A Study of Pralsetinib Versus Standard of Care for First-Line Treatment of Advanced Non-Small Cell Lung Cancer (NSCLC) (AcceleRET-Lung)
RET-fusion Non Small Cell Lung Cancer, Lung Neoplasm, Carcinoma, Non-Small-Cell Lung
About this trial
This is an interventional treatment trial for RET-fusion Non Small Cell Lung Cancer focused on measuring Advanced Non-Small Cell Lung Cancer, RET Lung, RET Mutation, RET Alteration, RET Positive, RET Inhibitor, RET Altered, RET Rearrangement, RET NSCLC, RET-Rearranged NSCLC, RET Fusion, RET Fusion Lung Cancer, M918T, TRIM33-RET, Lung Cancer Mutation, BLU 667, Pralsetinib, RET Tyrosine Kinase, RET Gene Mutation, RET Kinase, Advanced Lung Cancer, Metastatic Lung Cancer, KIF5B-RET, CCDC6-RET
Eligibility Criteria
Inclusion criteria:
- Participant has pathologically confirmed, definitively diagnosed, locally advanced (not able to be treated with surgery or radiotherapy) or metastatic NSCLC and has not been treated with systemic anticancer therapy for metastatic disease.
- Participant must have a documented RET-fusion
- Participant has measurable disease based on RECIST 1.1 as determined by the local site Investigator/radiology assessment.
- Participant has an ECOG Performance Status of 0 or 1.
Participant should not have received any prior anticancer therapy for metastatic disease.
- Participants can have received previous anticancer therapy (except a selective RET inhibitor) in the neoadjuvant or adjuvant setting but must have experienced an interval of at least ≥ 6 months from completion of therapy to recurrence.
- Participants that received previous immune checkpoint inhibitors in the adjuvant or consolidation following chemoradiation are not allowed to receive pembrolizumab if randomized in Arm B
- Participant is an appropriate candidate for and agrees to receive 1 of the Investigator choice platinum-based chemotherapy regimens if randomized to Arm B.
- For women of childbearing potential: participants who agree to remain abstinent (refrain from heterosexual intercourse) or use contraception.
- For men: participants who agree to remain abstinent (refrain from heterosexual intercourse) or use a condom and agree to refrain from donating sperm.
Exclusion criteria:
- Participant's tumor has any additional known primary driver alterations other than RET, such as targetable mutations of EGFR, ALK, ROS1, MET, and BRAF. Investigators should discuss enrollment with Sponsor designee regarding co-mutations.
- Participant previously received treatment with a selective RET inhibitor.
- Participant received radiotherapy or radiosurgery to any site within 14 days before randomization or more than 30 Gy of radiotherapy to the lung in the 6 months before randomization.
- Participant with a history of pneumonitis within the last 12 months.
- Participant has CNS metastases or a primary CNS tumor that is associated with progressive neurological symptoms or requires increasing doses of corticosteroids to control the CNS disease. If a participant requires corticosteroids for management of CNS disease, the dose must have been stable for the 2 weeks before Cycle 1 Day 1.
- Participant has had a history of another primary malignancy that has been diagnosed or required therapy within the past 3 years prior to randomization.
