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Phase 2 Study of Poziotinib in Participants With NSCLC Having EGFR or HER2 Exon 20 Insertion Mutation

Phase 2
Terminated
Conditions
NSCLC
Interventions
Registration Number
NCT03318939
Lead Sponsor
Spectrum Pharmaceuticals, Inc
Brief Summary

This is a Phase 2, open-label, multi-center study to evaluate the efficacy and the safety/tolerability of poziotinib in seven participant cohorts for up to 603 previously treated and treatment-naïve NSCLC participant. Cohorts 3 and 4 were added with Amendment 1 and three additional cohorts were added with Amendment 2 (Cohorts 5, 6 and 7).

Detailed Description

The Screening period (Day -30 to Day -1) lasts up to approximately 30 days prior to Cycle 1, Day 1. Participant must meet all Inclusion/Exclusion Criteria to participate in the study. Eligible participants will provide written Informed Consent prior to undergoing any study procedures.

Each treatment cycle is 28 calendar days in duration. There will be seven participant cohorts and eligible participants will be enrolled into each cohort in parallel based on EGFR or HER2 exon 20 mutation status and prior treatment status:

* Cohort 1: Previously treated participant with EGFR exon 20 insertion mutation positive NSCLC (complete)

* Cohort 2: Previously treated participant with HER2 exon 20 insertion mutation positive NSCLC (complete)

* Cohort 3: Treatment naïve participant with EGFR exon 20 insertion mutation positive NSCLC (complete)

* Cohort 4: Treatment naïve participant with HER2 exon 20 insertion mutation positive NSCLC (fully enrolled)

* Cohort 5: Participants who meet the criteria for enrollment in Cohort 1 to 4, but the enrollment in the respective cohort has been closed (closed to enrollment)

* Cohort 6: Participants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib (closed to enrollment)

* Cohort 7: Participants with EGFR or HER2 activating mutations (closed to enrollment)

Toxicity will be assessed based on the grade of the adverse events using CTCAE version 4.03.

On Day 1 of each 28-day cycle, the participant's absolute neutrophil count (ANC) must be ≥1.5×10\^9/L and platelet count must be ≥100×10\^9/L before administering poziotinib. All participants will be treated until disease progression (except for first progression in Cohort 5), death, intolerable adverse events (AEs), or other protocol-specified reasons for participant withdrawal.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
648
Inclusion Criteria
  • Participant must be willing and capable of giving written Informed Consent, adhering to dosing and visit schedules, and meeting all study requirements

  • Participant has histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer (NSCLC) that is not amenable to treatment with curative intent

  • Prior treatment status:

    • Cohorts 1 and 2: Participant has had at least one prior systemic treatment for locally advanced or metastatic NSCLC
    • Cohorts 3 and 4: Participant is treatment-naïve for locally advanced or metastatic NSCLC and eligible to receive first-line treatment with poziotinib as determined by the Investigator. Adjuvant/neo-adjuvant therapies (chemotherapy, radiotherapy, or investigational agents) are permissible as long as they end at least 15 days prior to study entry.
    • Cohort 5: Participants who meet the criteria for enrollment in Cohorts 1 to 4, but the enrollment in the respective cohort has been closed
    • Cohort 6: Participant with EGFR mutation-positive NSCLC who progressed while on treatment with first-line osimertinib
    • Cohort 7: Participant has had at least one prior systemic treatment for locally advanced or metastatic NSCLC
  • Specific mutations:

    • Cohort 1 and 3: Documented EGFR exon 20 insertion mutation
    • Cohort 2 and 4: Documented HER2 exon 20 insertion mutation
    • Cohort 5: Documented EGFR or HER2 exon 20 insertion mutations
    • Cohort 6: Documented acquired EGFR mutation (tested after osimertinib progression)
    • Cohort 7: Documented EGFR or HER2 activating mutations
  • Participant has adequate organ function at Baseline

Key

Exclusion Criteria
  • Participant has had previous treatment with poziotinib or any other EGFR or HER2 exon 20 insertion mutation-selective tyrosine kinase inhibitor (TKI) prior to study participation. The currently approved TKIs (ie, erlotinib, gefitinib, afatinib, osimertinib) are not considered to be exon 20 insertion-selective and are permissible (Cohorts 1 and 2).
  • Participant is concurrently receiving chemotherapy, biologics, immunotherapy for cancer treatment; systemic anti-cancer treatment or investigational treatment should not be used within 2 weeks or 5 half lives, whichever is longer; local radiation therapy for bone pain may be allowed
  • Participant has had other malignancies within the past 3 years, except for stable non-melanoma skin cancer, fully-treated and stable, early-stage prostate cancer, or carcinoma in situ of the cervix or breast without need of treatment
  • Participant is pregnant or breast-feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
PoziotinibPoziotinib* Cohort 1: Previously treated participants with EGFR exon 20 insertion mutant positive NSCLC (closed to enrollment) * Cohort 2: Previously treated participants with HER2 exon 20 insertion mutant positive NSCLC (closed to enrollment) * Cohort 3: Treatment naïve participants with EGFR exon 20 insertion-mutant positive NSCLC (fully enrolled) * Cohort 4: Treatment naïve participants with HER2 exon 20 insertion mutant positive NSCLC * Cohort 5: Participants who meet the criteria for enrollment in Cohort 1 to 4, but the enrollment in the respective cohort has been closed * Cohort 6: Participants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib * Cohort 7: Participants with EGFR or HER2 activating mutations
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)24 months

The proportion of subjects who achieve Complete Response (CR) and Partial Response (PR) by the best response from the first dose of poziotinib to the end of study.

