Repotrectinib (TPX-0005), effectively reduces growth of ALK driven neuroblastoma cells

Sci Rep. 2019 Dec 18;9(1):19353. doi: 10.1038/s41598-019-55060-7.


Neuroblastoma is the most commonly diagnosed extracranial tumor in the first year of life. Approximately 9% of neuroblastoma patients present germline or somatic aberrations in the gene encoding for anaplastic lymphoma kinase (ALK). This increases in high-risk neuroblastomas, which have a 14% frequency of ALK aberrations at the time of diagnosis and show increasing numbers at relapse. Abrogating ALK activity with kinase inhibitors is employed as clinical therapy in malignancies such as non-small cell lung cancer and has shown good results in pediatric inflammatory myofibroblastic tumors and anaplastic large cell lymphomas. A phase I clinical trial of the first generation ALK inhibitor, crizotinib, in neuroblastoma patients showed modest results and suggested that further investigation was needed. Continuous development of ALK inhibitors has resulted in the third generation inhibitor repotrectinib (TPX-0005), which targets the active kinase conformations of ALK, ROS1 and TRK receptors. In the present study we investigated the effects of repotrectinib in a neuroblastoma setting in vitro and in vivo. Neuroblastoma cell lines were treated with repotrectinib to investigate inhibition of ALK and to determine its effect on proliferation. PC12 cells transfected with different ALK mutant variants were used to study the efficacy of repotrectinib to block ALK activation/signaling. The in vivo effect of repotrectinib was also analyzed in a neuroblastoma xenograft model. Our results show that repotrectinib is capable of inhibiting signaling activity of a range of ALK mutant variants found in neuroblastoma patients and importantly it exhibits strong antitumor effects in a xenograft model of neuroblastoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anaplastic Lymphoma Kinase / metabolism*
  • Animals
  • Apoptosis / drug effects
  • Cell Line, Tumor
  • Cell Proliferation
  • Female
  • Humans
  • Inhibitory Concentration 50
  • Macrocyclic Compounds / pharmacology
  • Macrocyclic Compounds / therapeutic use*
  • Mice, Inbred BALB C
  • Mutation / genetics
  • Neovascularization, Pathologic / drug therapy
  • Neurites / drug effects
  • Neurites / metabolism
  • Neuroblastoma / blood supply
  • Neuroblastoma / drug therapy*
  • Neuroblastoma / enzymology
  • Neuroblastoma / pathology*
  • PC12 Cells
  • Phosphorylation / drug effects
  • Poly(ADP-ribose) Polymerases / metabolism
  • Pyrazoles / pharmacology
  • Pyrazoles / therapeutic use*
  • Rats
  • Xenograft Model Antitumor Assays


  • Macrocyclic Compounds
  • Pyrazoles
  • repotrectinib
  • Poly(ADP-ribose) Polymerases
  • Anaplastic Lymphoma Kinase