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Zidesamtinib

Phase 1FDA approved

Locally Advanced Solid Tumor | Small molecule | Oncology |Nuvalent, Inc.|Trials Updated: Sep 24, 2026

Zidesamtinib development status

FDA approval on record Jul 22, 2026
Highest phase Phase 1
Registered trials 1 across 1 sponsor since Jan 2025

Zidesamtinib target and mechanism

Target class-Tinib (Kinase)
ModalitySmall molecule

Also known as Zidesamtinib (NVL-520), NVL-520

Success Probability

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Market & Valuation

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Trial Design

CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment359

FDA Designations

ORPHAN_DRUG

Zidesamtinib clinical trials

Zidesamtinib · 1 trial · 2 indications

Phase 1 1
NCT05118789A Study of Zidesamtinib (NVL-520) in Patients With Advanced NSCLC and Other Solid Tumors Harboring ROS1 Rearrangement (ARROS-1)Locally Advanced Solid Tumor
RECRUITING359 Analytics
PHASE1RECRUITING
A Study of Zidesamtinib (NVL-520) in Patients With Advanced NSCLC and Other Solid Tumors Harboring ROS1 Rearrangement (ARROS-1)
Locally Advanced Solid TumorUnlock trial analytics

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 to 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)

LOWSep 24, 2026NCT05118789lastUpdatePostDate: changed
LOWSep 24, 2026NCT05118789lastUpdatePostDate: changed

Frequently asked questions about Zidesamtinib

What is Zidesamtinib?

Zidesamtinib is an investigational small molecule kinase inhibitor being developed by Nuvalent, Inc. for locally advanced and metastatic solid tumors. It is designed for patients whose tumors harbor a ROS1 rearrangement, a biomarker-selected population. Zidesamtinib has received Orphan Drug designation from the FDA and is currently in Phase 1 clinical development.

What is Zidesamtinib used for in locally advanced solid tumors?

Zidesamtinib is being studied for the treatment of locally advanced and metastatic solid tumors that harbor a ROS1 rearrangement, including advanced non-small cell lung cancer. It is an investigational therapy and has not been approved for any indication. Treatment is directed at biomarker-selected patients whose tumors test positive for ROS1 rearrangement.

What does Zidesamtinib target?

Zidesamtinib is a kinase inhibitor, a small molecule in the -tinib class, directed at ROS1-rearranged tumors. It is being developed for patients whose cancers carry a ROS1 rearrangement, which is the biomarker used to select patients for treatment in its clinical program.

Who makes Zidesamtinib?

Zidesamtinib is being developed by Nuvalent, Inc., a biopharmaceutical company that trades under the ticker symbol NUVL. Nuvalent is the sponsor of the clinical program evaluating the drug in ROS1-rearranged solid tumors.

What phase is Zidesamtinib in?

Zidesamtinib is in Phase 1 clinical development. It is an investigational drug and has not been approved by the FDA for any indication. The FDA has granted Zidesamtinib Orphan Drug designation. The Phase 1 program is currently recruiting participants.

What clinical trials is Zidesamtinib in?

Zidesamtinib is being evaluated in the ARROS-1 trial, registered as NCT05118789, titled A Study of Zidesamtinib (NVL-520) in Patients With Advanced NSCLC and Other Solid Tumors Harboring ROS1 Rearrangement. The Phase 1 trial is recruiting, with an enrollment of 359 participants across the United States, Europe, Asia, and Australia.

Is Zidesamtinib the same as NVL-520?

Yes, Zidesamtinib is also known as NVL-520. Both names refer to the same investigational kinase inhibitor developed by Nuvalent, Inc. The ARROS-1 clinical trial lists the drug as Zidesamtinib (NVL-520), and the two names are used interchangeably in reference to this ROS1-targeted therapy.