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A Trial to Learn How the Combination of Fianlimab With Cemiplimab and Chemotherapy Works Compared With Cemiplimab and Chemotherapy for Treating Adult Patients With Advanced Non-small Cell Lung Cancer

Primary Purpose

Non-small Cell Lung Cancer

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
fianlimab
cemiplimab
Pemetrexed
Paclitaxel
Carboplatin
Cisplatin
Placebo
Sponsored by
Regeneron Pharmaceuticals
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 NSCLC, Lung cancer, Programmed cell death ligand-1, PD-L1, Lymphocyte-activation gene 3, LAG-3, African descent

Eligibility Criteria

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

Key Inclusion Criteria: Patients with non-squamous or squamous histology NSCLC with stage IIIB or stage IIIC disease who are not candidates for surgical resection or definitive chemoradiation per investigator assessment or stage IV (metastatic disease), who received no prior systemic treatment for recurrent or metastatic NSCLC. Availability of an archival or on-study formalin-fixed, paraffin-embedded tumor tissue sample, without intervening therapy between biopsy collection and screening as described in the protocol A valid result of PD-L1, regardless of expression level using an assay as performed by a central laboratory. Available tissue for retrospective testing using an assay as performed by a central laboratory. At least 1 radiographically measurable lesion by computed tomography (CT) or magnetic resonance imaging (MRI) per RECIST 1.1 criteria. Target lesions may be located in a previously irradiated field if there is documented (radiographic) disease progression in that site. Eastern Cooperative Oncology Group (ECOG) performance status of ≤1. Adequate organ and bone marrow function as defined in the protocol. Key Exclusion Criteria: Active or untreated brain metastases or spinal cord compression. Patients are eligible if central nervous system (CNS) metastases are adequately treated and patients have neurologically returned to baseline (except for residual signs or symptoms related to the CNS treatment) for at least 2 weeks prior to enrollment. Patients must be off (immunosuppressive doses of) corticosteroid therapy. Patients with tumors tested positive for estimated glomerular filtration rate (EGFR) gene mutations, anaplastic lymphoma kinase (ALK) gene translocations, or ROS oncogene 1 (ROS1) fusions. All patients will have tumor evaluated for EGFR mutations, ALK rearrangement, and ROS1 fusions confirmed by a central laboratory when local laboratory results are not available. Encephalitis, meningitis, or uncontrolled seizures in the year prior to enrollment. History of interstitial lung disease (eg, idiopathic pulmonary fibrosis or organizing pneumonia), of active, noninfectious pneumonitis that required immune-suppressive doses of glucocorticoids to assist with management, or of pneumonitis within the last 5 years. A history of radiation pneumonitis in the radiation field is permitted as long as pneumonitis resolved ≥6 months prior to enrollment. Known primary immunodeficiencies, either cellular (eg, DiGeorge syndrome, T-cell-negative severe combined immunodeficiency [SCID]) or combined T- and B-cell immunodeficiencies (eg, T- and B-cell negative SCID, Wiskott Aldrich syndrome, ataxia telangiectasia, common variable immunodeficiency). Ongoing or recent (within 2 years) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk of immune-mediated treatment-emergent adverse events (imTEAEs). Patients with uncontrolled type 1 diabetes mellitus or with uncontrolled adrenal insufficiency are excluded. The following are not exclusionary: vitiligo, childhood asthma that has resolved, residual hypothyroidism that required only hormone replacement, or psoriasis that does not require systemic treatment. Patients with a condition requiring corticosteroid therapy (>10 mg prednisone/day or equivalent) within 14 days of randomization. Physiologic replacement doses are allowed even if they are >10 mg of prednisone/day or equivalent, as long as they are not being administered for immunosuppressive intent. Patients with clinically relevant systemic immune suppression within the last 3 months before trial enrollment are excluded. Inhaled or topical steroids are permitted, provided that they are not for treatment of an autoimmune disorder. Patients who have received prior systemic therapies are excluded with the exception of the following: Adjuvant or neoadjuvant platinum-based doublet chemotherapy (after surgery and/or radiation therapy) if recurrent or metastatic disease develops more than 6 months after completing therapy as long as toxicities have resolved to CTCAE grade ≤1 or baseline with the exception of alopecia and peripheral neuropathy. Anti-PD-(L)1 with or without LAG-3 as an adjuvant or neoadjuvant therapy as long as the last dose is >12 months prior to enrollment. Prior exposure to other immunomodulatory or vaccine therapies such as anti-CTLA-4 antibodies as long as the last dose is >3 months prior to enrollment. Immune-mediated AEs must be resolved to CTCAE grade ≤1 or baseline by the time of enrollment. Endocrine immunemediated AEs controlled with hormonal or other nonimmunosuppressive therapies without resolution prior to enrollment are allowed. Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Sites / Locations

