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TGRX-326 Chinese Phase III for Advanced Non-small Cell Lung Cancer (NSCLC)

Primary Purpose

Non Small Cell Lung Cancer

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
TGRX-326
Crizotinib
Sponsored by
Shenzhen TargetRx, Inc.
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: Willing to follow the treatment protocol and visit schedule, and participate in the study with the ICF signed; ≥ 18 years of age on the day of ICF signing, regardless of gender. Diagnosed as incurable stage IIIB - IV ALK-positive NSCLC; Providing prior ALK positive test results at screening; Naïve to ALK-inhibitor; patients could be intolerant or have progressive disease from previous first-line chemotherapy; Patients could have metastases to central nervous system at screening if the condition is asymptomatic, stable or completely recovered; At least one measurable lesion; An ECOG PS score within 0-2; Adequate bone marrow, liver, kidney, coagulation and pancreatic functions; Expected survival ≥ 3 months; Willing to take effective contraceptive measures (for men of reproductive potential and women of reproductive age only) from ICF signing to 6 months after last administration of the investigational drug. Women of reproductive age include women before menopause and within 1 year after menopause; those women must have a negative pregnancy test ≤ 7 days prior to the first dose of the investigational drug. Exclusion Criteria: Known hypersensitivity to any of the active ingredients or excipients of TGRX-326 or crizotinib pills; or a history of severe allergic reactions; Having another type of cancer except for lung cancer; Radiotherapy within 14 days prior to the first dose; Received other systemic anti-tumor treatment within 4 weeks prior to the first dose, or is within 5 half-lives of the said treatment; received traditional Chinese medicine indicated for anti-tumor purposes within 14 days prior to the first dose; Major surgery within 4 weeks prior to the first dose; Spinal cord compression caused by tumor, unless the subject achieves significant pain control and full recovery of neurological function within 4 weeks prior to the first dose. Abnormal gastrointestinal function that affect absorption within the past 6 months; History of active pneumonia or clinically significant interstitial pneumonia, or radiation or drug-induced lung disorder with treatment needs; Cardiac insufficiency; Abnormal and clinically significant QTc on ECG or need of concomitant use of any drug known to prolong QT interval and cause torsades de pointes; Uncontrolled hypertension after drug treatment; Uncontrolled hyperglycaemia, acute attack of cholelithiasis, and susceptibility to acute pancreatitis; Severe or uncontrolled systemic diseases causing expected intolerance to the investigational drug as judged by the investigator; Toxic reactions associated with prior surgery and prior antineoplastic therapies that have not recovered and may affect the subject safety as assessed by the investigator. Clinically significant active bacterial, fungal or viral infections, including a positive result for hepatitis B surface antigen and HBV DNA ≥ ULN, one or more positive results for hepatitis C antibody or HIV antibody, or the presence of any uncontrolled infection. Use of strong CYP3A4 inducers or inhibitors or CYP3A4 substrates with a narrow therapeutic window within two weeks prior to the first dose of the investigational drug; Pregnant and breastfeeding female; Women of childbearing age who are unwilling or unable to use acceptable methods for contraception during the entire treatment period in the trial and within 6 months after the last dose of the investigational drug (women of childbearing age include: any one with menarche, and those who have not received successful artificial sterilization [hysterectomy, bilateral fallopian tube ligation, or bilateral oophorectomy] or premenopausal women); a fertile male patient who is unwilling or unable to take effective contraceptive measures, and whose partner is a woman of childbearing age; Being involved in other clinical studies (except for the non-interventional phase of interventional clinical study, such as survival follow-up period); less than 4 weeks from the end of the dose of other investigational drug to the first dose of the investigational drug or 5 half-lives of the previous drug, whichever is shorter; Any mental or cognitive disorders which may limit subjects' understanding and implementation of the informed consent form; Other situations, such as poor compliance, which are considered by the investigator to be not suitable for participation in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    TGRX-326

    Crizotinib

    Arm Description

    Subjects to be treated with the investigational drug TGRX-326 at 60 mg once day in 28-day cycles.

