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Inetetamab in Combination With Pyrotinib in HER2 Mutant or Amplified Advanced Non-small Cell Lung Cancer

Primary Purpose

Non-small Cell Lung Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
inetetamab
Pytotinib
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-small Cell Lung Cancer focused on measuring Non-small Cell Lung Cancer, Inetetamab, Pyrotinib, HER2-activated mutation, HER2-amplification

Eligibility Criteria

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

Inclusion Criteria:

  1. Age over 18;
  2. Histologically or cytologically documented metastatic NSCLC, HER2 activation amplification or mutation stage IIIB-IV NSCLC patient;
  3. At least 1 measurable lesion according to RECIST 1.1;
  4. ECOG score 0 or 1;
  5. Life expectancy of at least 3 months;
  6. Within one week before admission, blood routine examination was basically normal:

    1. hemoglobin ≥90g/L or ≥5.6mmol/L;
    2. neutrophil count (ANC) ≥ 1.5 × 10 ^ 9 / L;
    3. platelet count (PLT) ≥ 100 × 10 ^ 9 / L;
    4. Liver and kidney function tests were basically normal within one week before enrollment;
    5. total bilirubin (TBIL) ≤ 1.5 × upper limit of normal value (ULN);
    6. alanine aminotransferase (ALT / AST) ≤ 2.5 × ULN (liver metastasis patients ≤ 5xuln);
    7. serum creatinine ≤ 1.5 × ULN;
    8. Partially activated thrombin time(APTT)≤ 1.5 × ULN;
  7. For fertile women had negative blood pregnancy tests 7 days before screening;
  8. willing to participate and sign the informed consent in person.

Exclusion Criteria:

  1. Patients who have received anti-HER2 monoclonal antibody therapy;
  2. Have received chemotherapy, biotherapy, targeted therapy, immunotherapy and other anti-tumor therapies within 4 weeks prior to the first use of the study drug including: oral small molecule targeted drugs within 2 weeks prior to the first use of the study drug or within 5 half-lives of known drugs (depending on the time);Radiotherapy was performed within 2 weeks prior to the first administration of the study drug;
  3. Have received other clinical study drugs within 4 weeks prior to the first study drug administration;
  4. Patients who underwent major surgery within 4 weeks prior to the first dosing of the study drug(except needle biopsy or significant trauma);
  5. Those who have been known to have allergic history to the drug components of this regimen;
  6. Study drugs that had used a CYP3A4 inhibitor, inducer, or a narrow therapeutic window with a CYP3A4-sensitive substrate ,P-ep strong inducer and inhibitor within 14 days before first administration;
  7. The adverse reactions of previous antitumor therapy have not recovered to CTCAE 5.0 grade 1(Hair loss and other toxicities were excluded for which the researchers judged no safety risk);
  8. Patients with central nervous system metastasis and clinical symptoms;
  9. History of immunodeficiency, including positive HIV test, or suffering from other acquired, congenital immunodeficiency diseases, or history of organ transplantation;
  10. Active hepatitis B (HBV virus titer 1000 copies /ml or 200IU/ml);Hepatitis C virus, syphilis infection;
  11. Severe heart disease or discomfort, including, but not limited to, the following: complete left bundle branch block or degree atrioventricular block, history of myocardial infarction, angioplasty, coronary artery bridging, patients with prolonged QT/QTc interval at baseline (QTcF men >450 ms, women >480ms), significant ventricular arrhythmias (such as ventricular tachycardia), history of heart failure or systolic dysfunction (LVEF < 50%), cardiac failure, New York College of Cardiology (NYHA) grade II or higher, uncontrolled hypertension (systolic blood pressure > 180 mmHg ), history or current history of cardiomyopathy that the investigator judged to have an impact on the study;
  12. Inability to swallow medications orally, or that the investigator determines severely affect gastrointestinal absorption;
  13. Other malignant tumors in the past 5 years, excluding cured cervical carcinoma in situ, skin basal cell carcinoma or skin squamous cell carcinoma or in situ cervical cancer and/or breast cancer;
  14. Any history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonia requiring steroid treatment, or evidence of clinically active interstitial lung disease;
  15. Patients with a history of other serious systemic diseases who were judged by the investigator to be unsuitable for clinical trials;
  16. Alcohol or drug dependence;
  17. Have a clear history of neurological or mental disorders, including epilepsy or dementia;
  18. Pregnant and/or breastfeeding;
  19. Any other reason the investigator considers the patient is not suitable to participate in the study.

