ClinicalTrials.gg
RecruitingNCT06528691Updated Nov 3, 2026

Entrectinib as a Single Agent in Upfront Therapy for Children <3 Years of Age With NTRK1/2/3 or ROS1-FUSED CNS Tumors

A Phase 2 interventional study of Entrectinib and Cyclophosphamide in High Grade Glioma and CNS Tumor, sponsored by St. Jude Children's Research Hospital. Recruiting at 6 sites in 4 countries. Open to participants aged Up to 3 Years. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by St. Jude Children's Research Hospital · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started May 2026; still recruiting 6 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
52
Allocation
Not applicable
Ages
Up to 3 Years
Sex
All
01

Study summary

This clinical trial tests how well entrectinib works to treat patients less than 3 years of age with NTRK 1/2/3 or ROS1 fused, high grade glioma or other central nervous system (CNS) tumors.

Read the detailed description

PRIMARY OBJECTIVE

  • To determine the overall response rate of entrectinib when used as first line therapy in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused high-grade glioma (HGG) (Cohort 1).

SECONDARY OBJECTIVES

  • To estimate the 2-year and 5-year progression free survival (PFS) and overall survival (OS) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused HGG treated with entrectinib as first line therapy (Cohort 1).
  • To estimate the duration of response (DOR) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused HGG treated with entrectinib as first line therapy (Cohort 1).
  • To evaluate the fraction of patients with NTRK1/2/3- or ROS1-fused HGG treated who have second surgeries and a gross-total resection after treatment with entrectinib is achieved, overall and by country and hospital (Cohort 1).
  • To describe the overall response rate of entrectinib when used as first line therapy in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG (Cohort 2).
  • To estimate the 2-year and 5-year PFS and OS in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG treated with entrectinib as first line therapy (Cohort 2).
  • To estimate the duration of response (DOR) in patients who are younger than 3 years of age with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG treated with entrectinib as first line therapy (Cohort 2).
  • To evaluate the fraction of patients with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG who have second surgeries and a gross-total resection after treatment with entrectinib is achieved, overall and by country and hospital (Cohort 2).
  • To describe toxicities experienced by patients younger than 3 years of age treated with entrectinib (Cohort 1 and 2).
  • To evaluate number of patients that are screened for the study and eligible versus enrolled and treated with entrectinib (Cohort 1 and 2).
  • To measure the time intervals (days) from time of initial diagnostic surgery to screening and enrollment in this study (Cohort 1 and 2).

The trial will have 2 cohorts: Cohort 1: patients diagnosed with NTRK1/2/3- or ROS1-fused high-grade glioma (HGG) and Cohort 2: patients diagnosed with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG.

Patients receive entrectinib enterally once daily (QD) on days 1-28 of each cycle. Treatment repeats every 28 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. Patients requiring bridging therapy prior to starting entrectinib may receive cyclophosphamide intravenously (IV) over 1 hour on day 1, etoposide IV over 1 hour on day 1 and 2, carboplatin IV over 1 hour on day 2, filgrastim subcutaneously (SC) or IV or pegfilgrastim SC on day 3.

A gross total resection or significant debulking may become possible if a response to entrectinib is seen. If surgical resection is performed and a gross total resection is achieved, 24 cycles of entrectinib will be completed, including those before and after surgery.

After treatment, patients will be followed for 5 years.

02

Conditions studied

  • High Grade Glioma
  • CNS Tumor

Keywords

  • CNS Tumors
  • High Grade Glioma with NTRK1/2/3 gene fusion
  • High Grade Glioma with ROS1 gene fusion
  • CNS tumor other than HGG harboring NTRK1/2/3 gene fusion
  • CNS tumor other than HGG harboring ROS1 gene fusion
  • Children
03

In context

Glioma

1,452 studies on the registry are indexed under Glioma; 349 are open to participants now.

This study's planned enrollment of 52 is above the median of 32 across 1,075 interventional studies indexed under Glioma.

Browse Glioma studies →

Lead sponsor

St. Jude Children's Research Hospital is the lead sponsor of 440 studies on the registry; 102 are open to participants now.

Of its 61 completed or terminated interventional studies of FDA-regulated products, 37 (61%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Up to 3 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria: Screening Phase

  • Age from birth to age \<3 years at the time of diagnosis (date of surgical resection/)
  • Participant with presumed newly diagnosed tumor in the supratentorial compartment
  • Patient must have based on RAPNO criteria
  • ≤84 days since surgery (resection or biopsy)
  • Available tumor tissue for central review
  • Parent/guardian has the ability to understand and the willingness to sign a written document according to institutional guidelines

