HERTHENA-Lung02: A Study of Patritumab Deruxtecan Versus Platinum-based Chemotherapy in Metastatic or Locally Advanced EGFRm NSCLC After Failure of EGFR TKI Therapy
Nonsquamous Non-small Cell Lung Cancer, EGFR L858R, EGFR Exon 19 Deletion
About this trial
This is an interventional treatment trial for Nonsquamous Non-small Cell Lung Cancer focused on measuring Nonsquamous Non-small Cell Lung Cancer, EGFR L858R, EGFR exon 19 deletion, Patritumab deruxtecan, HER3-DXd, U3-1402
Eligibility Criteria
Inclusion Criteria:
- Is a male or female subject aged ≥18 years (follow local regulatory requirements if the legal age of consent for study participation is >18 years old).
- Has histologically or cytologically documented metastatic or locally advanced non-squamous NSCLC not amenable to curative surgery or radiation.
- Has documentation of an EGFR-activating mutation detected from tumor tissue or blood sample: exon 19 deletion or L858R at diagnosis or thereafter.
- Received 1 or 2 prior line(s) of an approved EGFR TKI treatment in the metastatic or locally advanced setting, which must include a third -generation EGFR TKI
- May have received either neoadjuvant and/or adjuvant treatment if progression to metastatic or locally advanced disease occurred at least 12 months after the last dose of such therapy and subsequently experienced disease progression on or after third-generation EGFR TKI treatment administered in the metastatic or locally advanced setting.
- Has not received any other prior systemic therapies in the metastatic or locally advanced setting (including chemotherapy, immunotherapy etc) (even if administered in combination with EGFR TKI).
- Has documentation of radiographic disease progression while receiving or after receiving a third generation EGFR TKI for metastatic or locally advanced disease.
- Has at least 1 measurable lesion as per RECIST v1.1 by Investigator assessment.
- Is willing to have a tumor biopsy or provide recently obtained tumor tissue.
- Has an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 at Screening.
Has adequate bone marrow reserve and organ function based on local laboratory evaluation within 14 days prior to randomization:
- Platelet count: ≥100,000/mm^3 or ≥100 × 10^9/L
- Absolute neutrophil count: ≥1500/mm^3 or ≥1.5 × 10^9/L
- Hemoglobin (Hgb): ≥9.0 g/dL
- Creatine clearance (CrCl): CrCl ≥45 mL/min calculated by using the Cockcroft-Gault equation or measured CrCl
- Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT): AST/ALT ≤3× Upper limit of normal (ULN)
- Total bilirubin (TBL): TBL ≤1.5 × ULN
- Serum albumin: ≥2.5 g/dL
- Prothrombin time (PT) or Prothrombin time-International normalized ratio (PT-INR) and activated partial thromboplastin time (aPTT)/partial thromboplastin time (PTT): ≤1.5 × ULN, except for participants receiving coumarin-derivative anticoagulants or other similar anticoagulant therapy who must have PT-INR within therapeutic range as deemed appropriate by the Investigator
Exclusion Criteria:
- Has any previous histologic or cytologic evidence of small cell OR combined small cell/non-small cell disease in the archival tumor tissue or pretreatment tumor biopsy, or squamous NSCLC histology
- Has any history of interstitial lung disease (ILD) (including pulmonary fibrosis or radiation pneumonitis), has current ILD, or is suspected to have such disease by imaging during Screening
Has clinically severe respiratory compromise (based on the Investigator's assessment) resulting from intercurrent pulmonary illnesses including, but not limited to the following:
- Any underlying pulmonary disorder, restrictive lung disease, or pleural effusion