Sites / Locations

  • Sun Yat-Sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Inetetamab+Pyrotinib

Arm Description

Dose Escalation and Dose Expansion: Inetetamab in combination with Pyrotinib in HER2 mutant or amplified participants with advanced or metastatic NSCLC

Outcomes

Primary Outcome Measures

Dose escalation
Number of Participants with a Dose-Limiting Toxicity (DLT)
Incidence of adverse events
Incidence, severity, and serious adverse events (SAEs) based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0

Secondary Outcome Measures

Objective response rate
Per RECIST v1.1 criteria, the proportion of patients whose best remission was CR or PR accounted for the total number of evaluable patients.
Disease Control Rate
Per RECIST v1.1 criteria, the proportion of patients whose best remission was CR , PR and SD accounted for the total number of evaluable patients.
Progression free survival
PFS is defined as the time from the date of first dosing till the first documentation of disease progression (per RECIST v1.1 criteria) assessed by the investigator or death due to any cause (whichever occurs first).
Overall survival
Overall survival (OS) is defined as the time from the date of first dosing till death due to any cause.
Investigation on molecular markers associated with the clinical efficacy and the mechanism of drug resistance
Using next generation sequencing (NGS) method to detect 22 genes from circulating free DNA (cf-DNA) in patients, periphereal blood sample were collected at baseline, first time tumor efficacy evaluation, and withdrawn study due to disease progression.

Full Information

First Posted
August 8, 2021
Last Updated
August 16, 2021
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT05016544
Brief Title
Inetetamab in Combination With Pyrotinib in HER2 Mutant or Amplified Advanced Non-small Cell Lung Cancer
Official Title
A Phase Ib Clinical Study Evaluating the Safety and Efficacy of Inetetamab in Combination With Pyrotinib in HER2 Mutant or Amplified Patients With Advanced Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Recruiting
Study Start Date
July 28, 2021 (Actual)
Primary Completion Date
August 1, 2023 (Anticipated)
Study Completion Date
February 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1, open-label study to evaluate the safety and the efficacy of inetetamab in combination with pyrotinib in patients in HER2 mutant or amplified patients with advanced non-small cell lung cancer
Detailed Description
This study is a multi-center, opening, dose-escalating phase Ib clinical trial. The aim of the study is to evaluate the safety and efficacy of inetetamab combined with pyrotinib in the treatment of patients in HER2 mutant or amplified patients with advanced non-small cell lung cancer .Primary endpoint of the study is dose-limiting toxicity dosage and safety. Efficacy indicators including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) are as Secondary endpoint. Up to 48 NSCLC patients will be enrolled the treatment will be performed 3+3 dose-escalation phase I design and expanded to phase II study. A treatment cycle lasts 3 weeks,and the combined medication will be continued until the occurrence of toxicity intolerance,disease progression,or death,or patients refuse to continue participating in this clinical study,or the investigators determine that the medication must be terminated. The recommended initial consistent dose of inetetamab in groups 1-3 are 8 mg/kg, intravenous infusion for more than 90 minutes, and the maintenance dose is 6 mg/kg. The oral doses of pyrotinib in groups 1-3 were 240 mg, 320 mg, or 400 mg, respectively. Safety evaluation will be taken according to hematological toxicity, non-hematological toxicity and National Cancer Institute (NCI)-Common Terminology Criteria (CTC) For Adverse Events (AE) V5.0.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-small Cell Lung Cancer
Keywords
Non-small Cell Lung Cancer, Inetetamab, Pyrotinib, HER2-activated mutation, HER2-amplification

