Clinical trial • Phase II • Oncology

PATRITUMAB DERUXTECAN for Non-small cell lung cancer (EGFR-mutated)

Phase II trial of PATRITUMAB DERUXTECAN for Non-small cell lung cancer (EGFR-mutated). Randomised, open-label. 240 participants.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Non-small cell lung cancer (EGFR-mutated)
Trial Stage
Phase II
Drug Modality
ADC

Key dates

Initial CTIS Submission Date
09-08-2024
First CTIS Authorization Date
12-09-2024

Trial design

Randomised, open-label Phase II trial in Belgium, Germany, France and others.

Randomised
Yes
Open Label
Yes
Target Sample Size
240

Eligibility

Recruits 240 Vulnerable population selected in CTIS metadata. Consent requirements: subjects must "Sign and date the tissue ICF and the main ICF, prior to the start of any study-specific qualification procedures." Participants must be aged ≥18 years (with local legal age of consent respected). No assent procedures for minors are described in the available documents..

Pregnancy Exclusion
17. Female who is pregnant or breast-feeding or intends to become pregnant during the study.
Vulnerable Population
Vulnerable population selected in CTIS metadata. Consent requirements: subjects must "Sign and date the tissue ICF and the main ICF, prior to the start of any study-specific qualification procedures." Participants must be aged ≥18 years (with local legal age of consent respected). No assent procedures for minors are described in the available documents.

Inclusion criteria

  • {"criterion_text":"- 1. Sign and date the tissue ICF and the main ICF, prior to the start of any study-specific qualification procedures.\n- 10. If the subject is a female of childbearing potential, she must have a negative serum pregnancy test at Screening and must be willing to use highly effective birth control, upon enrollment, during the Treatment Period, and for 7 months following the last dose of study drug. A female is considered of childbearing potential following menarche and until becoming postmenopausal (no menstrual period for a minimum of 12 months) unless permanently sterile (undergone a hysterectomy, bilateral salpingectomy or bilateral oophorectomy) with surgery at least 1 month before the first dose or confirmed by follicle stimulating hormone (FSH) test.\n- 11. Female subjects must not donate, or retrieve for their own use, ova from the time of screening and throughout the study treatment period, and for at least 7 months after the final study drug administration.\n- 12. If male, the subject must be surgically sterile or willing to use highly effective birth control upon enrollment, during the treatment period, and for at least 4 months following the last dose of study drug.\n- 13. Male subjects must not freeze or donate sperm starting at Screening and throughout the study period, and at least 4 months after the final study drug administration.\n- 14. Is willing and able to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures, and study restrictions.\n- 2. Male or female subjects aged ≥18 years (follow local regulatory requirements if the legal age of consent for study participation is >18 years old).\n- 3. Histologically or cytologically documented locally advanced or metastatic NSCLC not amenable to curative surgery or radiation.\n- 4. Documentation of radiological disease progression while on/after receiving most recent treatment regimen for locally advanced or metastatic disease. Subjects must have received both of the following: a. prior treatment with osimertinib. Subjects receiving an EGFR TKI at the time of signing informed consent should continue to take the EGFR TKI until 5 days prior to Cycle 1 Day 1. b. Systemic therapy with at least 1 platinum-based chemotherapy regimen.\n- 5. Documentation of an EGFR-activating mutation detected from tumor tissue or blood sample: exon 19 deletion or L858R.\n- 6. At least 1 measurable lesion confirmed by BICR as per RECIST v1.1\n- 7. Consented and willing to provide required tumor tissue of sufficient quantity (as defined in the Laboratory Manual) and of adequate tumor tissue content (as confirmed by H&E staining at the central laboratory). Required tumor tissue can be provided as either: a. Pretreatment tumor biopsy from at least 1 lesion not previously irradiated and amenable to core biopsy OR b. Archival tumor tissue collected from a biopsy performed within 3 months prior to signing of the tissue consent and since progression while on or after treatment with the most recent cancer therapy regimen.\n- 8. Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 at Screening.\n- 9. Has adequate bone marrow reserve and organ function, based on local laboratory data within 14 days prior to Cycle 1 Day 1 as defined in the protocol."}