Secondary Outcome Measures
NameTimeMethod
Disease Control Rate (DCR)24 months

The proportion of subjects who achieve CR, PR, and Stable Disease (SD) by the best response from the first dose of poziotinib to the end of study.

Duration of Response (DoR)24 months

Number of days from the date that measurement criteria are first met for CR or PR (whichever status is recorded first) until the first subsequent date that progressive disease or death is documented.

Trial Locations

Locations (63)

UCLA Hematology/Oncology

🇺🇸

Santa Monica, California, United States

Kaiser Permanente Medical Center

🇺🇸

Vallejo, California, United States

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

Hattiesburg Clinic Hematology/Oncology

🇺🇸

Hattiesburg, Mississippi, United States

The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

🇺🇸

Torrance, California, United States

Los Angeles Hematology Oncology Medical Group

🇺🇸

Los Angeles, California, United States

CTCA - Eastern Regional Medical Center

🇺🇸

Philadelphia, Pennsylvania, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

The Ohio State University

🇺🇸

Columbus, Ohio, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

Minnesota Oncology Hematology, P.A.

🇺🇸

Minneapolis, Minnesota, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

NYU Langone Medical Center

🇺🇸

New York, New York, United States

Georgetown University Medical Center

🇺🇸

Washington, District of Columbia, United States

Baptist Cancer Center

🇺🇸

Memphis, Tennessee, United States

Rambam Healthcare Campus

🇮🇱

Haifa, Israel

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

General Hospital Delta

🇧🇪

Roeselare, Belgium

BC Cancer - Vancouver

🇨🇦

Vancouver, British Columbia, Canada

Saint Luc University Hospital

🇧🇪

Brussels, Belgium

Ambroise Pare University Hospital Center

🇧🇪

Mons, Belgium

Weill Cornell Medical College

🇺🇸

New York, New York, United States

Mayo Clinic Hospital

🇺🇸

Phoenix, Arizona, United States

UCSF Helen Diller Comprehensive Cancer Center at Mt Zion

🇺🇸

San Francisco, California, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

UC Davis Comprehensive Cancer Center

🇺🇸

Sacramento, California, United States

Yale University, Yale Cancer Center Smilow Cancer Hospital at Yale

🇺🇸

New Haven, Connecticut, United States

Florida Hospital

🇺🇸

Orlando, Florida, United States

H. Lee Moffitt Cancer Center & Research Institute

🇺🇸

Tampa, Florida, United States

USC/Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Oncology Physician's Network Inc./OPN Healthcare

🇺🇸

Arcadia, California, United States

City of Hope

🇺🇸

Duarte, California, United States

UCSD -Moores Cancer Center

🇺🇸

La Jolla, California, United States

Rocky Mountain Cancer Center

🇺🇸

Boulder, Colorado, United States

The Bond & Steele Clinic, P.A. dba Bond Clinic, P.A.

🇺🇸

Winter Haven, Florida, United States

CTCA - Southeastern Regional Medical Center

🇺🇸

Newnan, Georgia, United States

University Cancer & Blood Center, LLC

🇺🇸

Athens, Georgia, United States

CTCA - Midwestern Regional Medical Center

🇺🇸

Zion, Illinois, United States

North Shore Hematology Oncology Associates DBA New York Cancer and Blood Specialists

🇺🇸

Bronx, New York, United States

Montefiore Einstein Medical Center for Cancer Care

🇺🇸

Bronx, New York, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

North Shore Hematology Oncology Associates P.C. DBA NY Cancer and Blood Specialists

🇺🇸

Port Jefferson Station, New York, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Oklahoma Cancer Specialists and Research Institute, LLC

🇺🇸

Tulsa, Oklahoma, United States

Texas Oncology- Austin

🇺🇸

Austin, Texas, United States

Virginia Cancer Specialists, PC

🇺🇸

Fairfax, Virginia, United States

University Hospitals Leuven

🇧🇪

Leuven, Belgium

Gustave Roussy Oncology Institute, Department of Medical Oncology

🇫🇷

Villejuif, France

London Regional Cancer Program

🇨🇦

London, Ontario, Canada

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

Hopital Larrey, CHU Toulouse, Unité d'Oncologie des Voies Respiratoires

🇫🇷

Toulouse, France

National Cancer Institute, IRCCS, Department of Medical Oncology

🇮🇹

Milan, Italy

Soroka Medical Center

🇮🇱

Be'er Sheva, Israel

Rabin Medical Center

🇮🇱

Petah Tikva, Israel

Santa Maria delle Croci Hospital

🇮🇹

Ravenna, Italy

National Cancer Institute Regina Elena, IRCCS, Operative Unit of Medical Oncology A 1

🇮🇹

Rome, Italy

Erasmus Medical Center

🇳🇱

Rotterdam, Netherlands

University Hospital Germans Trias i Pujol, Department of Medical Oncology

🇪🇸

Barcelona, Spain

University Hospital 12 de Octubre

🇪🇸

Madrid, Spain

Pacific Shores Medical Group

🇺🇸

Long Beach, California, United States

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