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Study Comparing WX-0593 to Crizotinib in ALK Positive Non-Small Cell Lung Cancer (NSCLC) Patients

Primary Purpose

Non-small Cell Lung Cancer

Status
Unknown status
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
WX-0593 Tablets
crizotinib
Sponsored by
Qilu Pharmaceutical 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 - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. ≥18 years
  2. Female or male
  3. Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  4. Life expectancy of at least 12 weeks.
  5. At least one measurable lesion (according to RECIST v1.1)
  6. Histologically or cytologically confirmed diagnosis of advanced or recurrent or metastatic NSCLC that is ALK-positive by an Abbott FISH assay in the central lab. Randomization will occur after ALK positive confirmation is received from the central lab or local test using an method including Abbott FISH、RT-PCR or Ventana IHC.
  7. No brain metastasis, or asymptomatic brain metastasis, or symptomatic brain metastasis but stable for more than 4 weeks after treatment, and have stopped systemic hormone treatment (prednisone of > 10 mg/day or equivalent hormone) for more than 2 weeks
  8. Patients must have normal function as defined: ANC≥1.5*10^9/L; PLT≥90*10^9/L, Hb≥90 g/L, Total Bilirubin (TBIL)≤1.5*Upper Limit of Normal(ULN) ( Gilbert's Syndrome TBIL ≤3.0*ULN and DBIL≤1.5*ULN ),Alanine Transaminase (ALT)and Aspartate Aminotransferase(AST)≤2.5*ULN. For liver metastasis patients, ALT and AST≤5*ULN, Cr≤1.5*ULN, LVEF≥50%.
  9. Any surgery or prior radiation (expect for palliative radiation) /operations must have been completed at least 4 weeks prior to first dosing. Palliative radiation must have been completed at least 48 hours prior to first dosing.
  10. Patients must be able to understand and volunteer to sign the informed consent.

Exclusion Criteria:

  1. Patients that have previously received cancer therapy (i.e., other targeted therapies, chemotherapy, immunotherapy, biologic therapy, hormonal therapy).
  2. Patients with tumor meningeal metastasis
  3. Clinically significant cardiovascular disease within 6 months prior to first dosing.
  4. Two consecutive corrected QT interval (QTc) > 480 ms through ECG examination during screening, ≥2 arrhythmias, ≥2 heart failure (according to CTCAE 4.03), atrial fibrillation and ventricular fibrillation of any grade, or clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention
  5. Patients need medications that may prolong QT interval or induce torsades de pointes within 14 days prior to the first dosing or during the study.
  6. Continuous use of corticosteroids for more than 30 days, or require chronic use of corticosteroids or other immunosuppressants
  7. Past history of a large area of diffuse/interstitial pulmonary fibrosis, or known history of Grade 3 or 4 interstitial pulmonary fibrosis or interstitial lung disease.
  8. Patients with Grade > 1 nausea, vomiting, or diarrhea (CTCAE 4.03), other GI dysfunction or GI disease that may potentially affect drug absorption.
  9. Patients at risk for GI perforation or intestinal obstruction
  10. Patient has received other investigational drug within 1 month prior to first dosing. Subject received other clinical trial treatment within 1 month prior to the first dose of the investigational drug.
  11. Patients who are HBsAg-positive and/or HBcAB positive and HBV DNA > 103copies/mL, or HCV antibody-positive, or syphilis antibody- positive or known HIV infected.
  12. Patients who cannot suspend the use of a strong CYP3A4 inducer or inhibitor at least 1 weeks prior to this study and during the study.
  13. Patients who cannot suspend the use of a CYP3A4 substrate at least 1 weeks prior to this study and during the study, and the therapeutic index is low.
  14. Females who are pregnant or breastfeeding. Pregnant or lactating female patients or a positive pregnancy test at baseline for females of childbearing potential.
  15. Female patients who are unwilling to use effective contraceptive measures during the entire course of the study and within 6 months after the end of the study, or male patients who plan to have children.
  16. Concurrent diseases that may seriously affect patient safety or impact patient completion of the study as determined by the investigator (such as clinically uncontrolled hypertension (blood pressure > 160/110 mmHg), severe diabetes, or thyroid disease).
  17. Drug abusers and alcoholics. Drug or alcohol abuse. Alcohol abuse refers to drinking 14 units of alcohol per week: 1 unit = 285mL of beer, or 25mL of spirits, or 100mL of wine;
  18. History of definitive neurological or mental disorder, including epilepsy or dementia
  19. Patients with other malignant tumors within 5 years prior to screening (except for cured basal cell carcinoma of the skin, cervical carcinoma in situ, thyroid carcinoma in situ, and papillary thyroid carcinoma).
  20. Patients with added risks associated with the study or may interfere with the interpretation of study results as determined by the investigator, or deemed unsuitable by the investigator and/or sponsor.