- Any autoimmune, connective tissue, or inflammatory disorders where there is documented, or a suspicion of pulmonary involvement at the time of Screening
- OR prior complete pneumonectomy
- Is receiving chronic systemic corticosteroids dosed at >10 mg prednisone or equivalent anti-inflammatory activity or any form of immunosuppressive therapy prior to randomization
- Has evidence of any leptomeningeal disease
- Has evidence of clinically active spinal cord compression or brain metastases, defined as being symptomatic and untreated, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms
- Any prior treatment with any agent including an antibody drug conjugate (ADC) containing a chemotherapeutic agent targeting topoisomerase I, human epidermal growth factor receptor 3 (HER3) antibody, and any systemic therapies (other than EGFR TKIs) in the metastatic/locally advanced setting, including chemotherapy or any other systemic therapy in combination with an EGFR TKI
- Has history of other active malignancy within 3 years prior to randomization, except for adequately resected nonmelanoma skin cancer, adequately treated intraepithelial carcinoma of the cervix, and any other curatively treated in situ disease
- Has uncontrolled or significant cardiovascular disease prior to randomization
- Has active hepatitis B and/or hepatitis C infection, such as those with serologic evidence of active viral infection within 28 days of randomization
- Has a known human immunodeficiency virus (HIV) infection that is not well controlled
- Has clinically significant corneal disease
Sites / Locations
- Alaska Oncology and Hematology LLCRecruiting
- Highlands OncologyRecruiting
- City of HopeRecruiting
- Moores Cancer Center at the UC San Diego HealthRecruiting
- Scripps MD Anderson Cancer CenterRecruiting
- USC Norris Comprehensive Cancer CenterRecruiting
- Kaiser Permanente - Vallejo Medical CenterRecruiting
- Innovative Clinical Research InstituteRecruiting
- Sarah Cannon/Florida Cancer Specialists - FCS SouthRecruiting
- Emory UniversityRecruiting
- St Luke's Cancer InstituteRecruiting
- The University of Chicago
- American Oncology Partners of MarylandRecruiting
- Dana-Farber Cancer InstituteRecruiting
- Dartmouth Hitchcock Medical CenterRecruiting
- Hackensack Meridian Health-Southern Ocean Medical CenterRecruiting
- Montefiore Medical CenterRecruiting
- Memorial Sloan Kettering Cancer CenterRecruiting
- Providence Portland Medical CenterRecruiting
- Sarah Cannon Research InstituteRecruiting
- University of Texas Southwestern Medical CenterRecruiting
- Inova Schar Cancer InstituteRecruiting
- Virginia Cancer SpecialistsRecruiting
- University of Wisconsin Carbone Cancer CenterRecruiting
- The Chris O'Brien LifehouseRecruiting
- St George Public HospitalRecruiting
- Liverpool HospitalRecruiting
- Austin HospitalRecruiting
- St John of God Subiaco HospitalRecruiting
- Princess Alexandra HospitalRecruiting
- Landeskrankenhaus FeldkirchRecruiting
- Medizinische Universitaet InnsbruckRecruiting
- Klinikum Klagenfurt PulmologieRecruiting
- Klinikum Wels-GrieskirchenRecruiting
- Karl Landsteiner Institut fur Lungenforschung und pneumologische Onkologie c/o Klinik FloridsdorfRecruiting
- Cliniques Universitaires Saint-LucRecruiting
- UZ LeuvenRecruiting
- AZ Sint Maarten MechelenRecruiting
- AZ DeltaRecruiting
- William Osler Health System - Brampton Civic HospitalRecruiting
- Sunnybrook Health Sciences Ctr
- Peking University Cancer HospitalRecruiting
- Jilin Cancer Hospital
- Hunan Cancer HospitalRecruiting
- University of Electronic Science Technology of China UESTC - Sichuan Cancer Hospital Institute Sichuan Provincial Tumor Hospital
- National Cancer Center Hospital EastRecruiting
