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Pamiparib (BGB-290) Was Used in EGFR-TkIs Resistant Non-small Cell Lung Cancer

Primary Purpose

Carcinoma, Non-Small-Cell Lung, EGF-R Positive Non-Small Cell Lung Cancer

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Parimparib
Chemotherapy drug
Targeted Therapy Agent
Sponsored by
Affiliated Hospital of Jiangnan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Non-Small-Cell Lung

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients: ≥18 years old
  2. Histologically or cytologically confirmed non-small cell lung cancer, and the disease has progressed after first-generation and/or second-generation TKIs treatment with first-line therapy and no T790 mutation, or after third-generation EGFR-TKI treatment After the disease progresses, the guidelines do not recommend a standard protocol.
  3. No other concurrent cancer.
  4. At least one previously unirradiated lesion that can be accurately measured at baseline with longest diameter ≥ 10 mm (must have a short lymph node excluding axis ≥ 15 mm) according to RECIST criteria with computed tomography (CT), magnetic resonance imaging (MRI) or clinical examination for accurate repeated measures. Or an unevaluable lesion, including but not limited to pleural and ascites, bone metastasis, etc.
  5. ECOG physical condition score: 0-3 points.
  6. Expected survival period ≥ 3 months.
  7. The function of major organs is good, that is, the relevant inspection indicators within 14 days before randomization meet the following requirements: a) Routine blood test:i. Hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); ii. Neutrophil count > 1.5×109/L; iii. Platelet count ≥ 90×109/L; b) Biochemical examination: i. Total bilirubin ≤ 1.5×ULN (upper limit of normal); ii. Blood alanine aminotransferase (ALT) or blood aspartate aminotransferase (AST) ≤ 2.5×ULN; if liver metastasis, ALT or AST ≤ 5×ULN; iii. Endogenous creatinine clearance ≥ 60 ml/min (Cockcroft-Gault formula); c) Cardiac Doppler ultrasound assessment: Left ventricular ejection fraction (LVEF) ≥ 50%.
  8. Sign the informed consent.
  9. The patient is willing and able to comply with the protocol during the study, including receiving treatment and scheduled visits and examinations, including follow-up.

Exclusion Criteria:

  1. Participated in clinical trials of other drugs within four weeks.
  2. Histologically or cytologically confirmed small cell, large cell neuroendocrine or carcinoid.
  3. There are clinical symptoms or diseases of the heart that cannot be well controlled, such as: NYHA class 2 or higher heart failure, unstable angina pectoris, myocardial infarction within 1 year, clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention of patients.
  4. For female subjects: should be surgically sterilized, postmenopausal patients, or agree to use a medically approved contraceptive during the study treatment period and within 6 months after the end of the study treatment period; Serum or urine pregnancy test must be negative within 7 days and must be non-nursing. Male subjects: Patients who should be surgically sterilized, or who agree to use a medically-approved contraceptive method during the study treatment period and within 6 months after the end of the study treatment period.
  5. The patient has active pulmonary tuberculosis, bacterial or fungal infection (≥ grade 2 of NCI-CTC, 3rd edition); HIV infection, HBV infection, HCV infection.
  6. Those who have a history of psychotropic substance abuse and cannot quit or have mental disorders.
  7. The subject has any active autoimmune disease or has a history of autoimmune disease (such as the following, but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism, thyroid Reduced function; subjects with vitiligo or complete remission of asthma in childhood without any intervention in adulthood can be included; subjects with asthma requiring bronchodilator medical intervention are not included).
  8. According to the judgment of the investigator, there are concomitant diseases that seriously endanger the patient's safety or affect the patient's completion of the study.

Sites / Locations

  • Affiliated Hospital of Jiangnan UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Pamilarib in combination with Chemotherapy Drugs

Pamiparib in combination with Targeted Therapy Drugs

Arm Description

The specific chemotherapy regimen was formulated by the investigator. The dosage of chemotherapy drugs is selected according to the drug use guidelines. Combination medication, the initial dose is 40mg each time (2 capsules), 2 times a day, the total daily dose is 80mg. Can be taken with a meal or on an empty stomach. If the patient misses a dose, no additional dose should be taken, and the next prescribed dose should be taken normally at the planned time. Continue the treatment until the disease progresses or unacceptable adverse reactions occur, and the dose is adjusted.

The specific targeted therapy plan is formulated by the investigator. The dosage of targeted therapeutic drugs is selected according to the drug use guidelines. Combination medication, the initial dose is 40mg each time (2 capsules), 2 times a day, the total daily dose is 80mg. Can be taken with a meal or on an empty stomach. If the patient misses a dose, no additional dose should be taken, and the next prescribed dose should be taken normally at the planned time. Continue the treatment until the disease progresses or unacceptable adverse reactions occur, and the dose is adjusted.