Sites / Locations

  • Cancer Institute and Hospital, Chinese Academy of Medical SciencesRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

WX-0593 Tablets

crizotinib

Arm Description

Eligible patients with ALK+ NSCLC will receive WX-0593 tablets without food until documented disease progression or unacceptable toxicity. 60 mg of WX-0593 tablets, once daily for 7 days, followed by 180 mg of WX-0593 tablets, once daily in a 28-days cycle.

Eligible patients with ALK+ NSCLC will receive oral crizotinib at 250mg BID without food until documented disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS)
PFS as assessed by independent radiology review based on RECIST v. 1.1 criteria

Secondary Outcome Measures

Progression-free survival (PFS)
PFS based on investigator assessment
OS
Overall survival (OS)
Confirmed Objective Response Rate (ORR) Assessed By independent radiology review
ORR is defined the percentage of the participants who have achieved complete response (CR) or partial response (PR) per independent radiology review using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.
Confirmed Objective Response Rate (ORR) Assessed By Investigators
ORR is defined the percentage of the participants who have achieved complete response (CR) or partial response (PR) per Investigators using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.
Time to Response (TTR) Assessed By independent radiology
Assessed from date of the first dose until the date of progression per independent radiology review
Time to Response (TTR) Assessed By Investigators
Assessed from date of the first dose until the date of progression per investigator.
Duration of response (DOR) Assessed By independent radiology
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
Duration of response (DOR) Assessed By Investigators
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
CNS response rate based on independent radiology review
CNS response rate based on independent radiology review
CNS response rate based on investigator assessment
CNS response rate based on investigator assessment
Time to CNS progression
Time to CNS progression
Percentage of patients with adverse events
the incidence of adverse events, including adverse events (AEs), serious adverse events (SAEs), treatment-emergent adverse events (TEAEs). Causality is determined by the investigator.
Plasma concentrations (Cssmin)
Minimum value of steady plasma-drug concentration for WX-0593 at participating sites
Patient reported time to deterioration (TTD)
Patient reported time to deterioration (TTD) as measured by EORTC C30/LC13 QoL questionnaire
Patient reported time to deterioration (TTD)
Patient reported time to deterioration (TTD) as measured by Lung Cancer Symptom Scale (LCSS) questionnaire
Patient reported health-related quality of life (HRQoL)
Patient reported health-related quality of life (HRQoL) as measured by EORTC C30/LC13 QoL questionnaire
Patient reported health-related quality of life (HRQoL)
Patient reported health-related quality of life (HRQoL) as measured by Lung Cancer Symptom Scale (LCSS) questionnaire

Full Information

First Posted
September 5, 2020
Last Updated
November 11, 2020
Sponsor
Qilu Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04632758
Brief Title
Study Comparing WX-0593 to Crizotinib in ALK Positive Non-Small Cell Lung Cancer (NSCLC) Patients
Official Title
An Open-label, Randomized, Multicenter Phase 3 Study Comparing WX-0593 to Crizotinib in Anaplastic Lymphoma Kinase (ALK) Positive Non-Small Cell Lung Cancer (NSCLC) Patients
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 1, 2019 (Actual)
Primary Completion Date
June 1, 2021 (Anticipated)
Study Completion Date
December 1, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Qilu Pharmaceutical 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
The primary purpose of this study is to evaluate the efficacy and safety of WX-0593 vs. crizotinib in patients with ALK-positive non-small cell lung cancer who had not received prior systemic therapy
Detailed Description
To evaluate the efficacy and safety of WX-0593 vs. crizotinib in patients with ALK-positive NSCLC who had not received prior systemic therapy, to obtain additional pharmacokinetic (PK) data from sparse PK sampling, to compare the quality of life (QoL) in patients receiving WX-0593 vs. crizotinib, to evaluate the status of exploratory biomarkers and correlate with clinical outcome, and to obtain germline DNA samples for possible pharmacogenetic analysis in the event that outliers with respect to efficacy, tolerability/safety, or exposure are identified.