- Fujian Medical University - Union Hospital Foochow Christian Union HospitalRecruiting
- Guangdong Academy of Medical Science (GAMS) - Guangdong Provincial Peoples HospitalRecruiting
- The First Affiliated Hospital Sun-Yat-Sen UniversityRecruiting
- Pecking University Third HospitalRecruiting
- The First Affiliated Hospital of College of Medicine Zhejiang UniversityRecruiting
- Zhejiang Cancer hospitalRecruiting
- Harbin Medical University - Tumor Hospital The Third Affiliated HospitalRecruiting
- The First Affiliated Hospital - Anhui Medical University Dept of Medical OncologyRecruiting
- Henan Provincial Peoples HospitalRecruiting
- The Second Affiliated Hospital of Kunming Medical UniversityRecruiting
- Lin Yi Cancer HospitalRecruiting
- General Hospital of Eastern Theater CommandRecruiting
- The First Affiliated Hospital of Guangxi Medical UniversityRecruiting
- Fudan University - Shanghai Cancer Center FUSCCRecruiting
- Cancer Hospital of Shantou University Medical CollegeRecruiting
- The First Hospital of China Medical UniversityRecruiting
- Liaoning Cancer Hospital & Institute
- Union Hospital of Tongji Medical College Huazhong University of Science and TechnologyRecruiting
- Huazhong University of Science and Technology - Tongji Medical College - Tongji Hospital TJH
- The First Affiliate Hospital of Xi'an Jiaotong UniversityRecruiting
- Henan Cancer HospitalRecruiting
- Affiliated Cancer Hospital of Xinjiang Medical UniversityRecruiting
- Hopital Morvan CHU de BrestRecruiting
- Centre Francois BaclesseRecruiting
- Centre Francois Baclesse
- Centre Leon BerardRecruiting
- Montpellier Cancer Institute ICMRecruiting
- Institut CurieRecruiting
- APHP - Hopital Saint LouisRecruiting
- Centre Hospitalier Lyon SudRecruiting
- Centre Hospitalier Universitaire (CHU) de Rennes - Hopital de PontchaillouRecruiting
- Institut de Cancrologie de lOuest ICORecruiting
- Gustave RoussyRecruiting
- Universitaetsklinikum EssenRecruiting
- Klinikum Esslingen GmbHRecruiting
- IKF Krankenhaus NordwestRecruiting
- Asklepios Fachklinik Muenchen-GautingRecruiting
- Universitatsklinik Giessen und MarburgRecruiting
- LungenClinic GrosshansdorfRecruiting
- Thoraxklinik Heidelberg gGmbHRecruiting
- LKI Lungenfachklinik ImmenhausenRecruiting
- Klinikverbund AllgaeuRecruiting
- Klinikum Nuernberg Nord
- Pius-Hospital OldenburgRecruiting
- Universitaetsklinikum Wurzburg
- Pamela Youde Nethersole Eastern Hospital
- Prince of Wales HospitalRecruiting
- University of Hong Kong/Queen Mary HospitalRecruiting
- Queen Elizabeth HospitalRecruiting
- IRCCS Istituto Oncologico Giovanni Paolo IIRecruiting
- University G. D'Annunzio ChietiRecruiting
- Ospedale San LucaRecruiting
- IRCCS Istituto Europeo di OncologiaRecruiting
- Asst Grande Ospedale Metropolitano NiguardaRecruiting
- Azienda Ospedaliero-Universitaria San Luigi GonzagaRecruiting
- Azienda Ospedaliero Universitaria di ParmaRecruiting
- Ospedale Santa Maria della MisericordiaRecruiting
- IFO Regina ElenaRecruiting
- IRCCS Humanitas Research HospitalRecruiting
- ASST Sette LaghiRecruiting
- Hyogo Cancer CenterRecruiting
- Kyushu University HospitalRecruiting
- Saitama Medical University International Medical CenterRecruiting
- Kansai Medical University HospitalRecruiting
- Iwakuni Clinical CenterRecruiting
- Izumi City General HospitalRecruiting
- Kanazawa University HospitalRecruiting
- The Cancer Institute Hospital of JFCRRecruiting
- Saiseikai Kumamoto HospitalRecruiting
- Kurashiki Central HospitalRecruiting
- Kurume University HospitalRecruiting
- Matsusaka Municipal HospitalRecruiting
- NHO Shikoku Cancer CenterRecruiting
- National Hospital Organization Nagoya Medical CenterRecruiting
