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Clinical Trial Profile - ROS1+ NSCLC

ARROS-1 Trial

ARROS-1 is the pivotal Phase 1/2 trial of zidesamtinib (Jideytro), a brain-penetrant, ROS1-selective, TRK-sparing TKI. In 117 TKI-pretreated ROS1-positive NSCLC patients it delivered an objective response rate of 44% (95% CI 34-53%) with durable intracranial activity. On July 22, 2026 the FDA approved Jideytro (Nuvalent, a GSK company) for ROS1+ NSCLC after a prior ROS1 TKI.

FDA Approved - July 22, 2026 ROS1-positive NSCLC Phase 1/2 - NCT05118789 Zidesamtinib (Jideytro) Nuvalent / GSK
See the FDA Approval & KOL Reaction

ARROS-1 Key Takeaways

Regulatory

FDA approved July 22, 2026 - Jideytro (zidesamtinib) for adults with locally advanced or metastatic ROS1-positive NSCLC who received a prior ROS1 TKI. Ahead of the Sept 18, 2026 target action date. FDA approved (2L+ ROS1+ NSCLC) Source: Nuvalent/GSK press release

Design

Global registrational Phase 1/2 trial (NCT05118789); pivotal TKI-pretreated cohort n=117; primary endpoint objective response rate by blinded independent central review (BICR). Data cutoff March 21, 2025 (WCLC 2025).

Efficacy (pretreated, n=117)

ORR 44% (95% CI 34-53%); duration of response 82% at 6 months and 69% at 12 months (FDA label / Nuvalent PR). ORR 51% after a single prior TKI; ORR 47% after prior repotrectinib and 43% after prior taletrectinib (ARROS-1, WCLC 2025, DCO 21-Mar-2025). ORR 44% - 12-mo DoR 69%

CNS activity

Intracranial ORR 48% (27/56, 95% CI 35-62) in patients with measurable CNS lesions; durable intracranial responses including after prior brain-penetrant TKIs; activity against the ROS1 G2032R resistance mutation (ARROS-1, WCLC 2025).

Tolerability

Generally well tolerated: dose reduction ~10%, treatment discontinuation ~2%; TRK-sparing design intended to reduce neurotoxicity (ARROS-1, WCLC 2025).

Investigational Data - Not FDA Approved

The front-line / TKI-naive ARROS-1 data (ORR ~89% (31/35)) are investigational and NOT part of the FDA-approved indication; front-line development is ongoing.

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Top KOLs Discussing ARROS-1

Alexander Drilon, MD
Alexander Drilon, MD
@alexdrilon
ARROS-1 Presenter (WCLC 2025)
Benjamin Besse, MD
Benjamin Besse, MD
@BenjaminBesseMD
ARROS-1 Co-Investigator
Stephen V. Liu, MD
Stephen V. Liu, MD
@StephenVLiu
17.4K impressions
Antonio Calles, MD
Antonio Calles, MD
@Tony_Calles
3.8K impressions
Masahiro Torasawa, MD, PhD
Masahiro Torasawa, MD, PhD
@M_Torasawa
2.6K impressions
Julien Mazieres, MD
Julien Mazieres, MD
@JulienMazieres
2.3K impressions
Sarah Waliany, MD, MS
Sarah Waliany, MD, MS
@SWaliany
1.8K impressions
Patrick Forde, MD
Patrick Forde, MD
@FordePatrick
1.8K impressions
Chul Kim, MD
Chul Kim, MD
@chulkimMD
1.7K impressions
Preeti Gul, MD
Preeti Gul, MD
@ipreeshagul
1.4K impressions
Joshua Reuss, MD
Joshua Reuss, MD
@Joshua_Reuss
1.1K impressions
Tejas Patil, MD
Tejas Patil, MD
@TejasPatilMD
821 impressions
Riyaz Shah, MD, PhD
Riyaz Shah, MD, PhD
@DrRiyazShah
702 impressions
Estela Rodriguez, MD
Estela Rodriguez, MD
@Latinamd
373 impressions
Eric K. Singhi, MD
Eric K. Singhi, MD
@lungoncdoc
347 impressions
Martin Dietrich, MD, PhD
Martin Dietrich, MD, PhD
@DoctorDietrich
335 impressions
Bartomeu Massuti, MD
Bartomeu Massuti, MD
@bmassutis
309 impressions
Rami Manochakian, MD
Rami Manochakian, MD
@RManochakian
43 impressions
Miguel Gonzalez Velez, MD
Miguel Gonzalez Velez, MD
@mgonzalezvelMD
34 impressions

ARROS-1 Key Slides & Visuals

Presented by Dr. Alexander Drilon at WCLC 2025 (data cutoff March 21, 2025). Tap a slide to open the source post; expand OCR text where available.

Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
WCLC 2025 - ARROS-1
13.2K impressions - 2025-09-07
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[Slide 1] 2023 Conference #WCLC25 ARROS-1: Objective Response in ROS1 TKI Pre-treated Patients Advanced ROS1+ Any prior ROS1 TKI 1 prior ROS1 TKI Responses were also observed in NSCLC (range 1-4) (crizotinib or entrectinib) patients previously treated with: RECIST 1.1 by BICR 1 chemotherapy 1 chemotherapy 22 prior ROS1 TKIs * chemotherapy: ORR, % (n/N) 44% (51/117) 51% (28/55) ORR = 38% (22/58; 95% Cl: [26, 52]) (95% CI] [34, 53] [37,65] Prior repotrectinib: ORR . 47% (8/17), DOR range 3.5 to 17.2 months CR, % (n/N) 1% (1/117) 2% (1/55) Prior taletrectinib: ORR . 43% (3/7), Prior crizotinib only 1 chemotherapy ORR - 68% (19/28) Prior entrectinib only 1 chemotherapy ORR - 33% (9/27). DOR range 5.2 to 7.0+ months so 1 Prior ROS1 TKI (crizotinib or entrectinib) = chemotherapy 40 20 * change Insure a 1 Prior crizotinib 0 30 Prior entrectinib 40 60 + Prior chemotherapy 80 100 (ata off March 21,2025 CI. confidence intervat OR complete response PD, progresse disease, PR partial response, RECIST 1.1. Response Evaluation Citteria n Sold tumours version 1.1.SD stable disease
Julien Mazieres
Julien Mazieres@JulienMazieres
WCLC 2025 - ARROS-1
2.3K impressions - 2025-09-07
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[Slide 1] ------ ARROS-1: Summary PIVOTAL DATASET Preliminary In the pivotal dataset for TKI pre-treated patients with Any prior 1 prior ROS1 TKI Advanced advanced ROS1+ NSCLC, zidesamtinib demonstrated a ROS1 TKIs (crizotinib or ROS1 ROS1+ NSCLC (range 1-4) entrectinib) TKI-naive clinical profile consistent with its preclinical design goals: 1 chemotherapy 1 chemotherapy Durable activity, including in heavily pre-treated patients that ORR (BICR) 44% 51% 89% have exhausted available options (including prior % DOR repotrectinib or taletrectinib) and patients with the ROS1 78% 93% 96% : 12 months G2032R resistance mutation % DOR 62% 93% : 18 months Durable intracranial responses, including in patients who % PFS 48% 68% previously received the brain-penetrant TKIs entrectinib, 11 12 months lorlatinib, repotrectinib or taletrectinib % PFS 40% 68% E 18 months Generally well-tolerated with low rates of dose reduction Any prior Prior crizotinib Intracranial ROS1 (10%) and treatment discontinuation (2%), and a safety profile ROS1 TKIs Activity only t TKI-naive t chemotherapy chemotherapy consistent with its ROS1-selective, TRK sparing design IC-ORR (BICR) 48% 85% 83% Encouraging preliminary data in a TKI-naive population No CNS 71% 91% support ongoing investigation in the front-line setting IC-DOR progression : 12 months : 12 months among confirmed CNS responders Tab out off March 21,2025 9 wclc.iaslc.org
Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
WCLC 2025 - ARROS-1
1.5K impressions - 2025-09-07
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[Slide 1] ASC 2023 Conference #WCLC25 Cancer ARROS-1: G2032R Resistance Mutation and CNS Subgroups ROS1 G2032R Resistance Mutation Measurable CNS lesions by BICR at baseline Advanced ROS1+ 1 prior ROS1 TKI Advanced ROS1+ NSCLC Any prior ROS1 TKI (crizotinib or entrectinib) NSCLC Any prior ROS1 TKI Prior crizotinib only 1 chemotherapy 1 chemotherapy 1 chemotherapy 1 chemotherapy Analysis by BICR Analysis by BICR ORR, % (n/N) 54% (14/26) 83% (5/6) IC-ORR, % (n/N) 48% (27/56) 85% (11/13) (95% ci] [33,73] 36, 100] 195% ci] (35, 62] (55, 98] IC-CR % (n/N) 20% (11/56) 54% (7/13) % DOR t 6 months 79% 80% (95% CI] [47,93] [20, 97] % IC-DOR : 6 months 79% 91% 95% ci] [56, 91] [51,99] % DOR t 12 months 60% 80% % IC-DOR : 12 months 71% 91% 95% ci] [28,81] [20,97] (95% ci] [46, 87] [51,99] Responses