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PF-06463922 for Crizotinib Pretreated ROS1 Positive Non-small-cell Lung Cancer (PFROST)

Primary Purpose

Carcinoma, Non-Small-Cell Lung

Status
Unknown status
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Lorlatinib
Sponsored by
Fondazione Ricerca Traslazionale
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Non-Small-Cell Lung focused on measuring ROS1 positive, NSCLC

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Written informed consent;
  2. Male or female patient ages ≥ 18 years;
  3. Histologically/cytologically confirmed diagnosis of NSCLC with evidence of ROS1 rearrangement;
  4. Possibility to perform a new tumor biopsy or tumor tissue collected at the time or after crizotinib failure;
  5. Patient pretreated with crizotinib with evidence of disease progression during crizotinib therapy;
  6. At least one radiological measurable disease according to RECIST criteria;
  7. At least 1 previous standard chemotherapy regimen;
  8. Performance status 0-2 (ECOG);
  9. Patient compliance to trial procedures
  10. Adequate bone marrow function (ANC ≥ 1.5x109/L, platelets ≥ 100x109/L, haemoglobin > 9 g/dl);
  11. Adequate liver function (bilirubin < grade 2, transaminases no more than 3xULN/<5xULN in present of liver metastases);
  12. Normal level of alkaline phosphatase and creatinine;
  13. If female: childbearing potential either terminated by surgery, radiation, or menopause, or attenuated by use of approved contraceptive method [intrauterine contraceptive device (IUD), birth control pills, or barrier device] during and for ninety (90) days after end of treatment.

Exclusion Criteria:

1. No ROS1 rearrangement 2. No previous therapy with crizotinib; 3. No evidence of crizotinib failure; 4. No post-crizotinib tumor tissue available; 5. Absence of any measurable lesions; 6. No previous chemotherapy; 7. Concomitant radiotherapy or chemotherapy; 8. Symptomatic brain metastases; 9. Diagnosis of any other malignancy during the last 5 years, except for in situ carcinoma of cervix uteri and squamous cell carcinoma of the skin; 10. Predisposing factors for acute pancreatitis (e.g., uncontrolled hyperglycaemia, current gallstone disease, alcoholism); 11. History of extensive disseminated/bilateral or known presence of Grade 3 or 4 interstitial fibrosis or interstitial lung disease including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, interstitial lung disease, obliterative bronchiolitis and pulmonary fibrosis (but not history of prior radiation pneumonitis); 12. Pregnancy or lactating female; 13. Other serious illness or medical condition potentially interfering with the study.

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Sites / Locations

  • IRCCS - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)- Oncologia Medica
  • Sacro Cuore- Don Calabria Hospital- U.O.C. Oncologia Medica
  • Istituto Toscano Tumori Ospedale San Donato- U.O.C. di Oncologia Medica Dipartimento di Oncologia USL-8
  • Azienda Ospedaliera di Rilievo Nazionale "S.G. Moscati"
  • IRCCS Istituto Tumori Giovanni Paolo II
  • IRCCS A.O.U. San Martino- IST- Istituto Nazionale per la Ricerca sul Cancro- U.O.S. Tumori Polmonari
  • Istituto Europeo di Oncologia - Divisione di Oncologia Toracica
  • A.O.U. Policlinico di Modena- Oncologia Ematologia e Malattie Apparato Respiratorio
  • A.O. San Gerardo
  • Istituto Nazionale Tumori IRCCS Fondazione Pascale
  • Istituto Oncologico Veneto IRCCS- UOS Oncologia Toracica UOC. Oncologia Medica 2
  • Casa di Cura La Maddalena- U.O. Oncologia medica
  • Azienda Ospedaliera Universitaria di Parma- Struttura Complessa di Oncologia Medica
  • Azienda Ospedaliera di Perugia- S.C. Oncologia Medica
  • Ospedale di Ravenna- Oncologia Medica
  • Ospedale "Infermi" Rimini
  • ASST della Valle Olona - Ospedale di Saronno
  • A.O.U. San Luigi Gonzaga
  • Azienda ULSS 9 TREVISO-UOC Oncologia Medica
  • Policlinico 'G.B.Rossi' Borgo Roma - A.O.U. Integrata (Giampaolo Tortora)- Oncologia Medica

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lorlatinb Arm

Arm Description

Eligible patients will be treated with Lorlatinib at the dose of 100 mg QD p.o.

