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Trial of Two Adagrasib Dosing Regimens in NSCLC With KRAS G12C Mutation (KRYSTAL 21)

Phase 2
Recruiting
Conditions
Advanced Cancer
Metastatic Cancer
Malignant Neoplasm of Lung
Interventions
Registration Number
NCT05853575
Lead Sponsor
Mirati Therapeutics Inc.
Brief Summary

This study will evaluate the efficacy of two dosing regimens of adagrasib (600 mg BID versus 400 mg BID) in patients with NSCLC with KRAS G12C mutation.

Detailed Description

CA239-0012 is a phase 2 study of adagrasib monotherapy in which patients are randomized between two dosing regimens. The study will evaluate the efficacy of two dosing regimens of adagrasib (600 mg BID without regard to food versus 400 mg BID with food) in patients with NSCLC with KRAS G12C mutation and who have received prior treatment with a platinum-based regimen and immune checkpoint inhibitor therapy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Are at least 18 years old (or old enough to legally make their own treatment decisions, according to local laws).
  • Have advanced NSCLC or metastatic NSCLC (NSCLC that started in the lungs and then spread to other parts of the body) with the KRAS G12C mutation.
  • Have had previous treatment with 1) chemotherapy that included a drug called cisplatin or a drug called carboplatin and 2) a type of drug called an immune checkpoint inhibitor.
  • Have recovered from their prior treatment and blood tests are within a safe range.

Key

Exclusion Criteria
  • Have had previous treatment with a drug that targets KRAS G12C.
  • Have cancer that can potentially be removed with surgery.
  • Patients with brain lesions are not eligible if 1) any untreated brain lesions are > 2.0 cm in size 2) any brainstem lesions are present 3) ongoing steroid dosing >10 mg daily prednisone (or equivalent) and 4) poorly controlled (> 1/week) generalized or complex partial seizures or neurologic progression/instability due to brain lesions.
  • Have certain medical conditions or need to take certain medications that, in the opinion of a trial doctor, could make it unsafe for them to participate or difficult to complete the trial assessments, or are pregnant.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Adagrasib 600mg BIDAdagrasibAdagrasib 600mg BID without regard to food
Adagrasib 400mg BIDAdagrasibAdagrasib 400mg BID with food
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1).30 months

ORR evaluation of subjects treated with adagrasib 600 mg BID without regard to food versus 400 mg BID with food having NSCLC with KRAS G12C mutation (Study Population) will be completed per blinded independent central radiology (BICR) review. Objective response is the proportion of subjects that experience confirmed complete response (CR) or partial response (PR) based on RECIST v1.1 during the time period from 1st dose of adagrasib until last dose of adagrasib.

Secondary Outcome Measures
NameTimeMethod
Evaluate Duration of Response (DOR).30 months

Duration of response defined as the time from date of the first documentation of objective tumor response (CR or PR) to the first documentation of either PD (per BICR review) or death due to any cause, whichever occurs first.

Evaluate Overall Survival (OS).45 months

Overall survival is defined as time from date of randomization to date of death due to any cause.

Evaluate Progression Free Survival (PFS).30 months

Progression-free survival is defined as time from date of randomization to date of first progression per RECIST 1.1 or death from any cause, whichever occurs first.

Population pharmacokinetic (PK) Model Derived Area Under the Curve During the Dosing Interval at Steady State (AUCtau,ss).Pre-dose and 4-6 hours post dose; up to 6 months.

Sparse concentration data from this study will be pooled with other studies and analyzed using population PK methods to derive individual exposure parameters. Data for this Outcome Measure will not be reported here since ClinicalTrials.gov is designed for reporting results from only those participants who were enrolled in the study and described in the Participant Flow and Baseline Characteristics modules.