  • Desert Hematology Oncology Medical Group, Inc.Recruiting
  • Emad Ibrahim, MD, Inc.Recruiting
  • Clermont Oncology CenterRecruiting
  • Mid Florida Hematology and Oncology CenterRecruiting
  • Gabrail cancer centerRecruiting
  • University of Tennessee Medical CenterRecruiting
  • Southern Medical Day Care CentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Phase 2 - Arm A

Phase 2 - Arm B

Phase 2 - Arm C

Phase 3 - Arm A or B

Phase 3 - Arm C

Arm Description

Randomized 1:1:1 fianlimab (higher dose) + cemiplimab + platinum-doublet chemotherapy

Randomized 1:1:1 fianlimab (lower dose) + cemiplimab + platinum-doublet chemotherapy

Randomized 1:1:1 cemiplimab + platinum-doublet chemotherapy + placebo

Randomized 1:1 fianlimab (chosen dose) + cemiplimab + platinum-doublet chemotherapy

Randomized 1:1 cemiplimab + platinum-doublet chemotherapy + placebo

Outcomes

Primary Outcome Measures

Objective response rate (ORR) as assessed by blinded independent review committee (BICR) using RECIST 1.1
Phase 2 ORR is defined as proportion of patients with a best overall response of confirmed complete response (CR) or partial response (PR).
Overall Survival (OS)
Phase 3 Defined as the time from randomization to the date of death due to any cause