Outcomes

Primary Outcome Measures

Response rate to PF-06463922 in patients with ROS1 translocation resistant to crizotinib
Response rate to PF-06463922 in patients with ROS1 translocation resistant to crizotinib

Secondary Outcome Measures

Progression-free survival (PFS), The length of time during and after the treatment of a disease,that a patient lives with the disease but it doesn't get worse.
Progression-free survival (PFS) will be calculated from the time between the baseline/start of treatment visit to the time of first occurrence of progressive disease (PD) or death from any cause. Patients who have neither progressed nor died at time of analysis will be censored at the date of last tumor assessment where non progression was documented (i.e. CR, PR or SD)
Overall Survival (OS): Time from the start of treatment until death from any cause
Overall survival (OS) will be calculated from the time between the baseline/start of treatment visit to the date of death, irrespective of the cause of death. Patients still alive at the time of analysis will be censored at the date they were last known to be alive
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Patients will be closely monitored for signs and symptoms of potential adverse events, and will undergo frequent laboratory tests to assess lipids, pancreas, liver, kidney, and haematological function.
Correlation with additional tumor biomarkers in tumor tissue or blood
Correlation with additional tumor biomarkers in tumor tissue or blood

Full Information

First Posted
February 1, 2018
Last Updated
July 13, 2021
Sponsor
Fondazione Ricerca Traslazionale
Collaborators
Clinical research technology Srl
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1. Study Identification

Unique Protocol Identification Number
NCT03439215
Brief Title
PF-06463922 for Crizotinib Pretreated ROS1 Positive Non-small-cell Lung Cancer
Acronym
PFROST
Official Title
PF-06463922 for Crizotinib Pretreated ROS1 Positive Non-small-cell Lung Cancer: a Phase II Trial (PFROST)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Unknown status
Study Start Date
June 13, 2017 (Actual)
Primary Completion Date
June 2022 (Anticipated)
Study Completion Date
June 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fondazione Ricerca Traslazionale
Collaborators
Clinical research technology Srl

