Non-Small Cell Lung Cancer
Conditions
Keywords
PD-L1, NSCLC
Brief summary
The main objective of this study was to evaluate the anti-tumor activity of gimistotug (BGB-A445) plus investigational agents in participants with non-small cell lung cancer (NSCLC).
Detailed description
This study tested whether gimistotug in combination with other agents could help treat participants with non-small cell lung cancer (NSCLC) who were already treated with other anticancer agents, including anti-programmed cell death protein-1 (anti-PD-1) and anti-programmed cell death protein ligand-1 (anti-PD-L1) antibodies and platinum-based chemotherapy. The main goal of this study was to see if gimistotug could increase participant response to treatment, also called the overall response rate. Only a portion of patients with advanced solid tumors have a durable response to currently available treatments. This represents an unmet medical need to develop improved therapeutic options. Combining immunotherapies with agents having different mechanism of action might improve outcomes for these patients. This study was designed as a proof of concept to show that gimistotug-based combination treatment may be able to improve responses and clinical benefit in patients with NSCLC. Treatments in all cohorts was administered up to 36 cycles (approximately 2 years) until participants experienced no benefits, too many side effects, or withdrew consent.
Interventions
Administered intravenously
75 milligrams per square meter (mg/m\^2) administered intravenously
Administered orally
Sponsors
Study design
Eligibility
Inclusion criteria
* Advanced or metastatic NSCLC (nonsquamous or squamous) that is histologically or cytologically confirmed * Participants who have received no more than 2 lines of prior systemic therapies which must include anti-programmed cell death protein ligand-1 (anti-PD-(L)1) treatment and a platinum-based chemotherapy administered in combination with, or sequentially before or after the anti-PD-(L)1 treatment * At least 1 measurable lesion as defined per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 * Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 * Adequate organ function as indicated by laboratory values during screening
Exclusion criteria
* With mixed small cell lung cancer * Has received prior therapy targeting OX40 or any other T-cell agonists * Has received prior therapy containing docetaxel and/or ramucirumab for advanced or metastatic NSCLC * Has received any Chinese herbal medicine or Chinese patent medicines used to control cancer ≤ 14 days before the first dose of study drug(s) * Active leptomeningeal disease or uncontrolled and untreated brain metastasis NOTE: Other criteria may apply
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Response Rate | Response was assessed every 6 weeks for the first 9 months and every 12 weeks thereafter; maximum time on follow-up was up to 13.5 months | Overall response rate (ORR) is defined as the percentage of participants with best overall response (BOR) of a confirmed complete response (CR) or partial response (PR) as assessed by the investigators per Response Evaluation Criteria in Solid Tumors (RECIST) Version (v)1.1. CR is defined as: * Disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \< 10 mm. * Disappearance of all nontarget lesions and normalization of tumor marker level. All lymph nodes must be nonpathological in size (\< 10 mm short axis). * No new lesions. PR is defined as: * At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. * Non-progressive disease with regard to non-target lesions, persistence of 1 or more nontarget lesion(s) and/or maintenance of tumor marker level above the normal limits. * No new lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Response (DOR) | From first dose to the end of study; maximum time on follow-up was up to 13.5 months. | DOR is defined as the time from the first determination of an objective response as assessed by the investigator per RECIST v1 until the first documentation of progression or death, whichever comes first. Median DOR was estimated using the Kaplan-Meier method. |
| Disease Control Rate (DCR) | From first dose to the end of study; maximum time on follow-up was up to 13.5 months | DCR is defined as the percentage of participants with BOR of a CR, PR, or stable disease. Stable disease is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease, with no new lesions. |
| Clinical Benefit Rate (CBR) | Assessed from first dose to the end of the study. Response was assessed every 6 weeks for the first 9 months and every 12 weeks thereafter; maximum time on follow-up was up to 13.5 months | CBR is defined as the percentage of participants with BOR of a CR, PR, or stable disease lasting ≥ 24 weeks. |
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) | From first dose of study drug to 30 days after last dose. Maximum time on treatment was 11.2 months | An adverse event is defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study drug, whether considered related to study drug or not. An SAE is any untoward medical occurrence that, at any dose, meet any of the following criteria: * Results in death * Is life-threatening * Requires hospitalization or prolongation of existing hospitalization * Results in disability/incapacity * Is a congenital anomaly/birth defect * Is considered a significant medical AE by the investigator or the sponsor based on medical judgement |
| Plasma Concentrations of BGB-15025 | Cycle 1 Day 1 2 hours and 4-6 hours post-dose, Cycle 1 Day 8 pre-dose, Cycle 1 Day 15 pre-dose, Cycle 2 Day 1 pre-dose and 2 hours and 4-6 hours post-dose, Cycle 3 Day 1 pre-dose | — |