Secondary Outcome Measures

Incidence of treatment-emergent adverse event (TEAEs)
Phase 2 & Phase 3 A TEAE is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment
Incidence of treatment-related TEAEs
Phase 2 & Phase 3
Incidence of serious adverse events (SAEs)
Phase 2 & Phase 3 Any untoward medical occurrence that at any dose: Results in death - includes all deaths, even those that appear to be completely unrelated to study drug (eg, a car accident in which a patient is a passenger) Is life-threatening Requires in-patient hospitalization or prolongation of existing hospitalization • Results in persistent or significant disability/incapacity Is a congenital anomaly/birth defect Is an important medical event
Incidence of adverse events of special interest (AESIs)
Phase 2 & Phase 3 Serious or non-serious; is one of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the Investigator to the sponsor can be appropriate. Such an event might warrant further investigation in order to characterize and understand it.
Incidence of immune-mediated adverse events (imAEs)
Phase 2 & Phase 3 Immune-mediated AEs are thought to be caused by unrestrained cellular immune responses directed at normal host tissues. An imAE can occur shortly after the first dose or several months after the last dose of treatment. Early detection and management reduces the risk of severe drug induced toxicity
Occurrence of interruption of study drug(s) due to AEs
Phase 2 & Phase 3
Occurrence of discontinuation of study drug(s) due to AEs
Phase 2 & Phase 3
Incidence of deaths due to TEAE
Phase 2 & Phase 3
Incidence of grade 3-4 laboratory abnormalities
Phase 2 & Phase 3 ≥ grade 3 per National Cancer Institute-Common Terminology Criteria for Adverse Events [NCI-CTCAE v5.0]
ORR by investigator assessment using RECIST 1.1
Phase 2 & Phase 3
Disease control rate (DCR) by BICR
Phase 2 and Phase 3 DCR is defined as CR + PR + stable disease (SD)
DCR by investigator assessment
Phase 2 and Phase 3 DCR is defined as CR + PR + stable disease (SD)
Time to tumor response (TTR) by BICR
Phase 2 and Phase 3 TTR is defined as the time from randomization to the date of the first response of CR or PR (whichever is first recorded) for patients with confirmed CR or PR.
TTR by investigator assessment
Phase 2 and Phase 3 TTR is defined as the time from randomization to the date of the first response of CR or PR (whichever is first recorded) for patients with confirmed CR or PR
Duration of response (DOR) by BICR
Phase 2 and Phase 3 DOR is defined as the time from first response of CR or PR to first radiographic progression or death due to any cause for patients with confirmed CR or PR
DOR by investigator assessment
Phase 2 and Phase 3 DOR is defined as the time from first response of CR or PR to first radiographic progression or death due to any cause for patients with confirmed CR or PR
Progression free survival (PFS) by BICR
Phase 2 and Phase 3 PFS is defined as the time from randomization to the date of the first radiographic progression or death due to any cause, whichever occurred earlier
PFS by investigator assessment
Phase 2 and Phase 3 PFS is defined as the time from randomization to the date of the first radiographic progression or death due to any cause, whichever occurred earlier
OS
Phase 2 Defined as the time from randomization to the date of death due to any cause
Change from baseline in patient-reported Global health status/QoLper European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
Phase 2 & Phase 3 EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including a global health status/quality of life (GHS/QoL) scale. Participants rate items on a four-point scale, with 1 as "not at all" and 4 as "very much." A change of 5 - 10 points is considered a small change. A change of 10 - 20 points is considered a moderate change.
Change from baseline in physical functioning per EORTC QLQ-C30
Phase 2 & Phase 3
Change from baseline in patient-reported chest pain per European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13)
Phase 2 & Phase 3 EORTC QLQ-LC 13 is a lung cancer specific module developed to assess lung cancer-associated symptoms and treatment-related side effects among lung cancer patients
Change from baseline in patient-reported dyspnea per EORTC QLQ-LC13
Phase 2 & Phase 3
Change from baseline in patient-reported cough per EORTC QLQ-LC13
Phase 2 & Phase 3
Time until definitive deterioration in patient-reported global health status/QoL per EORTC QLQ-C30
Phase 2 & Phase 3
Time until definitive deterioration in patient-reported physical functioning per EORTC QLQ-C30
Phase 2 & Phase 3
Time until definitive deterioration in patient-reported chest pain per EORTC QLQ-LC13
Phase 2 & Phase 3
Time until definitive deterioration in patient-reported dyspnea per EORTC QLQ-LC13
Phase 2 & Phase 3
Time until definitive deterioration in patient-reported cough per EORTC QLQ-LC13
Phase 2 & Phase 3
Time until definitive deterioration in a composite of these three symptoms: patient-reported chest pain, dyspnea and cough per EORTC QLQ-LC13
Phase 2 & Phase 3
Change from baseline in patient-reported general health status per EuroQoL 5-Dimensional 5-Level Scale (EQ-5D-5L) VAS
Phase 2 & Phase 3 The EQ-5D-5L VAS records the respondent's self-rated health on a 10 centimeter (cm) vertical, visual analogue scale. It is rated by the respondent on a scale 0 to 100, with 0 being "the worst health you can imagine" and 100 being "the best health you can imagine".
Change from baseline in patient-reported severity with usual or daily activities due to fatigue per the Patient Reported Outcomes for Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Phase 2 & Phase 3 PRO-CTCAE questionnaire assesses side effect symptoms in cancer clinical trials using a PRO-CTCAE score. The PRO-CTCAE includes an item library of 124 items representing 78 symptomatic toxicities drawn from the CTCAE.
Change from baseline in patient-reported interference with usual or daily activities due to fatigue per the PRO-CTCAE
Phase 2 & Phase 3
Concentrations of cemiplimab in serum
Phase 2 & Phase 3
Concentrations of fianlimab in serum
Phase 2 & Phase 3
Immunogenicity, as measured by anti-drug antibodies (ADA) to fianlimab
Phase 2 & Phase 3
Immunogenicity, as measured by ADA to cemiplimab
Phase 2 & Phase 3
Immunogenicity, as measured by neutralizing antibodies (NAb) to fianlimab
Phase 2 & Phase 3
Immunogenicity, as measured by NAb to cemiplimab
Phase 2 & Phase 3