Sites / Locations
- UC Irvine Medical Center
- Southern California Kaiser Permanente
- Sylvester Comprehensive Cancer Center; University of Miami School of Medicine
- University of Maryland Marlene and Stewart Greenebaum Cancer Center
- University of Michigan Hospital
- UPMC - Hillman Cancer Center
- Texas Oncology - Baylor Charles A. Sammons Cancer Center
- University of Texas Health Science Center
- Millennium Research & Clinical DevelopmentRecruiting
- Fundación CENIT para la Investigación en NeurocienciasRecruiting
- Hospital Britanico; OncologiaRecruiting
- Centro Oncologico Korben; OncologyRecruiting
- Centro Oncologico Riojano Integral (CORI)Recruiting
- Royal North Shore Hospital; Department of Medical OncologyRecruiting
- Flinders Medical CentreRecruiting
- Mogilev Regional Oncology Center
- State Inst N.N. Alexandrov Republican Scientific & Practical Centre of Oncology & Medical Radiology
- Vitebsk Regional Clinical Oncology Dispensary
- Institut Jules Bordet; Pulmonary Oncology
- UZ AntwerpenRecruiting
- Liga Norte Riograndense Contra O CâncerRecruiting
- Oncosite - Centro de Pesquisa Clinica Em Oncologia LtdaRecruiting
- Hospital Sao Lucas - PUCRSRecruiting
- Instituto do Cancer do Estado de Sao Paulo - ICESPRecruiting
- Hospital A. C. Camargo; OncologiaRecruiting
- Institut universitaire de cardiologie et de pneumologie de Québec (Hôpital Laval)
- Clinica CIMCARecruiting
- Rigshospitalet, Onkologisk Klinik; Klinisk Forskningsenhed
- Helsinki University Central Hospital; Dept of Oncology
- Institut Bergonie CLCC BordeauxRecruiting
- Hôpital Ambroise Paré - Boulogne-BillancourtRecruiting
- Hôpital Louis Pradel, Hospices Civils de LyonRecruiting
- CHRU Lille Service de Pneumologie et Oncologie ThoraciqueRecruiting
- Institut Paoli Calmettes; Oncologie MedicaleRecruiting
- Hopital Bichat Claude Bernard; Oncologie Serv.Recruiting
- Institut Curie; Oncologie Medicale
- Hopital Tenon;PneumologieRecruiting
- Hopital de Pontchaillou; Service de PneumologieRecruiting
- Ico Rene Gauducheau; OncologieRecruiting
- CHU Strasbourg - Nouvel Hopital CivilRecruiting
- CHU de Toulouse - Hôpital Larrey; Service de pneumologie et oncologie pneumologiqueRecruiting
- Institut Gustave Roussy; Departement Oncologie MedicaleRecruiting
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik I, Pneumologie MK1-A13
- Klinikum Esslingen
- Asklepios-Fachkliniken Muenchen-Gauting; Onkologie
- Thoraxklinik Heidelberg gGmbH
- Klinikum der Universität München; Campus Großhadern; Med. Klinik und Poliklinik V
- Pius-Hospital; Klinik fuer Haematologie und Onkologie
- Leopoldina-Krankenhaus Medizinische Klinik IIRecruiting
- Klinik Schillerhöhe; Pneumologische OnkologieRecruiting
- St. James Hospital; OncologyRecruiting
- Shaare Zedek Medical Center; Oncology Dept
- Meir Medical Center; Oncology
- Sourasky / Ichilov Hospital; Dept. of Oncology
- Ospedale Clinicizzato SS Annunziata
- Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione G. PascaleRecruiting
- Università degli Studi della Campania Luigi VanvitelliRecruiting
- Ospedale Provinciale Santa Maria Delle Croci; Oncologia Medica
- Istituto Nazionale Tumori Regina Elena
- AZ. Ospedaliera San Giovanni - Addolorata
- Azienda Ospedaliera Sant'AndreaRecruiting
- Irccs Ospedale San RaffaeleRecruiting
- Fondazione IRCCS Istituto Nazionale dei Tumori
- Istituto Europeo Di Oncologia
- A.O.U. Maggiore della CaritàRecruiting
- IRCCS Giovanni Paolo II Istituto Oncologico
- Azienda Ospedaliera Universitaria Pisana - Ospedale Cisanello; Dipartimento Cardio Toraco VascolareRecruiting
- IOV - Istituto Oncologico Veneto - IRCCS; Oncologia Medica IIRecruiting
- A.O.U. INTEGRATA DI VERONA-Ospedale Civile Maggiore Borgo Trento; U.O.C. OncologiaRecruiting
- Nagoya University HospitalRecruiting
- Hirosaki University HospitalRecruiting
- National Cancer Center Hospital EastRecruiting
- Ehime University HospitalRecruiting
- Kyushu University HospitalRecruiting
- Kurume University HospitalRecruiting
- National Hospital Organization Hokkaido Cancer CenterRecruiting
- National Hospital Organization Himeji Medical Center
- Iwate Medical University HospitalRecruiting
- Kanagawa Cancer CenterRecruiting
- Sendai Kousei HospitalRecruiting
- Niigata Cancer Center HospitalRecruiting
