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clinical / clinicalNTRK Fusions, Larotrectinib & Entrectinib in NSCLC

Lyudmila Bazhenova

柳德米拉·巴热诺娃

MD

🏢UC San Diego Moores Cancer Center(加利福尼亚大学圣地亚哥分校穆尔斯癌症中心)🌐USA

Professor of Medicine and Section Chief, Hematology/Oncology; Medical Director, Clinical Trials Office, UC San Diego Moores Cancer Center医学教授、血液肿瘤科科主任;加利福尼亚大学圣地亚哥分校穆尔斯癌症中心临床试验办公室医疗主任

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Key Contributions

👥Biography 个人简介

Lyudmila Bazhenova, MD is Professor of Medicine, Section Chief of Hematology/Oncology, and Medical Director of the Clinical Trials Office at UC San Diego Moores Cancer Center. She is a nationally recognized thoracic oncologist with particular expertise in rare oncogenic driver alterations in lung cancer, most notably NTRK gene fusions. Dr. Bazhenova was among the early investigators in the clinical development of larotrectinib (LOXO-101), the first highly selective pan-TRK inhibitor, contributing to the pivotal multi-tumor basket trial that demonstrated an 75% objective response rate across TRK fusion-positive cancers regardless of histology — leading to the first tumor-agnostic FDA approval based purely on molecular biomarker. In parallel, she contributed to clinical development of entrectinib, the second TRK inhibitor with additional ALK and ROS1 activity, in the STARTRK-2 trial. NTRK fusions in NSCLC are rare (~0.1–0.3%), and Dr. Bazhenova has championed the clinical and scientific infrastructure needed to identify these patients through broad-panel NGS and to enroll them in targeted therapy trials. She has also been an active clinical trials investigator across multiple areas of thoracic oncology including immunotherapy combinations, antibody-drug conjugates, and novel targeted agents in the acquired resistance setting. Under her direction, the UCSD clinical trials office has markedly expanded thoracic oncology trial capacity and accrual.

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🧪Research Fields 研究领域

NTRK Fusion-Positive NSCLC and Tumor-Agnostic Targeted TherapyNTRK融合阳性非小细胞肺癌与肿瘤不可知型靶向治疗
Larotrectinib (LOXO-101) Clinical Development拉罗替尼(LOXO-101)临床开发
Entrectinib in NTRK/ROS1/ALK-Fused Cancers恩曲替尼在NTRK/ROS1/ALK融合癌症中的应用
Rare Oncogenic Drivers in Thoracic Malignancies胸部恶性肿瘤少见致癌驱动基因
Lung Cancer Clinical Trials Program Development肺癌临床试验项目开发

🎓Key Contributions 主要贡献

Larotrectinib — NTRK Inhibitor Tumor-Agnostic Development

Contributed as an investigator to the pivotal basket trial of larotrectinib in TRK fusion-positive tumors, which demonstrated a 75% objective response rate across 17 different tumor types regardless of histology — providing a landmark validation of the tumor-agnostic drug approval paradigm and establishing the first purely biomarker-driven FDA approval in oncology.

Entrectinib in NTRK/ROS1/ALK-Fused Cancers — STARTRK Program

Participated in the STARTRK-2 trial establishing entrectinib activity in NTRK fusion-positive cancers (ORR 57%) and ROS1 fusion-positive NSCLC (ORR 67%), including intracranial activity, contributing to FDA approval of entrectinib as the second NTRK inhibitor and demonstrating the multi-target kinase inhibitor approach in rare driver-positive NSCLC.

NTRK Fusion Detection and Infrastructure for Rare Driver NSCLC

Championed systematic broad-panel NGS implementation at UCSD to detect rare oncogenic drivers including NTRK fusions in unselected advanced NSCLC, demonstrating that routine comprehensive genomic profiling enables identification of actionable rare fusions across the full NSCLC population and facilitating enrollment in tumor-agnostic targeted therapy trials.

Resistance Mechanisms to TRK Inhibitors and Next-Generation Approaches

Contributed clinical case series and mechanistic data characterizing acquired resistance to larotrectinib and entrectinib, identifying on-target TRK kinase domain mutations (TRKA G595R, G667C; TRKC G623R) and off-target bypass alterations, and evaluating next-generation TRK inhibitors (selitrectinib, repotrectinib) in these resistance settings.

Representative Works 代表性著作

[1]

Larotrectinib in TRK fusion-positive cancers in adults and children

New England Journal of Medicine (2018)

Pivotal basket trial of larotrectinib demonstrating 75% ORR in TRK fusion-positive cancers across 17 tumor types in 55 patients, establishing the tumor-agnostic approval paradigm and leading to the first purely biomarker-driven FDA approval.

[2]

Entrectinib in patients with advanced or metastatic NTRK fusion-positive solid tumours: integrated analysis of three phase 1–2 trials

The Lancet Oncology (2020)

Integrated NTRK basket analysis of entrectinib demonstrating 57.4% ORR and median duration of response of 10.4 months in NTRK fusion-positive tumors, including intracranial activity, supporting FDA approval of the second TRK inhibitor.

[3]

Repotrectinib in ROS1 fusion-positive non-small-cell lung cancer (TRIDENT-1)

New England Journal of Medicine (2024)

TRIDENT-1 trial demonstrating repotrectinib activity in both TKI-naïve (ORR 79%) and post-crizotinib (ORR 38%) ROS1-positive NSCLC with activity against G2032R resistance mutation, establishing repotrectinib as a new standard for ROS1+ NSCLC.

[4]

Acquired resistance to larotrectinib in NTRK-rearranged cancers

Cancer Discovery (2019)

Comprehensive molecular profiling of larotrectinib-resistant TRK fusion-positive tumors identifying on-target (TRKA G595R, G667C) and off-target (RAS/MAPK, MET) resistance mechanisms and demonstrating next-generation TRK inhibitor activity against on-target resistance.

🏆Awards & Recognition 奖项与荣誉

🏆UCSD Academic Senate Distinguished Teaching Award
🏆GO2 Foundation for Lung Cancer Research Investigator Award
🏆ASCO Clinical Trials Infrastructure Award
🏆California Breast Cancer Research Program Investigator Award

📄Data Sources 数据来源

Last updated: 2026-04-06 | All information from publicly available academic sources

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