were also observed in patients with CNS responses also observed in patients who had received 21 prior brain- ROS1 G2032R mutation following >2 prior ROS1 TKIs : chemotherapy, penetrant TKI. including prior entrectinib, forfatinib, repotrectinib. or including forlatinib or repotrectinib taletrectinib IC-ORR: 37% (16/43 95% CI 23, 53]), including 4 IC-CRs Other ROS1 resistance mutations, including G1957A L1982V, S1986F, No CNS progression was observed among patients who entered the study F2004C/V, G2032K, and D2033N without brain metastases at baseline per BICR Patients received zidesamtinib as their first TKI designed with activity against ROS1 02032R includes 2 unconfirmed intracranial partial responses (PR). Analyses of DOR based on Kaplan-Meier estimates. Analyses of DOR based on Kaplan-Meier estimates. One progression event among responders One CNS progression event among CNS responders (n=11). (ats off March 21, 2025 C. --- [Slide 2] EASLC 2025 World Conference #WCLC25 Lung Cancer ...... ARROS-1: Safety in Advanced ROS1+ NSCLC All Treatment-Emergent Adverse Events (TEAEs) in >15% of Patients Treated with Zidesamtinib 100 mg QD (N = 432) a Dose reduction due to TEAEs: 10% (43/432) Preferred or grouped term Any Grade Grade 2 3 Most common (>2 patients): peripheral edema Peripheral edema 36% 0.7% (n=8), blood CPK increased (n=4), peripheral Constipation 17% 0% sensory neuropathy (n=4), arthralgia (n=3), paresthesia (n=3) Blood CPK increased 16% 3.5% Fatigue 6 16% 0.7% Discontinuation due to TEAE: 2% (10/432) Dyspnea 15% 3.0% Most common (>2 patients): pneumonia (n=3) Patients received at least 1 dose of zidesamtinib at 100 mg QD with median duration of exposure of 5 months (range: 0. 32). The only treatment-related adverse event in >15% b Includes terms peripheral edema, peripheral swelling. edema, generalized edema. of patients was peripheral edema b (29%) includes terms fatigue, asthenia, malaise if Includes terms dyspnea, dyspnea exertional, orthopnea I ata pooled for patients a the Phase I or Phase 2 portion of ARROS I - a data cut-off of March 21,2025 CPK, creatine phosphokinase 8 wclc.iaslc.org
Bartomeu Massuti
WCLC 2025 - ARROS-1
309 impressions - 2025-09-07
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[Slide 1] ASLC 2025 World Conference #WCLC25 on Long Cancer SEPTEMBER ...... ARROS-1: G2032R Resistance Mutation and CNS Subgroups ROS1 G2032R Resistance Mutation Measurable CNS lesions by BICR at baseline Advanced ROS1+ 1 prior ROS1 TKI Advanced ROS1+ NSCLC Any prior ROS1 TKI (crizotinib or entrectinib) NSCLC Any prior ROS1 TKI Prior crizotinib only t chemotherapy * chemotherapy 1 chemotherapy t chemotherapy Analysis by BICR Analysis by BICR ORR, % (n/N) 54% (14/26) 83% (5/6) IC-ORR, % (n/N) 48% (27/56) 85% (11/13) 95% CI] [33, 73] [36, 100] [95% ci] [35,62] [55,98] IC-CR. % (n/N) 20% (11/56) 54% (7/13) % DOR : 6 months 79% 80% 95% ci] [47,93] [20, 97] % IC-DOR : 6 months 79% 91% 95% CI] b [56, 91] [51,99] % DOR : 12 months 60% 80% % IC-DOR : 12 months 71% 91% 95% ci] b [28, 81] [20, 97] 95% CI] [46,87] [51,99] Responses were also observed in patients with: CNS responses also observed in patients who had received 21 prior brain- ROS1 G2032R mutation following >2 prior ROS1 TKIs * chemotherapy, penetrant TKI, including prior entrectinib, lorlatinib, repotrectinib, or including lorlatinib or repotrectinib taletrectinib: IC-ORR: 37% (16/43 : 95% CI 23, 53]), including 4 IC-CRs Other ROS1 resistance mutations, including G1957A, L1982V, S1986F, No CNS progression was observed among patients who entered the study F2004C/V, G2032K, and D2033N without brain metastases at baseline per BICR Patients received zidesamtinib as their first TKI designed with activity against ROS1 