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This is a phase II study assessing response rate to PF-06463922 in patients with ROS1 translocation resistant to previous crizotinib therapy. Eligible patients will be treated with the study drug until disease progression, unacceptable toxicity or patient refusal. Disease assessment will be performed every 8 weeks according to RECIST criteria.
Detailed Description
PF-06463922 is a novel small-molecule ROS1/ALK inhibitor that was optimized for robust brain penetration. The results showed that PF-06463922 is most potent against ROS1 and ALK, with selectivity ratios >100-fold for ROS1 over the 204 kinases tested. A recent study has investigated the activity of PF-06463922 against the crizotinib-resistant ROS1G2032R mutation in both recombinant enzyme and cell-based assays. PF-06463922 effectively inhibited the catalytic activity of recombinant ROS1G2032R and the CD74-ROS1G2032R fusion kinase in BaF3 cells. This effect translated directly into an antiproliferative response. These results, together with its exquisite ROS1 potency and ability to suppress the resistant ROS1 mutations, supports the clinical evaluation of PF-06463922 in ROS1-positive NSCLC, including patients who have developed resistance to crizotinib because of the acquired G2032R mutation and/or brain metastases. This is a phase II study assessing response rate to PF-06463922 in patients with ROS1 translocation resistant to previous crizotinib therapy. Eligible patients will be treated with the study drug until disease progression, unacceptable toxicity or patient refusal. Disease assessment will be performed every 8 weeks according to RECIST criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Non-Small-Cell Lung
Keywords
ROS1 positive, NSCLC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Lorlatinb Arm
Arm Type
Experimental
Arm Description
Eligible patients will be treated with Lorlatinib at the dose of 100 mg QD p.o.
Intervention Type
Drug
Intervention Name(s)
Lorlatinib
Other Intervention Name(s)
Lorlatinb
Intervention Description
Lorlatinib is a novel small-molecule ROS1/ALK inhibitor that was optimized for robust brain penetration.
Primary Outcome Measure Information:
Title
Response rate to PF-06463922 in patients with ROS1 translocation resistant to crizotinib
Description
Response rate to PF-06463922 in patients with ROS1 translocation resistant to crizotinib
Time Frame
From date of the first enrolment until the date of last documented progression or date of death from any cause, assessed up to 36 months
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS), The length of time during and after the treatment of a disease,that a patient lives with the disease but it doesn't get worse.
Description
Progression-free survival (PFS) will be calculated from the time between the baseline/start of treatment visit to the time of first occurrence of progressive disease (PD) or death from any cause. Patients who have neither progressed nor died at time of analysis will be censored at the date of last tumor assessment where non progression was documented (i.e. CR, PR or SD)
Time Frame
From date of the first enrolment until the date of last documented progression or date of death from any cause, assessed up to 36 months
Title
Overall Survival (OS): Time from the start of treatment until death from any cause
Description
Overall survival (OS) will be calculated from the time between the baseline/start of treatment visit to the date of death, irrespective of the cause of death. Patients still alive at the time of analysis will be censored at the date they were last known to be alive
Time Frame
From date of the first enrolment until the date of last documented progression or date of death from any cause, assessed up to 36 months
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
Patients will be closely monitored for signs and symptoms of potential adverse events, and will undergo frequent laboratory tests to assess lipids, pancreas, liver, kidney, and haematological function.
Time Frame
From date of the first enrolment until the date of last documented progression or date of death from any cause, assessed up to 36 months
Title
Correlation with additional tumor biomarkers in tumor tissue or blood
Description
Correlation with additional tumor biomarkers in tumor tissue or blood
Time Frame
