A Prospective Phase II Clinical Trial Evaluating the Efficacy and Safety of Adebrelimab in Combination With Trastuzumab Rezetecan for Patients With Stage III Unresectable HER2-Positive NSCLC
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Meng Wang Meng Wang
- Telefonnummer: 18622221623
- E-mail: 18622221623@pm.com
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Aged 18-75 years, male or female.
- Histologically or cytologically confirmed stage III unresectable NSCLC per AJCC 9th edition, judged unresectable by institutional MDT team.
- Confirmed HER2 alteration: HER2 mutation/amplification detected by tissue NGS, or HER2 protein overexpression (IHC 2+ or 3+).
- No prior systemic anti-tumor therapy for NSCLC; prior anti-tumor Chinese herbal medicine allowed if ≥2 weeks washout before first dose.
- At least 1 measurable target lesion per RECIST v1.1.
- ECOG performance status 0 or 1.
- Able to provide tumor tissue specimen (archival ≤6 months or newly biopsied non-irradiated lesion).
- FEV1 >1.0 L and FEV1% predicted >40% within past 3 months.
Adequate organ function within 7 days before first dose (no blood product/G-CSF support within 14 days):
- Hematology: WBC ≥3.0×10⁹/L, ANC ≥1.5×10⁹/L, PLT ≥100×10⁹/L, Hb ≥90g/L
- Liver: AST/ALT ≤2.5×ULN (≤5×ULN for liver metastasis), TBIL ≤1.5×ULN
- Renal: Serum Cr ≤1.5×ULN or CrCl ≥50 mL/min
- Cardiac: LVEF ≥50% by echocardiogram
- Fertile male/female participants must use effective contraception during treatment and 6 months after last dose; female participants non-lactating, negative serum HCG within 14 days pre-first dose.
- Voluntarily sign written informed consent, good compliance for follow-up.
Exclusion Criteria:
- Mixed small cell/large cell neuroendocrine/sarcomatoid NSCLC histology.
- Concurrent other actionable driver gene alterations (EGFR, ALK, MET, BRAF, RET etc.) besides HER2.
- Past or concurrent other malignant tumor (except fully resected cancer ≥5 years without active treatment).
- Prior thoracic radiotherapy.
- Major surgery within 28 days or minor invasive surgery within 7 days before first dose.
- HIV infection, active hepatitis B/C, organ transplant history, congenital/acquired immunodeficiency.
- Systemic immune modulators (thymosin, interferon, IL-2) within 4 weeks pre-enrollment.
- Uncontrolled severe cardiovascular disease, unstable angina or intervention-required ventricular arrhythmia within 1 month.
- Confirmed or suspected interstitial lung disease, severe baseline pulmonary dysfunction interfering with lung toxicity monitoring.
- Active uncontrolled ≥2 grade infection within 2 weeks before enrollment.
- Active tuberculosis under treatment.
- Known hypersensitivity to any component of study drugs or other monoclonal antibodies/fusion proteins.
- Any condition judged by investigator to compromise participant safety or trial compliance.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Experimental: Adebrelimab + Trastuzumab rezetecan Induction Therapy
|
1200mg intravenous infusion on Day 1 of every 21-day cycle for 3-4 induction cycles; consolidation therapy after local treatment as physician discretion.
Infusion duration 30-60 minutes.
3.2mg/kg intravenous infusion on Day 1 of every 21-day cycle for 3-4 induction cycles; fixed dose 408mg if body weight ≥85kg.
First infusion over 90 mins, subsequent cycles 60 mins if well tolerated.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Objective Response Rate (ORR)
Tidsramme: End of Cycle 3/Cycle 4 induction (each cycle 21 days). Surgery-eligible patients assess tumor 6-8 weeks after Cycle3 last dose; others evaluate at Cycle4 end, ±7-day imaging window.
|
Proportion of participants achieving Complete Response (CR) or Partial Response (PR) after 3-4 cycles induction therapy, assessed per RECIST v1.1 by investigators
|
End of Cycle 3/Cycle 4 induction (each cycle 21 days). Surgery-eligible patients assess tumor 6-8 weeks after Cycle3 last dose; others evaluate at Cycle4 end, ±7-day imaging window.
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Surgical Conversion Rate
Tidsramme: Within 6 to 8 weeks after the last induction study drug infusion (42-56 days post final induction dose)
|
Percentage of subjects receiving R0 radical pulmonary resection after MDT re-evaluation post induction
|
Within 6 to 8 weeks after the last induction study drug infusion (42-56 days post final induction dose)
|
|
Major Pathological Response (MPR) Rate
Tidsramme: Within 4 weeks after curative lung resection (pathology report completion window)
|
Proportion of surgical patients with ≤10% viable tumor cells in resected primary tumor specimen (central blinded pathology review)
|
Within 4 weeks after curative lung resection (pathology report completion window)
|
|
Event-Free Survival (EFS)
Tidsramme: Up to 36 months after the first dose of study treatment (3-year full survival follow-up)
|
Time from first study drug dose to disease progression, local recurrence, distant metastasis, or death from any cause
|
Up to 36 months after the first dose of study treatment (3-year full survival follow-up)
|
|
Overall Survival (OS)
Tidsramme: 12 months, 18 months, 24 months, and 36 months after the first dose of study treatment
|
OS defined as time from first dose to all-cause death; survival rate calculated at fixed time points
|
12 months, 18 months, 24 months, and 36 months after the first dose of study treatment
|
|
Safety Profile (Treatment-Related Adverse Events)
Tidsramme: From the date of signed informed consent through 30 days after the last study treatment infusion; long-term safety follow-up continues up to 36 months post first dose for delayed irAEs.
|
Incidence and grade of all adverse events, ≥3 grade AEs, serious adverse events (SAE), immune-related AEs, interstitial lung disease graded per NCI CTCAE v6.0
|
From the date of signed informed consent through 30 days after the last study treatment infusion; long-term safety follow-up continues up to 36 months post first dose for delayed irAEs.
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- NSCLC-HER2-II-001
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