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A Study of RC48-ADC in Subjects With Advanced Non-small Cell Lung Cancer

Primary Purpose

Non Small Cell Lung Cancer

Status
Active
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
RC48
Sponsored by
RemeGen Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Small Cell Lung Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Voluntary signed informed consent.
  2. Male or female, Aged between 18 to 75 years.
  3. Predicted survival ≥ 12 weeks.
  4. According to UICC/AJCC 8th Edition, histologically and/or cytologically-confirmed, cannot be surgically removed, locally advanced or metastatic NSCLC.
  5. Locally advanced or metastatic disease had failed at least one systemic treatment.
  6. Based on imaging judgment (RECIST 1.1) or clinical status, tumor progression during or after the last treatment before enrollment.
  7. HER2 protein overexpression (IHC 2+ or 3 +) or HER2 gene mutation (defined as exon 20 mutation), the previous test results confirmed by the researchers, both research centers and major research centers can be acceptable.
  8. The researchers confirmed that the EGFR gene mutation status was negative or positive. For EGFR gene mutation-positive patients, one of the following is met: 1) T790M gene mutation negative, c-Met gene amplification negative and HER2 IHC 2+ or 3+ after first-generation EGFR-TKI drug resistance; 2) Third-generation EGFR-TKI treatment failed and HER2 IHC 2+ or 3+.
  9. Measurable lesion according to the RECIST 1.1.
  10. ECOG performance status score of 0 or 1.
  11. Adequate organ function: LVEF ≥ 50 %. Hemoglobin ≥ 9g/dL; ANC ≥ 1.5×10^9 /L; Platelets ≥ 100×10^9 /L; Total bilirubin ≤ 1.5×ULN; ALT, AST and ALP ≤ 2.5×ULN and ≤ 5 x ULN with hepatic metastasis; Serum creatinine ≤1.5×ULN, or CrCl ≥ 60mL/min; INR≤ 1.5× ULN, APTT≤ 1.5× ULN.
  12. For female subjects: should be surgically sterilized, postmenopausal, or agree to use a medically approved contraceptive (such as an intrauterine device, contraceptives, or condoms) during study treatment and within 6 months after the end of study, the blood pregnancy test within 7 days of study enrollment must be negative and must be non-lactating. Male subjects: Patients who should be surgically sterilized or agree to use a medically approved contraceptive during the study treatment period and within 6 months after the end of the study.
  13. Willing and able to follow trial and follow-up procedures.

Exclusion Criteria:

  1. Have used T-DM1 or participated in other HER2-ADC clinical studies.
  2. Received anti-tumor treatment 4 weeks before study administration, including chemotherapy (late toxicity chemotherapy was 6 weeks before study administration), radiotherapy (palliative local radiotherapy for bone metastases was 2 weeks before the study administration), biological therapy (small molecule targeted drugs were 8 days before the study administration) or immunotherapy, etc.
  3. Major surgery was performed within 4 weeks prior to study administration and did not fully recover.
  4. Other clinical trial drugs have been used within 4 weeks before the start of study administration.
  5. Live vaccine received within 4 weeks before the start of study administration.
  6. Have received anti-tumor Chinese medicine treatment within 2 weeks before the start of study administration.
  7. History of other malignant tumors within 5 years before signing the informed consent (except for non-melanoma skin cancer, cervical carcinoma in situ that has been effectively treated, or malignant tumors that have been resolved for more than 3 years after effective treatment and are considered to be cured) .
  8. Toxicity of previous anti-tumor treatment has not recovered to CTCAE (version 4.03) 0-1, except for the following conditions: a. Hair loss; b. Pigmentation; c. Long-term toxicity caused by radiotherapy, which cannot be restored by the judgement of the investigator.
  9. Active central nervous system (CNS) metastasis and/or cancerous meningitis (subjects who have received brain metastasis treatment can participate in this study, provided that the condition is stable (no evidence of progression confirmed by imaging studies at least 4 weeks before study dosing, and all neurological symptoms have returned to baseline levels), no evidence of new or enlarged brain metastases, and discontinuation of steroid treatment at least 7 days before the first dose of trial treatment. This exception does not include cancerous meningitis, which should be excluded whether clinical status was stable).
  10. Diagnosed with HBsAg positive and HBV DNA positive, or HCV Ab positive, or HIV Ab positive.
  11. Severe arterial/venous thrombosis or cardio-cerebral vascular accidents occurred within 1 year before the study, such as deep vein thrombosis, pulmonary embolism, cerebral infarction, cerebral hemorrhage, myocardial infarction, etc.
  12. Active infections requiring systemic treatment.
  13. Other lung diseases required systemic treatment such as active tuberculosis, interstitial lung disease, etc.
  14. Uncontrolled systemic diseases such as diabetes, hypertension, cirrhosis, etc.
  15. Heart failure graded 3 or above by the NYHA.
  16. Pleural effusion, pericardial effusion, or peritoneal effusion with clinical symptoms that cannot be controlled by drainage or other methods.
  17. Mental illness or substance abuse known to have an impact on compliance with study requirements.
  18. Hypersensitivity or delayed allergic reaction to certain components of RC48-ADC or similar drugs.
  19. Any other disease, metabolic abnormality, abnormal physical examination or abnormal laboratory test, etc., based on the judgment of the investigator, it is reasonable to suspect that the patient has a certain disease or condition unsuitable for the research drug, or will affect the interpretation of the research results, or putting patients at high risk.
  20. Pregnant or lactating female or female / male who are planning to have children.
  21. Insufficient adherence to participate in this clinical study.
  22. Any other condition in which the investigator considers the patient unsuitable for this study.