Full Information

First Posted
March 23, 2023
Last Updated
September 14, 2023
Sponsor
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05800015
Brief Title
A Trial to Learn How the Combination of Fianlimab With Cemiplimab and Chemotherapy Works Compared With Cemiplimab and Chemotherapy for Treating Adult Patients With Advanced Non-small Cell Lung Cancer
Official Title
A Randomized, Double-Blind Phase 2/3 Study of Fianlimab (Anti-LAG-3 Antibody), Cemiplimab (Anti-PD-1 Antibody), and Chemotherapy Versus Cemiplimab and Chemotherapy in First-Line Treatment of Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) Irrespective of PD-L1 Expression Levels
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 8, 2023 (Actual)
Primary Completion Date
November 8, 2029 (Anticipated)
Study Completion Date
October 22, 2031 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Regeneron Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
The study is researching an investigational drug called fianlimab (also called REGN3767) with two other medications called cemiplimab and chemotherapy, individually called a "study drug" or collectively called "study drugs" in this form. 'Investigational' means that the study drug is not approved for use outside of this study by any Health Authority. Examples of chemotherapy drugs include the following: Paclitaxel plus carboplatin, and Pemetrexed plus cisplatin. The study is being conducted in patients who have advanced non-small cell lung cancer (NSCLC). The aim of the study is to see how effective the combination of fianlimab, cemiplimab, and chemotherapy is for treating advanced NSCLC, in comparison with cemiplimab and chemotherapy. The study is looking at several other research questions, including: What side effects may happen from taking the study drugs How much of each study drug is in your blood at different times Whether the body makes antibodies against the study drugs (which could make the drug less effective or could lead to side effects) How administering the study drugs might improve your quality of life

