longkanker ALK-positive Non-Small Cell Lung Cancer
Conditions
Interventions
Not applicable.
Sponsors
Xcovery Holdings Inc.
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: 1.Histologically or cytologically confirmed diagnosis of advanced or recurrent (Stage IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC that is ALK-positive by an FDA-approved assay performed centrally. Patients must be ALK positive by local test prior to submitting tissue to the central lab. Randomization will occur after ALK positive confirmation is received from the central lab. Patients may have received up to 1 prior chemotherapy regimen for mestatic disease , which may also include maintenance therapy. 2. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0 to 2. 3. Life expectancy of at least 12 weeks. 4. Ability to swallow and retain oral medication. 5. Adequate organ system function, defined as follows: a. Absolute neutrophil count (ANC) >=1.5 x 109/L b. Platelets >=100 x 109/L c. Hemoglobin >=9 g/dL (>=90 g/L) Note that transfusions are allowed to meet the required hemoglobin level. d. Total bilirubin 1.5 x ULN, patient may still be eligible if calculated creatinine clearance >=50 mL/min (0.83 mL/s) as calculated by the Cockcroft-Gault method. 6. Brain metastases allowed if asymptomatic at study baseline. Patients with untreated brain metastases must not be on corticosteroids. If patients have neurological symptoms or signs due to CNS metastases, patients need to complete whole brain radiation or focal treatment at least 14 days before start of study treatment and be asymptomatic on stable or decreasing doses of corticosteroids at baseline. 7.Men with partners of childbearing potential willing to use adequate contraceptive measures during the study and for 90 days after the last dose of study medication. 8.Women who are not of child-bearing potential, and women of childbearing potential who agree to use adequate contraceptive measures during the study and for 90 days after the last dose of study medication, and who have a negative serum or urine pregnancy test within 1 week prior to initial trial treatment. 9. Patients must be >=18 years of age. 10. Patients must have measurable disease per RECIST v. 1.1. 11. Patients must be ALK-positive by IHC. Testing will be done centrally; however, patients will be allowed to enroll based on local results (positive by FISH or IHC), if available. 12. Willingness and ability to comply with the trial and follow-up procedures. 13. Ability to understand the nature of this trial and give written informed consent.
Exclusion criteria
Exclusion criteria: 1. Patients that have previously received an ALK TKI or PD-1 or PD-L1 therapy, and patients currently receiving cancer therapy (i.e., other targeted therapies, chemotherapy, radiation therapy, immunotherapy, biologic therapy, hormonal therapy, surgery and/or tumor embolization). 2. Use of an investigational drug within 21 days prior to the first dose of study drug. Note that to be eligible, any drug-related toxicity should have recovered to Grade 1 or less, with the exception of alopecia. 3. Any chemotherapy within 4 weeks, or major surgery or radiotherapy within the last 14 days. 4. Patients with primary CNS tumors and leptomeningeal disease are ineligible. 5. Patients with a previous malignancy within the past 3 years (other than curatively treated basal cell carcinoma of the skin, in situ carcinoma of the cervix, or any cancer that is considered to be cured and have no impact on PFS and OS for the current NSCLC). 6. Concomitant systematic use of anti-cancer herbal medications. These should be stopped prior to study entry. 7.Patients receiving a. strong CYP3A inhibitors (including, but not limited to, atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, troleandomycin, voriconazole, grapefruit, grapefruit juice) b. strong CYP3A inducers (including, but not limited to, carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, St. John's Wort) c. CYP3A substrates with narrow therapeutic window (including, but not limited to, alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, tacrolimus). 8. Women who are pregnant or breastfeeding. 9. Presence of active gastrointestinal (GI) disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of study medications. 10. Patients at risk for GI perforation 11. Clinically significant cardiovascular disease including: a. QTcF interval >450 ms for men and >470 ms for woman, symptomatic bradycardia 160/100 mmHg; note that isolated elevated readings considered to not be indicative of uncontrolled hypertension are allowed). The following within 6 months prior to Cycle 1 Day 1: a. Congestive heart failure (New York Heart Class III or IV). b. Arrhythmia or conduction abnormality requiring medication. Note: patients with atrial fibrillation/flutter controlled by medication and arrhythmias controlled by pacemakers are eligible. c. Severe/unstable angina, coronary artery/peripheral bypass graft, or myocardial infarction. d. Cerebrovascular accident or transient ischemia. 12. Patients who are immunosuppressed (including known HIV infection), have a serious active infection at the time of treatment, have interstitial lung disease/pneumonitis, or have any serious underlying medical condition that would impair the ability of the patient to receive protocol treatment. Patients with controlled hepatitis C, in the investigator's opinion, are allowed. Patients with known hepatitis B must be HBeAg and HB viral DNA negative for enrollment. Note that, because of the high pre
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Progression-free survival (PFS) as assessed by independent radiology review based on RECIST v. 1.1 criteria. | — |
Secondary
| Measure | Time frame |
|---|---|
| • Key Secondary Efficacy Endpoints: Overall survival, CNS response rate (based on IRR), time to CNS progression (based on IRR), objective response rate (based on IRR) • Other Secondary Efficacy Endpoints: PFS (based on investigator assessment), ORR (based on investigator assessment), time to response (based on investigator assessment and IRR), duration of response (based on investigator assessment and IRR), CNS response rate (based on investigator assessment ), time to CNS progression (based on investigator assessment).. Exploratory: Patient reported time to deterioration (TTD) as measured by the EORTC C30/LC13 QoL questionnaire and Lung Cancer Symptom Scale (LCSS), patient reported healthrelated quality of life (HRQoL) as measured by the EORTC C30/LC13 QoL questionnaire and LCSS, pharmacodynamic (PD) and possible pharmacogenetic (PG) assessments. | — |
Countries
Netherlands
Outcome results
None listed