    Subjects to be treated with the active control drug crizotinib at 250 mg twice day in 28-day cycles.

    Outcomes

    Primary Outcome Measures

    Progression Free Survival (PFS) by independent review committee (IRC)
    PFS defined by the time from randomization to progressive disease or death of any cause; PFS as evaluated by independent review committee (IRC).

    Secondary Outcome Measures

    Progression Free Survival (PFS) by investigator
    PFS defined by the time from randomization to progressive disease or death of any cause; PFS as evaluated by investigator.
    One-year Progression Free Survival (PFS)
    One-year PFS defined by the time from randomization to progressive disease or death of any cause, with data collection up to 1 year from randomization; one-year PFS as evaluated by investigator or IRC.
    Objective Response Rate (ORR)
    ORR defined by the ratio of patients who reached the treatment response; ORR as evaluated by independent review committee (IRC) and investigator
    Duration of Response (DOR)
    DOR defined as the duration from first occurence of treatment response to progressive disease/relapse; DOR as evaluated by IRC and investigator
    Disease Control Rate (DCR)
    DCR defined by the ratio of patients who reached the treatment response or maintained as stable disease; DCR as evaluated by IRC and investigator
    Time to Response (TTR)
    TTR defined by the time from the start of treatment to the first ORR; TTR as evaluated by IRC and investigator
    Intracranial Objective Response Rate (IC-ORR)
    IC-ORR defined by the ratio of patients who reached the intracranial treatment response; ORR as evaluated by IRC and investigator.
    Intracranial Disease Control Rate (IC-DCR)
    IC-DCR defined by the ratio of patients who reached the treatment response intracranially or maintained as stable disease; IC-DCR as evaluated by IRC and investigator
    Intracranial Duration of Response (IC-DOR)
    IC-DOR defined as the duration from first occurrence of Intracranial treatment response to progressive disease/relapse; DOR as evaluated by IRC and investigator
    Intracranial Time to Response (IC-TTR)
    IC-TTR defined by the time from the start of treatment to the first IC-ORR; TTR as evaluated by IRC and investigator
    Intracranial Progression Free Survival (IC-PFS)
    IC-PFS defined by the time from randomization to progressive disease or death of any cause in patients with intracranial lesions; PFS as evaluated by IRC and investigator.
    Overall Survival (OS)
    OS defined by the time from randomization to death of any cause
    Adverse Events (AEs)
    To record and analyze subjects with adverse events (AEs)
    Serious Adverse Events (SAEs)
    To record and analyze subjects with serious adverse events (SAEs)

    Full Information

    First Posted
    October 8, 2023
    Last Updated
    October 8, 2023
    Sponsor
    Shenzhen TargetRx, Inc.
    Collaborators
    Sun Yat-sen University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06082635
    Brief Title
    TGRX-326 Chinese Phase III for Advanced Non-small Cell Lung Cancer (NSCLC)
    Official Title
    A Multi-centered, Randomized, Open-label Phase III Study to Evaluate the Efficacy and Safety of TGRX-326 Comparing With Crizotinib in Patients of Advanced ALK-positive or Metastatic Non-Small Cell Lung Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    November 30, 2023 (Anticipated)
    Primary Completion Date
    December 31, 2024 (Anticipated)
    Study Completion Date
    November 30, 2028 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Shenzhen TargetRx, Inc.
    Collaborators
    Sun Yat-sen 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
    This is a multi-center, randomized, open-label, Phase III clinical trial which compares the safety and efficacy of TGRX-326 with crizotinib in patients with ALK-positive advanced or metastatic NSCLC
    Detailed Description
    This Phase III study aims to evaluate the safety profile and efficacy profile in patients with ALK-positive advanced or metastatic NSCLC and to compare the efficacy and safety of TGRX-326 with that of crizotinib. The primary purpose of this study is to evaluate and compare the efficacy profile of TGRX-326 with crizotinib, with progression-free survival (PFS) as evaluated by independent review committee (IRC) as end point. Secondary objectives include comparing efficacy profile of other endpoints and safety profiles of the investigational drug with crizotinib. Exploratory objective includes the evaluation of population pharmacokinetic (PK) profile of TGRX-326 and efficacy of TGRX-326 in ALK-positive advanced NSCLC patients determined as progressive disease after crizotinib treatment.