Patient -reported quality of life during adagrasib administration from first dose to End of Treatment visit.30 months

Patient reported quality of life questionnaire will be used to assess five dimensions of patient health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression using the 5-Level EQ-5D version (EQ-5D-5L) established by the EuroQol Group. This is presented descriptively, and patient responses correspond to a value of 1 (low) or 5 (high). Additionally, a one- page Visual Analog Scale (VAS) will be provided to patients so they may report their self-rated health from the best (100) and worst (0) health imaginable.

Safety and tolerability in the study population.30 months

Safety characterized by number of participants with AEs, with abnormal laboratory test results and number of patients modifying or discontinuing study treatment due to an AE:

1. Type, incidence, severity, timing, seriousness, and relationship to study treatment of Adverse Events.

2. Laboratory abnormalities as measured by changes in lab results such as hematologic or chemistry parameters while on study treatment.

3. Number of patients modifying or discontinuing study treatment due to Adverse Event.

Patient-reported symptoms during adagrasib administration from first dose to 28 days after last dose of adagrasib.30 months

Patient reported outcomes (PROs) will be used to assess symptomatic toxicity of adagrasib using the NCI Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) Measurement System. PRO items reflect the specific symptom 1) frequency, severity, interference with usual or daily activities, 2) amount, or 3) presence or absence. PRO-CTCAE responses are scored from 0 (low) to 4 (high), or 0/1 for absent/present, and scores for each attribute (frequency, severity and/or interference) are presented descriptively.

Trial Locations

Locations (104)

Providence Medical Foundation

🇺🇸

Santa Rosa, California, United States

Local Institution - 106

🇺🇸

Chicago, Illinois, United States

Local Institution - 103

🇺🇸

Minneapolis, Minnesota, United States

Kansas City VA Medical Center

🇺🇸

Kansas City, Missouri, United States

Veterans Affairs Medical Center (VAMC) - Durham

🇺🇸

Durham, North Carolina, United States

Hospital Evangélico de Cachoeiro de Itapemirim

🇧🇷

Cachoeiro Do Itapemirim, Espírito Santo, Brazil

Oncocentro de Minas Gerais

🇧🇷

Belo Horizonte, Minas Gerais, Brazil

Hospital Sao Lucas da PUCRS

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Catarina Pesquisa Clinica

🇧🇷

Itajaí, Santa Catarina, Brazil

AMO Assistencia Multidisciplinar em Oncologia

🇧🇷

Salvador, Brazil

A.C. Camargo Cancer Center

🇧🇷

São Paulo, Brazil

Klinički bolnički centar Sestre milosrdnice

🇭🇷

Zagreb, Grad Zagreb, Croatia

Local Institution - 525

🇭🇷

Pula, Croatia

Hopital Haut-Leveque - Maladies respiratoires

🇫🇷

Pessac, Gironde, France

Institut de Cancerologie de I'Ouest - Service d'Oncologie Medicale

🇫🇷

Saint-Herblain Cedex, Loire-Atlantique, France

Centre Hospitalier Universitaire D' Angers Hôpital Larrey - PNEUMOLOGIE

🇫🇷

Angers, Maine-et-Loire, France

Centre Hospitalier Universitaire de Poitiers

🇫🇷

Poitiers, Poitou-Charentes, France

CHU de Grenoble

🇫🇷

Grenoble, Rhône-Alpes, France

Centre Hosptalier De Villefranche-Sur-Saone - Oncologie Medicale - Cancerolo

🇫🇷

Villefranche Sur Saone, Rhône, France

Centre Hôspitalier de Bretagne Sud - Hôpital du Scorff

🇫🇷

Lorient, France

APHM Hopital Nord

🇫🇷

Marseille, France

CHU de Nantes - Hôpital Nord Laënnec (HGRL)

🇫🇷

Nantes cedex 1, France

Centre Hospitalier de Cornouaille

🇫🇷

Quimper, France

Hôpital Bégin - Service d'Oncologie

🇫🇷

Saint-Mandé, France

General University Hospital Of Patras

🇬🇷

Patras, Achaïa, Greece

General Hospital of Athens "Alexandra"

🇬🇷

Athens, Attiki, Greece

Local Institution - 582

🇬🇷

Athens, Attiki, Greece

University General Hospital Attikon

🇬🇷

Haidari - Athens, Attiki, Greece

Theageneio Anticancer Hospital of T

🇬🇷

Thessaloniki, Kentriki Makedonia, Greece

St. Luke's Hospital S.A.