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
NSCLC, Lung cancer, Programmed cell death ligand-1, PD-L1, Lymphocyte-activation gene 3, LAG-3, African descent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
950 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Phase 2 - Arm A
Arm Type
Experimental
Arm Description
Randomized 1:1:1 fianlimab (higher dose) + cemiplimab + platinum-doublet chemotherapy
Arm Title
Phase 2 - Arm B
Arm Type
Experimental
Arm Description
Randomized 1:1:1 fianlimab (lower dose) + cemiplimab + platinum-doublet chemotherapy
Arm Title
Phase 2 - Arm C
Arm Type
Experimental
Arm Description
Randomized 1:1:1 cemiplimab + platinum-doublet chemotherapy + placebo
Arm Title
Phase 3 - Arm A or B
Arm Type
Experimental
Arm Description
Randomized 1:1 fianlimab (chosen dose) + cemiplimab + platinum-doublet chemotherapy
Arm Title
Phase 3 - Arm C
Arm Type
Experimental
Arm Description
Randomized 1:1 cemiplimab + platinum-doublet chemotherapy + placebo
Intervention Type
Drug
Intervention Name(s)
fianlimab
Other Intervention Name(s)
REGN3767
Intervention Description
Administered intravenously (IV) every 3 weeks (Q3W)
Intervention Type
Drug
Intervention Name(s)
cemiplimab
Other Intervention Name(s)
REGN2810, Libtayo
Intervention Description
Administered IV Q3W
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Other Intervention Name(s)
Alimta
Intervention Description
IV Infusion, Q3W
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
IV Infusion, Q3W
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Paraplatin
Intervention Description
IV Infusion, Q3W
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinol
Intervention Description
IV infusion, Q3W
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
IV infusion, Q3W
Primary Outcome Measure Information:
Title
Objective response rate (ORR) as assessed by blinded independent review committee (BICR) using RECIST 1.1
Description
Phase 2 ORR is defined as proportion of patients with a best overall response of confirmed complete response (CR) or partial response (PR).
Time Frame
Up to 136 Weeks
Title
Overall Survival (OS)
Description
Phase 3 Defined as the time from randomization to the date of death due to any cause
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Incidence of treatment-emergent adverse event (TEAEs)
Description
Phase 2 & Phase 3 A TEAE is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment
Time Frame
Up to 108 weeks
Title
Incidence of treatment-related TEAEs
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Incidence of serious adverse events (SAEs)
Description
Phase 2 & Phase 3 Any untoward medical occurrence that at any dose: Results in death - includes all deaths, even those that appear to be completely unrelated to study drug (eg, a car accident in which a patient is a passenger) Is life-threatening Requires in-patient hospitalization or prolongation of existing hospitalization • Results in persistent or significant disability/incapacity Is a congenital anomaly/birth defect Is an important medical event
Time Frame
Up to 108 weeks
Title
Incidence of adverse events of special interest (AESIs)
Description
Phase 2 & Phase 3 Serious or non-serious; is one of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the Investigator to the sponsor can be appropriate. Such an event might warrant further investigation in order to characterize and understand it.
Time Frame
Up to 108 weeks
Title
Incidence of immune-mediated adverse events (imAEs)
Description
Phase 2 & Phase 3 Immune-mediated AEs are thought to be caused by unrestrained cellular immune responses directed at normal host tissues. An imAE can occur shortly after the first dose or several months after the last dose of treatment. Early detection and management reduces the risk of severe drug induced toxicity
Time Frame
Up to 108 weeks
Title
Occurrence of interruption of study drug(s) due to AEs
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Occurrence of discontinuation of study drug(s) due to AEs
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Incidence of deaths due to TEAE
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Incidence of grade 3-4 laboratory abnormalities
Description
Phase 2 & Phase 3 ≥ grade 3 per National Cancer Institute-Common Terminology Criteria for Adverse Events [NCI-CTCAE v5.0]
Time Frame
Up to 108 weeks
Title
ORR by investigator assessment using RECIST 1.1
Description
Phase 2 & Phase 3
Time Frame
Up to 136 Weeks
Title
Disease control rate (DCR) by BICR
Description
Phase 2 and Phase 3 DCR is defined as CR + PR + stable disease (SD)
Time Frame
Up to 136 Weeks
Title
DCR by investigator assessment
Description
Phase 2 and Phase 3 DCR is defined as CR + PR + stable disease (SD)
Time Frame
Up to 136 Weeks
Title
Time to tumor response (TTR) by BICR
Description
Phase 2 and Phase 3 TTR is defined as the time from randomization to the date of the first response of CR or PR (whichever is first recorded) for patients with confirmed CR or PR.
Time Frame
Up to 136 Weeks
Title
TTR by investigator assessment
Description
Phase 2 and Phase 3 TTR is defined as the time from randomization to the date of the first response of CR or PR (whichever is first recorded) for patients with confirmed CR or PR
Time Frame
Up to 136 Weeks
Title
Duration of response (DOR) by BICR
Description
Phase 2 and Phase 3 DOR is defined as the time from first response of CR or PR to first radiographic progression or death due to any cause for patients with confirmed CR or PR
Time Frame
Up to 5 Years
Title
DOR by investigator assessment
Description
Phase 2 and Phase 3 DOR is defined as the time from first response of CR or PR to first radiographic progression or death due to any cause for patients with confirmed CR or PR
Time Frame
Up to 5 Years
Title
Progression free survival (PFS) by BICR
Description