| Number of Participants With Anti-Drug Antibodies to Gimistotug | Up to 30 days following last dose. Maximum time on treatment was 11.2 months. | — |
| Serum Concentrations of Gimistotug | Cycle 1 Day 1 0.5 hours post-dose, Cycle 2 Day 1 predose, Cycle 5 Day 1 pre- and 0.5 hours post-dose, Cycle 9 Day 1 Predose, End of Treatment visit (30 days after last dose) | — |
Countries
China, South Korea
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Gimistotug + Docetaxel Participants received gimistotug and docetaxel 75 mg/m\^2 both by intravenous infusion once every 3 weeks until disease progression, intolerable toxicity, withdrawal of informed consent, or other discontinuation criterion were met. | 21 |
| Gimistotug + BGB-15025 Participants received gimistotug by intravenous infusion once every 3 weeks and BGB-15025 orally once daily during each 3-week cycle until disease progression, intolerable toxicity, withdrawal of informed consent, or other discontinuation criterion were met. | 14 |
| Total | 35 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 12 | 7 |
| Overall Study | Declined Follow-Up Contact | 0 | 1 |
| Overall Study | Lost to Follow-up | 1 | 0 |
| Overall Study | Study Closed by Sponsor | 6 | 6 |
| Overall Study | Withdrawal by Subject | 2 | 0 |
Baseline characteristics
| Characteristic | Gimistotug + Docetaxel | Gimistotug + BGB-15025 | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 11 Participants | 4 Participants | 15 Participants |
| Age, Categorical Between 18 and 65 years | 10 Participants | 10 Participants | 20 Participants |
| Age, Continuous | 62.48 years STANDARD_DEVIATION 8.892 | 61.36 years STANDARD_DEVIATION 9.532 | 62.03 years STANDARD_DEVIATION 9.031 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 21 Participants | 14 Participants | 35 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 21 Participants | 14 Participants | 35 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment China | 21 participants | 14 participants | 35 participants |
| Sex: Female, Male Female | 5 Participants | 2 Participants | 7 Participants |
| Sex: Female, Male Male | 16 Participants | 12 Participants | 28 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 12 / 21 | 7 / 14 |
| other Total, other adverse events | 20 / 21 | 12 / 14 |
| serious Total, serious adverse events | 8 / 21 | 1 / 14 |
Outcome results
Overall Response Rate
Overall response rate (ORR) is defined as the percentage of participants with best overall response (BOR) of a confirmed complete response (CR) or partial response (PR) as assessed by the investigators per Response Evaluation Criteria in Solid Tumors (RECIST) Version (v)1.1. CR is defined as: * Disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \< 10 mm. * Disappearance of all nontarget lesions and normalization of tumor marker level. All lymph nodes must be nonpathological in size (\< 10 mm short axis). * No new lesions. PR is defined as: * At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. * Non-progressive disease with regard to non-target lesions, persistence of 1 or more nontarget lesion(s) and/or maintenance of tumor marker level above the normal limits. * No new lesions.
Time frame: Response was assessed every 6 weeks for the first 9 months and every 12 weeks thereafter; maximum time on follow-up was up to 13.5 months
Population: The Intent-to-Treat population included all participants who were enrolled or randomized to a treatment cohort.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Gimistotug + Docetaxel | Overall Response Rate | 0.0 percentage of participants |
| Gimistotug + BGB-15025 | Overall Response Rate | 0.0 percentage of participants |
Clinical Benefit Rate (CBR)
CBR is defined as the percentage of participants with BOR of a CR, PR, or stable disease lasting ≥ 24 weeks.
Time frame: Assessed from first dose to the end of the study. Response was assessed every 6 weeks for the first 9 months and every 12 weeks thereafter; maximum time on follow-up was up to 13.5 months
Population: The Intent-to-Treat Analysis Set included all participants who were enrolled or randomized to a treatment cohort.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Gimistotug + Docetaxel | Clinical Benefit Rate (CBR) | 19.0 percentage of participants |
| Gimistotug + BGB-15025 | Clinical Benefit Rate (CBR) | 0.0 percentage of participants |
Disease Control Rate (DCR)
DCR is defined as the percentage of participants with BOR of a CR, PR, or stable disease. Stable disease is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease, with no new lesions.
Time frame: From first dose to the end of study; maximum time on follow-up was up to 13.5 months
Population: The Intent-to-Treat Analysis Set included all participants who were enrolled or randomized to a treatment cohort.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Gimistotug + Docetaxel | Disease Control Rate (DCR) | 71.4 percentage of participants |
| Gimistotug + BGB-15025 | Disease Control Rate (DCR) | 21.4 percentage of participants |
Duration of Response (DOR)
DOR is defined as the time from the first determination of an objective response as assessed by the investigator per RECIST v1 until the first documentation of progression or death, whichever comes first. Median DOR was estimated using the Kaplan-Meier method.
Time frame: From first dose to the end of study; maximum time on follow-up was up to 13.5 months.
Population: The Intent-to-Treat Analysis Set included all participants who were enrolled or randomized to a treatment cohort. Only responders were included in the analysis. No participants had a confirmed CR or PR.
Number of Participants With Anti-Drug Antibodies to Gimistotug
Time frame: Up to 30 days following last dose. Maximum time on treatment was 11.2 months.
