MedPath

Study of DS-1062a in Advanced or Metastatic Non-small Cell Lung Cancer With Actionable Genomic Alterations (TROPION-Lung05)

Phase 2
Active, not recruiting
Conditions
Non-small Cell Lung Cancer
Interventions
Registration Number
NCT04484142
Lead Sponsor
Daiichi Sankyo
Brief Summary

This is a study of the efficacy, pharmacokinetics, and safety of DS-1062a in participants with advanced or metastatic non-small cell lung cancer (NSCLC) with known actionable genomic alterations.

Detailed Description

This study will evaluate DS-1062a 6.0 mg/kg in participants with advanced or metastatic NSCLC with actionable genomic alterations and who have been previously been treated with 1 platinum-containing therapy and 1 or more lines of targeted therapy. The study will be divided into 3 periods: Screening Period, Treatment Period, and Follow-up Period. The primary analysis of Objective Response Rate (ORR) by blinded Independent Central Review (BICR) will be conducted after all participants either have been followed for at least 9 months after the start of study treatment or have discontinued from the study, whichever occurs first.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
137
Inclusion Criteria

Participants eligible for inclusion in the study must meet all inclusion criteria for this study.

  • Sign and date the inform consent form (ICF) prior to the start of any study- specific qualification procedures.

  • Adults ≥18 years (if the legal age of consent is >18 years old, then follow local regulatory requirements)

  • Has pathologically documented NSCLC that:

    1. Has stage IIIB, IIIC, or stage IV NSCLC disease at the time of enrollment (based on the American Joint Committee on Cancer, Eighth Edition).
    2. Has one or more of the following documented activating genomic alterations: EGFR, ALK, ROS1, NTRK, BRAF, MET exon 14 skipping, or RET.

KRAS mutations in the absence of any of the genomic alterations specified above will be excluded.

Overexpression of EGFR, in the absence of activating mutations, is NOT sufficient for enrollment.

Participants who have not received osimertinib should be evaluated for the presence of EGFR T790M mutation after relapse/progression on/after the most recent EGFR tyrosine kinase inhibitor (TKI), unless the participant is already known to be positive with document results for this mutation or unless osimertinib is not locally approved.

  • Has documentation of radiographic disease progression while on or after receiving the most recent treatment regimen for advanced or metastatic NSCLC.

  • Participant must meet the following for advanced or metastatic NSCLC:

    1. Has been treated with at least one but no more than two cytotoxic agent-containing therapy in the metastatic setting:

      • One platinum-containing regimen (either as monotherapy or combination therapy).
      • May have received up to one additional line of cytotoxic agent-containing therapy.
      • Those who received a platinum-containing regimen as adjuvant therapy for early stage disease must have relapsed or progressed while on the treatment or within 6 months of the last dose OR received at least one additional course of platinum-containing therapy (which may or may not be same as in the adjuvant setting) for relapsed/progressive disease.
    2. May have received up to one checkpoint inhibitor (CPI)-containing regimen (may be in combination with a cytotoxic agent as part of a regimen described above or as an additional CPI regimen without a cytotoxic agent).

    3. Has been treated with 1 or more lines of non-CPI targeted therapy that is locally approved for the participant's applicable genomic alteration at the time of screening:

      • Those who received a targeted agent for the applicable genomic alterations in the study as adjuvant therapy for early stage disease must have relapsed or progressed while on the treatment or within 6 months of the last dose OR received at least one additional course of targeted therapy for the same genomic alterations (which may or may not be same agent used in the adjuvant setting) for relapsed/progressive disease.
      • Participants who have been treated with a prior TKI must receive additional targeted therapy, if clinically appropriate, for the genomic alterations that are considered amenable or the participant will not be allowed in the study.
  • Must undergo a mandatory pre-treatment tumor biopsy procedure or if available, a tumor biopsy that was recently collected (within 3 months of screening) after completion of the most recent anticancer treatment regimen and that has a minimum of 10 × 4 micron sections or a tissue block equivalent of 10 × 4 micron sections may be substituted for the mandatory biopsy collected during screening.

  • Measurable disease based on local imaging assessment using RECIST v1.1.

  • Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 - 1 at screening.

Exclusion Criteria

Participants meeting any exclusion criteria for this study will be excluded from this study.

  • Has spinal cord compression or clinically active central nervous system metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. Participants with clinically inactive brain metastases may be included in the study.

  • Has leptomeningeal carcinomatosis.