- Kurashiki Central HospitalRecruiting
- Osaka City General HospitalRecruiting
- Osaka International Cancer Institute
- Kansai Medical University Hospital
- Saitama Cancer CenterRecruiting
- Juntendo University Hospital
- The Cancer Institute Hospital of JFCR
- National Hospital Organization Yamaguchi - Ube Medical Center
- National Cancer CenterRecruiting
- Seoul National University Hospital
- Severance Hospital, Yonsei University Health System
- Asan Medical CenterRecruiting
- COI Centro Oncologico Internacional SAPI de CV
- Health Pharma Professional Research
- Oncologico PotosinoRecruiting
- NKI/AvL
- Universitair Medisch Centrum GroningenRecruiting
- Maastricht University Medical CenterRecruiting
- Auckland City Hospital, Cancer and Blood ResearchRecruiting
- Oslo universitetssykehus HF, Ullevål, KreftsenteretRecruiting
- Hemato Oncología de Panamá Especializada
- Narod.Inst.Onkol. im. M.Sklodowskiej - Curie-Panst.Inst.Bad; Klinika Nowot.Pluca i Klatki PiersRecruiting
- Hospital Garcia de Orta; Servico de PneumologiaRecruiting
- Hospital de Braga; Serviço de PneumologiaRecruiting
- IPO do Porto; Servico de Oncologia Medica
- Centro Hospitalar de Vila Nova de Gaia / Espinho E.P.ERecruiting
- Hospital Univ. Central de Asturias; Servicio de OncologiaRecruiting
- Hospital Universitario Germans Trias i PujolRecruiting
- Insititut Catala D'OncologiaRecruiting
- Hospital Universitario Marques de Valdecilla; Servicio de Oncologia
- Complejo Hospitalario Universitario A CoruñaRecruiting
- Hospital Universitario Puerta de Hierro; Servicio de OncologiaRecruiting
- Hospital Universitari Vall d'HebronRecruiting
- Hospital Clínic. BarcelonaRecruiting
- Hospital General Universitario Gregorio Marañon; Servicio de OncologiaRecruiting
- Hospital Ramon y Cajal; Servicio de Oncologia
- Hospital Universitario 12 de OctubreRecruiting
- HOSPITAL DE MADRID NORTE SANCHINARRO- CENTRO INTEGRAL ONCOLOGICO CLARA CAMPAL; Servicio de OncologiaRecruiting
- Hospital Regional Universitario de MalagaRecruiting
- Hospital Universitario Virgen del Rocio; Servicio de OncologiaRecruiting
- Hospital General Universitario de Valencia; Servicio de oncologiaRecruiting
- Hosp Clinico Univ Lozano Blesa; División De Oncología MédicaRecruiting
- Karolinska Universitetssjukhuset, Solna; Kliniska prövningsenheten Z:4:01Recruiting
- UniversitätsSpital Zürich; Zentrum für Hämatologie und Onkologie, Klinik für OnkologieRecruiting
- Adana City Hospital, Medical OncologyRecruiting
- Adana Baskent University Hospital; Medical OncologyRecruiting
- Ankara Bilkent City Hospital
- Medipol Mega Üniversite Hastanesi GöztepeRecruiting
- ?zmir Medical Point; OncologyRecruiting
- Medical Park Seyhan Hospital; Oncology DepartmentRecruiting
- CI of Kherson Regional Council Kherson Regional Oncology Dispensary
- Ivano-Frankivsk Regional Oncology Center
- MI Zaporizhzhia Regional Clinical Oncological Dispensary Zaporizhzhia SMU Ch of Oncology
- Velindre Cancer Centre; Oncology DeptRecruiting
- Leicester Royal Infirmary; Dept. of Medical OncologyRecruiting
- University College Hospital; Department of OncologyRecruiting
- Guys & St Thomas Hospital; Department of OncologyRecruiting
- Royal Marsden Hospital; Dept of Med-OncRecruiting
- Christie Hospital Nhs Trust; Medical OncologyRecruiting
- Royal Marsden Hospital; Dept of Medical OncologyRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pralsetinib
Platinum-based chemotherapy with or without pembrolizumab
Participants randomized to the Experimental Arm will receive Pralsetinib
Participants randomized to the Active Comparator Arm will receive 1 of 6 platinum-based chemotherapy treatment regimens (with or without pembrolizumab) at the study center as chosen by the treating Investigator (based on histology) Nonsquamous histology Carboplatin or cisplatin / pemetrexed (with vitamin supplementation); with optional pemetrexed (with vitamin supplementation) maintenance. Pembrolizumab / carboplatin or cisplatin / pemetrexed (with vitamin supplementation); followed by pembrolizumab and optional pemetrexed (with vitamin supplementation) maintenance. Squamous histology Carboplatin or cisplatin / gemcitabine Carboplatin with paclitaxel/nab-paclitaxel and pembrolizumab