Population: The Anti-Drug Antibody Analysis Set included all participants who received the study drug and in whom both baseline anti-drug antibody and at least one postbaseline anti-drug antibody results are available.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Gimistotug + Docetaxel | Number of Participants With Anti-Drug Antibodies to Gimistotug | 2 Participants |
| Gimistotug + BGB-15025 | Number of Participants With Anti-Drug Antibodies to Gimistotug | 2 Participants |
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
An adverse event is defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study drug, whether considered related to study drug or not. An SAE is any untoward medical occurrence that, at any dose, meet any of the following criteria: * Results in death * Is life-threatening * Requires hospitalization or prolongation of existing hospitalization * Results in disability/incapacity * Is a congenital anomaly/birth defect * Is considered a significant medical AE by the investigator or the sponsor based on medical judgement
Time frame: From first dose of study drug to 30 days after last dose. Maximum time on treatment was 11.2 months
Population: The Safety Analysis Set included all participants who were enrolled or randomized and received any dose of any study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Gimistotug + Docetaxel | Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) | Number of Participants Experiencing TEAEs | 20 Participants |
| Gimistotug + Docetaxel | Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) | Number of Participants Experiencing SAEs | 8 Participants |
| Gimistotug + BGB-15025 | Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) | Number of Participants Experiencing TEAEs | 12 Participants |
| Gimistotug + BGB-15025 | Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) | Number of Participants Experiencing SAEs | 1 Participants |
Plasma Concentrations of BGB-15025
Time frame: Cycle 1 Day 1 2 hours and 4-6 hours post-dose, Cycle 1 Day 8 pre-dose, Cycle 1 Day 15 pre-dose, Cycle 2 Day 1 pre-dose and 2 hours and 4-6 hours post-dose, Cycle 3 Day 1 pre-dose
Population: The Pharmacokinetic Analysis Set included all participants who received any dose of study drug and for whom the valid pharmacokinetic parameters can be estimated.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 1 Day 1 Postdose 2 Hours | 0.36 µg/mL | Geometric Coefficient of Variation 214 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 1 Day 1 Postdose 4-6 Hours | 0.49 µg/mL | Geometric Coefficient of Variation 47 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 1 Day 8 Predose | 0.29 µg/mL | Geometric Coefficient of Variation 50 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 1 Day 15 Predose | 0.25 µg/mL | Geometric Coefficient of Variation 61 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 2 Day 1 Predose | 0.18 µg/mL | Geometric Coefficient of Variation 132 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 2 Day 1 Postdose 2 Hours | 0.47 µg/mL | Geometric Coefficient of Variation 38 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 2 Day 1 Postdose 4-6 Hours | 0.59 µg/mL | Geometric Coefficient of Variation 30 |
| Gimistotug + Docetaxel | Plasma Concentrations of BGB-15025 | Cycle 3 Day 1 Predose | 0.30 µg/mL | Geometric Coefficient of Variation 27 |
Serum Concentrations of Gimistotug
Time frame: Cycle 1 Day 1 0.5 hours post-dose, Cycle 2 Day 1 predose, Cycle 5 Day 1 pre- and 0.5 hours post-dose, Cycle 9 Day 1 Predose, End of Treatment visit (30 days after last dose)
Population: The Pharmacokinetic Analysis Set included all participants who received any dose of study drug and for whom the valid study drug pharmacokinetic parameters could be estimated. Results included participants with data available at each time point.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | Cycle 5 Day 1 Postdose 0.5 Hours | 1027.57 µg/mL | Geometric Coefficient of Variation 45 |
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | Cycle 5 Day 1 Predose | 163.77 µg/mL | Geometric Coefficient of Variation 113 |
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | Cycle 9 Day 1 Predose | 244.00 µg/mL | — |
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | End of Treatment Visit | 109.90 µg/mL | Geometric Coefficient of Variation 106 |
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | Cycle 1 Day 1 Postdose 0.5 Hours | 737.95 µg/mL | Geometric Coefficient of Variation 54 |
| Gimistotug + Docetaxel | Serum Concentrations of Gimistotug | Cycle 2 Day 1 Predose | 99.84 µg/mL | Geometric Coefficient of Variation 57 |
| Gimistotug + BGB-15025 | Serum Concentrations of Gimistotug | End of Treatment Visit | 176.79 µg/mL | Geometric Coefficient of Variation 23 |
| Gimistotug + BGB-15025 | Serum Concentrations of Gimistotug | Cycle 1 Day 1 Postdose 0.5 Hours | 846.58 µg/mL | Geometric Coefficient of Variation 18 |
| Gimistotug + BGB-15025 | Serum Concentrations of Gimistotug | Cycle 2 Day 1 Predose | 105.90 µg/mL | Geometric Coefficient of Variation 100 |
| Gimistotug + BGB-15025 | Serum Concentrations of Gimistotug | Cycle 5 Day 1 Predose | 222.92 µg/mL | Geometric Coefficient of Variation 4 |
| Gimistotug + BGB-15025 | Serum Concentrations of Gimistotug | Cycle 5 Day 1 Postdose 0.5 Hours | 935.41 µg/mL | Geometric Coefficient of Variation 9 |