Phase 2 and Phase 3 PFS is defined as the time from randomization to the date of the first radiographic progression or death due to any cause, whichever occurred earlier
Time Frame
Up to 5 Years
Title
PFS by investigator assessment
Description
Phase 2 and Phase 3 PFS is defined as the time from randomization to the date of the first radiographic progression or death due to any cause, whichever occurred earlier
Time Frame
Up to 5 Years
Title
OS
Description
Phase 2 Defined as the time from randomization to the date of death due to any cause
Time Frame
Up to 5 Years
Title
Change from baseline in patient-reported Global health status/QoLper European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
Description
Phase 2 & Phase 3 EORTC-QLQ-C30 is a 30-item subject self-report questionnaire composed of both multi-item and single scales, including a global health status/quality of life (GHS/QoL) scale. Participants rate items on a four-point scale, with 1 as "not at all" and 4 as "very much." A change of 5 - 10 points is considered a small change. A change of 10 - 20 points is considered a moderate change.
Time Frame
Up to 108 weeks
Title
Change from baseline in physical functioning per EORTC QLQ-C30
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported chest pain per European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13)
Description
Phase 2 & Phase 3 EORTC QLQ-LC 13 is a lung cancer specific module developed to assess lung cancer-associated symptoms and treatment-related side effects among lung cancer patients
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported dyspnea per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported cough per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in patient-reported global health status/QoL per EORTC QLQ-C30
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in patient-reported physical functioning per EORTC QLQ-C30
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in patient-reported chest pain per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in patient-reported dyspnea per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in patient-reported cough per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Time until definitive deterioration in a composite of these three symptoms: patient-reported chest pain, dyspnea and cough per EORTC QLQ-LC13
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported general health status per EuroQoL 5-Dimensional 5-Level Scale (EQ-5D-5L) VAS
Description
Phase 2 & Phase 3 The EQ-5D-5L VAS records the respondent's self-rated health on a 10 centimeter (cm) vertical, visual analogue scale. It is rated by the respondent on a scale 0 to 100, with 0 being "the worst health you can imagine" and 100 being "the best health you can imagine".
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported severity with usual or daily activities due to fatigue per the Patient Reported Outcomes for Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Description
Phase 2 & Phase 3 PRO-CTCAE questionnaire assesses side effect symptoms in cancer clinical trials using a PRO-CTCAE score. The PRO-CTCAE includes an item library of 124 items representing 78 symptomatic toxicities drawn from the CTCAE.
Time Frame
Up to 108 weeks
Title
Change from baseline in patient-reported interference with usual or daily activities due to fatigue per the PRO-CTCAE
Description
Phase 2 & Phase 3
Time Frame
Up to 108 weeks
Title
Concentrations of cemiplimab in serum
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks
Title
Concentrations of fianlimab in serum
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks
Title
Immunogenicity, as measured by anti-drug antibodies (ADA) to fianlimab
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks
Title
Immunogenicity, as measured by ADA to cemiplimab
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks
Title
Immunogenicity, as measured by neutralizing antibodies (NAb) to fianlimab
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks
Title
Immunogenicity, as measured by NAb to cemiplimab
Description
Phase 2 & Phase 3
Time Frame
Up to 136 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Patients with non-squamous or squamous histology NSCLC with stage IIIB or stage IIIC disease who are not candidates for surgical resection or definitive chemoradiation per investigator assessment or stage IV (metastatic disease), who received no prior systemic treatment for recurrent or metastatic NSCLC. Availability of an archival or on-study formalin-fixed, paraffin-embedded tumor tissue sample, without intervening therapy between biopsy collection and screening as described in the protocol A valid result of PD-L1, regardless of expression level using an assay as performed by a central laboratory. Available tissue for retrospective testing using an assay as performed by a central laboratory. At least 1 radiographically measurable lesion by computed tomography (CT) or magnetic resonance imaging (MRI) per RECIST 1.1 criteria. Target lesions may be located in a previously irradiated field if there is documented (radiographic) disease progression in that site. Eastern Cooperative Oncology Group (ECOG) performance status of ≤1. Adequate organ and bone marrow function as defined in the protocol. Key Exclusion Criteria: Active or untreated brain metastases or spinal cord compression. Patients are eligible if central nervous system (CNS) metastases are adequately treated and patients have neurologically returned to baseline (except for residual signs or symptoms related to the CNS treatment) for at least 2 weeks prior to enrollment. Patients must be off (immunosuppressive doses of) corticosteroid therapy. Patients with tumors tested positive for estimated glomerular filtration rate (EGFR) gene mutations, anaplastic lymphoma kinase (ALK) gene translocations, or ROS