HER2 Mutant Non-small Cell Lung Cancer
Conditions
Keywords
Non-Small Cell Lung Cancer, Rare Mutation of HER2, Pyrotinib
Brief summary
At present, the main characteristics of the enrolled population in the clinical study of HER2-mutated non-small cell lung cancer are the YVMA mutation type. There are no relevant clinical trials specifically targeting rare mutation types. Pyrotinib has been approved for the treatment of HER2-positive advanced breast cancer in China, and pyrotinib has shown good development prospects in the treatment of advanced non-small cell lung cancer. The purpose of this study is to observe the efficacy and safety of pyrotinib maleate in patients with HER2 rare mutation in advanced non-small cell lung cancer.
Interventions
Pyrotinib maleate tablets 400 mg/day, oral within 30 minutes after breakfast, every 4 weeks is a cycle
Sponsors
Study design
Eligibility
Inclusion criteria
* 1\. Age: 18-70 years old; * 2\. Advanced/metastatic non-small lung cancer (IV) confirmed by pathology with measurable lesions; * 3\. HER2 mutation and amplification confirmed by gene testing of tumor tissue or blood, pleural effusion, cerebrospinal fluid and other specimens; * 4\. ECOG:0-1; * 5\. At least one radiographically measurable lesion * 6\. Expected survival period ≥ 3 months * 7\. Left ventricular ejection fraction (LVEF) ≥ 50% on echocardiography * 8\. Before using the drug for the first time, it was confirmed by laboratory tests that the subject's bone marrow function, liver and kidney function met the following requirements: 1. Neutrophil count (ANC) ≥ 1,500/mm3 (1.5×109/L); 2. Platelet count (PLT) ≥ 100,000/mm3 (100×109/L); 3. Hemoglobin (Hb) ≥ 8 g/dL (80 g/L); 4. Serum creatinine (SCr) ≤ 1.5 times the upper limit of normal (ULN) or creatinine clearance ≥ 60 ml/min; 5. Total bilirubin (TBIL) ≤ 1.5 times the upper limit of normal (ULN); 6. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels ≤ 2.5 times the upper limit of normal (ULN), and subjects with liver metastases should be ≤ 5×ULN; 7. International normalized ratio (INR) ≤ 1.5, prothrombin time (PT) and activated partial thromboplastin time (APTT) ≤ 1.5 times ULN; 8. Urine protein \<2+; if urine protein ≥2+, the 24-hour urine protein quantification shows that protein must be ≤1g; * 9\. The medication regimen of the subjects during the clinical diagnosis and treatment was pyrotinib as a single drug * 10\. Patients voluntarily entered the study and signed informed consent form (ICF)
Exclusion criteria
* Common types of HER2 mutations: YVMA mutations; * Patients with hypertension that cannot be well controlled by antihypertensive drug treatment (systolic blood pressure\>140 mmHg, diastolic blood pressure\>90 mmHg); Uncontrolled or severe cardiovascular disease, such as refractory angina pectoris, congestive heart failure occurred within 6 months before screening; Myocardial infarction within 12 months prior to screening; Any history of clinically significant ventricular arrhythmia, prolonged QT interval; History of cerebrovascular accident, symptomatic coronary heart disease requiring drug treatment; * There are significant digestive tract dysfunction, which may affect the intake, transport or absorption of oral drugs (such as inability to swallow, chronic diarrhea, intestinal obstruction, etc.); * Subjects with a recent history of active bleeding, clinically significant bleeding symptoms, and a clear bleeding tendency, such as hemoptysis, gastrointestinal bleeding, hemorrhagic gastric ulcer, positive fecal occult blood at baseline and above, etc.; * Major surgical operations or severe traumatic injuries, fractures, or poorly healing wounds have been received within 4 weeks; * Uncontrollable history of important respiratory system such as bronchiectasis, chronic obstructive pulmonary disease, lung abscess, pulmonary embolism, etc.; * Active serious clinical infection (\>NCI-CTCAE, 5.0 version 2 infection standard) and viral infections such as hepatitis B, hepatitis C, syphilis and HIV; * Symptomatic brain metastases or meningeal metastases; * Combined with previously untreated tumors other than primary lung cancer; * Participated in clinical trials of other drugs within 4 weeks before the start of the study; * Received treatment with pyrotinib maleate; * Those who have serious adverse reactions and allergies to pyrotinib maleate; * Pregnant or lactating female subjects, female subjects who are fertile and have a positive baseline pregnancy test, or subjects of childbearing age who are unwilling to take effective contraceptive measures throughout the trial; * Have serious concomitant diseases, or any other conditions that the investigator considers unsuitable to participate in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ORR | 2 Year | It is defined as the proportion of patients whose tumors shrink to a predetermined size and maintain a minimum time limit. It includes the cases of CR and PR. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PFS | 1 Year | From the date Into this study to tumor progression or death for any |
| OS | 2 Year | The time from the beginning of treatment to the death of the subject due to various reasons, calculated by the intended treatment population (ITT) |
| DCR | 2 Year | the rate of CR, PR plus SD |
| AEs and SAEs | 1 Year | Number of Participants With adverse events (AEs) and serious adverse events (SAEs) Incidence, nature, and severity of adverse events graded according to the NCI CTCAE v5.0. |
| QoL | 1 Year | The quality of life of the subjects was assessed according to the EORTC QLQ-C30 quality of life questionnaire. |