Sites / Locations

  • Shanghai Pulmonary Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RC48

Arm Description

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR)
Objective Response Rate was defined as the percentage of participants with a complete response (CR) or partial response (PR).
Disease Control Rate (DCR)
Disease Control Rate (DCR) was defined as the percentage of patients with advanced or metastatic cancer who have achieved complete response, partial response and stable disease to a therapeutic intervention in clinical trials of anticancer agents.
Progression Free Survival (PFS)
Progression-free Survival (PFS) (median) was determined using the number of months measured from the initial date of treatment to the date of documented progression, or the date of death (in the absence of progression) of participants. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Duration of Response (DOR)
Duration of response is the length of time that a tumor continues to respond to treatment without the cancer growing or spreading.
Overall Survival (OS)
Overall survival, or OS, measures how long patients, who undergo a certain treatment regimen.

Secondary Outcome Measures

Adverse events (AEs)
The drug safety was assessed by investigator(s) according to NCI-CTCAE v4.03.

Full Information

First Posted
March 13, 2020
Last Updated
January 26, 2022
Sponsor
RemeGen Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04311034
Brief Title
A Study of RC48-ADC in Subjects With Advanced Non-small Cell Lung Cancer
Official Title
A Phase Ib Study to Evaluate the Efficacy and Safety of RC48-ADC for Injection in Subjects With Advanced Non-small Cell Lung Cancer With HER2 Overexpression or HER2 Mutation
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 26, 2018 (Actual)
Primary Completion Date
August 19, 2021 (Actual)
Study Completion Date
May 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RemeGen Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate the efficacy and safety of RC48-ADC for injection in subjects with advanced non-small cell lung cancer with HER2 overexpression or HER2 mutation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
37 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RC48
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
RC48
Intervention Description
Participants will be treated with RC48-ADC at a dose of 2.0 mg/kg, every 2 weeks. They will continue the medication until one of the following conditions occurred: disease progression, intolerance of toxicity, investigators believed that the subject could no longer benefit from treatment, or this study ended.
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
Objective Response Rate was defined as the percentage of participants with a complete response (CR) or partial response (PR).
Time Frame
15 months
Title
Disease Control Rate (DCR)
Description
Disease Control Rate (DCR) was defined as the percentage of patients with advanced or metastatic cancer who have achieved complete response, partial response and stable disease to a therapeutic intervention in clinical trials of anticancer agents.
Time Frame
15 months
Title
Progression Free Survival (PFS)
Description
Progression-free Survival (PFS) (median) was determined using the number of months measured from the initial date of treatment to the date of documented progression, or the date of death (in the absence of progression) of participants. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
15 months
Title
Duration of Response (DOR)
Description
Duration of response is the length of time that a tumor continues to respond to treatment without the cancer growing or spreading.
Time Frame
15 months
Title
Overall Survival (OS)
Description
Overall survival, or OS, measures how long patients, who undergo a certain treatment regimen.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Adverse events (AEs)
Description
The drug safety was assessed by investigator(s) according to NCI-CTCAE v4.03.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntary signed informed consent. Male or female, Aged between 18 to 75 years. Predicted survival ≥ 12 weeks. According to UICC/AJCC 8th Edition, histologically and/or cytologically-confirmed, cannot be surgically removed, locally advanced or metastatic NSCLC. Locally advanced or metastatic disease had failed at least one systemic treatment. Based on imaging judgment (RECIST 1.1) or clinical status, tumor progression during or after the last treatment before enrollment. HER2 protein overexpression (IHC 2+ or 3 +) or HER2 gene mutation (defined as exon 20 mutation), the previous test results confirmed by the researchers, both research centers and major research centers can be acceptable. The researchers confirmed that the EGFR gene mutation status was negative or positive. For EGFR gene mutation-positive patients, one of the following is met: 1) T790M gene mutation negative, c-Met gene amplification negative and HER2 IHC 2+ or 3+ after first-generation