G2032R. Includes 2 unconfirmed intracranial partial responses (PR). a Analyses of DOR based on Kaplan-Meier estimates Analyses of DOR based on Kaplan-Meier estimates. One progression event among responders. One CNS progression event among CNS responders (n=11). I ata cut off March 2025 IC intracrapial 6 wclc.iaslc.org --- [Slide 2] ASIC 2025 World Conference #WCLC25 Lung Cancer SEPTEMBER ...... ARROS-1: Duration of Response and Progression-Free Survival Duration of Response Progression-Free Survival Advanced ROS1+ NSCLC Any prior ROS1 TKIs 1 prior ROS1 TKI Any prior ROS1 TKIs 1 prior ROS1 TKI (range 1-4) (crizotinib or entrectinib) (range 1-4) (crizotinib or entrectinib) Kaplan-Meier Estimate * chemotherapy : chemotherapy : chemotherapy 1 chemotherapy %2 6 months 95% ci] 84% [71, 92] 93% 74. 98] 57% [47, 66] 70% [56, 81] % : 12 months [95% ci] 78% 62, 88] 93% 74, 98] 48% [38, 57] 68% [53, 79] % 2 18 months [95% CI] 62% [28, 84] 93% 74, 98] 40% [24, 55] 68% [53, 79] Tata out off March 21, 2025 100 93% 93% 93% 100 "Any prior ROST TKL Emerging median DOR of 22 months (95% CE 17.NET continues to manure 75 84% 75 70% 68% 68% Median PFS was 9.7 5.5. NE] months with median follow up of Paters Response 2 $ 78% 50 62% Progression-Free Surval 50 11.1 months trange 02-25-6) 57% 48% 1 prior ROS1 110 (crizotinib)(C) or 40% 25 25 entrectinib] Emerging median DOR of 22 months 95% DI 22. NE] and median PFS of 23.8 0 0 months 295% Ct 23.8 NE) 0 0 12 18 24 Months 0 0 12 18 24 Months continue to mature median ALRISK ALROA folow up was 11.8 months Any proor ROST Tide 11 40 10 3 - ROST DOB 117 04 27 $ trange 1.2-25.6) Prior Cer only 29 26 0 3 0 Prior or only 55 37 14 4 0 In patients that received prior crizotinib only, there were no progression events among responders (DOR range: 7.3+ to 23.2+ months). PFS rate was 89% (95% Cl: 70, 96) at 6, 12, and 18 months with median not reached. In patients that received >2 prior ROS1 TKIs 1 chemotherapy, DOR rate was 71% (95% Cl: 46, 86) at 6 months and 56% (95% CI: 29, 76) at 12 months. 5 wclc.iaslc.org --- [Slide 3] ASC World Conference #WCLC25 Lung Cancer ARROS-1 Preliminary Data: TKI-Naive Patients with Advanced ROS1+ NSCLC TKI-naive advanced Response-evaluable TKI-naive advanced Measurable intracranial lesions ROS1+ NSCLC ROS1+ NSCLC n 35 n= 6 Analysis by BICR Analysis by BICR ORR, % (n/N) 89% (31/35) IC-ORR, % (n/N) 83% (5/6) CR, % (n/N) 9% (3/35) % DOR : 6 months [95% CI] 96% [76, 99] IC-CR, % (n/N) 67% (4/6) % DOR 2 12 months [95% CI] 96% [76, 99] IC-DOR No CNS progression events among DOR range 1.9+ to 13.9+ months intracranial responders 1 Includes 1 unconfirmed CR following confirmed partial response (PR). IC-DOR range 4.6+ to 11.1+ months . Analyses of DOR based on Kaplan-Meier estimates 40 ROS1 TKI-naive Best %change in target lesions 20 0 No prior 2 chemotherapy $ 1 prior line of 00 chemotherapy 8 100 so PD so PR PR PM PR PM PR PR PM PR PR PR PR PR PM CR PR PR PM PM PR PR PM PR PR UCR PR PR PR PR PM CR Date for patients treated with ridesar with 100Γ or by August 31, 2024 in the Phose 2) portion of ARROS I with a data cut off of March 21, 2025 Patients may have received up to 1 prior line of chemoltherapy 7 wclc.iaslc.org
Dr. Antonio Calles 🫁🚭
WCLC 2025 - ARROS-1
3.8K impressions - 2025-09-07
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LUNGevity Foundation
WCLC 2025 - ARROS-1
2.3K impressions - 2025-09-07
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Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
WCLC 2025 - ARROS-1
2.3K impressions - 2025-10-04
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Sarah Waliany, MD, MS
WCLC 2025 - ARROS-1
1.8K impressions - 2025-09-07
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ARROS-1 Top Tweets

Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
Dr. @alexdrilon at #WCLC25 presents important update on zidesamtinib in #ROS1 NSCLC. In previously treated subgroup, RR around 50% with very impressive duration of response, emerging around 2y.
13.2K impressions63 likes2025-09-07
Dr. Antonio Calles 🫁🚭
Dr. Antonio Calles 🫁🚭@Tony_Calles
ARROS-1: Zidesamtinib in TKI Pretreated Patients with Advanced/Metastatic ROS1 + NSCLC #LCSM #WCLC25 @ros1cancer Durable activity, including in heavily pre-treated patients that have exhausted available options (including prior repotrectinib or talletirectinib) and patients
3.8K impressions22 likes2025-09-07
Masahiro TORASAWA, MD. PhD.
Masahiro TORASAWA, MD. PhD.@M_Torasawa
Two recent major lung cancer deals: 1️⃣ GSK acquires Nuvalent 🧬 Zidesamtinib for ROS1+ NSCLC (ARROS-1) 🧬 Neladalkib for ALK+ NSCLC (ALKOVE-1) 🧠 Both designed to address resistance mutations and CNS disease 🔗 https://t.co/vQOiWPTLwx 2️⃣ AstraZeneca licenses global rights to
2.6K impressions15 likes2026-07-20
LUNGevity Foundation
LUNGevity Foundation@LUNGevity
Zidesamtinib (NVL-520) continues to show benefit in TKI-naive and TKI-pretreated #ROS1 positive metastatic #NSCLC (including G2032R resistance mutation). Cognitive side effects not seen consistent with TRK-soaring profile. @alexdrilon @MSKCancerCenter @IASLC @ros1cancer #WCLC25
2.3K impressions16 likes2025-09-07
Julien Mazieres
Julien Mazieres@JulienMazieres
What an achievement for ROS1 pts. @alexdrilon reported the updated result of the ARROS1 trial. Impressive RR (89#) and duration of response with favorable safety profile in naive pts treated with Zidesamtinib. #WCLC2025
2.3K impressions26 likes2025-09-07
Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
Dr. @JessicaJLinMD updates #DCLung25 on the latest advances in #ROS1 NSCLC, including taletrectinib and zidesamtinib, and #ALK, where lorlatinib provides the longest PFS but will neladalkib provide even better outcomes? So much progress in these subsets over the past few years.
2.3K impressions32 likes2025-10-04
Sarah Waliany, MD, MS
Sarah Waliany, MD, MS@SWaliany
Exciting #ARROS1 phase 1/2 trial results of #zidesamtinib in ROS+ mNSCLC #WCLC25 @alexdrilon 💠Active in heavily pretreated pts: ORR 44% after 1-4 prior ROS1 TKIs; 51% after 1 prior TKI (criz or entrect) 💠Responses after prior repotrectinib & taletrectinib; active against G2032R
1.8K impressions19 likes2025-09-07
Patrick Forde
Patrick Forde@FordePatrick
Now @alexdrilon #wclc25 with ARROS-1 zidesamtinib for ROS1 lung cancer - overall an impressive drug, active in heavily pretreated disease (4 prior TKIs) & importantly avoids TRK mediated neurotox. Early 1st line data also encouraging given the good tox profile #LCSM
1.8K impressions30 likes2025-09-07
Chul Kim
Chul Kim@chulkimMD
ARROS-1: #Zidesamtinib in advanced ROS1+ NSCLC - ORR 44% in pretreated (51% after 1 prior TKI), 89% TKI-naïve - Intracranial efficacy & activity against G2032R observed - Overall well tolerated, low discontinuation rate (2%) A promising agent for ROS1+ NSCLC #wclc2025
1.7K impressions23 likes2025-09-07
Stephen V Liu, MD
Stephen V Liu, MD@StephenVLiu
#WCLC25 Very active in the face of ROS1 resistance mutations and highly CBS active. In TKI naive subset, RR 89%, intracranial RR 83%, at 1y, 96% of responses still ongoing. By avoiding TRK, safety profile seems reassuring.
1.5K impressions12 likes2025-09-07