Outcomes

Primary Outcome Measures

Objective response rate
Total response and partial response ratio

Secondary Outcome Measures

Progression-free survival
Time from randomization to any disease progression and/or death, defined according to strict RECIST (Response Evaluation Criteria in Solid Tumors) v1.1. Lesion will be assessed in comparison to baseline measurements.
Overall survival
Randomize time to date of death or last known alive date calculation.
Disease control rate
The proportion of patients with a best response grade of complete response, partial response, or stable disease that has shrunk or stabilized for a period of time.
Objective response rate
Assessed according to disease progression as defined by RECIST (Response Evaluation Criteria in Solid Tumors) v1.1
Changes in tumor volume shrinking
Change in tumor volume reduction from randomization to 6 months
Tolerability and Safety
Assessed based on the number of treatment reductions, delays and withdrawals, including the incidence and nature of dose-limiting toxicities.

Full Information

First Posted
September 22, 2022
Last Updated
January 30, 2023
Sponsor
Affiliated Hospital of Jiangnan University
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1. Study Identification

Unique Protocol Identification Number
NCT05573373
Brief Title
Pamiparib (BGB-290) Was Used in EGFR-TkIs Resistant Non-small Cell Lung Cancer
Official Title
Double Arm Single Center Clinical Trial of Pamiparib (BGB-290) for EGFR TKIs Resistant Non-small Cell Lung Cance
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 20, 2022 (Actual)
Primary Completion Date
November 30, 2023 (Anticipated)
Study Completion Date
December 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affiliated Hospital of Jiangnan University