EGFR-TKI drug resistance; 2) Third-generation EGFR-TKI treatment failed and HER2 IHC 2+ or 3+. Measurable lesion according to the RECIST 1.1. ECOG performance status score of 0 or 1. Adequate organ function: LVEF ≥ 50 %. Hemoglobin ≥ 9g/dL; ANC ≥ 1.5×10^9 /L; Platelets ≥ 100×10^9 /L; Total bilirubin ≤ 1.5×ULN; ALT, AST and ALP ≤ 2.5×ULN and ≤ 5 x ULN with hepatic metastasis; Serum creatinine ≤1.5×ULN, or CrCl ≥ 60mL/min; INR≤ 1.5× ULN, APTT≤ 1.5× ULN. For female subjects: should be surgically sterilized, postmenopausal, or agree to use a medically approved contraceptive (such as an intrauterine device, contraceptives, or condoms) during study treatment and within 6 months after the end of study, the blood pregnancy test within 7 days of study enrollment must be negative and must be non-lactating. Male subjects: Patients who should be surgically sterilized or agree to use a medically approved contraceptive during the study treatment period and within 6 months after the end of the study. Willing and able to follow trial and follow-up procedures. Exclusion Criteria: Have used T-DM1 or participated in other HER2-ADC clinical studies. Received anti-tumor treatment 4 weeks before study administration, including chemotherapy (late toxicity chemotherapy was 6 weeks before study administration), radiotherapy (palliative local radiotherapy for bone metastases was 2 weeks before the study administration), biological therapy (small molecule targeted drugs were 8 days before the study administration) or immunotherapy, etc. Major surgery was performed within 4 weeks prior to study administration and did not fully recover. Other clinical trial drugs have been used within 4 weeks before the start of study administration. Live vaccine received within 4 weeks before the start of study administration. Have received anti-tumor Chinese medicine treatment within 2 weeks before the start of study administration. History of other malignant tumors within 5 years before signing the informed consent (except for non-melanoma skin cancer, cervical carcinoma in situ that has been effectively treated, or malignant tumors that have been resolved for more than 3 years after effective treatment and are considered to be cured) . Toxicity of previous anti-tumor treatment has not recovered to CTCAE (version 4.03) 0-1, except for the following conditions: a. Hair loss; b. Pigmentation; c. Long-term toxicity caused by radiotherapy, which cannot be restored by the judgement of the investigator. Active central nervous system (CNS) metastasis and/or cancerous meningitis (subjects who have received brain metastasis treatment can participate in this study, provided that the condition is stable (no evidence of progression confirmed by imaging studies at least 4 weeks before study dosing, and all neurological symptoms have returned to baseline levels), no evidence of new or enlarged brain metastases, and discontinuation of steroid treatment at least 7 days before the first dose of trial treatment. This exception does not include cancerous meningitis, which should be excluded whether clinical status was stable). Diagnosed with HBsAg positive and HBV DNA positive, or HCV Ab positive, or HIV Ab positive. Severe arterial/venous thrombosis or cardio-cerebral vascular accidents occurred within 1 year before the study, such as deep vein thrombosis, pulmonary embolism, cerebral infarction, cerebral hemorrhage, myocardial infarction, etc. Active infections requiring systemic treatment. Other lung diseases required systemic treatment such as active tuberculosis, interstitial lung disease, etc. Uncontrolled systemic diseases such as diabetes, hypertension, cirrhosis, etc. Heart failure graded 3 or above by the NYHA. Pleural effusion, pericardial effusion, or peritoneal effusion with clinical symptoms that cannot be controlled by drainage or other methods. Mental illness or substance abuse known to have an impact on compliance with study requirements. Hypersensitivity or delayed allergic reaction to certain components of RC48-ADC or similar drugs. Any other disease, metabolic abnormality, abnormal physical examination or abnormal laboratory test, etc., based on the judgment of the investigator, it is reasonable to suspect that the patient has a certain disease or condition unsuitable for the research drug, or will affect the interpretation of the research results, or putting patients at high risk. Pregnant or lactating female or female / male who are planning to have children. Insufficient adherence to participate in this clinical study. Any other condition in which the investigator considers the patient unsuitable for this study.
Facility Information:
Facility Name
Shanghai Pulmonary Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200433
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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A Study of RC48-ADC in Subjects With Advanced Non-small Cell Lung Cancer

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