oncogene 1 (ROS1) fusions. All patients will have tumor evaluated for EGFR mutations, ALK rearrangement, and ROS1 fusions confirmed by a central laboratory when local laboratory results are not available. Encephalitis, meningitis, or uncontrolled seizures in the year prior to enrollment. History of interstitial lung disease (eg, idiopathic pulmonary fibrosis or organizing pneumonia), of active, noninfectious pneumonitis that required immune-suppressive doses of glucocorticoids to assist with management, or of pneumonitis within the last 5 years. A history of radiation pneumonitis in the radiation field is permitted as long as pneumonitis resolved ≥6 months prior to enrollment. Known primary immunodeficiencies, either cellular (eg, DiGeorge syndrome, T-cell-negative severe combined immunodeficiency [SCID]) or combined T- and B-cell immunodeficiencies (eg, T- and B-cell negative SCID, Wiskott Aldrich syndrome, ataxia telangiectasia, common variable immunodeficiency). Ongoing or recent (within 2 years) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk of immune-mediated treatment-emergent adverse events (imTEAEs). Patients with uncontrolled type 1 diabetes mellitus or with uncontrolled adrenal insufficiency are excluded. The following are not exclusionary: vitiligo, childhood asthma that has resolved, residual hypothyroidism that required only hormone replacement, or psoriasis that does not require systemic treatment. Patients with a condition requiring corticosteroid therapy (>10 mg prednisone/day or equivalent) within 14 days of randomization. Physiologic replacement doses are allowed even if they are >10 mg of prednisone/day or equivalent, as long as they are not being administered for immunosuppressive intent. Patients with clinically relevant systemic immune suppression within the last 3 months before trial enrollment are excluded. Inhaled or topical steroids are permitted, provided that they are not for treatment of an autoimmune disorder. Patients who have received prior systemic therapies are excluded with the exception of the following: Adjuvant or neoadjuvant platinum-based doublet chemotherapy (after surgery and/or radiation therapy) if recurrent or metastatic disease develops more than 6 months after completing therapy as long as toxicities have resolved to CTCAE grade ≤1 or baseline with the exception of alopecia and peripheral neuropathy. Anti-PD-(L)1 with or without LAG-3 as an adjuvant or neoadjuvant therapy as long as the last dose is >12 months prior to enrollment. Prior exposure to other immunomodulatory or vaccine therapies such as anti-CTLA-4 antibodies as long as the last dose is >3 months prior to enrollment. Immune-mediated AEs must be resolved to CTCAE grade ≤1 or baseline by the time of enrollment. Endocrine immunemediated AEs controlled with hormonal or other nonimmunosuppressive therapies without resolution prior to enrollment are allowed. Note: Other protocol-defined Inclusion/ Exclusion Criteria apply
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Trials Administrator
Phone
844-734-6643
Email
clinicaltrials@regeneron.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trial Management
Organizational Affiliation
Regeneron Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Desert Hematology Oncology Medical Group, Inc.
City
Rancho Mirage
State/Province
California
ZIP/Postal Code
92270
Country
United States
Individual Site Status
Recruiting
Facility Name
Emad Ibrahim, MD, Inc.
City
Redlands
State/Province
California
ZIP/Postal Code
92373
Country
United States
Individual Site Status
Recruiting
Facility Name
Clermont Oncology Center
City
Clermont
State/Province
Florida
ZIP/Postal Code
34711
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gopal Kunta, MD
Email
drgkunta@aorcorp.com
First Name & Middle Initial & Last Name & Degree
Gopal Kunta, Doctorate
Facility Name
Mid Florida Hematology and Oncology Center
City
Orange City
State/Province
Florida
ZIP/Postal Code
32763
Country
United States
Individual Site Status
Recruiting
Facility Name
Gabrail cancer center
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gabrail Nashat, MD
Email
research@gabrailcancercenter.com
First Name & Middle Initial & Last Name & Degree
Ga Nashat, Doctorate
Facility Name
University of Tennessee Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37920
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Faulkner, MD
Email
NFaulkner@utmck.edu
First Name & Middle Initial & Last Name & Degree
Neil Faulkner, Doctorate
Facility Name
Southern Medical Day Care Centre
City
Wollongong
ZIP/Postal Code
NSW 2500
Country
Australia
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing
IPD Sharing Time Frame
When Regeneron has received marketing authorization from major health authorities (e.g., FDA, European Medicines Agency (EMA), Pharmaceuticals and Medical Devices Agency (PMDA), etc.) for the product and indication, has made the study results publicly available (e.g., scientific publication, scientific conference, clinical trial registry), has the legal authority to share the data, and has ensured the ability to protect participant privacy.
IPD Sharing Access Criteria
Qualified researchers can submit a proposal for access to individual patient or aggregate level data from a Regeneron-sponsored clinical trial through Vivli. Regeneron's Independent Research Request Evaluation Criteria can be found at: https://www.regeneron.com/sites/default/files/Regeneron-External-Data-Sharing-Policy-and-Independent-Research-Request-Evaluation-Criteria.pdf
IPD Sharing URL
https://vivli.org/

Learn more about this trial

A Trial to Learn How the Combination of Fianlimab With Cemiplimab and Chemotherapy Works Compared With Cemiplimab and Chemotherapy for Treating Adult Patients With Advanced Non-small Cell Lung Cancer

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