Exclusion Criteria: Screening Phase

  • Previous exposure to cytotoxic chemotherapy or radiotherapy

Inclusion Criteria: COHORT 1

  • Patients must be \<3 years of age at the time of diagnosis (date of surgical resection/biopsy)
  • High-grade glioma (World Health Organization [WHO] grade III or IV) harboring NTRK1/2/3 or ROS1 gene fusions as determined by central pathology review
  • Patients must have measurable disease as defined by RAPNO criteria
  • Patients are eligible at the time of diagnosis, prior to any exposure to chemotherapy, targeted therapy, immunotherapy, cellular therapy or radiation
  • ≤28 days since study screening
  • Lansky score ≥50% and a minimum of ≥ 12 weeks
  • Neurologic deficits must have been stable for at least 7 days prior to study enrollment
  • ≥ 8 g/dL (without transfusion or erythropoietin use within 7 days prior to enrollment)
  • count ≥ 75,000/µL (without transfusion within 7-day period prior to enrollment)
  • >1,000/µL
  • (AST) and alanine aminotransferase (ALT) ≤2.5x the (ULN)
  • ≤ 1.5 x ULN
  • Adequate renal function as defined by the following age-based serum creatinine concentrations:

    • 0 to \<1 year: 0.5 mg/dL
    • 1 to \<2 years: 0.6 mg/dL
    • 2 to 3 years: 0.8 mg/dL
  • Adequate cardiac function as defined by (ECG) with Fridericia's interval (QTc) ≤ 450 msec and echocardiogram (LVEF) >50%
  • Screening and enrollment consents signed
  • Willingness and ability to comply with treatment plan, scheduled visits, laboratory tests and other study procedures

Inclusion Criteria: COHORT 2

  • Patients must be \<3 years of age at the time of diagnosis (date of surgical resection/biopsy)
  • CNS tumor other than HGG harboring NTRK1/2/3 or ROS1 gene fusions as determined by central pathology review
  • Patients must have measurable disease as defined by RAPNO criteria
  • Patients are eligible at the time of diagnosis, prior to any exposure to chemotherapy, targeted therapy, immunotherapy, cellular therapy or radiation
  • ≤28 days since study screening
  • Lansky score ≥50% and a minimum life expectancy of ≥ 12 weeks
  • Neurologic deficits must have been stable for at least 7 days prior to study enrollment.
  • Hemoglobin ≥ 8 g/dL (without transfusion or erythropoietin use within 7 days prior to enrollment)
  • Platelet count ≥ 75,000/µL (without transfusion within 7-day period prior to enrollment);
  • Absolute neutrophil count >1,000/µL.
  • ALT and ALT ≤2.5x the upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 x ULN
  • Adequate renal function as defined by the following age-based serum creatinine concentrations:

    • 0 to \<1 year: 0.5 mg/dL
    • 1 to \<2 years: 0.6 mg/dL
    • 2 to 3 years: 0.8 mg/dL
  • Adequate cardiac function as defined by ECG with QTc ≤ 450 msec and echocardiogram LVEF >50%
  • Screening and enrollment consents signed
  • Willingness and ability to comply with treatment plan, scheduled visits, laboratory tests and other study procedures

Exclusion Criteria: COHORT 1 AND 2

  • medical disorder that could compromise the ability to tolerate study therapy or would interfere with the study procedures or results history
  • History of recent (3 months) symptomatic congestive heart failure
  • Known active, uncontrolled infection (bacterial, fungal, or viral)
  • Receiving enzyme inducing antiepileptic drugs (EIAEDs)
  • Any prior cancer therapy including chemotherapy (excluding Bridging Chemotherapy Cycle), targeted therapy, immunotherapy, cellular therapy, or radiation
  • Receiving another agent concurrently
  • Surgery within 2 weeks prior to treatment enrollment
  • Patients with known to of the investigational medicinal product
  • Active gastrointestinal disease or malabsorption disorder (e.g. Crohn's disease, ulcerative colitis, short-gut syndrome) that would impair drug absorption
  • Inability to take medication enterally
Terms in these criteria, in plain language(17)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
52 participants (estimated)

Study arms

  • Experimental
    Entrectinib therapy, Cohort 1 and Cohort 2

    Cohort 1: Patients who are younger than 3 years of age diagnosed with NTRK1/2/3- or ROS1-fused high-grade glioma (HGG) will receive therapy as outline in Detailed Description. Cohort 2: Patients who are younger than 3 years of age diagnosed with NTRK1/2/3- or ROS1-fused CNS tumors other than HGG will receive therapy as outline in Detailed Description.

    Drug: Entrectinib · Drug: Cyclophosphamide · Drug: Etoposide · Drug: Carboplatin · Biological: G-CSF · Biological: Pegfilgrastim · Procedure: Surgery

Interventions

  • Given orally (PO) or enterally

    Also known as: Rozlytrek

  • Given intravenous (IV)

    Also known as: Cytoxan®

  • Given IV

    Also known as: VP-16

  • Given IV

    Also known as: Paraplatin®

  • BiologicalG-CSF

    Given subcutaneous (SQ) or IV

    Also known as: Filgrastim

  • BiologicalPegfilgrastim

    Given SQ as part of recommended Bridging Therapy instead of G-CSF.

    Also known as: Neulasta

  • ProcedureSurgery

    A gross total resection or significant debulking may become possible if a response to entrectinib is seen.