From date of the first enrolment until the date of last documented progression or date of death from any cause, assessed up to 36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent; Male or female patient ages ≥ 18 years; Histologically/cytologically confirmed diagnosis of NSCLC with evidence of ROS1 rearrangement; Possibility to perform a new tumor biopsy or tumor tissue collected at the time or after crizotinib failure; Patient pretreated with crizotinib with evidence of disease progression during crizotinib therapy; At least one radiological measurable disease according to RECIST criteria; At least 1 previous standard chemotherapy regimen; Performance status 0-2 (ECOG); Patient compliance to trial procedures Adequate bone marrow function (ANC ≥ 1.5x109/L, platelets ≥ 100x109/L, haemoglobin > 9 g/dl); Adequate liver function (bilirubin < grade 2, transaminases no more than 3xULN/<5xULN in present of liver metastases); Normal level of alkaline phosphatase and creatinine; If female: childbearing potential either terminated by surgery, radiation, or menopause, or attenuated by use of approved contraceptive method [intrauterine contraceptive device (IUD), birth control pills, or barrier device] during and for ninety (90) days after end of treatment. Exclusion Criteria: 1. No ROS1 rearrangement 2. No previous therapy with crizotinib; 3. No evidence of crizotinib failure; 4. No post-crizotinib tumor tissue available; 5. Absence of any measurable lesions; 6. No previous chemotherapy; 7. Concomitant radiotherapy or chemotherapy; 8. Symptomatic brain metastases; 9. Diagnosis of any other malignancy during the last 5 years, except for in situ carcinoma of cervix uteri and squamous cell carcinoma of the skin; 10. Predisposing factors for acute pancreatitis (e.g., uncontrolled hyperglycaemia, current gallstone disease, alcoholism); 11. History of extensive disseminated/bilateral or known presence of Grade 3 or 4 interstitial fibrosis or interstitial lung disease including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, interstitial lung disease, obliterative bronchiolitis and pulmonary fibrosis (but not history of prior radiation pneumonitis); 12. Pregnancy or lactating female; 13. Other serious illness or medical condition potentially interfering with the study. -
Facility Information:
Facility Name
IRCCS - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)- Oncologia Medica
City
Meldola
State/Province
Forlì- Cesena
ZIP/Postal Code
47014
Country
Italy
Facility Name
Sacro Cuore- Don Calabria Hospital- U.O.C. Oncologia Medica
City
Negrar
State/Province
Verona
ZIP/Postal Code
37024
Country
Italy
Facility Name
Istituto Toscano Tumori Ospedale San Donato- U.O.C. di Oncologia Medica Dipartimento di Oncologia USL-8
City
Arezzo
ZIP/Postal Code
52100
Country
Italy
Facility Name
Azienda Ospedaliera di Rilievo Nazionale "S.G. Moscati"
City
Avellino
ZIP/Postal Code
83100
Country
Italy
Facility Name
IRCCS Istituto Tumori Giovanni Paolo II
City
Bari
ZIP/Postal Code
70124
Country
Italy
Facility Name
IRCCS A.O.U. San Martino- IST- Istituto Nazionale per la Ricerca sul Cancro- U.O.S. Tumori Polmonari
City
Genova
ZIP/Postal Code
16132
Country
Italy
Facility Name
Istituto Europeo di Oncologia - Divisione di Oncologia Toracica
City
Milano
ZIP/Postal Code
20141
Country
Italy
Facility Name
A.O.U. Policlinico di Modena- Oncologia Ematologia e Malattie Apparato Respiratorio
City
Modena
ZIP/Postal Code
41124
Country
Italy
Facility Name
A.O. San Gerardo
City
Monza
ZIP/Postal Code
20900
Country
Italy
Facility Name
Istituto Nazionale Tumori IRCCS Fondazione Pascale
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Istituto Oncologico Veneto IRCCS- UOS Oncologia Toracica UOC. Oncologia Medica 2
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Casa di Cura La Maddalena- U.O. Oncologia medica
City
Palermo
ZIP/Postal Code
90146
Country
Italy
Facility Name
Azienda Ospedaliera Universitaria di Parma- Struttura Complessa di Oncologia Medica
City
Parma
ZIP/Postal Code
43126
Country
Italy
Facility Name
Azienda Ospedaliera di Perugia- S.C. Oncologia Medica
City
Perugia
ZIP/Postal Code
06132
Country
Italy
Facility Name
Ospedale di Ravenna- Oncologia Medica
City
Ravenna
ZIP/Postal Code
48121
Country
Italy
Facility Name
Ospedale "Infermi" Rimini
City
Rimini
ZIP/Postal Code
47900
Country
Italy
Facility Name
ASST della Valle Olona - Ospedale di Saronno
City
Saronno
ZIP/Postal Code
21047
Country
Italy
Facility Name
A.O.U. San Luigi Gonzaga
City
Torino
ZIP/Postal Code
10043
Country
Italy
Facility Name
Azienda ULSS 9 TREVISO-UOC Oncologia Medica
City
Treviso
ZIP/Postal Code
31100
Country
Italy
Facility Name
Policlinico 'G.B.Rossi' Borgo Roma - A.O.U. Integrata (Giampaolo Tortora)- Oncologia Medica
City
Verona
ZIP/Postal Code
37134
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.cr-technology.com/fort/?studio_clinico=pfrost
Description
PFROST trial

Learn more about this trial

PF-06463922 for Crizotinib Pretreated ROS1 Positive Non-small-cell Lung Cancer

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