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Phase 3 Study of Pyrotinib Versus Docetaxel in Patients With Advanced Non-squamous NSCLC Harboring a HER2 Exon 20 Mutation Who Failed Platinum Based Chemotherapy

Phase 3
Active, not recruiting
Conditions
HER2 Exon 20 Mutation
Non-squamous NSCLC
Interventions
Registration Number
NCT04447118
Lead Sponsor
Jiangsu HengRui Medicine Co., Ltd.
Brief Summary

This is a randomized, positive-controlled, open-label, international multicenter, Phase 3 clinical study to compare the efficacy and safety of pyrotinib versus docetaxel in patients with advanced non-squamous NSCLC harboring a HER2 exon 20 mutation who failed platinum based chemotherapy.

Detailed Description

150 eligible subjects will be randomized in a 2:1 ratio (Study treatment Arm: Control Arm = 100 : 50 subjects) to receive pyrotinib or docetaxel monotherapy.

Each treatment cycle is defined as 21 days for subjects in both arms. Treatment regimen of pyrotinib (Study treatment Arm): 400 mg/d (QD) oral pyrotinib will be administered within 30 minutes after completion of a meal.

Treatment regimen of docetaxel (Control Arm): 75 mg/m2 (Q3W) of docetaxel will be administered via intravenous infusion.

In this study, crossover treatment is allowed for subjects in Control Arm. Within the specified time window of each cycle, subjects should complete physical examinations, laboratory tests, quality of life questionnaires and other tests to assess the safety and quality of life of the subjects.

During study treatment, tumor radiological assessments will be performed every 6 weeks (42 ± 7 days) in the first 52 weeks and every 12 weeks (84 ± 7 days) thereafter.

After the end of treatment and safety follow-up, all subjects will be followed for survival (every 56 ± 7 days) until death, withdrawal of informed consent, lost to follow-up, or termination of the study (whichever occurs first).

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
151
Inclusion Criteria
  • Signed and dated written informed consent which is approved by IRB/EC, willing and able to comply with scheduled treatment, all examinations at study visits, and other study procedures.
  • ECOG PS 0-1.
  • Have histologically or cytologically confirmed locally advanced or metastatic non-squamous NSCLC disease.
  • Before enrollment, a documented confirmed presence of activating mutations in exon 20 of the HER2 gene must be provided. Sufficient tumor tissue samples should be provided to retrospectively confirm the mutation status of the HER2 gene.
  • Must have measureable disease per RECIST v1.1.
  • For advanced NSCLC, patients must have had progressive disease on or after a platinum based chemotherapy, with or without immune checkpoint inhibitors (PD-1/PD-L1 inhibitors) and/or anti-angiogenic drugs. No more than 2 prior lines of systemic therapy are allowed.
  • The laboratory test values must meet the following standards to manifest that the functional level of important organs/systems meets the requirements.
  • Female patient of childbearing potential (WOCBP) and male patient whose - partner is WOCBP must agree to use effective contraception method during the study period.
Exclusion Criteria
  • Malignant tumors with other pathological types.
  • Medical history of other active malignancies within last 5 years.
  • Subjects with active CNS metastases.
  • Previously treated with targeted drugs for HER2 gene mutations,or previously treated with docetaxel.
  • Prior to the first dose of study treatment, patients with severe effusions with clinical symptoms, severe cardiac disease, or severe infection.
  • Prior to the first dose of study treatment, patients with diseases or special conditions that affect drug administration and absorption.
  • Congenital or acquired immunodeficiency.
  • History of allergy to the study drugs or components.
  • Prior to the first dose of study treatment, or during the study period, patients receive or are anticipated to receive continuous strong CYP3A4 inducers or inhibitors, P-gp inhibitors, or medications that are known to cause QT/QTc prolongation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Study treatment ArmPyrotinibPyrotinib maleate tablet, 400 mg, once daily (QD)
Control ArmDocetaxelDocetaxel injection, 75 mg/m2, once every 3 weeks (Q3W)
Primary Outcome Measures
NameTimeMethod
Progression-free survival (PFS)26 months

Time from the date of randomization to the date of first disease progression documented by BIRC according to the RECIST v1.1 or death for any cause, whichever comes first.

Secondary Outcome Measures
NameTimeMethod
Progression-free survival 2(PFS2)36 months

Assessed by investigator according to the RECIST v1.1, or death for any cause, whichever comes first.

Patient reported outcome (PRO) using EORTC QLQ-C3026 months

Symptoms related to NSCLC,

Duration of response (DoR)26 months

Assessed by BIRC and investigator according to the RECIST v1.1.

Time to tumor progression (TTP)26 months

Assessed by BIRC and investigator according to the RECIST v1.1.

Objective response rate (ORR)26 months

Assessed by BIRC and investigator according to the RECIST v1.1.

Plasma concentrations of pyrotinib26 months

Pharmacokinetics (PK) of pyrotinib

AEs and SAEs26 months

Judged in accordance with NCI-CTCAE v5.0

Patient reported outcomes (PRO) using the QLQ-LC1326 months

Symptoms related to NSCLC

Overall survival (OS)36 months

Time from the date of randomization to death for any cause.

Disease control rate (DCR)26 months

Assessed by BIRC and investigator according to the RECIST v1.1.

Trial Locations

Locations (102)

University of California - Irvine Medical Center

🇺🇸

Orange, California, United States

University of California (UC) Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

Innovative Clinical Research Institute

🇺🇸

Whittier, California, United States

Florida Cancer Specialists South Divisio

🇺🇸

Fort Myers, Florida, United States

Florida Cancer Specialists North Divisio

🇺🇸

Saint Petersburg, Florida, United States

University of Kansas Medical Center (KUMC)

🇺🇸

Kansas City, Kansas, United States

David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

Gabrail Cancer Center

🇺🇸

Canton, Ohio, United States

Tennessee Oncology

🇺🇸

Nashville, Tennessee, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

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University of California - Irvine Medical Center
🇺🇸Orange, California, United States
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