  • Has prior treatment with:

    1. Any chemotherapeutic agent targeting topoisomerase I, including antibody drug conjugate (ADC) containing such agent.
    2. TROP2-targeted therapy.
  • Uncontrolled or significant cardiovascular disease:

    1. History of myocardial infarction within 6 months prior to Cycle 1 Day 1.
    2. History of uncontrolled angina pectoris within 6 months prior to Cycle 1 Day 1.
    3. Symptomatic congestive heart failure (CHF) (New York Heart Association Class II to IV) at screening. Participants with a history of Class II to IV CHF prior to screening must have returned to Class I CHF and have LVEF ≥50% (by either an ECHO or MUGA scan within 28 days of Cycle 1 Day 1) in order to be eligible.
    4. History of serious cardiac arrhythmia requiring treatment.
    5. LVEF <50% or institutional lower limit of normal by ECHO or MUGA scan.
    6. Uncontrolled hypertension (resting systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg).
  • Has a history of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening.

  • Clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses

  • Clinically significant corneal disease.

  • Has other primary malignancies, except adequately resected non-melanoma skin cancer, curatively treated in situ disease, or other solid tumors curatively treated, with no evidence of disease for ≥3 years.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
DS-1062a 6.0 mg/kgDS-1062aParticipants will receive 6.0 mg/kg of DS-1062a
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Objective Response Rate (ORR) Based on Blinded Independent Central Review (BICR)From baseline until disease progression, death, or other protocol defined reason, up to approximately 24 months.

ORR is defined as the proportion of participants with a best overall response of confirmed complete response (CR) or confirmed partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.

Secondary Outcome Measures
NameTimeMethod
Duration of Response (DOR)From baseline up to approximately 24 months
Progression-free Survival (PFS)From baseline up to approximately 24 months
Pharmacokinetic Parameter Maximum Concentration (Cmax)From baseline up to approximately 24 months
Pharmacokinetic Parameter Area Under the Concentration-Time Curve (AUC)From baseline up to approximately 24 months
Percentage of Participants Who Reported Treatment-emergent Adverse Events (TEAE)From baseline up to approximately 24 months
Overall Survival (OS)From baseline up to approximately 24 months
Pharmacokinetic Parameter Time to Maximum Concentration (Tmax)From baseline up to approximately 24 months

Trial Locations

Locations (82)

Massachusetts General Hospital Cancer Center

🇺🇸

Boston, Massachusetts, United States

Sarah Cannon Research Institute at Florida Cancer Center, South

🇺🇸

Port Charlotte, Florida, United States

UCLA

🇺🇸

Santa Monica, California, United States

Sarah Cannon Research Institute at Tennessee Oncology - Chattanooga

🇺🇸

Chattanooga, Tennessee, United States

Mary Crowley Cancer Research

🇺🇸

Dallas, Texas, United States

Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

AdventHealth Orlando

🇺🇸

Orlando, Florida, United States

The Netherlands Cancer Institute

🇳🇱

Amsterdam, North Holland, Netherlands

University of Michigan

🇺🇸

Detroit, Michigan, United States

Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

Osaka City General Hospital

🇯🇵

Osaka-shi, Osaka, Japan

Osaka International Cancer Institute

🇯🇵

Osaka-shi, Osaka, Japan

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Shizuoka Cancer Center

🇯🇵

Nagaizumi-chō, Shizuoka, Japan

Koo Foundation Sun Yat-Sen Cancer Center

🇨🇳

Taipei, Taiwan

University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Weill Cornell Medical College

🇺🇸

New York, New York, United States

Kyoto University Hospital

🇯🇵

Kyoto-shi, Kyoto, Japan

Niigata Cancer Center Hospital

🇯🇵

Niigata-shi, Niigata, Japan

NYU Langone Medical Center

🇺🇸

New York, New York, United States

Taipei Veterans General Hospital

🇨🇳

Taipei City, Taiwan

Kansai Medical University Hospital

🇯🇵

Hirakata-shi, Osaka, Japan

National Taiwan University Hospital NTUH

🇨🇳

Taipei, Taiwan

Tokushima University Hospital

🇯🇵

Tokushima-shi, Tokushima, Japan

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

University of California San Diego

🇺🇸

La Jolla, California, United States

Boca Raton Regional Hospital

🇺🇸

Boca Raton, Florida, United States

The Office of Dr. Frederick P. Smith MD

🇺🇸

Chevy Chase, Maryland, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

XCancer / Regional Cancer Care Associate (Astera)