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Sequential assignment by traditional 3+3 dose escalation
Masking
None (Open Label)
Allocation
N/A
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Inetetamab+Pyrotinib
Arm Type
Experimental
Arm Description
Dose Escalation and Dose Expansion: Inetetamab in combination with Pyrotinib in HER2 mutant or amplified participants with advanced or metastatic NSCLC
Intervention Type
Drug
Intervention Name(s)
inetetamab
Intervention Description
All dose levels will receive 8 mg/kg loading dose for cycle 1, followed by 6 mg/kg in subsequent cycles, every 3 weeks.
Intervention Type
Drug
Intervention Name(s)
Pytotinib
Intervention Description
Starting pytotinib Dose of 240mg: Cohort 1: pyrotinib 240mg p.o. d1 to d21, q3w; Cohort 2: pyrotinib 320mg p.o. d1 to d21, q3w; Cohort 3: pyrotinib 400mg p.o. d1 to d21, q3w.
Primary Outcome Measure Information:
Title
Dose escalation
Description
Number of Participants with a Dose-Limiting Toxicity (DLT)
Time Frame
Up to 21 days after the first dose
Title
Incidence of adverse events
Description
Incidence, severity, and serious adverse events (SAEs) based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0
Time Frame
Up to 30 days after the last dose of inetetamab or pyrotinib
Secondary Outcome Measure Information:
Title
Objective response rate
Description
Per RECIST v1.1 criteria, the proportion of patients whose best remission was CR or PR accounted for the total number of evaluable patients.
Time Frame
up to12 months
Title
Disease Control Rate
Description
Per RECIST v1.1 criteria, the proportion of patients whose best remission was CR , PR and SD accounted for the total number of evaluable patients.
Time Frame
up to12 months
Title
Progression free survival
Description
PFS is defined as the time from the date of first dosing till the first documentation of disease progression (per RECIST v1.1 criteria) assessed by the investigator or death due to any cause (whichever occurs first).
Time Frame
24 months
Title
Overall survival
Description
Overall survival (OS) is defined as the time from the date of first dosing till death due to any cause.
Time Frame
36 months
Title
Investigation on molecular markers associated with the clinical efficacy and the mechanism of drug resistance
Description
Using next generation sequencing (NGS) method to detect 22 genes from circulating free DNA (cf-DNA) in patients, periphereal blood sample were collected at baseline, first time tumor efficacy evaluation, and withdrawn study due to disease progression.
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age over 18; Histologically or cytologically documented metastatic NSCLC, HER2 activation amplification or mutation stage IIIB-IV NSCLC patient; At least 1 measurable lesion according to RECIST 1.1; ECOG score 0 or 1; Life expectancy of at least 3 months; Within one week before admission, blood routine examination was basically normal: hemoglobin ≥90g/L or ≥5.6mmol/L; neutrophil count (ANC) ≥ 1.5 × 10 ^ 9 / L; platelet count (PLT) ≥ 100 × 10 ^ 9 / L; Liver and kidney function tests were basically normal within one week before enrollment; total bilirubin (TBIL) ≤ 1.5 × upper limit of normal value (ULN); alanine aminotransferase (ALT / AST) ≤ 2.5 × ULN (liver metastasis patients ≤ 5xuln); serum creatinine ≤ 1.5 × ULN; Partially activated thrombin time(APTT)≤ 1.5 × ULN; For fertile women had negative blood pregnancy tests 7 days before screening; willing to participate and sign the informed consent in person. Exclusion Criteria: Patients who have received anti-HER2 monoclonal antibody therapy; Have received chemotherapy, biotherapy, targeted therapy, immunotherapy and other anti-tumor therapies within 4 weeks prior to the first use of the study drug including: oral small molecule targeted drugs within 2 weeks prior to the first use of the study drug or within 5 half-lives of known drugs (depending on the time);Radiotherapy was performed within 2 weeks prior to the first administration of the study drug; Have received other clinical study drugs within 4 weeks prior to the first study drug administration; Patients who underwent major surgery within 4 weeks prior to the first dosing of the study drug(except needle biopsy or significant trauma); Those who have been known to have allergic history to the drug components of this regimen; Study drugs that had used a CYP3A4 inhibitor, inducer, or a narrow therapeutic window with a CYP3A4-sensitive substrate ,P-ep strong inducer and inhibitor within 14 days before first administration; The adverse reactions of previous antitumor therapy have not recovered to CTCAE 5.0 grade 1(Hair loss and other toxicities were excluded for which the researchers judged no safety risk); Patients with central nervous system metastasis and clinical symptoms; History of immunodeficiency, including positive HIV test, or suffering from other acquired, congenital immunodeficiency diseases, or history of organ transplantation; Active hepatitis B (HBV virus titer 1000 copies /ml or 200IU/ml);Hepatitis C virus, syphilis infection; Severe heart disease or discomfort, including, but not limited to, the following: complete left bundle branch block or degree atrioventricular block, history of myocardial infarction, angioplasty, coronary artery bridging, patients with prolonged QT/QTc interval at baseline (QTcF men >450 ms, women >480ms), significant ventricular arrhythmias (such as ventricular tachycardia), history of heart failure or systolic dysfunction (LVEF < 50%), cardiac failure, New York College of Cardiology (NYHA) grade II or higher, uncontrolled hypertension (systolic blood pressure > 180 mmHg ), history or current history of cardiomyopathy that the investigator judged to have an impact on the study; Inability to swallow medications orally, or that the investigator determines severely affect gastrointestinal absorption; Other malignant tumors in the past 5 years, excluding cured cervical carcinoma in situ, skin basal cell carcinoma or skin squamous cell carcinoma or in situ cervical cancer and/or breast cancer; Any history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonia requiring steroid treatment, or evidence of clinically active interstitial lung disease; Patients with a history of other serious systemic diseases who were judged by the investigator to be unsuitable for clinical trials; Alcohol or drug dependence; Have a clear history of neurological or mental disorders, including epilepsy or dementia; Pregnant and/or breastfeeding; Any other reason the investigator considers the patient is not suitable to participate in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Zhang, MD.
Phone
86-20-87343458
Email
zhangli6@mail.sysu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wenfeng Fang, MD, PhD.
Phone
86-020-8734-3894
Email
fangwf@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Li Zhang, MD.
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sun Yat-Sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Zhang, professor
Phone
86-20-8734-3458
Email
zhangli6@mail.sysu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No
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Inetetamab in Combination With Pyrotinib in HER2 Mutant or Amplified Advanced Non-small Cell Lung Cancer

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