Efficacy and Safety of Furmonertinib in Patients With Locally Advanced or Metastatic NSCLC With EGFR Exon 20 Insertion
Primary Purpose
NSCLC
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Furmonertinib
Sponsored by
About this trial
This is an interventional treatment trial for NSCLC
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years at time of signing Informed Consent Form
- Histologically or cytologically documented, locally advanced or metastatic NSCLC not amenable to curative surgery or radiotherapy
- Documented validated results from local or central testing (as designated by the Sponsor) of blood or tumor tissue confirming the presence of an EGFR exon 20 insertion mutation
- Documented radiologic progression on or after prior platinum-based chemotherapy (with or without anti-PD1/PD-L1 agents) in the locally advanced or metastatic setting
- Documented radiologic disease progression during or after the last systemic anticancer therapy before the first dose of furmonertinib
- Measurable disease per RECIST v1.1
- ECOG performance status of 0 or 1
- Life expectancy of ≥ 12 weeks
- Patients with CNS metastases are eligible, provided they meet all of the following criteria: Measurable disease outside the CNS; No ongoing requirement for corticosteroids as therapy for CNS metastases, with corticosteroids discontinued for ≥ 2 weeks prior to enrollment; No ongoing symptoms attributed to CNS metastases; No active CNS metastases or spinal cord compression (i.e., progressing or requiring anticonvulsants or corticosteroids for symptomatic control); No evidence of interim CNS disease progression between the completion of CNS-directed therapy and the screening radiographic study; Time since whole brain radiation therapy (WBRT) is ≥ 21 days prior to first dose of study treatment, time since stereotactic radiosurgery (SRS) is ≥ 7 days prior to first dose of study treatment, or time since surgical resection is ≥ 28 days
- Adequate hematologic and organ function within 14 days prior to initiation of study treatment
- For women of childbearing potential or men who are not surgically sterile: Agreement to remain abstinent or use contraception, and agreement to refrain from donating eggs or sperm
Exclusion Criteria:
- Prior treatment with any EGFR-targeting agents (e.g., EGFR tyrosine kinase inhibitors [TKIs], monoclonal antibodies, or bispecific antibodies).
- More than 3 prior systemic anticancer therapy regimens for locally advanced or metastatic NSCLC
- Inability or unwillingness to swallow pills
- Severe acute or chronic infections
- Previous interstitial lung disease (ILD), drug-induced ILD, radiation pneumonitis requiring steroid therapy; or having the clinical manifestations of suspected ILD
- History of or active clinically significant cardiovascular dysfunction
- Mean resting corrected QT interval (QTc) > 470 msec, obtained from triplicate ECGs, using the screening clinic ECG machine derived Fridericia's formula (QTcF) value
- Clinically significant prolonged QT interval or other arrhythmia or clinical status considered by investigators that may increase the risk of prolonged QT interval (e.g., complete left bundle branch block, degree III atrioventricular block, second-degree heart block, PR interval > 250 msec, congenital long QT syndrome, family history of long QT syndrome, or unexplained sudden death under 40 years of age in first-degree relatives, serious hypokalemia, heart failure) or current use of the drugs that may lead to prolonged QT interval.
- AEs from prior anticancer therapy that have not resolved to Grade ≤ 1 except for alopecia, vitiligo, endocrinopathy managed with replacement therapy, or Grade ≤ 2 peripheral neuropathy.
Sites / Locations
- Jilin Province Cancer HospitalRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Furmonertinib 240mg QD
Arm Description
Treating patients of locally advanced or metastatic NSCLC with EGFR exon 20 insertions who have progressed during or after platinum-based chemotherapy.
Outcomes
Primary Outcome Measures
ORR, Objective Response Rate
Percentage of patients with a confirmed CR or PR relative to the total number of patients.
Secondary Outcome Measures
DOR, Duration of response
Time from first documented evidence of confirmed CR or PR until the first documented evidence of disease progression or death, whichever occurs earlier
DCR, Disease control rate
Proportion of patients with CR, PR, or SD
Depth of response
Maximum reduction in BICR and investigator assessment using RECIST v1.1 compared to baseline
PFS, Progression Free Survival
Time from first dose date to the first occurrence of disease progression, or death from any cause, whichever occurs first
OS, Overall Survival
Time from first dose to death from any cause
CNS ORR, CNS DOR, CNS PFS
Evaluated by BICR per modified RECIST criteria in patients with CNS lesion(s) on baseline brain scan
Adverse Events
Incidence and severity of adverse events, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0).
Maximum Plasma Concentration [Cmax]
Plasma concentrations of furmonertinib and its major metabolite (AST5902) at specified time points
Minimum Plasma Concentration [Cmin]
Plasma concentrations of furmonertinib and its major metabolite (AST5902) at specified time points
Full Information
NCT ID
NCT05466149
First Posted
July 14, 2022
Last Updated
January 30, 2023
Sponsor
Allist Pharmaceuticals, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT05466149
Brief Title
Efficacy and Safety of Furmonertinib in Patients With Locally Advanced or Metastatic NSCLC With EGFR Exon 20 Insertion
Official Title
A Phase 2, Multicenter, Open-Label Study to Assess the Efficacy and Safety of Furmonertinib in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) With Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertion Mutations
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 27, 2022 (Actual)
Primary Completion Date
April 2024 (Anticipated)
Study Completion Date
August 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Allist Pharmaceuticals, Inc.
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 Phase 2, Multicenter, Open-Label Study to Assess the Efficacy and Safety of Furmonertinib in Patients with Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) with Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertion Mutations.
The study plans to enroll approximately 100 patients from approximately 70 sites. Patients are locally advanced or metastatic NSCLC with EGFR exon 20 insertions who have progressed during or after platinum-based chemotherapy. Furmonertinib Mesilate will be treated 240 mg QD until disease progression or unacceptable toxicity.