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 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
330 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
WX-0593 Tablets
Arm Type
Experimental
Arm Description
Eligible patients with ALK+ NSCLC will receive WX-0593 tablets without food until documented disease progression or unacceptable toxicity. 60 mg of WX-0593 tablets, once daily for 7 days, followed by 180 mg of WX-0593 tablets, once daily in a 28-days cycle.
Arm Title
crizotinib
Arm Type
Active Comparator
Arm Description
Eligible patients with ALK+ NSCLC will receive oral crizotinib at 250mg BID without food until documented disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
WX-0593 Tablets
Other Intervention Name(s)
FL-006
Intervention Description
tablets, 60 mg→180mg, QD
Intervention Type
Drug
Intervention Name(s)
crizotinib
Intervention Description
Capsules, 250mg, BID
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
PFS as assessed by independent radiology review based on RECIST v. 1.1 criteria
Time Frame
from randomization until firstly recorded disease progression or death (whichever occurs earlier), or to the date that the last patients observed for 12 months
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS based on investigator assessment
Time Frame
from randomization until firstly recorded disease progression or death (whichever occurs earlier), or to the date that the last patients observed for 12 months
Title
OS
Description
Overall survival (OS)
Time Frame
from randomization until death due to any cause, withdraws informed consent, is lost to follow-up or refuses phone visits, or study completion(up to 2.5 years)
Title
Confirmed Objective Response Rate (ORR) Assessed By independent radiology review
Description
ORR is defined the percentage of the participants who have achieved complete response (CR) or partial response (PR) per independent radiology review using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Confirmed Objective Response Rate (ORR) Assessed By Investigators
Description
ORR is defined the percentage of the participants who have achieved complete response (CR) or partial response (PR) per Investigators using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Time to Response (TTR) Assessed By independent radiology
Description
Assessed from date of the first dose until the date of progression per independent radiology review
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Time to Response (TTR) Assessed By Investigators
Description
Assessed from date of the first dose until the date of progression per investigator.
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Duration of response (DOR) Assessed By independent radiology
Description
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Duration of response (DOR) Assessed By Investigators
Description
The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
CNS response rate based on independent radiology review
Description
CNS response rate based on independent radiology review
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
CNS response rate based on investigator assessment
Description
CNS response rate based on investigator assessment
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Time to CNS progression
Description
Time to CNS progression
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Percentage of patients with adverse events
Description
the incidence of adverse events, including adverse events (AEs), serious adverse events (SAEs), treatment-emergent adverse events (TEAEs). Causality is determined by the investigator.
Time Frame
from the signing of the informed consent form until at least 28 days after the last dose of study drug was administered.
Title
Plasma concentrations (Cssmin)
Description
Minimum value of steady plasma-drug concentration for WX-0593 at participating sites
Time Frame
Cssmin before dosing on Cycle 1 Day 1, Cycle 1 Day 7, Cycle 1 Day 21, Cycle 2 Day 21, and Cycle 4 Day 21
Title
Patient reported time to deterioration (TTD)
Description
Patient reported time to deterioration (TTD) as measured by EORTC C30/LC13 QoL questionnaire
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Patient reported time to deterioration (TTD)
Description
Patient reported time to deterioration (TTD) as measured by Lung Cancer Symptom Scale (LCSS) questionnaire
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Patient reported health-related quality of life (HRQoL)
Description
Patient reported health-related quality of life (HRQoL) as measured by EORTC C30/LC13 QoL questionnaire
Time Frame
From fist administration to the date that the last patients observed for 12 months
Title
Patient reported health-related quality of life (HRQoL)
Description
Patient reported health-related quality of life (HRQoL) as measured by Lung Cancer Symptom Scale (LCSS) questionnaire
Time Frame