    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
    297 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    TGRX-326
    Arm Type
    Experimental
    Arm Description
    Subjects to be treated with the investigational drug TGRX-326 at 60 mg once day in 28-day cycles.
    Arm Title
    Crizotinib
    Arm Type
    Active Comparator
    Arm Description
    Subjects to be treated with the active control drug crizotinib at 250 mg twice day in 28-day cycles.
    Intervention Type
    Drug
    Intervention Name(s)
    TGRX-326
    Other Intervention Name(s)
    TGRX-326 QD (once a day)
    Intervention Description
    Subjects will be treated with the investigational drug TGRX-326 at 60 mg once a day in 28-day cycles
    Intervention Type
    Drug
    Intervention Name(s)
    Crizotinib
    Other Intervention Name(s)
    Crizotinib 250 mg BID (twice a day)
    Intervention Description
    Subjects will be treated with the control drug crizotinib at 250 mg twice a day in 28-day cycles
    Primary Outcome Measure Information:
    Title
    Progression Free Survival (PFS) by independent review committee (IRC)
    Description
    PFS defined by the time from randomization to progressive disease or death of any cause; PFS as evaluated by independent review committee (IRC).
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Secondary Outcome Measure Information:
    Title
    Progression Free Survival (PFS) by investigator
    Description
    PFS defined by the time from randomization to progressive disease or death of any cause; PFS as evaluated by investigator.
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    One-year Progression Free Survival (PFS)
    Description
    One-year PFS defined by the time from randomization to progressive disease or death of any cause, with data collection up to 1 year from randomization; one-year PFS as evaluated by investigator or IRC.
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Objective Response Rate (ORR)
    Description
    ORR defined by the ratio of patients who reached the treatment response; ORR as evaluated by independent review committee (IRC) and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Duration of Response (DOR)
    Description
    DOR defined as the duration from first occurence of treatment response to progressive disease/relapse; DOR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Disease Control Rate (DCR)
    Description
    DCR defined by the ratio of patients who reached the treatment response or maintained as stable disease; DCR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Time to Response (TTR)
    Description
    TTR defined by the time from the start of treatment to the first ORR; TTR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Intracranial Objective Response Rate (IC-ORR)
    Description
    IC-ORR defined by the ratio of patients who reached the intracranial treatment response; ORR as evaluated by IRC and investigator.
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Intracranial Disease Control Rate (IC-DCR)
    Description
    IC-DCR defined by the ratio of patients who reached the treatment response intracranially or maintained as stable disease; IC-DCR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Intracranial Duration of Response (IC-DOR)
    Description
    IC-DOR defined as the duration from first occurrence of Intracranial treatment response to progressive disease/relapse; DOR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Intracranial Time to Response (IC-TTR)
    Description
    IC-TTR defined by the time from the start of treatment to the first IC-ORR; TTR as evaluated by IRC and investigator
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Intracranial Progression Free Survival (IC-PFS)
    Description
    IC-PFS defined by the time from randomization to progressive disease or death of any cause in patients with intracranial lesions; PFS as evaluated by IRC and investigator.
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Overall Survival (OS)
    Description
    OS defined by the time from randomization to death of any cause
    Time Frame
    Every 8 weeks between Cycle 1 and Cycle 17, and every 12 weeks from Cycle 17 and onwards (every cycle is 28 days); an average of 1.5 years
    Title
    Adverse Events (AEs)
    Description
    To record and analyze subjects with adverse events (AEs)
    Time Frame
    At Screening; Day 1 of every Cycle (each cycle is 28 days) until end of study
    Title
    Serious Adverse Events (SAEs)
    Description
    To record and analyze subjects with serious adverse events (SAEs)
    Time Frame
    At Screening; Day 1 of every Cycle (each cycle is 28 days) until end of study
    Other Pre-specified Outcome Measures:
    Title
    Plasma Cmax
    Description
    To measure plasma TGRX-326 concentration
    Time Frame