🇺🇸

East Brunswick, New Jersey, United States

University Hospitals Case Medical Center

🇺🇸

Cleveland, Ohio, United States

New York Cancer and Blood Specialists

🇺🇸

Port Jefferson, New York, United States

Avera Cancer Institute Sioux Falls

🇺🇸

Sioux Falls, South Dakota, United States

Virginia Cancer Specialists

🇺🇸

Athens, Virginia, United States

Kadlec Clinic Hematology and Oncology

🇺🇸

Kennewick, Washington, United States

University Hospital of Nantes

🇫🇷

Nantes, Loire-Atlantique, France

APHM - Hopital Nord

🇫🇷

Marseille Cedex 20, Bouches-Du-Rhône, France

Gustav Roussy Cancer Campus Grand Paris

🇫🇷

Villejuif, ile-de-France, France

CHU Toulouse Hopital Larrey

🇫🇷

Toulouse, Occitanie, France

Centre Leon Berard

🇫🇷

Lyon, Rhone, France

CHU Louis Pradel

🇫🇷

Lyon, France

Hopitaux Universitaire de Strasbourg- Nouvel Hopital Civil

🇫🇷

Strasbourg, France

Institut Curie

🇫🇷

Paris, France

Centre Hospitalier Intercommunal Toulon La Seyne sur mer Hopital Sainte-Musse

🇫🇷

Toulon, France

Thoraxklinik Heidelberg

🇩🇪

Heidelberg, Baden-Württemberg, Germany

Asklepios Fachklinik Muenchen-Gauting

🇩🇪

Gauting, Bayern, Germany

IKF Krankenhaus Nordwest

🇩🇪

Frankfurt Am Main, Hessen, Germany

Azienda Ospedaliera Universitaria Policlinico-OVE

🇮🇹

Catania, CT, Italy

Universitaet zu Koeln - Uniklinik Koeln

🇩🇪

Koeln, North Rhine-Westphal, Germany

National Koranyi Institute for TB and Pulmonology

🇭🇺

Budapest, Hungary

Pulmonology Hospital Törökbálint

🇭🇺

Torokbalint, Hungary

Medizinische Hochschule Hannover

🇩🇪

Hannover, Germany

Thoraxklinik Heidelberg gGmbH

🇩🇪

Heidelberg, Germany

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

🇮🇹

Rome, RM, Italy

University of Turin San Luigi Hospital

🇮🇹

Orbassano, Torino, Italy

Azienda Ospedaliero-Universitaria S. Orsola Malpighi

🇮🇹

Bologna, Italy

Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico

🇮🇹

Milano, Italy

Istituto Europeo di Oncologia

🇮🇹

Milano, Italy

Azienda Ospedaliera Arcispedale Santa Maria

🇮🇹

Reggio Emilia, Italy

Fujita Health University Hospital

🇯🇵

Toyoake-shi, Aichi, Japan

Azienda Ospedaliero Universitaria di Parma

🇮🇹

Parma, Italy

National Cancer Center Hospital East

🇯🇵

Kashiwa-shi, Chiba, Japan

Hokkaido Cancer Center

🇯🇵

Sapporo-shi, Hokkaido, Japan

Kindai University Hospital

🇯🇵

Ōsaka-sayama, Osaka, Japan

National Cancer Center Hospital

🇯🇵

Chuo Ku, Tokyo, Japan

The Cancer Institute Hospital of JFCR

🇯🇵

Koto-Ku, Tokyo, Japan

Aichi Cancer Center Hospital

🇯🇵

Aichi, Japan

Seoul National University Bundang Hospital

🇰🇷

Seongnam, Gyeonggi-do, Korea, Republic of

Hospital Universitario Puerta de Hierro de Majadahonda

🇪🇸

Majadahonda, Madrid, Spain

Hospital Regional Universitario Malaga

🇪🇸

Málaga, Malaga, Spain

Erasmus MC

🇳🇱

Rotterdam, Zuid Holland, Netherlands

Hospital General Universitario de Alicante

🇪🇸

Alicante, Spain

Hospital Universitario Vall dHebron

🇪🇸

Barcelona, Spain

Hospital Clinic i Provincial de Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Sarah Cannon Research Institute at Florida Cancer Center, North

🇺🇸

Gainesville, Florida, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

© Copyright 2025. All Rights Reserved by MedPath