Larotrectinib (Vitrakvi, Bayer) has a conditional marketing authorisation for 'the treatment of adult and paediatric patients with solid tumours that display a neurotrophic tyrosine receptor kinase (NTRK) gene fusion:
who have a disease that is locally advanced, metastatic or where surgical resection is likely to result in severe morbidity and
who have no satisfactory treatment options'.
Adults: The recommended dose in adults is 100 mg larotrectinib twice daily, until disease progression or until unacceptable toxicity occurs. Children: Dosing in children is based on body surface area. The recommended dose is 100 mg/m2 larotrectinib twice daily with a maximum of 100 mg per dose until disease progression or until unacceptable toxicity occurs.
The cost of larotrectinib is £5,000 per 100‑ml vial of 20 mg per ml oral solution (excluding VAT; BNF online, accessed January 2020; £15,000 per 30‑day supply). Larotrectinib will be available as hard capsules (25 mg and 100 mg) to be taken orally twice daily (company submission). The company has a commercial arrangement. This makes larotrectinib available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.