    Day 1 of Cycle 2, 3 and 5 (each cycle is 28 days)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willing to follow the treatment protocol and visit schedule, and participate in the study with the ICF signed; ≥ 18 years of age on the day of ICF signing, regardless of gender. Diagnosed as incurable stage IIIB - IV ALK-positive NSCLC; Providing prior ALK positive test results at screening; Naïve to ALK-inhibitor; patients could be intolerant or have progressive disease from previous first-line chemotherapy; Patients could have metastases to central nervous system at screening if the condition is asymptomatic, stable or completely recovered; At least one measurable lesion; An ECOG PS score within 0-2; Adequate bone marrow, liver, kidney, coagulation and pancreatic functions; Expected survival ≥ 3 months; Willing to take effective contraceptive measures (for men of reproductive potential and women of reproductive age only) from ICF signing to 6 months after last administration of the investigational drug. Women of reproductive age include women before menopause and within 1 year after menopause; those women must have a negative pregnancy test ≤ 7 days prior to the first dose of the investigational drug. Exclusion Criteria: Known hypersensitivity to any of the active ingredients or excipients of TGRX-326 or crizotinib pills; or a history of severe allergic reactions; Having another type of cancer except for lung cancer; Radiotherapy within 14 days prior to the first dose; Received other systemic anti-tumor treatment within 4 weeks prior to the first dose, or is within 5 half-lives of the said treatment; received traditional Chinese medicine indicated for anti-tumor purposes within 14 days prior to the first dose; Major surgery within 4 weeks prior to the first dose; Spinal cord compression caused by tumor, unless the subject achieves significant pain control and full recovery of neurological function within 4 weeks prior to the first dose. Abnormal gastrointestinal function that affect absorption within the past 6 months; History of active pneumonia or clinically significant interstitial pneumonia, or radiation or drug-induced lung disorder with treatment needs; Cardiac insufficiency; Abnormal and clinically significant QTc on ECG or need of concomitant use of any drug known to prolong QT interval and cause torsades de pointes; Uncontrolled hypertension after drug treatment; Uncontrolled hyperglycaemia, acute attack of cholelithiasis, and susceptibility to acute pancreatitis; Severe or uncontrolled systemic diseases causing expected intolerance to the investigational drug as judged by the investigator; Toxic reactions associated with prior surgery and prior antineoplastic therapies that have not recovered and may affect the subject safety as assessed by the investigator. Clinically significant active bacterial, fungal or viral infections, including a positive result for hepatitis B surface antigen and HBV DNA ≥ ULN, one or more positive results for hepatitis C antibody or HIV antibody, or the presence of any uncontrolled infection. Use of strong CYP3A4 inducers or inhibitors or CYP3A4 substrates with a narrow therapeutic window within two weeks prior to the first dose of the investigational drug; Pregnant and breastfeeding female; Women of childbearing age who are unwilling or unable to use acceptable methods for contraception during the entire treatment period in the trial and within 6 months after the last dose of the investigational drug (women of childbearing age include: any one with menarche, and those who have not received successful artificial sterilization [hysterectomy, bilateral fallopian tube ligation, or bilateral oophorectomy] or premenopausal women); a fertile male patient who is unwilling or unable to take effective contraceptive measures, and whose partner is a woman of childbearing age; Being involved in other clinical studies (except for the non-interventional phase of interventional clinical study, such as survival follow-up period); less than 4 weeks from the end of the dose of other investigational drug to the first dose of the investigational drug or 5 half-lives of the previous drug, whichever is shorter; Any mental or cognitive disorders which may limit subjects' understanding and implementation of the informed consent form; Other situations, such as poor compliance, which are considered by the investigator to be not suitable for participation in the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Bing Liu
    Phone
    (+86)18629418910
    Email
    bing.liu@tjrbiosciences.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Li Zhang, MD
    Organizational Affiliation
    Sun Yat-sen University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    TGRX-326 Chinese Phase III for Advanced Non-small Cell Lung Cancer (NSCLC)

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