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Zidesamtinib

Phase 1

Locally Advanced Solid Tumor | Small molecule | Oncology |Nuvalent, Inc.|Last Updated: Oct 24, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment359
FDA Designations
BREAKTHROUGH_THERAPYORPHAN_DRUG
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT05118789A Study of Zidesamtinib (NVL-520) in Patients With Advanced NSCLC and Other Solid Tumors Harboring ROS1 Rearrangement (ARROS-1)PHASE1 RECRUITING 359Jan 4, 2022Dec 31, 2028Oct 24, 202563 United States, Australia +12
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Study Endpoints
Primary Endpoints
Maximum Tolerated Dose (MTD) (Phase 1)
Within 28 days of last patient dosed during dose escalation

Highest dose with dose-limiting toxicity (DLT) rate ≤ 25%

Recommended Phase 2 Dose (RP2D)
Within 28 days of last patient dosed during dose escalation.

To determine the RP2D

Objective Response Rate (ORR) (Phase 2)
2-3 years after first patient dosed.

To determine ORR as assessed by BICR

Secondary Endpoints
Number of participants with treatment-emergent adverse events, as assessed by CTCAE, v5.0
Approximately 3 years.
Maximum plasma concentration (Cmax) of NVL-520
Pre-dose and up to 24 hours post-dose
Plasma concentration at the end of the dosing interval (Ctau) of NVL-520
Pre-dose and up to 24 hours post-dose
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Study Design & Arms
AllocationNON_RANDOMIZED
MaskingNONE
ModelSEQUENTIAL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Phase 1 dose escalationEXPERIMENTALZidesamtinib (NVL-520) oral daily dosing
Cohort 2aEXPERIMENTALROS1+ NSCLC naïve to TKI therapy and up to 1 prior chemotherapy and/or immunotherapy
Cohort 2bEXPERIMENTALROS1+ NSCLC treated with 1 prior ROS1 TKI and no prior chemotherapy or immunotherapy
Cohort 2cEXPERIMENTALROS1+ NSCLC treated with 1 prior ROS1 TKI and 1 prior platinum-based chemotherapy with or without immunotherapy
Cohort 2dEXPERIMENTALROS1+ NSCLC treated with ≥2 prior ROS1 TKIs and up to 1 prior chemotherapy and/or immunotherapy
Cohort 2eEXPERIMENTALROS1+ solid tumor and progressed on any prior therapy
Interventions
NameTypeDescription
Zidesamtinib (NVL-520)DRUGOral tablet of zidesamtinib (NVL-520)
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Eligibility Criteria
Age Range12 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites63

Inclusion Criteria: 1. Age ≥18 years (Cohort 2e only: Age ≥12 years). 2. Disease Criteria: 1. Phase 1: Histologically or cytologically confirmed locally advanced or metastatic solid tumor with documented ROS1 rearrangement. 2. Phase 2: Cohorts 2a, 2b, 2c and 2d: Histologically or cytological...

Countries:United StatesAustraliaBelgiumCanadaFranceGermanyItalyJapanNetherlandsSingaporeSouth KoreaSpainTaiwanUnited Kingdom
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT05118789primaryCompletionDate: changed
LOWMay 24, 2026NCT05118789studyFirstPostDate: changed