- Niigata Cancer Center HospitalRecruiting
- Okayama University HospitalRecruiting
- National Hospital Organization Hokkaido Cancer CenterRecruiting
- Sendai Kousei HospitalRecruiting
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalRecruiting
- Fujita Health University HospitalRecruiting
- Wakayama Medical University HospitalRecruiting
- Kindai University HospitalRecruiting
- Chungbuk National University HospitalRecruiting
- National Cancer CenterRecruiting
- Seoul National University Bundang HospitalRecruiting
- Seoul National University HospitalRecruiting
- Severance HospitalRecruiting
- Asan Medical CenterRecruiting
- Samsung Medical CenterRecruiting
- The Catholic University of Korea, Seoul St. Marys HospitalRecruiting
- Samsung Medical Center
- Netherlands Cancer Institute
- Rijnstate ZiekenhuisRecruiting
- St. Jansdal ZiekenhuisRecruiting
- Leiden University Medical CenterRecruiting
- Erasmus MC
- University Medical Center UtrechtRecruiting
- Akershus University HospitalRecruiting
- Oslo University Hospital-The Norwegian Radium HospitalRecruiting
- Stavanger University HospitalRecruiting
- II Klinika Chorob Pluc i GruzlicyRecruiting
- Onko-Centrum Sp. z o.o.Recruiting
- Med Polonia Sp. z o.o.Recruiting
- Centro Clinico ChampalimaudRecruiting
- Instituto Portugues de Oncologio de LisboaRecruiting
- Centro Hospitalar Universitario do Porto - Hospital de Santo AntonioRecruiting
- Centro Hospitalar de Vila Nova de Gaia - EspinhoRecruiting
- National University Cancer Institute National University HospitalRecruiting
- National Cancer Centre Singapore NCCSRecruiting
- Tan Tock Seng HospitalRecruiting
- ICON Cancer CentreRecruiting
- Hospital Teresa Herrera C.H.U.A.C.Recruiting
- Hospital del MarRecruiting
- Hospital Universitari Vall d'HebronRecruiting
- Hospital Clinic i Provincial de BarcelonaRecruiting
- Complejo Hospitalario Materno-Insular - Hospital Insular de Gran CanariaRecruiting
- Hospital General Universitario Gregorio MaranonRecruiting
- MD Anderson Cancer CenterRecruiting
- Hospital Universitario Fundacion Jimenez DiazRecruiting
- Hospital Universitario 12 de OctubreRecruiting
- Hospital Regional Universitario MalagaRecruiting
- Hospital Univeritario Marques de ValdecillaRecruiting
- Hospital Universitario Virgen Macarena
- Hospital Universitario Virgen MacarenaRecruiting
- University Hospital Basel
- Kantonsspital Graubuenden - HauptstandortRecruiting
- Kantonsspital Winterthur KSWRecruiting
- E-Da HospitalRecruiting
- Taichung Veterans General HospitalRecruiting
- National Cheng Kung University Hospital NCKUHRecruiting
- National Taiwan University Hospital NTUHRecruiting
- Taipei Veterans General HospitalRecruiting
- Chang Gung Memorial Hospital-Linkou BranchRecruiting
- University Hospital Birmingham NHS TrustRecruiting
- Beatson West of Scotland Cancer CentreRecruiting
- Leeds Cancer CentreRecruiting
- University Hospitals of LeicesterRecruiting
- Barts and The London NHS Trust - St Bartholomew s hospital - PET CT CentreRecruiting
- The Royal Marsden Hospital NHS Foundation TrustRecruiting
- The Royal Marsden NHS Foundation TrustRecruiting
- The Christie HospitalRecruiting
- The Royal Wolverhampton NHS TrustRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Patritumab deruxtecan
Platinum-based chemotherapy
Participants who will be randomized to receive patritumab deruxtecan (HER3-DXd) 5.6 mg/kg q3W.
Participants who will be randomized to receive platinum-based chemotherapy for 4 cycles: pemetrexed plus either cisplatin or carboplatin. Participants without disease progression after 4 cycles of platinum plus pemetrexed therapy may continue treatment with maintenance pemetrexed with no restriction on the number of cycles.