FDA Approval - Jideytro (Zidesamtinib)

FDA APPROVED July 22, 2026

The U.S. FDA approved Jideytro (zidesamtinib) for the treatment of adult patients with locally advanced or metastatic ROS1-positive non-small cell lung cancer (NSCLC) who received a prior ROS1 kinase inhibitor. The approval - granted to Nuvalent, Inc. (now part of GSK following completion of the acquisition) about two months ahead of the September 18, 2026 target action date - is based on the pivotal ARROS-1 Phase 1/2 trial (ORR 44%, 95% CI 34-53%; duration of response 82% at 6 months and 69% at 12 months). No companion diagnostic was co-approved.

Approved indication is limited to prior-TKI (2L+) patients; front-line / TKI-naive use remains investigational.

Nuvalent / GSK press release (PR Newswire)
ClinicalTrials.gov - ARROS-1 (NCT05118789)

KOL reaction to the approval

About the ARROS-1 Trial

ARROS-1 (NCT05118789) is the global registrational Phase 1/2 study of zidesamtinib (Jideytro), a next-generation ROS1-selective kinase inhibitor engineered by Nuvalent to be brain-penetrant, to remain active against ROS1 resistance mutations (including G2032R), and to spare TRK - the mechanism behind the neurologic toxicity seen with earlier ROS1/TRK inhibitors. The pivotal cohort enrolled 117 patients with advanced or metastatic ROS1-positive NSCLC who had received one or more prior ROS1 TKIs (crizotinib, entrectinib, repotrectinib, or taletrectinib). Results were presented by Dr. Alexander Drilon at the 2025 World Conference on Lung Cancer (WCLC 2025) and formed the basis of the July 22, 2026 FDA approval. The trial also includes an encouraging TKI-naive (front-line) cohort that remains under investigation.

Trial Methodology & Results

Study Design

Global registrational Phase 1/2, open-label; response assessed by RECIST 1.1 and CNS response by BICR.

Population

Advanced/metastatic ROS1-positive NSCLC; pivotal cohort n=117 with 1-4 prior ROS1 TKIs (+/- chemotherapy).

Intervention

Zidesamtinib (Jideytro) 100 mg once daily - ROS1-selective, brain-penetrant, TRK-sparing TKI.

Primary Endpoint

Objective response rate (ORR) by BICR; key secondary endpoints DoR, intracranial ORR, PFS, safety.

Companion Dx

None co-approved; ROS1 fusion status determined by standard molecular testing.

Lead Investigator

Alexander Drilon, MD (presenter, WCLC 2025); Benjamin Besse, MD and colleagues.

Objective Response (pretreated)

ORR 44% (51/117; 95% CI 34-53%), CR 1% (1/117). ORR 51% (28/55) after a single prior TKI (crizotinib or entrectinib); 68% after prior crizotinib only. Responses after prior repotrectinib (ORR 47%, 8/17) and taletrectinib (ORR 43%, 3/7); ORR 38% (22/58) after >=2 prior ROS1 TKIs. ORR 44% (95% CI 34-53%) Source: ARROS-1, WCLC 2025 (DCO 21-Mar-2025)

Duration of Response

In the FDA-label pivotal population, DoR was 82% at 6 months and 69% at 12 months (Nuvalent/GSK press release / FDA label). The WCLC 2025 dataset (DCO 21-Mar-2025) reported a 12-month DoR of 78% in the any-prior-TKI cohort - a different analysis cut; the two are not mixed here. 12-month DoR 69% (FDA label) Source: Nuvalent/GSK press release

