "value": "Duration of overall survival (OS) following initiation of larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/5/description",
    "value": "Number of months from the initiation of larotrectinib (LOXO-101) to the date of death due to any cause."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/5/timeFrame",
    "value": "Through study completion up to 42 months"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/6/measure",
    "value": "To assess the safety profile and tolerability of larotrectinib (LOXO-101)."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/6/timeFrame",
    "value": "Through study completion up to 42 months"
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/6/description",
    "value": "Incidence, duration, and severity of adverse events"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/7/measure",
    "value": "Comparison of Progression Free Survival following initiation of larotrectinib (LOXO-101) to that following the line of therapy immediately preceding larotrectinib (LOXO-101) in each subject who has received prior therapy."
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/7/description",
    "value": "Number of months from initiation of larotrectinib (LOXO-101) to the earlier of disease progression or death due to any cause"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/8/measure",
    "value": "Evaluate the clinical benefit rate (CBR) based on the proportion of subjects with best overall response of CR, PR, or stable disease lasting 16 or more weeks following initiation of larotrectinib (LOXO-101)"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/9/measure",
    "value": "&quot;Evaluate the concordance of prior molecular profiling that detected an NTRK fusion within the subject&#x27;s tumor with the diagnostic test being evaluated by the Sponsor&quot;"
  },
  {
    "op": "remove",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/10"
  },
  {
    "op": "replace",
    "path": "/protocolSection/eligibilityModule/eligibilityCriteria",
    "value": "<p>Key Inclusion Criteria:</p><ol><li>Locally-advanced or metastatic malignancy with an NTRK1, NTRK2, or NTRK3 gene fusion, identified through molecular assays as routinely performed at CLIA or other similarly-certified laboratories.\nSubjects who have NTRK gene fusion identified in a lab where certification of the lab cannot be confirmed by the Sponsor at the time of consent may enroll to Cohort 9.</li><li>Subjects must have received prior standard therapy appropriate for their tumor type and stage of disease, or in the opinion of the Investigator, would be unlikely to tolerate or derive clinical benefit from appropriate standard of care therapy.</li><li><p>Adequate organ function as defined by the following criteria:</p><ul><li>Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) &lt; 2.5 upper limit of normal (ULN), or AST and ALT &lt; 5 ULN if liver function abnormalities are due to underlying malignancy.</li><li>Total bilirubin &lt; 2.5 x ULN, except in the setting of biliary obstruction.\nSubjects with a known history of Gilberts Disease and an isolated elevation of indirect bilirubin are eligible</li><li>Serum creatinine &lt; 2.0 x ULN OR an estimated glomerular filtration rate ≥ 30 mL&#x2F;minute using the Cockcroft-Gault formula</li><li>ECOG score &lt; 3 (age &gt;16 years) or Lansky Performance Score (LPS) &gt;40% (age &lt;16 years).\nIf enrolled with primary CNS tumor to be assessed by RANO, Karnofsky Performance Score (KPS) (age &gt;16 years) or LPS (age &lt;16 years) &gt;50%</li><li>Archived tumor tissue.\nIf archival tissue is known to not be available, then an on-study tumor biopsy should be attempted if it can be safely performed.</li></ul></li></ol><p>Key Exclusion Criteria:</p><ol><li>Symptomatic or unstable brain metastases.\n(Note: Subjects with asymptomatic brain metastases are eligible to participate in the study).\nSubjects with primary CNS tumors are eligible.</li><li>Investigational agent or anticancer therapy within 2 weeks prior to the planned start of larotrectinib (LOXO-101) or 5 half-lives, whichever is shorter, and without recovery of clinically significant toxicities from that therapy.</li><li>Pregnancy or lactation.</li></ol>"
  },
  {
    "op": "remove",
    "path": "/protocolSection/contactsLocationsModule/locations/7"
  },
  {
    "op": "remove",
    "path": "/protocolSection/contactsLocationsModule/locations/7"
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/23",
    "value": {
      "zip": "277-8577",
      "city": "Kashiwa",
      "state": "Chiba",
      "status": "RECRUITING",
      "country": "Japan",
      "contacts": [
        {
          "name": "Makoto Tahara",
          "role": "CONTACT"
        }
      ],
      "facility": "National Cancer Center Hospital East",
      "geoPoint": {
        "lat": 35.86224,
        "lon": 139.97732
      }
    }
  }
]