From fist administration to the date that the last patients observed for 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ≥18 years Female or male Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. Life expectancy of at least 12 weeks. At least one measurable lesion (according to RECIST v1.1) Histologically or cytologically confirmed diagnosis of advanced or recurrent or metastatic NSCLC that is ALK-positive by an Abbott FISH assay in the central lab. Randomization will occur after ALK positive confirmation is received from the central lab or local test using an method including Abbott FISH、RT-PCR or Ventana IHC. No brain metastasis, or asymptomatic brain metastasis, or symptomatic brain metastasis but stable for more than 4 weeks after treatment, and have stopped systemic hormone treatment (prednisone of > 10 mg/day or equivalent hormone) for more than 2 weeks Patients must have normal function as defined: ANC≥1.5*10^9/L; PLT≥90*10^9/L, Hb≥90 g/L, Total Bilirubin (TBIL)≤1.5*Upper Limit of Normal(ULN) ( Gilbert's Syndrome TBIL ≤3.0*ULN and DBIL≤1.5*ULN ),Alanine Transaminase (ALT)and Aspartate Aminotransferase(AST)≤2.5*ULN. For liver metastasis patients, ALT and AST≤5*ULN, Cr≤1.5*ULN, LVEF≥50%. Any surgery or prior radiation (expect for palliative radiation) /operations must have been completed at least 4 weeks prior to first dosing. Palliative radiation must have been completed at least 48 hours prior to first dosing. Patients must be able to understand and volunteer to sign the informed consent. Exclusion Criteria: Patients that have previously received cancer therapy (i.e., other targeted therapies, chemotherapy, immunotherapy, biologic therapy, hormonal therapy). Patients with tumor meningeal metastasis Clinically significant cardiovascular disease within 6 months prior to first dosing. Two consecutive corrected QT interval (QTc) > 480 ms through ECG examination during screening, ≥2 arrhythmias, ≥2 heart failure (according to CTCAE 4.03), atrial fibrillation and ventricular fibrillation of any grade, or clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention Patients need medications that may prolong QT interval or induce torsades de pointes within 14 days prior to the first dosing or during the study. Continuous use of corticosteroids for more than 30 days, or require chronic use of corticosteroids or other immunosuppressants Past history of a large area of diffuse/interstitial pulmonary fibrosis, or known history of Grade 3 or 4 interstitial pulmonary fibrosis or interstitial lung disease. Patients with Grade > 1 nausea, vomiting, or diarrhea (CTCAE 4.03), other GI dysfunction or GI disease that may potentially affect drug absorption. Patients at risk for GI perforation or intestinal obstruction Patient has received other investigational drug within 1 month prior to first dosing. Subject received other clinical trial treatment within 1 month prior to the first dose of the investigational drug. Patients who are HBsAg-positive and/or HBcAB positive and HBV DNA > 103copies/mL, or HCV antibody-positive, or syphilis antibody- positive or known HIV infected. Patients who cannot suspend the use of a strong CYP3A4 inducer or inhibitor at least 1 weeks prior to this study and during the study. Patients who cannot suspend the use of a CYP3A4 substrate at least 1 weeks prior to this study and during the study, and the therapeutic index is low. Females who are pregnant or breastfeeding. Pregnant or lactating female patients or a positive pregnancy test at baseline for females of childbearing potential. Female patients who are unwilling to use effective contraceptive measures during the entire course of the study and within 6 months after the end of the study, or male patients who plan to have children. Concurrent diseases that may seriously affect patient safety or impact patient completion of the study as determined by the investigator (such as clinically uncontrolled hypertension (blood pressure > 160/110 mmHg), severe diabetes, or thyroid disease). Drug abusers and alcoholics. Drug or alcohol abuse. Alcohol abuse refers to drinking 14 units of alcohol per week: 1 unit = 285mL of beer, or 25mL of spirits, or 100mL of wine; History of definitive neurological or mental disorder, including epilepsy or dementia Patients with other malignant tumors within 5 years prior to screening (except for cured basal cell carcinoma of the skin, cervical carcinoma in situ, thyroid carcinoma in situ, and papillary thyroid carcinoma). Patients with added risks associated with the study or may interfere with the interpretation of study results as determined by the investigator, or deemed unsuitable by the investigator and/or sponsor.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shunjiang Yu, CMO
Phone
0531-83129659
Email
shunjiang.yu@qilu-pharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yuankai Shi, M.D
Phone
010-67781331
Email
syuankaipumc@126.com
Facility Information:
Facility Name
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuankai Shi, M.D.
Phone
010-67781331
Email
syuankaipumc@126.com

12. IPD Sharing Statement

Learn more about this trial

Study Comparing WX-0593 to Crizotinib in ALK Positive Non-Small Cell Lung Cancer (NSCLC) Patients

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