Exclusion criteria

  • {"criterion_text":"- 1. Any previous or current histologic or cytologic evidence of small cell OR combined small cell/non-small cell disease in the archival tumor tissue or pretreatment tumor biopsy.\n- 10. Has unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0, Grade ≤1 or baseline. Subjects with chronic Grade 2 toxicities may be eligible at the discretion of the Investigator after consultation with the Sponsor Medical Monitor or designee.\n- 11. Has history of other active malignancy within 3 years prior to enrollment, except: a. Adequately treated non-melanoma skin cancer; b. Superficial bladder tumors (Ta, Tis, T1); c. Adequately treated intraepithelial carcinoma of the cervix uteri; d. Low risk non-metastatic prostate cancer (with Gleason score <7, and following local treatment or ongoing active surveillance); e. Any other curatively treated in situ disease.\n- 12. Uncontrolled or significant cardiovascular disease prior to Cycle 1 Day 1 as defined in the protocol points a/b/c/d/e/f/g (page 64).\n- 13. Active hepatitis B and/or hepatitis C infection, such as those with serologic evidence of viral infection within 28 days of Cycle 1 Day 1 as defined in the protocol points a/b (page 64).\n- 14. Subject with any human immunodeficiency virus (HIV) infection.\n- 15. Any evidence of severe or uncontrolled diseases including active bleeding diatheses, active infection, psychiatric illness/social situations, geographical factors, substance abuse, or other factors which in the Investigator's opinion makes it undesirable for the subject to participate in the study or which would jeopardize compliance with the protocol. Screening for chronic conditions is not required.\n- 16. History of hypersensitivity to either the drug substance or any excipients in patritumab deruxtecan.\n- 17. Female who is pregnant or breast-feeding or intends to become pregnant during the study.\n- 18. Prior or ongoing clinically relevant illness, medical condition, surgical history, physical finding, or laboratory abnormality that, in the Investigator's opinion, could affect the safety of the subject; alter the absorption, distribution, metabolism or excretion of the study drug; or confound the assessment of study results.\n- 19. Has clinically significant corneal disease.\n- 2. Any history of interstitial lung disease (including pulmonary fibrosis or radiation pneumonitis), has current interstitial lung disease (ILD), or is suspected to have such disease by imaging during screening.\n- 3. Clinically severe respiratory compromise (based on Investigator's assessment) resulting from intercurrent pulmonary illnesses including, but not limited to: a. Any underlying pulmonary disorder (eg, pulmonary emboli within 3 months prior to the study enrollment, severe asthma, severe chronic obstructive pulmonary disease [COPD], restrictive lung disease, pleural effusion); b. Any autoimmune, connective tissue or inflammatory disorders with pulmonary involvement (e.g., rheumatoid arthritis, Sjogren's syndrome, sarcoidosis); OR prior complete pneumonectomy.\n- 4. Is receiving chronic systemic corticosteroids dosed at >10 mg prednisone or equivalent anti-inflammatory or any form of immunosuppressive therapy prior to enrollment. Subjects who require use of bronchodilators, inhaled or topical steroids, or local steroid injections may be included in the study.\n- 5. Evidence of any leptomeningeal disease\n- 6. Evidence of clinically active spinal cord compression or brain metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. Subjects with clinically inactive or treated brain metastases who are asymptomatic (i.e., without neurologic signs or symptoms and not requiring treatment with corticosteroids or anticonvulsants) may be included in the study. Subjects must have a stable neurologic status for at least 2 weeks prior to Cycle 1 Day 1.\n- 7. Inadequate washout period prior to Cycle 1 Day 1 as defined in the protocol points a/b/c/d/e/f (page 53).\n- 8. Prior treatment with an anti-HER3 antibody or single-agent topoisomerase I inhibitor.\n- 9. Prior treatment with an ADC that consists of any topoisomerase I inhibitor"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Objective Response Rate (ORR) as assessed by Blinded Independent Central Review (BICR) per RECIST v1.1","definition_or_measurement_approach":"Assessed by Blinded Independent Central Review (BICR) using RECIST v1.1"}

Secondary endpoints

  • {"endpoint_text":"- -Duration of Response (DoR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Progression-free Survival (PFS)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Objective Response Rate (ORR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Disease Control Rate (DCR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Time to Response (TTR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Best percentage change in the sum of diameters (SoD) of measurable tumors","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Overall Survival (OS)","definition_or_measurement_approach":""}
  • {"endpoint_text":"- - Safety parameters (AEs, ECOG PS, vital signs, clinical laboratory parameters, ECG etc.)","definition_or_measurement_approach":"Safety assessed using adverse events (AEs), ECOG performance status, vital signs, clinical laboratory parameters, ECGs"}
  • {"endpoint_text":"- - Correlation between HER3 protein expression and efficacy","definition_or_measurement_approach":"HER3 protein expression evaluated in tumor tissue and correlated with efficacy measures"}
  • {"endpoint_text":"- - Anti-drug antibody (ADA) status at baseline and post-baseline.","definition_or_measurement_approach":"ADA status measured at baseline and at post-baseline timepoints"}

Recruitment

Planned Sample Size
240
Recruitment Window Months
62
Consent Approach
Participants must "Sign and date the tissue ICF and the main ICF, prior to the start of any study-specific qualification procedures." Subjects aged ≥18 years (local legal age of consent followed if >18). Subject information and informed consent forms are provided in multiple languages (documents available in English, French, Dutch, Spanish, German, Italian and country-specific versions such as NLD/DEU/ITA/ES/FR). Optional genotyping, tissue collection and pregnant partner information sheets are available as separate ICF documents.

