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Study to Evaluate Adverse Events, Optimal Dose, and Change in Disease Activity, With Livmoniplimab in Combination With Budigalimab Plus Chemotherapy Versus IV Infused Pembrolizumab Plus Chemotherapy in Adult Participants With Untreated Metastatic Non-Squamous Non-Small Cell Lung Cancer (NSCLC)

Registration Number
NCT06236438
Lead Sponsor
AbbVie
Brief Summary

Non-Squamous Non-Small Cell Lung Cancer (NSCLC) remains a leading cause of cancer mortality worldwide, with poor survival prospects for metastatic disease. The purpose of this study is to evaluate the optimized dose, adverse events, and efficacy of livmoniplimab in combination with budigalimab plus chemotherapy versus pembrolizumab plus chemotherapy in participants with untreated metastatic non-squamous non-small cell lung cancer.

Livmoniplimab is an investigational drug being developed for the treatment of NSCLC. There are 2 stages to this study. In Stage 1, there are 4 treatment arms. Participants will either receive livmoniplimab (at different doses) in combination with budigalimab (another investigational drug) + chemotherapy, budigalimab +chemotherapy, or pembrolizumab +chemotherapy. In Stage 2, there are 2 treatments arms. Participants will either receive livmoniplimab (optimized dose) in combination with budigalimab +chemotherapy or placebo in combination with pembrolizumab +chemotherapy. Chemotherapy consists of IV Infused pemetrexed + IV infused cisplatin or IV infused or injected carboplatin. Approximately 840 adult participants will be enrolled in the study across 200 sites worldwide.

Stage 1: In cohort 1, participants will receive intravenously (IV) infused livmoniplimab (dose A)+ IV infused budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + IV Infused pemetrexed. In cohort 2, participants will receive livmoniplimab (dose B) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed. In cohort 3, participants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed . In cohort 4, participants will receive IV Infused pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed. Stage 2: In arm 1, participants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed. In arm 2, participants will receive IV Infused placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed. The estimated study duration is 55 months.

There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic and may require frequent medical assessments, blood tests, questionnaires, and scans.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
840
Inclusion Criteria
  • Diagnosis of histologically or cytologically confirmed metastatic nonsquamous non-small cell lung cancer (NSCLC) with no known epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) mutation, or other genomic aberration for which a locally approved targeted therapy is available.
  • Must have at least 1 measurable lesion per response evaluation criteria in solid tumors (RECIST) v1.1 as determined by the local site Investigator/radiology assessment.
  • Life expectancy of at least 3 months and adequate organ function.
Exclusion Criteria
  • Received prior systemic therapy for the treatment of metastatic NSCLC.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Stage 2 (Arm 2): PlaceboPemetrexedParticipants will receive placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 1 (Cohort 2): Livmoniplimab Dose BBudigalimabParticipants will receive livmoniplimab (dose B) + budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 2): Livmoniplimab Dose BCarboplatinParticipants will receive livmoniplimab (dose B) + budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 3): BudigalimabBudigalimabParticipants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed.
Stage 1 (Cohort 2): Livmoniplimab Dose BLivmoniplimabParticipants will receive livmoniplimab (dose B) + budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 1): Livmoniplimab Dose ACarboplatinParticipants will receive livmoniplimab (dose A)+ budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 2): Livmoniplimab Dose BPemetrexedParticipants will receive livmoniplimab (dose B) + budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 2 (Arm 1): Livmoniplimab (Dose Optimized)PemetrexedParticipants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 1): Livmoniplimab Dose ALivmoniplimabParticipants will receive livmoniplimab (dose A)+ budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 2 (Arm 1): Livmoniplimab (Dose Optimized)LivmoniplimabParticipants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 1): Livmoniplimab Dose ACisplatinParticipants will receive livmoniplimab (dose A)+ budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 2 (Arm 1): Livmoniplimab (Dose Optimized)BudigalimabParticipants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 1): Livmoniplimab Dose ABudigalimabParticipants will receive livmoniplimab (dose A)+ budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 1): Livmoniplimab Dose APemetrexedParticipants will receive livmoniplimab (dose A)+ budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 4): PembrolizumabCisplatinParticipants will receive pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 1 (Cohort 2): Livmoniplimab Dose BCisplatinParticipants will receive livmoniplimab (dose B) + budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 1 (Cohort 3): BudigalimabPemetrexedParticipants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed.
Stage 1 (Cohort 3): BudigalimabCisplatinParticipants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed.
Stage 1 (Cohort 3): BudigalimabCarboplatinParticipants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed.
Stage 1 (Cohort 4): PembrolizumabPembrolizumabParticipants will receive pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 1 (Cohort 4): PembrolizumabPemetrexedParticipants will receive pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 1 (Cohort 4): PembrolizumabCarboplatinParticipants will receive pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 2 (Arm 1): Livmoniplimab (Dose Optimized)CarboplatinParticipants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 2 (Arm 2): PlaceboCarboplatinParticipants will receive placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 2 (Arm 2): PlaceboPembrolizumabParticipants will receive placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Stage 2 (Arm 1): Livmoniplimab (Dose Optimized)CisplatinParticipants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed.
Stage 2 (Arm 2): PlaceboCisplatinParticipants will receive placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed.
Primary Outcome Measures
NameTimeMethod
Stage 1: Best Overall Response (BOR) of Complete Response (CR)/Partial Response (PR)Up to 21 Months

BOR of CR/PR is defined as achieving CR or PR according to response evaluation criteria in solid tumors (RECIST) v1.1 as determined by investigators at any time prior to subsequent anticancer therapy. Objective response rate (ORR), defined as the percentage of participants with a BOR of CR/PR, will be summarized.

