A Phase 2 interventional study of Biospecimen Collection and Bone Marrow Aspiration and Biopsy in Advanced Malignant Solid Neoplasm, Recurrent Ependymoma and Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor, sponsored by National Cancer Institute (NCI). Active, not recruiting at 124 sites in 2 countries. Open to participants aged 12 Months to 21 Years. Per ClinicalTrials.gov, last updated 2026-06-17.
Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment
This phase II Pediatric MATCH trial studies how well larotrectinib works in treating patients with solid tumors, non-Hodgkin lymphoma, or histiocytic disorders with NTRK fusions that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) and have come back (relapased) or does not respond to treatment (refractory). Larotrectinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
PRIMARY OBJECTIVE:
I. To determine the objective response rate (ORR; complete response + partial response) in pediatric patients treated with larotrectinib sulfate (LOXO-101 [larotrectinib]) with advanced solid tumors (including central nervous system [CNS] tumors), non-Hodgkin lymphomas or histiocytic disorders harboring NTRK 1/2/3 fusions.
SECONDARY OBJECTIVES:
I. To estimate the progression free survival in pediatric patients treated with LOXO-101 (larotrectinib) with advanced solid tumors (including CNS tumors), non-Hodgkin lymphomas or histiocytic disorders with NTRK 1/2/3 fusions.
II. To obtain additional information about the tolerability of LOXO-101 (larotrectinib) in children with relapsed or refractory cancer.
III. To provide preliminary estimates of the pharmacokinetics of LOXO-101 (larotrectinib) in children with relapsed or refractory cancer.
EXPLORATORY OBJECTIVE:
I. To explore approaches to profiling changes in tumor genomics over time through evaluation of circulating tumor deoxyribonucleic acid (DNA).
OUTLINE:
Patients receive larotrectinib sulfate orally (PO) or via nasogastric (NG)- or gastric (G)-tube twice per day (BID) on days 1-28. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo a computed tomography (CT) scan, magnetic resonance imaging (MRI), an x-ray, bone scan, and/or iobenguane (MIBG) scintigraphy during screening and on study. Patients also undergo bone marrow aspiration and/or biopsy during screening and may undergo blood sample collection on study.
After completion of study treatment, patients are followed up at 30 days, then periodically thereafter.
Patients must have radiographically measurable disease at the time of study enrollment; patients with neuroblastoma who do not have measurable disease but have MIBG+ evaluable disease are eligible; measurable disease in patients with CNS involvement is defined as any lesion that is at minimum 10 mm in one dimension on standard MRI or CT; Note: The following do not qualify as measurable disease:
Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment; if after the required time frame, the numerical eligibility criteria are met, e.g. blood count criteria, the patient is considered to have recovered adequately
Cytotoxic chemotherapy or other anti-cancer agents known to be myelosuppressive; for agents not listed, the duration of this interval must be discussed with the study chair and the study-assigned research coordinator prior to enrollment
Stem cell Infusions (with or without total body irradiation [TBI]):
For patients with solid tumors without known bone marrow involvement:
A serum creatinine based on age/gender as follows (within 7 days prior to enrollment):
Exclusion Criteria:
Patients receive larotrectinib sulfate PO or via NG- or G-tube BID on days 1-28. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo a CT scan, MRI, an x-ray, bone scan, and/or MIBG scintigraphy during screening and on study. Patients also undergo bone marrow aspiration and/or biopsy during screening and may undergo blood sample collection on study.
Procedure: Biospecimen Collection · Procedure: Bone Marrow Aspiration and Biopsy · Procedure: Bone Scan · Procedure: Computed Tomography · Drug: Larotrectinib Sulfate · Procedure: Magnetic Resonance Imaging · Procedure: Radionuclide Imaging · Procedure: X-Ray Imaging
Undergo blood sample collection
Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Undergo a bone marrow aspiration and/or biopsy
Undergo a bone scan
Also known as: Bone Scintigraphy
Undergo a CT scan
Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography
Given PO or via nasogastric- or gastric-tube
Also known as: ARRY 470 Sulfate, LOXO 101 Sulfate, LOXO-101 Sulfate, Vitrakvi
Undergo MRI
Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI
Undergo a MIBG scintigraphy
Also known as: Gamma Scan, NM, Nuclear Medicine, nuclear medicine scan, radioimaging, Radionuclide Scanning, Scan, Scintigraphy
Undergo an x-ray
Also known as: Conventional X-Ray, Diagnostic Radiology, Medical Imaging, X-Ray, Plain film radiographs, Radiographic Imaging, Radiographic imaging procedure (procedure), Radiography, RG, Static X-Ray, X-Ray
Objective Response Rate
A responder is defined as a patient who achieves a best response of partial response or complete response on the study. Response rates will be calculated as the percent of evaluable patients who are responders. The revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) was used to determine response and progression in this study, with specific criteria outlined for the different subtypes of tumors (e.g., 2-dimensional measurements for central nervous system (CNS) tumors).
Time frame: Up to 2 years from study entry
Progression Free Survival (PFS)
The Kaplan-Meier method will be used to estimate the 6 month PFS. PFS is defined as time from initiation of protocol treatment to disease progression, recurrence, death from any cause, or date of last contact.
Time frame: Up to 6 months from study entry
Percentage of Patients Experiencing Grade 3 or Higher Adverse Events
Percentage of patients experiencing grade 3 or higher adverse events will be evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.