🇬🇷

Panorama, Greece

General Hospital Of Thessaloniki Papageorgiou

🇬🇷

Thessaloniki, Greece

Assuta Medical Center

🇮🇱

Tel Aviv-Yafo, Tel-Aviv, Israel

Shaare Zedek Medical center

🇮🇱

Jerusalem, Yerushalayim, Israel

Bnai Zion Medical Center

🇮🇱

Haifa, Israel

Rambam Health Care Campus

🇮🇱

Haifa, Israel

The Tel Aviv Sourasky MC

🇮🇱

Tel-Aviv, Israel

Azienda Sanitaria Territoriale Pesaro Urbino (AST PU)

🇮🇹

Pesaro, Pesaro E Urbino, Italy

Istituto di Candiolo, IRCCS

🇮🇹

Candiolo, Torino, Italy

IEO - Istituto Europeo di Oncologia, IRCCS

🇮🇹

Milano, Italy

Azienda Ospedaliero-Universitaria Maggiore Della Carita

🇮🇹

Novara, Italy

Ospedale S.Maria della Misericordia, AO di Perugia, Università degli Studi di Perugia

🇮🇹

Perugia, Italy

Regina Elena, Istituto Nazionale dei Tumori , IFO, IRCCS

🇮🇹

Roma, Italy

Local Institution - 401

🇯🇵

Toon, Ehime, Japan

National Cancer Center

🇰🇷

Gyeonggido [Kyonggi-do], Seoul Teugbyeolsi [Seoul-T'ukpyolshi], Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Seoul Teugbyeolsi [Seoul-T'ukpyolshi], Korea, Republic of

Korea University Guro Hospital

🇰🇷

Seoul, Seoul Teugbyeolsi [Seoul-T'ukpyolshi], Korea, Republic of

Gangnam Severance Hospital, Yonsei University Health System

🇰🇷

Seoul Teugbyeolsi [Seoul-T'ukpyolshi], Korea, Republic of

Local Institution - 128

🇲🇽

Tuxtla Gutiérrez, Chiapas, Mexico

Local Institution - 129

🇲🇽

Cdmx, Distrito Federal, Mexico

Local Institution - 127

🇲🇽

Col. Roma, Distrito Federal, Mexico

Local Institution - 125

🇲🇽

Toluca, Mexico

Local Institution - 802

🇳🇱

Breda, Noord-Brabant, Netherlands

Anthoni van Leeuwenhoek Ziekenhuis, Nederlands Kanker Instit

🇳🇱

Amsterdam, Noord-Holland, Netherlands

St. Antonius Ziekenhuis

🇳🇱

Nieuwegein, Utrecht, Netherlands

Local Institution - 152

🇵🇪

San Martin de Porres, Lima, Peru

Pratia MCM Krakow

🇵🇱

Krakow, Malopolskie, Poland

Szpitale Pomorskie Sp. z o.o.

🇵🇱

Gdynia, Pomorskie, Poland

MS Pneumed Janusz Milanowski, Katarzyna Szmygin-Milanowska Sp. Jawna

🇵🇱

Lublin, Poland

Medisprof

🇷🇴

Cluj-Napoca, Cluj, Romania

Ovidius Clinical Hospital

🇷🇴

Ovidiu, Constanta, Romania

Local Institution - 727

🇷🇴

Craiova, Dolj, Romania

Oncolab

🇷🇴

Craiova, Dolj, Romania

Centrul de Oncologie Sf. Nectarie

🇷🇴

Craiova, Dolj, Romania

Oncocenter-Oncologie Clinica

🇷🇴

Timisoara, Timis, Romania

Centrul de Oncologie Euroclinic

🇷🇴

Iasi, Romania

Spitalul Clinic Judetean De Urgenta Sibiu

🇷🇴

Sibiu, Romania

Sigmedical Services S.R.L.

