Ensatinib Treat Second-generation ALK-TKI Resistance After Second-generation ALK-TKI Resistance (ERSGATR)

January 4, 2022 updated by: Li Zhang, MD

a Prospective, Open Phase ii Clinical Study in Patients With alK-positive Non-small Cell Lung Cancer Treated With Ensatinib After Second-generation ALK-TKI Resistance

After the use of second-generation ALK-TKI drug resistance, about 50% of tissue biopsies showed mutations in the ALK kinase domain, and appropriate ALK-TKI could be selected according to different mutation sites .Phase I/II clinical trials in the US of ensatinib showed ORR of 25% (4/16) in patients previously treated with crizotinib and second-generation ALK-TKI (N=16) .In the phase II registered clinical study in China, biomarker analysis also showed that the ORR of ensatinib against drug resistance site G1202R was 33% (2/6).The ORR of I1171 and F1174 were 50% (2/4) and 71% (5/7), respectively, suggesting that ensatinib may still be effective in patients with drug resistance to other second-generation ALK inhibitors . Investigators designed this study to evaluate the clinical efficacy of ensatinib after second-generation ALK-TKI resistance.The study was a single-arm, multi-center Phase II clinical study, using ORR of patients with measurable lesions as the primary endpoint, and using Simon two-stage design to estimate the required sample size.At a 5% level of significance and 85% confidence, a minimum of 40 evaluable subjects were required for both phases.In the first stage, 20 patients were enrolled. If 2 patients had objective response, an additional 20 patients were enrolled in the second stage. If more than 5 patients /40 patients had objective response, the therapeutic drugs were considered effective.Eligible patients will take 225mg of ensaritinib orally once daily, on an empty stomach or with food, until the patient develops disease progression, develops unacceptable toxicity, the investigator or subject decides to drop out, loses follow-up, starts another antitumor therapy, or dies.The primary end points were objective response rate (ORR) to disease progression, occurrence of unacceptable toxicity, investigator or subject decision to drop out, loss of follow-up, initiation of other antitumor therapy, or death.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
40

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • China
    • Guangdong
      • Guangzhou, Guangdong, China, 510060
        • Recruiting
        • Sun Yat-sen University
        • Contact:
          • Fang WenFeng, dooctor

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) confirmed histologically or cytologically ;
  • Patients confirmed as ALK positive (FISH or Ventana IHC or RT-PCR, NGS) in previous written reports.Disease progression after continuing treatment with prior second-generation ALK-TKI resistance (allowing crizotinib resistance) (as per RECIST 1.1);
  • Maximum one chemotherapy is allowed;The interval between the last administration of second-generation ALK-TKI and the trial enrollment should be at least 7 days;
  • Gender: both male and female;Age: ≥18 years old;
  • physical status score was 0-2;
  • survival ≥3 months;
  • certain organ system functions (no blood transfusion or use of constituent blood within 14 days before test)；
  • Asymptomatic CNS metastases that do not require treatment with steroids or anticonvulsants;If there is CNS metastasis, radiotherapy can be performed first, and no progress can be made after ≥28 days.Meningeal disease was not included in the group;
  • Patients must have measurable lesions according to RECIST1.1 criteria;
  • Willing and able to follow the trial and follow-up procedures;
  • Able to understand the nature of the experiment and sign written informed consent voluntarily.

Exclusion Criteria:

  • Patients who had previously only used crizotinib or loratinib；
  • Currently receiving other systemic anti-tumor treatments；
  • history of malignancy other than lung cancer in the past 3 years (excluding cured basal cell tumor of the skin, early gastrointestinal [GI] tumor resected under endoscope, carcinoma in situ of the cervix)；
  • Patients who participated in clinical trials of other investigational drugs within weeks prior to initial ensatinib administration；
  • Major surgery or immunotherapy within 4 weeks prior to initial; dosing;Radiation therapy was received within 2 weeks prior to initial dosing；
  • In the investigator's opinion, may increase the risk associated with study participation or may interfere with the interpretation of study results;
  • Other conditions considered unsuitable for participation in the study by the investigator.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: hydrochloric acid ensartinib
Ensatinib 225mg daily, QD, until progression or intolerance
Drug: Ensartinib
Ensaritinib was taken orally once 225mg, on an empty stomach or with food, until the patient developed disease progression, developed unacceptable toxicity, the investigator or subject decided to drop out, lost follow-up, initiated other antitumor therapy, or died
Other Names:
  • X-396

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Objective response rate
Time Frame: 0 up to 8 weeks
0 up to 8 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Time Frame
Progression free survival
Time Frame: 0 up to12 months
0 up to12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Li Zhang, MD

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 1, 2021

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2023

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 2, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 4, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 5, 2022

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 5, 2022

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 4, 2022

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • BD-EN-IV001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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