    Also known as: Surgical resection

06

What researchers measure

Primary outcomes

  1. Overall response rate (ORR) (Cohort 1)

    ORR is defined as the percentage of patients with either partial or complete response assessed at the protocol-defined evaluation timepoint. Overall response will be determined by the central imaging review based on the scheduled evaluations.

    Time frame: After cycle 4 (each cycle is 28 days).

Secondary outcomes

  1. Progression free survival (PFS) (Cohort 1)

    PFS is defined as the time from initiation of protocol treatment to first event (progressive disease, death due to any cause), or date last follow-up among those who have not had an event. Described using Kaplan Meier method.

    Time frame: At 2 and 5 years

  2. Overall survival (OS) (Cohort 1)

    OS is defined as the time from date of diagnosis to date of death due to any cause or date last follow-up. Described using Kaplan Meier method.

    Time frame: At 2 and 5 years

  3. Duration of response (DOR) (Cohort 1)

    DOR is defined as time from date of first response (partial or complete) until the date of progression or last follow-up. Described as median time.

    Time frame: Up to 5 years

  4. Patients who have second surgeries (Cohort 1)

    Percentage of patients who had second surgeries.

    Time frame: Up to 5 years

  5. Patients who undergo gross-total resection after treatment (Cohort 1)

    Percentage of patients who underwent a gross-total resection.

    Time frame: Up to 5 years

  6. ORR (Cohort 2)

    ORR is defined as the percentage of patients with either partial or complete response assessed at the protocol-defined evaluation timepoint. Overall response will be determined by the central imaging review based on the scheduled evaluations.

    Time frame: After cycle 4 (each cycle is 28 days).

  7. PFS (Cohort 2)

    PFS is defined as the time from initiation of protocol treatment to first event (progressive disease, death due to any cause), or date last follow-up among those who have not had an event. Described using Kaplan Meier method.

    Time frame: At 2 and 5 years

  8. OS (Cohort 2)

    OS is defined as the time from date of diagnosis to date of death due to any cause or date last follow-up. Described using Kaplan Meier method.

    Time frame: At 2 and 5 years

  9. DOR (Cohort 2)

    DOR is defined as time from date of first response (partial or complete) until the date of progression or last follow-up. Described as median time.

    Time frame: Up to 5 years

  10. Patients who have second surgeries (Cohort 2)

    Percentage of patients who had second surgeries. \[Time Frame: Up to 5 years\]

    Time frame: Up to 5 years

  11. Patients who undergo gross-total resection after treatment (Cohort 2)

    Percentage of patients who underwent a gross-total resection.

    Time frame: Up to 5 years

  12. Incidence of adverse events (Cohort 1 and 2)

    Percentage of adverse events on therapy including Entrectinib, captured using National Cancer Institute Common Terminology Criteria for Adverse Events 5.0.

    Time frame: Up to 5 years

  13. Number of patients screened versus enrolled and treated (Cohort 1 and 2)

    Number of enrolled and treated patients as a percentage of number of patients screened and eligible for study.

    Time frame: Up to 5 years

  14. Time from initial diagnostic surgery to screening and enrollment (Cohort 1 and 2)

    Median time in days from initial surgery to screening and enrollment on study.

    Time frame: Up to 5 years

07

Study locations

6 of 6 sites recruiting
08

References and documents

Publications

  • Bagchi A, Chiang J, Pinto S, Dhanda S, Gajjar A. Infant-Type Hemispheric Gliomas: A Review of Clinical, Radiologic, Histopathologic, and Molecular Features. J Natl Compr Canc Netw. 2025 Nov;23(11):e257064. doi: 10.6004/jnccn.2025.7064. PubMed 41213248 ↗

Individual participant data

Plan to share: Yes — Individual participant de-identified datasets containing the variables analyzed in the published article will be made available (related to the study primary or secondary objectives contained in the publication). Supporting documents such as the protocol, statistical analyses plan, and informed consent are available through the CTG website for the specific study. Data used to generate the published article will be made available at the time of article publication. Investigators who seek access to individual level de-identified data will contact the computing team in the Department of Biostatistics (ClinTrialDataRequest@stjude.org) who will respond to the data request.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Data will be made available at the time of article publication.

Access criteria: Data will be provided to researchers following a formal request with the following information: full name of requestor, affiliation, data set requested, and timing of when data is needed. As an informational point, the lead statistician and study principal investigator will be informed that primary results datasets have been requested.

09

Updates

1 registry update since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date
1 update, last Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    Minor edits only
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06528691
Collaborators
Hoffmann-La Roche
Responsible party
Sponsor
First posted
Jul 30, 2024
Start date
May 1, 2026
Primary completion
Nov 2027 (estimated)
Completion
Nov 2032 (estimated)
Last update
Nov 3, 2026

Study contacts

Tabatha E. Doyle, RN
Contact
tabatha.doyle@stjude.org
901-595-2544
Daniel Moreira, MD, MEd
Contact
daniel.moreira@stjude.org
901-585-1911
Daniel Moreira, MD, MEd
principal investigator · St. Jude Children's Research Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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