Stage 2: Overall Survival (OS)Up to 55 Months

OS is defined as the time measured from randomization until death from any cause.

Secondary Outcome Measures
NameTimeMethod
Stage 2: PFS per InvestigatorUp to 55 Months

PFS is defined as the time measured from randomization until the first documentation of progressive disease according to RECIST 1.1 as determined by the investigator or death from any cause, whichever occurs first.

Stage 1: Progression Free Survival (PFS)Up to 21 Months

PFS is defined as the time measured from randomization until the first documentation of progressive disease (PD) according to RECIST 1.1 as determined by investigators or death from any cause, whichever occurs first.

Stage 1: Duration of Response (DOR)Up to 21 Months

DOR is defined as the time from first CR/PR until the first documentation of PD according to RECIST 1.1 as determined by investigators or death from any cause, whichever occurs first.

Stage 1: OSUp to 21 Months

OS is defined as the time measured from randomization until death from any cause.

Stage 2: PFSUp to 55 Months

PFS is defined as the time measured from randomization until the first documentation of progressive disease according to RECIST 1.1 as determined by blinded independent central review (BICR) or death from any cause, whichever occurs first.

Stage 2: BOR of CR/PRUp to 55 Months

BOR of CR/PR is defined as achieving CR or PR according to RECIST 1.1 as determined by investigators at any time prior to subsequent anticancer therapy. ORR, defined as the percentage of participants with a BOR of CR/PR, will be summarized.

Stage 2: Change from Baseline in Physical Functioning (PF) as measured by the PF domain of European Organization for Research Treatment of Cancer Quality of Life Questionnaire 17 (EORTC QLQ-F17)Up to 55 Months

The EORTC QLQ-F17, a shorter, 17-item version that includes only the functional scales and the Global Health Status / Quality of Life scale of the EORTC QLQ-C30. QLQ-F17 includes the Physical (PF), Role (RF), Emotional (EF), Cognitive (CF) and Social Functioning (SF) scales as well as the Global Health Status/Quality of Life (QL) scale in their original wording. Participants rate items on a 4 point scale ranging form 1 to 4 (1- Not at All, 2= A Little, 3 = Quite a Bit, and 4= Very Much).

Stage 2: DOR per investigatorUp to 55 Months

DOR is defined as the time from first CR/PR until the first documentation of PD according to RECIST 1.1 as determined by investigators or death from any cause, whichever occurs first.

Stage 2: Change from Baseline in Non-Small Cell Lung Cancer Symptom Assessment Questionnaire (NSCLC-SAQ)Up to 55 Months

The NSCLC -SAQ scale with seven items assessing 5 symptoms of NSCLC (cough, pain, dyspnea, fatigue and poor appetites). The recall period is "over the last 7 days." Each item has a 5-point verbal rating scale from either 0 "No \<symptom\> at All" to 4 "Very severe \<symptom\>" or from 0 "Never" to 4 "Always," depending on the item's format.

Stage 2: Change from Baseline in Quality of Life as Measured by the Global Health Status/Quality of Life Domain of the EORTC QLQ-F17Up to 55 Months

The EORTC QLQ-F17, a shorter, 17-item version that includes only the functional scales and the Global Health Status / Quality of Life scale of the EORTC QLQ-C30. QLQ-F17 includes the Physical (PF), Role (RF), Emotional (EF), Cognitive (CF) and Social Functioning (SF) scales as well as the Global Health Status/Quality of Life (QL) scale in their original wording. Participants rate items on a 4 point scale ranging form 1 to 4 (1- Not at All, 2= A Little, 3 = Quite a Bit, and 4= Very Much).

Stage 1: BOR of CR/PR per InvestigatorUp to 21 Months

BOR of CR/PR is defined as achieving CR or PR according to RECIST 1.1 as determined by investigators. ORR, defined as the percentage of participants with a BOR of CR/PR, will be summarized.

Stage 2: DORUp to 55 Months

DOR is defined as the time from first CR/PR until the first documentation of PD according to RECIST 1.1 as determined by BICR or death from any cause, whichever occurs first.

Trial Locations

Locations (61)

Canberra Hospital /ID# 261891

🇦🇺

Garran, Australian Capital Territory, Australia

Institut Curie /ID# 261127

🇫🇷

Paris CEDEX 05, Paris, France

Zuyderland Medisch Centrum /ID# 261190

🇳🇱

Heerlen, Limburg, Netherlands

Moores Cancer Center /ID# 267782

🇺🇸

La Jolla, California, United States

Memorial Hospital West /ID# 262221

🇺🇸

Pembroke Pines, Florida, United States

Bond Clinic /ID# 262611

🇺🇸

Winter Haven, Florida, United States

University Cancer & Blood Cent /ID# 261824

🇺🇸

Athens, Georgia, United States

The University of Chicago Medical Center /ID# 262259

🇺🇸

Chicago, Illinois, United States

University of Kansas Medical Center /ID# 263196

🇺🇸

Westwood, Kansas, United States

Baptist Health Lexington /ID# 261823

🇺🇸

Lexington, Kentucky, United States

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Canberra Hospital /ID# 261891
🇦🇺Garran, Australian Capital Territory, Australia

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