Intracranial Activity

Among patients with measurable CNS lesions, intracranial ORR was 48% (27/56; 95% CI 35-62) with IC-CR 20% (11/56). Durable CNS responses were observed, including in patients previously treated with the brain-penetrant TKIs entrectinib, lorlatinib, repotrectinib or taletrectinib (IC-ORR 37%, 16/43). No CNS progression occurred among patients without baseline brain metastases. Intracranial ORR 48% Source: ARROS-1, WCLC 2025 (DCO 21-Mar-2025)

Safety & Tolerability

Zidesamtinib was generally well tolerated, with a treatment discontinuation rate of ~2% and dose reduction ~10%. Its ROS1-selective, TRK-sparing design is intended to avoid the neurologic toxicity associated with TRK inhibition. Discontinuation ~2% Source: ARROS-1, WCLC 2025 (DCO 21-Mar-2025)

ARROS-1 in the News

ARROS-1 & Zidesamtinib FAQ

Is Jideytro (zidesamtinib) FDA approved?

Yes. On July 22, 2026, the U.S. FDA approved Jideytro (zidesamtinib), a ROS1-selective TKI from Nuvalent (now part of GSK), for adults with locally advanced or metastatic ROS1-positive non-small cell lung cancer (NSCLC) who received a prior ROS1 kinase inhibitor. The approval is based on the pivotal ARROS-1 Phase 1/2 trial.

What were the ARROS-1 efficacy results for zidesamtinib?

In the TKI-pretreated pivotal population (n=117), zidesamtinib showed an objective response rate (ORR) of 44% (95% CI 34-53%), with duration of response of 82% at 6 months and 69% at 12 months (FDA label / Nuvalent press release). At WCLC 2025 (data cutoff March 21, 2025), intracranial ORR was 48% (27/56, 95% CI 35-62) and ORR was 51% after a single prior TKI.

Does zidesamtinib work against ROS1 resistance mutations and brain metastases?

Yes. ARROS-1 (WCLC 2025) reported activity against the ROS1 G2032R resistance mutation and responses after prior repotrectinib (ORR 47%, 8/17) and taletrectinib (ORR 43%, 3/7). Intracranial ORR was 48% (27/56), and durable CNS responses were seen in patients previously treated with brain-penetrant TKIs. Zidesamtinib is designed to spare TRK, reducing neurotoxicity.

Is zidesamtinib approved for first-line (TKI-naive) ROS1-positive NSCLC?

No. The FDA approval is limited to patients who received a prior ROS1 TKI. The TKI-naive front-line data reported in ARROS-1 (ORR ~89% (31/35)) are investigational and not part of the approved indication; front-line investigation is ongoing.

Who presented the ARROS-1 trial and where?

The pivotal ARROS-1 dataset was presented by Dr. Alexander Drilon at the 2025 World Conference on Lung Cancer (WCLC 2025) and discussed widely by lung-cancer KOLs including Stephen V. Liu, Patrick Forde, Julien Mazieres, Sarah Waliany and Chul Kim.