Primary endpoint is ORR. Secondary endpoints include DOR, DCR, DepOR, PFS, OS, CNS ORR, CNS DOR, CNS PFS, safety and the PK profile of Furmonertinib Mesilate and its metabolites (AST5902).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
NSCLC
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Furmonertinib 240mg QD
Arm Type
Experimental
Arm Description
Treating patients of locally advanced or metastatic NSCLC with EGFR exon 20 insertions who have progressed during or after platinum-based chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Furmonertinib
Other Intervention Name(s)
AST2818
Intervention Description
240mg QD on a continuous dosing schedule.
Primary Outcome Measure Information:
Title
ORR, Objective Response Rate
Description
Percentage of patients with a confirmed CR or PR relative to the total number of patients.
Time Frame
Approximately 7.5 months following the last patient enrolled
Secondary Outcome Measure Information:
Title
DOR, Duration of response
Description
Time from first documented evidence of confirmed CR or PR until the first documented evidence of disease progression or death, whichever occurs earlier
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
DCR, Disease control rate
Description
Proportion of patients with CR, PR, or SD
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
Depth of response
Description
Maximum reduction in BICR and investigator assessment using RECIST v1.1 compared to baseline
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
PFS, Progression Free Survival
Description
Time from first dose date to the first occurrence of disease progression, or death from any cause, whichever occurs first
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
OS, Overall Survival
Description
Time from first dose to death from any cause
Time Frame
Approximately 3 years following the last patient enrolled
Title
CNS ORR, CNS DOR, CNS PFS
Description
Evaluated by BICR per modified RECIST criteria in patients with CNS lesion(s) on baseline brain scan
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
Adverse Events
Description
Incidence and severity of adverse events, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0).
Time Frame
Until 28 days from the last dose of study drugs or initiation of a new anticancer treatment
Title
Maximum Plasma Concentration [Cmax]
Description
Plasma concentrations of furmonertinib and its major metabolite (AST5902) at specified time points
Time Frame
Approximately 7.5 months following the last patient enrolled
Title
Minimum Plasma Concentration [Cmin]
Description
Plasma concentrations of furmonertinib and its major metabolite (AST5902) at specified time points
Time Frame
Approximately 7.5 months following the last patient enrolled
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years at time of signing Informed Consent Form
Histologically or cytologically documented, locally advanced or metastatic NSCLC not amenable to curative surgery or radiotherapy
Documented validated results from local or central testing (as designated by the Sponsor) of blood or tumor tissue confirming the presence of an EGFR exon 20 insertion mutation
Documented radiologic progression on or after prior platinum-based chemotherapy (with or without anti-PD1/PD-L1 agents) in the locally advanced or metastatic setting
Documented radiologic disease progression during or after the last systemic anticancer therapy before the first dose of furmonertinib
Measurable disease per RECIST v1.1
ECOG performance status of 0 or 1
Life expectancy of ≥ 12 weeks
Patients with CNS metastases are eligible, provided they meet all of the following criteria: Measurable disease outside the CNS; No ongoing requirement for corticosteroids as therapy for CNS metastases, with corticosteroids discontinued for ≥ 2 weeks prior to enrollment; No ongoing symptoms attributed to CNS metastases; No active CNS metastases or spinal cord compression (i.e., progressing or requiring anticonvulsants or corticosteroids for symptomatic control); No evidence of interim CNS disease progression between the completion of CNS-directed therapy and the screening radiographic study; Time since whole brain radiation therapy (WBRT) is ≥ 21 days prior to first dose of study treatment, time since stereotactic radiosurgery (SRS) is ≥ 7 days prior to first dose of study treatment, or time since surgical resection is ≥ 28 days
Adequate hematologic and organ function within 14 days prior to initiation of study treatment
For women of childbearing potential or men who are not surgically sterile: Agreement to remain abstinent or use contraception, and agreement to refrain from donating eggs or sperm
Exclusion Criteria:
Prior treatment with any EGFR-targeting agents (e.g., EGFR tyrosine kinase inhibitors [TKIs], monoclonal antibodies, or bispecific antibodies).
More than 3 prior systemic anticancer therapy regimens for locally advanced or metastatic NSCLC
Inability or unwillingness to swallow pills
Severe acute or chronic infections
Previous interstitial lung disease (ILD), drug-induced ILD, radiation pneumonitis requiring steroid therapy; or having the clinical manifestations of suspected ILD
History of or active clinically significant cardiovascular dysfunction
Mean resting corrected QT interval (QTc) > 470 msec, obtained from triplicate ECGs, using the screening clinic ECG machine derived Fridericia's formula (QTcF) value
Clinically significant prolonged QT interval or other arrhythmia or clinical status considered by investigators that may increase the risk of prolonged QT interval (e.g., complete left bundle branch block, degree III atrioventricular block, second-degree heart block, PR interval > 250 msec, congenital long QT syndrome, family history of long QT syndrome, or unexplained sudden death under 40 years of age in first-degree relatives, serious hypokalemia, heart failure) or current use of the drugs that may lead to prolonged QT interval.
AEs from prior anticancer therapy that have not resolved to Grade ≤ 1 except for alopecia, vitiligo, endocrinopathy managed with replacement therapy, or Grade ≤ 2 peripheral neuropathy.
Facility Information:
Facility Name
Jilin Province Cancer Hospital
City
Changchun
State/Province
Jilin
ZIP/Postal Code
130000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ying Chen, Doctor
Phone
86-0431-80596067
Email
jpchirb@163.com
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Efficacy and Safety of Furmonertinib in Patients With Locally Advanced or Metastatic NSCLC With EGFR Exon 20 Insertion
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