Geography

Total Number Of Sites
12
Total Number Of Participants
76

Belgium

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
12-09-2024
Processing Time Days
7
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
UZ Leuven
Department Name
Respiratory oncology
Contact Person Name
Christophe Dooms
Contact Person Email
christophe.dooms@uzleuven.be

Germany

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
13-09-2024
Processing Time Days
8
Number Of Sites
2
Number Of Participants
4

Sites

Site Name
University Hospital Cologne AöR
Contact Person Name
Juergen Wolf
Contact Person Email
juergen.wolf@uk-koeln.de
Site Name
Kliniken der Stadt Koeln gGmbH
Department Name
Studienzentrum und Pneumologische Klinik Lungenkrebszentrum Koeln-Merheim
Contact Person Name
Eva Lotte Buchmeier
Contact Person Email
BuchmeierE@kliniken-koeln.de

France

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
17-09-2024
Processing Time Days
12
Number Of Sites
6
Number Of Participants
25

Sites

Site Name
Institut Curie (Saint-Cloud)
Department Name
Institut du Thorax
Contact Person Name
Nicolas GIRARD
Contact Person Email
nicolas.girard2@curie.fr
Site Name
Centre Leon Berard
Department Name
Département d’oncologie médicale
Contact Person Name
Maurice PEROL
Site Name
Centre Hospitalier Universitaire De Nantes
Department Name
Service de pneumologie / unité d’oncologie thoracique
Contact Person Name
Elvire PONS TOSTIVINT
Contact Person Email
elvire.pons@chu-nantes.fr
Site Name
Institut Curie (Paris)
Department Name
Institut du Thorax
Contact Person Name
Nicolas GIRARD
Contact Person Email
nicolas.girard2@curie.fr
Site Name
Centre Hospitalier Universitaire De Rennes
Department Name
Service de Pneumologie
Contact Person Name
Hervé LENA
Contact Person Email
herve.lena@chu-rennes.fr
Site Name
Institut Gustave Roussy
Department Name
Département de Médecine Oncologique
Contact Person Name
Benjamin BESSE

Spain

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
15-10-2024
Processing Time Days
40
Number Of Sites
1
Number Of Participants
23

Sites

Site Name
Hospital Universitario 12 De Octubre
Department Name
Oncology
Contact Person Name
Luis Paz-Ares Rodríguez
Contact Person Email
lpazares@hotmail.com

Italy

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
23-09-2024
Processing Time Days
18
Number Of Sites
1
Number Of Participants
17

Sites

Site Name
Humanitas Mirasole S.p.A.
Department Name
Oncology
Contact Person Name
Luca Toschi

Netherlands

Earliest CTIS Part Ii Submission Date
05-09-2024
Latest Decision Or Authorization Date
12-09-2024
Processing Time Days
7
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Netherlands Cancer Institute
Department Name
Oncology
Contact Person Name
Joop A.J. de Langen
Contact Person Email
j.d.langen@nki.nl

Sponsor

Primary sponsor

Full Name
Daiichi Sankyo Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
Pharmaceutical Product Development LLC
Responsibilities
PK/ ADA Bioanalysis
Name
Syneos Health Inc.
Responsibilities
Site management (and other operational duties as coded in CTIS)

Third parties

  • {"country":"United States","full_name":"Guardant Health Inc.","duties_or_roles":"cfDNA / ctDNA OMNI","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Pharmaceutical Product Development LLC","duties_or_roles":"PK/ ADA Bioanalysis","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Bioclinica Inc.","duties_or_roles":"Medical image analysis/review- X-ray, MRI, ultrasound, etc.","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Ventana Medical Systems Inc.","duties_or_roles":"Protein testing; HER3 IHC reagent development, validation, qualification of Q2 lab, reagent supply, clinical monitoring of HER3 IHC testing","organisation_type":"Pharmaceutical company"}
  • {"country":"Japan","full_name":"Daiichi Sankyo Rd Novare Co. Ltd.","duties_or_roles":"mRNA Gene Expression, yH2AX IHC, PD-L1 or other BM with multiplex IHC, cfRNA","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Q Squared Solutions Holdings LLC","duties_or_roles":"IHC HER3, Real Time GT-PCR COVID-19 Testing","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Syneos Health Inc.","duties_or_roles":"Site management (other duties coded in CTIS: 1,12,2,5,8)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Azenta US Inc.","duties_or_roles":"Storage of samples for future research.","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Patritumab deruxtecan
Active Substance
PATRITUMAB DERUXTECAN
Modality
ADC
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
IMP12181/00001; MIA (IMP) 20377 (authorised for clinical trial use)
Maximum Dose
6.40 mg/kg

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