🇷🇴

Suceava, Romania

Local Institution - 753

🇷🇸

Belgrade, Beograd, Serbia

Local Institution - 754

🇷🇸

Nis, Niaavski Okrug, Serbia

Local Institution - 403

🇷🇸

Nis, Vojvodina, Serbia

Local Institution - 752

🇷🇸

Kragujevac, Šumadijski Okrug, Serbia

Complexo Hospitalario Universitario De Santiago

🇪🇸

Santiago De Compostela, A Coruña, Spain

Hospital Regional Universitario De Málaga

🇪🇸

Malaga, Andalucía, Spain

Hospital Universitario Central de Asturias

🇪🇸

Oviedo, Asturias, Spain

Hospital Universitario Son Espases

🇪🇸

Palma de Mallorca, Baleares, Spain

Ankara Bilkent Sehir Hastanesi Tibbi Onkoloji Klinigi

🇹🇷

Ankara, Turkey

Local Institution - 684

🇪🇸

Valencia, Valenciana, Comunidad, Spain

Local Institution - 689

🇪🇸

Barcelona, Spain

Hospital Universitari Dexeus Grupo Quironsalud

🇪🇸

Barcelona, Spain

Hospital Universitari Vall D Hebron

🇪🇸

Barcelona, Spain

Hospital de La Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Hospital General Universitario Gregorio Marañón

🇪🇸

Madrid, Spain

M.D. Anderson Center Madrid

🇪🇸

Madrid, Spain

Local Institution - 688

🇪🇸

Madrid, Spain

Hospital Universitario Virgen De La Macarena

🇪🇸

Sevilla, Spain

Hospital Clinico Universitario De Valencia

🇪🇸

Valencia, Spain

Chang Gung Medical Foundation - Kaohsiung Chang Gung Memorial Hospital

🇨🇳

Kaohsuing City, Kaohsiung, Taiwan

China Medical University Hospital - Internal Medicine

🇨🇳

Taichung City, Taichung Municipality, Taiwan

Chung Shan Medical University Hospital

🇨🇳

Taichung City, Taichung, Taiwan

Local Institution - 377

🇹🇭

Bangkok, Krung Thep Maha Nakhon [Bangkok], Thailand

Local Institution - 376

🇹🇭

Chiang Mai, Thailand

Srinagarind Hospital - ACADEMIC CLINICAL RESEARCH OFFICE

🇹🇭

Khon Kaen, Thailand

Local Institution - 378

🇹🇭

Songkhla, Thailand

Local Institution - 703

🇹🇷

Istanbul, Samsun, Turkey

Local Institution - 355

🇹🇷

Ankara, Turkey

Gulhane Egitim ve Arastirma Hastanesi Tibbi Onkoloji Klinigi

🇹🇷

Ankara, Turkey

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim ve Arastirma Hastanesi

🇹🇷

Ankara, Turkey

Memorial Ankara Hastanesi Tibbi Onkoloji

🇹🇷

Ankara, Turkey

Ankara Liv Hospital Tibbi Onkoloji

🇹🇷

Ankara, Turkey

Trakya Univ Hastanesi Ic Hastal

🇹🇷

Edirne, Turkey

Medipol Mega Universite Hastanesi Tibbi Onkoloji

🇹🇷

Istanbul, Turkey

Prof. Dr. Suleyman Yalcin Sehir Hastanesi

🇹🇷

Istanbul, Turkey

Istanbul Onkoloji Hastanesi Tibbi Onkoloji

🇹🇷

Istanbul, Turkey

Ege Universitesi Hastanesi Ic Hastaliklari Anabilim Dali Onkoloji Bilim Dali

🇹🇷

Izmir, Turkey

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