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study was to investigate the efficacy and safety of pamiparib in patients with EGFR-TKIs-resistant NSCLC, using a single-center, dual-arm, open-label design.
Detailed Description
Lung cancer is the second most common cancer type worldwide and remains the leading cause of cancer death worldwide. Non-small cell lung cancer accounts for 80% of the total number of lung cancers, 15-55% of NSCLC have EGFR mutations, of which about 50% of Asians, targeted drugs - epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) ) showed good clinical benefit. However, patients with EGFR-mutant lung cancer experience disease progression within about a year of treatment with EGFR-TKIs, and acquired resistance develops and limits the long-term efficacy of these EGFR-TKIs. About 50% of EGFR-TKIs acquired resistance mutations by the mechanism of T790 mutation. Third-generation EGFR-TKIs can be used to overcome drug resistance against T790 mutation. Unfortunately, acquired resistance to third-generation EGFR-TKIs will eventually emerge, and when third-generation EGFR-TKIs acquire resistance, effective treatment options are still being explored. PARP (poly(ADP-ribose) polymerase) inhibitors represent a new class of anticancer therapy. They exploit synthetic lethality and induce cell death by exploiting defects in DNA repair, poly(ADP-ribose) polymerase-1 (PARP1) and poly(ADP-ribose) polymerase-2 (PARP2) are PARP enzymes Members of the family that play key roles in the DNA damage response (DDR) by acting as DNA damage sensors and signal transducers. PARP inhibitors can be used in combination with conventional NSCLC treatment regimens or as monotherapy. In clinical applications, PARP inhibitors have demonstrated sustained antitumor responses as single agents in BRCA1- or BRCA2-mutated patients. Studies have shown that the single-drug toxicity of PARP inhibitors is much lower than that of platinum drugs, and experimental results in NSCLC cell lines have shown that PARP inhibitors have single-drug activity in NSCLC. The characteristics of the domestic PARP inhibitor, Pamiparib, reflect its advantages over other PARP inhibitors: 1)low drug resistance, 2)high selectivity, 3)high capture of PARP-DNA complexes, 4)high membrane permeability, 5)Dual pathway metabolism, 6)Blood-brain barrier permeability. Multiple clinical data show that Pamiparib as a single agent has favorable safety and antitumor activity in advanced recurrent solid tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Non-Small-Cell Lung, EGF-R Positive Non-Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Non-Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pamilarib in combination with Chemotherapy Drugs
Arm Type
Experimental
Arm Description
The specific chemotherapy regimen was formulated by the investigator. The dosage of chemotherapy drugs is selected according to the drug use guidelines. Combination medication, the initial dose is 40mg each time (2 capsules), 2 times a day, the total daily dose is 80mg. Can be taken with a meal or on an empty stomach. If the patient misses a dose, no additional dose should be taken, and the next prescribed dose should be taken normally at the planned time. Continue the treatment until the disease progresses or unacceptable adverse reactions occur, and the dose is adjusted.
Arm Title
Pamiparib in combination with Targeted Therapy Drugs
Arm Type
Experimental
Arm Description
The specific targeted therapy plan is formulated by the investigator. The dosage of targeted therapeutic drugs is selected according to the drug use guidelines. Combination medication, the initial dose is 40mg each time (2 capsules), 2 times a day, the total daily dose is 80mg. Can be taken with a meal or on an empty stomach. If the patient misses a dose, no additional dose should be taken, and the next prescribed dose should be taken normally at the planned time. Continue the treatment until the disease progresses or unacceptable adverse reactions occur, and the dose is adjusted.
Intervention Type
Drug
Intervention Name(s)
Parimparib
Other Intervention Name(s)
BGB-290, Poly (ADP-ribose) polymerase (PARP) inhibitor
Intervention Description
The dosage and protocol of the drug were carried out according to the description.
Intervention Type
Drug
Intervention Name(s)
Chemotherapy drug
Other Intervention Name(s)
Chemotherapy Drug, Cancer
Intervention Description
The dosage and protocol of the drug were carried out according to the description.
Intervention Type
Drug
Intervention Name(s)
Targeted Therapy Agent
Other Intervention Name(s)
Targeted drug
Intervention Description
The dosage and protocol of the drug were carried out according to the description.
Primary Outcome Measure Information:
Title
Objective response rate
Description
Total response and partial response ratio
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
Time from randomization to any disease progression and/or death, defined according to strict RECIST (Response Evaluation Criteria in Solid Tumors) v1.1. Lesion will be assessed in comparison to baseline measurements.
Time Frame
1 year
Title
Overall survival
Description
Randomize time to date of death or last known alive date calculation.
Time Frame
72 weeks
Title
Disease control rate
Description
The proportion of patients with a best response grade of complete response, partial response, or stable disease that has shrunk or stabilized for a period of time.
Time Frame
an average of 1 year
Title
Objective response rate
Description
Assessed according to disease progression as defined by RECIST (Response Evaluation Criteria in Solid Tumors) v1.1
Time Frame
72 weeks
Title
Changes in tumor volume shrinking
Description
Change in tumor volume reduction from randomization to 6 months
Time Frame
6 months
Title
Tolerability and Safety
Description
Assessed based on the number of treatment reductions, delays and withdrawals, including the incidence and nature of dose-limiting toxicities.
Time Frame
an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients: ≥18 years old Histologically or cytologically confirmed non-small cell lung cancer, and the disease has progressed after first-generation and/or second-generation TKIs treatment with first-line therapy and no T790 mutation, or after third-generation EGFR-TKI treatment After the disease progresses, the guidelines do not recommend a standard protocol. No other concurrent cancer. At least one previously unirradiated lesion that can be accurately measured at baseline with longest diameter ≥ 10 mm (must have a short lymph node excluding axis ≥ 15 mm) according to RECIST criteria with computed tomography (CT), magnetic resonance imaging (MRI) or clinical examination for accurate repeated measures. Or an unevaluable lesion, including but not limited to pleural and ascites, bone metastasis, etc. ECOG physical condition score: 0-3 points. Expected survival period ≥ 3 months. The function of major organs is good, that is, the relevant inspection indicators within 14 days before randomization meet the following requirements: a) Routine blood test:i. Hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); ii. Neutrophil count > 1.5×109/L; iii. Platelet count ≥ 90×109/L; b) Biochemical examination: i. Total bilirubin ≤ 1.5×ULN (upper limit of normal); ii. Blood alanine aminotransferase (ALT) or blood aspartate aminotransferase (AST) ≤ 2.5×ULN; if liver metastasis, ALT or AST ≤ 5×ULN; iii. Endogenous creatinine clearance ≥ 60 ml/min (Cockcroft-Gault formula); c) Cardiac Doppler ultrasound assessment: Left ventricular ejection fraction (LVEF) ≥ 50%. Sign the informed consent. The patient is willing and able to comply with the protocol during the study, including receiving treatment and scheduled visits and examinations, including follow-up. Exclusion Criteria: Participated in clinical trials of other drugs within four weeks. Histologically or cytologically confirmed small cell, large cell neuroendocrine or carcinoid. There are clinical symptoms or diseases of the heart that cannot be well controlled, such as: NYHA class 2 or higher heart failure, unstable angina pectoris, myocardial infarction within 1 year, clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention of patients. For female subjects: should be surgically sterilized, postmenopausal patients, or agree to use a medically approved contraceptive during the study treatment period and within 6 months after the end of the study treatment period; Serum or urine pregnancy test must be negative within 7 days and must be non-nursing. Male subjects: Patients who should be surgically sterilized, or who agree to use a medically-approved contraceptive method during the study treatment period and within 6 months after the end of the study treatment period. The patient has active pulmonary tuberculosis, bacterial or fungal infection (≥ grade 2 of NCI-CTC, 3rd edition); HIV infection, HBV infection, HCV infection. Those who have a history of psychotropic substance abuse and cannot quit or have mental disorders. The subject has any active autoimmune disease or has a history of autoimmune disease (such as the following, but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism, thyroid Reduced function; subjects with vitiligo or complete remission of asthma in childhood without any intervention in adulthood can be included; subjects with asthma requiring bronchodilator medical intervention are not included). According to the judgment of the investigator, there are concomitant diseases that seriously endanger the patient's safety or affect the patient's completion of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
liu quan, doctor
Phone
15995299079
Email
quanliu@jiangnan.edu.cn; quanliu.lq@outlook.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
liu quan, doctor
Organizational Affiliation
Affiliated Hospital of Jiangnan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Affiliated Hospital of Jiangnan University
City
Wuxi
State/Province
Jiangsu
ZIP/Postal Code
214000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
liu quan, doctor
Phone
15995299079
Email
quanliu@jiangnan.edu.cn; quanliu.lq@outlook.com
First Name & Middle Initial & Last Name & Degree
liu quan, doctor

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
The associated efficacy is uncertain.

Learn more about this trial

Pamiparib (BGB-290) Was Used in EGFR-TkIs Resistant Non-small Cell Lung Cancer

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