Time frame: Up to 2 years from study entry
Pharmacokinetics of Larotrectinib
A descriptive analysis of pharmacokinetic parameters of LOXO-101 (larotrectinib) will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The pharmacokinetic parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit). All these analyses will be descriptive and exploratory and hypotheses generating in nature.
Time frame: Pre-dose, 1, 2, 4, and 6-8 hours after morning dose of day 1 cycle 1 and pre-dose of day 1 cycle 2
Ability to Detect NTRK Fusions in Circulating Cell-free Tumor Deoxyribonucleic Acid in Plasma
A descriptive analysis of the exploratory aims will be performed and will be summarized with simple summary statistics. All of these analyses will be descriptive in nature.
Time frame: Up to 5 years
| Milestone | Treatment (Larotrectinib Sulfate) |
|---|---|
| Started | 9 |
| Completed | 1 |
| Not completed | 8 |
| Withdrew: Physician decision | 3 |
| Withdrew: Protocol violation | 1 |
| Withdrew: Progressive disease | 4 |
A responder is defined as a patient who achieves a best response of partial response or complete response on the study. Response rates will be calculated as the percent of evaluable patients who are responders. The revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1) was used to determine response and progression in this study, with specific criteria outlined for the different subtypes of tumors (e.g., 2-dimensional measurements for central nervous system (CNS) tumors).
| percentage of participants | Treatment (Larotrectinib Sulfate) |
|---|---|
| Objective Response Rate | 33 (14.2 to 60.2) |
The Kaplan-Meier method will be used to estimate the 6 month PFS. PFS is defined as time from initiation of protocol treatment to disease progression, recurrence, death from any cause, or date of last contact.
| percentage of participants | Treatment (Larotrectinib Sulfate) |
|---|---|
| Progression Free Survival (PFS) | 76 (33.2 to 93.5) |
Percentage of patients experiencing grade 3 or higher adverse events will be evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.
| percentage of participants | Treatment (Larotrectinib Sulfate) |
|---|---|
| Percentage of Patients Experiencing Grade 3 or Higher Adverse Events | 44 (13.7 to 78.8) |
A descriptive analysis of pharmacokinetic parameters of LOXO-101 (larotrectinib) will be performed to define systemic exposure, drug clearance, and other pharmacokinetic parameters. The pharmacokinetic parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit). All these analyses will be descriptive and exploratory and hypotheses generating in nature.
Results for this outcome have not been posted.
A descriptive analysis of the exploratory aims will be performed and will be summarized with simple summary statistics. All of these analyses will be descriptive in nature.
Results for this outcome have not been posted.
Collected over Adverse Events monitored/assessed from enrollment to 30 days after the end of treatment, up to 2 years. All-Cause Mortality monitored/assessed up to 5 years. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Treatment (Larotrectinib Sulfate) | 3/9 (33.3%) | 2/9 (22.2%) | 7/9 (77.8%) |
| Event | Treatment (Larotrectinib Sulfate) |
|---|---|
| DiarrheaGastrointestinal disorders | 1/9 |
| NauseaGastrointestinal disorders | 1/9 |
| Disease progressionGeneral disorders | 1/9 |
| FeverGeneral disorders | 1/9 |
| SepsisInfections and infestations | 1/9 |
| Neutrophil count decreasedInvestigations | 1/9 |
| Depressed level of consciousnessNervous system disorders | 1/9 |
| HypotensionVascular disorders | 1/9 |
| HypoglycemiaMetabolism and nutrition disorders | 1/9 |
| Event | Treatment (Larotrectinib Sulfate) |
|---|---|
| VomitingGastrointestinal disorders | 5/9 |
| White blood cell decreasedInvestigations | 5/9 |
| AnemiaBlood and lymphatic system disorders | 4/9 |
| Lymphocyte count decreasedInvestigations | 4/9 |
| HyperglycemiaMetabolism and nutrition disorders | 4/9 |
| HypocalcemiaMetabolism and nutrition disorders | 4/9 |
| Sinus tachycardiaCardiac disorders | 3/9 |
| NauseaGastrointestinal disorders | 3/9 |
| FatigueGeneral disorders | 3/9 |
| FeverGeneral disorders | 3/9 |
| Age, Categorical(Participants) | Treatment (Larotrectinib Sulfate) |
|---|---|
| <=18 years | 8 |
| Between 18 and 65 years | 1 |
| >=65 years | 0 |
| Age, Continuous(years) | Treatment (Larotrectinib Sulfate) |
|---|---|
| Mean | 9.3 ± 6.5 |
| Sex: Female, Male(Participants) | Treatment (Larotrectinib Sulfate) |
|---|---|
| Female | 3 |
| Male | 6 |
| Ethnicity (NIH/OMB)(Participants) | Treatment (Larotrectinib Sulfate) |
|---|---|
| Hispanic or Latino | 6 |
| Not Hispanic or Latino | 3 |
| Unknown or Not Reported | 0 |
| Race (NIH/OMB)(Participants) | Treatment (Larotrectinib Sulfate) |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 3 |
| White | 3 |
| More than one race | 0 |
| Unknown or Not Reported | 3 |
| Region of Enrollment(participants) | Treatment (Larotrectinib Sulfate) |
|---|---|
| United States | 9 |
Showing the first 100 of 124 sites across 2 countries.
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