Key KOL Sentiments - ARROS-1

KOLComment (verbatim)Sentiment
Stephen V. Liu, MDDr. @alexdrilon at #WCLC25 presents important update on zidesamtinib in #ROS1 NSCLC. In previously treated subgroup, RR around 50% with very impressive duration of response, emerging around 2y.Positive
Antonio Calles, MDARROS-1: Zidesamtinib in TKI Pretreated Patients with Advanced/Metastatic ROS1 + NSCLC #LCSM #WCLC25 @ros1cancer Durable activity, including in heavily pre-treated patients that have exhausted available options (including prior repotrectinib or talletirectinib) and patientsPositive
Julien Mazieres, MDWhat an achievement for ROS1 pts. @alexdrilon reported the updated result of the ARROS1 trial. Impressive RR (89#) and duration of response with favorable safety profile in naive pts treated with Zidesamtinib. #WCLC2025Positive
Sarah Waliany, MD, MSExciting #ARROS1 phase 1/2 trial results of #zidesamtinib in ROS+ mNSCLC #WCLC25 @alexdrilon 💠Active in heavily pretreated pts: ORR 44% after 1-4 prior ROS1 TKIs; 51% after 1 prior TKI (criz or entrect) 💠Responses after prior repotrectinib & taletrectinib; active against G2032RPositive
Patrick Forde, MDNow @alexdrilon #wclc25 with ARROS-1 zidesamtinib for ROS1 lung cancer - overall an impressive drug, active in heavily pretreated disease (4 prior TKIs) & importantly avoids TRK mediated neurotox. Early 1st line data also encouraging given the good tox profile #LCSMPositive
Chul Kim, MDARROS-1: #Zidesamtinib in advanced ROS1+ NSCLC - ORR 44% in pretreated (51% after 1 prior TKI), 89% TKI-naïve - Intracranial efficacy & activity against G2032R observed - Overall well tolerated, low discontinuation rate (2%) A promising agent for ROS1+ NSCLC #wclc2025Positive
Preeti Gul, MDThe demogorgons did NOT get you @alexdrilon as you gave us a master class on ros-1 fusions in under 5 min! Very excited about zidesamtinib data esp ICRR of over 80% and lower rate of dose reductions ! @ros1cancer #texaslung26 @TLCconferencePositive
Joshua Reuss, MDDr. @alexdrilon presents impressive pivotal data for next generation ROS1-specific TKI zidesamtinib in TKI-refractory dz and first glimpse at treatment-naive dz from ARROS-1 clinical trial. 🏹 #WCLC25.Positive
Tejas Patil, MDPL02.10 Pivotal ARROS-1 Efficacy and Safety Data: Zidesamtinib in TKI Pre-treated Patients with Advanced/Metastatic ROS1+ NSCLC In #ROS1 #NSCLC, taletrectinib has impressive ORR data already. What differentiates zidesamtinib in this crowded ROS1 landscape? Pay attention toPositive
Estela Rodriguez, MD#WCLC25 #ARROS-1 #zidesamtinib next gen ROS1 TKI for naive and pretreated pts presented by @alexdrilon ➡️ high ORR and DoR ⬆️ CNS activity ( even complete long lasting responses) ⬇️ NTRK related toxicity 👉🏽The landscape of treatments for this small group of pts gets better wPositive
Eric K. Singhi, MDVery timely review of the evolution of ROS1 directed TKIS happening here at #BTGLung2026 And now, HOT off the press as of THIS MORNING, FDA approval for zidesamtinib in patients who received a prior ROS1 TKI. @OncLivePositive
Martin Dietrich, MD, PhDImpressive ARROS1 Update: 1st line: ORR 89% in tx naive patients (n=35) with DOR >12 mts at 93%. ORR 44% in 2+ lines pretreatment, including 47% (repotrectinib) and 43% (taletrectinib). TEAE with discontinuation rate 2%, Dose reduction 10% with no reported CNS/TRK relatedPositive
Bartomeu Massuti, MDZidesamtinib in pretreated ROS1 fusion+ lung cancer. A new option for this uncommon disease @OncoAlert #WCLC25Positive
Rami Manochakian, MD🚨🔥@OncoAlert Hot Off The Press ⭐️@US_FDA approves #Zidesamtinib for locally advanced or metastatic #ROS1+ non-small cell #LungCancer, previously treated with at least one prior TKI. Approval based on #ARROS1 Trial: ✅#ORR 44% ✅ 12-month DOR: 69% 👇🏻 https://t.co/R5OQWqMNwZPositive
Miguel Gonzalez Velez, MDZidesamtinib approved for pretreated ROS1 @ros1cancer NSCLC based on ARROS-1 by @alexdrilon @BenjaminBesseMD and colleagues. Take: ORR of ~44% between taletrectinib (55%), repotrectinib (38%) and lorlatinib (35%) but seems to have better toxicity profile (Cross-trial comparison)Positive
Masahiro Torasawa, MD, PhDTwo recent major lung cancer deals: 1️⃣ GSK acquires Nuvalent 🧬 Zidesamtinib for ROS1+ NSCLC (ARROS-1) 🧬 Neladalkib for ALK+ NSCLC (ALKOVE-1) 🧠 Both designed to address resistance mutations and CNS disease 🔗 https://t.co/vQOiWPTLwx 2️⃣ AstraZeneca licenses global rights toNeutral
Riyaz Shah, MD, PhDARROS-1; zidesamtinib; 100mg od; ORR pretreated 44-51%; >40% in repo and tale pretreated; ORR 89% in TKI naive #WCLC25Neutral
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated 2026-07-22. All clinical figures are traceable to the ARROS-1 WCLC 2025 presentation, the FDA label, or the Nuvalent/GSK press release; front-line (TKI-naive) data are labeled investigational.