[8-K] Nuvalent, Inc. Reports Material Event
Nuvalent, Inc. reported positive topline pivotal data for neladalkib, its investigational ALK-selective inhibitor, in tyrosine kinase inhibitor (TKI) pre-treated patients with advanced ALK-positive non-small cell lung cancer (NSCLC) from the global ALKOVE-1 Phase 1/2 trial. Among 253 evaluable TKI pre-treated patients treated at the recommended Phase 2 dose, the objective response rate was 31%, rising to 46% in the 63 lorlatinib‑naïve patients, with high estimated durability of responses through 18 months. Strong activity was also observed in patients with the G1202R resistance mutation and those with measurable brain metastases, including intracranial complete responses.
Nuvalent also shared encouraging preliminary data in 44 TKI‑naïve advanced ALK‑positive NSCLC patients, showing an 86% objective response rate and 9% complete response rate, with most responses ongoing beyond 6 and 12 months. Across 656 NSCLC patients treated at the recommended dose, neladalkib showed a generally well‑tolerated safety profile; the most common side effects were liver enzyme elevations and manageable gastrointestinal and constitutional events, with 17% requiring dose reductions and 5% discontinuing due to adverse events. The company plans a pre‑NDA meeting with the FDA and continues its Phase 3 ALKAZAR trial versus alectinib.
- Robust efficacy in difficult ALK NSCLC populations: Neladalkib achieved a 31% ORR in 253 TKI pre-treated patients, with higher response rates in lorlatinib-naïve, G1202R-mutant, and CNS-involved subgroups, alongside high estimated durability of response.
- Compelling early-line and intracranial activity: In 44 TKI-naïve advanced ALK-positive NSCLC patients, neladalkib showed an 86% ORR and strong intracranial responses without observed CNS progression among responders, supporting use in earlier lines of therapy.
- Manageable safety profile at scale: Among 656 NSCLC patients treated at the recommended dose, adverse events were generally manageable with 17% requiring dose reductions and 5% discontinuing, enabling continued development and planned FDA pre-NDA discussions.
- None.
Insights
Strong neladalkib efficacy and durability signal a potentially pivotal ALK NSCLC asset for Nuvalent.
The disclosed data position neladalkib as a competitive late‑stage ALK inhibitor candidate. In 253 TKI pre‑treated advanced ALK‑positive NSCLC patients at the recommended Phase 2 dose, the objective response rate of
Importantly, activity in patients harboring the difficult G1202R resistance mutation (ORR
Safety appears manageable in 656 NSCLC patients at the recommended dose, with liver enzyme elevations and other adverse events largely handled by protocol‑directed monitoring, dose interruptions, and reductions; only
ALKOVE‑1 data show robust systemic and intracranial activity with a tolerable safety profile for neladalkib.
The ALKOVE‑1 design, pooling Phase 1 and 2 data at the recommended 150 mg once‑daily dose, offers a large safety and efficacy dataset: 781 ALK‑positive solid tumor patients overall and 656 NSCLC patients at the pivotal dose. The pivotal analysis focuses on blinded independent central review of response, with key secondary endpoints including duration of response and intracranial activity, aligning with regulatory expectations for a registration‑directed ALK NSCLC program.
The durability metrics are noteworthy: in the TKI‑pretreated group, Kaplan‑Meier estimates show that a majority of responders remain in response at 6, 12, and 18 months, and similar trends are seen in G1202R and CNS‑involved subgroups. In TKI‑naïve patients, very high response rates and early durability, combined with strong intracranial activity and absence of CNS progression among responders at the current follow‑up, support exploration in the frontline setting in the ALKAZAR Phase 3 trial.
On safety, the most frequent treatment‑emergent adverse events—particularly transaminase elevations—are described as mostly low‑grade, transient, and reversible with dose modifications. The implementation of enhanced liver monitoring and prompt dose interventions in ALKAZAR reflects a proactive safety management strategy based on ALKOVE‑1 experience. The overall pattern of manageable toxicity, modest discontinuation rates, and substantial antitumor activity supports continued development and regulatory discussions for neladalkib in ALK‑positive NSCLC.
FAQ
What did Nuvalent (NUVL) announce about neladalkib in ALK-positive NSCLC?
Nuvalent announced positive topline pivotal data for neladalkib, its investigational ALK-selective inhibitor, from the global ALKOVE-1 Phase 1/2 trial in TKI pre-treated advanced ALK-positive NSCLC, along with encouraging preliminary data in TKI-naïve patients.
What were the key efficacy results for neladalkib in TKI pre-treated ALK-positive NSCLC?
In 253 TKI pre-treated patients with measurable advanced ALK-positive NSCLC at the recommended dose, neladalkib achieved an objective response rate of 31%, rising to 46% in the 63 lorlatinib-naïve patients, with high Kaplan-Meier estimates for maintaining responses up to 18 months.
How did neladalkib perform in patients with G1202R mutations and brain metastases?
Among patients with the G1202R mutation, neladalkib showed an ORR of 68%, and 83% in the lorlatinib-naïve G1202R subgroup. In patients with measurable CNS lesions, intracranial ORR reached 32% in the broader group and 63% in lorlatinib-naïve patients, including intracranial complete responses with durable intracranial benefit.
What were the preliminary results for neladalkib in TKI-naïve ALK-positive NSCLC patients?
In 44 TKI-naïve advanced ALK-positive NSCLC patients treated at the recommended dose, neladalkib showed an 86% objective response rate and a 9% complete response rate. Most responders maintained benefit at 6 and 12 months, and in 9 patients with measurable brain lesions the intracranial ORR was 78% with a 44% intracranial complete response rate.
What safety profile did neladalkib show in the ALKOVE-1 trial?
Across 656 advanced ALK-positive NSCLC patients treated at the recommended dose, the most frequent adverse events were liver enzyme elevations, constipation, dysgeusia, peripheral edema, cough, and nausea. These events were generally low-grade and manageable; 17% of patients required dose reductions and 5% discontinued due to treatment-emergent adverse events.
What are the next clinical and regulatory steps for neladalkib according to Nuvalent?
Nuvalent plans to discuss the topline pivotal data for TKI pre-treated ALK-positive NSCLC with the U.S. FDA at a pre-New Drug Application meeting. The company also continues global enrollment in ALKAZAR, a Phase 3 randomized controlled trial of neladalkib versus alectinib in TKI-naïve ALK-positive NSCLC, and intends to present detailed ALKOVE-1 results at a future medical meeting.