Trastuzumab Rezetecan and Adebrelimab, Alone or in Combination, After Chemoradiotherapy for HER2-Altered Unresectable Stage III Lung Cancer
A Randomized, Open-label, Multicenter, Phase II Study of Trastuzumab Rezetecan With Adebrelimab, Trastuzumab Rezetecan Alone and Adebrelimab Alone as Consolidation Therapy in Patients With Unresectable Stage III Non-Small Cell Lung Cancer Harboring HER2 Alterations Without Progression After Definitive Chemoradiotherapy
A randomized phase II study to assess the efficacy and safety of Trastuzumab Rezetecan and/or Adebrelimab as consolidation therapy following chemoradiotherapy in patients with unresectable stage III HER2-altered NSCLC.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This is a randomized, open-label, multi-center phase II study evaluating the efficacy and safety of consolidation therapy with Trastuzumab Rezetecan combined with Adebrelimab versus Trastuzumab Rezetecan monotherapy versus Adebrelimab monotherapy in patients with unresectable stage III NSCLC harboring HER2 alterations (mutation or overexpression) who have not progressed after definitive concurrent or sequential chemoradiotherapy. Eligible patients will be randomized in a 1:1:1 ratio to receive either combination therapy, SHR-A1811 alone, or Adebrelimab alone for up to 12 months. The primary endpoint is progression-free survival (PFS) per RECIST v1.1.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ming Chen, MD
- Telefonnummer: +86 020-87345647
- E-mail: chenming@sysucc.org.cn
Undersøgelse Kontakt Backup
- Navn: Chenfei Wu, MD
- Telefonnummer: +86 020-87345647
- E-mail: wucf@sysucc.org.cn
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age ≥18 years.
- ECOG performance status 0-1.
- Histologically or cytologically confirmed Non-Small Cell Lung Cancer (NSCLC).
- Radiologically confirmed unresectable Stage III NSCLC per AJCC 9th edition.
- Pathologically confirmed HER2 mutation or HER2 overexpression (IHC 2+ or 3+).
- Life expectancy ≥3 months.
- Completed at least two cycles of platinum-based chemotherapy (concurrent or sequential) with definitive radiotherapy. Consolidation chemotherapy after radiotherapy is not permitted; chemotherapy with or without immunotherapy before concurrent chemoradiotherapy is permitted.
- Total radiotherapy dose 60 Gy ± 10% (54-66 Gy) using IMRT (preferred) or 3D-CRT, with acceptable dosimetric constraints.
- Adequate organ and bone marrow function.
- Negative pregnancy test for women of childbearing potential within 7 days prior to first dose. Willing to use effective contraception during the study and for 180 days after the last dose.
- Signed informed consent form (ICF).
Exclusion Criteria:
- Known EGFR-activating mutations or ALK fusions.
- Presence of other driver gene mutations with approved targeted therapies available.
- Mixed SCLC and NSCLC, large cell neuroendocrine carcinoma, or sarcomatoid carcinoma.
- Prior treatment with HER2-targeted ADCs or HER2 TKIs.
- Malignant pleural effusion, pericardial effusion, or ascites.
- Participation in another clinical trial within 4 weeks or 5 half-lives prior to first dose.
- Systemic immunosuppressive therapy within 2 weeks prior to first dose.
- Known HIV infection.
- Active hepatitis B (HBsAg positive with detectable HBV-DNA and ALT > ULN) or active hepatitis C.
- Active autoimmune disease requiring systemic treatment.
- Other malignancies within 5 years, except adequately treated cervical carcinoma in situ, basal/squamous cell skin carcinoma, localized prostate cancer, or ductal carcinoma in situ.
- Active or history of Grade ≥2 radiation pneumonitis per RTOG/EORTC, or symptomatic interstitial lung disease. Participants with grade 2 radiation pneumonitis that resolves to grade 1 or lower within 14 days without systemic glucocorticoid treatment may undergo screening if the investigator considers there to be no risk of recurrence.
- Significant cardiovascular disease.
- Severe infection within 4 weeks prior to first dose.
- Prior or planned allogeneic bone marrow or solid organ transplantation.
- Live attenuated vaccine within 28 days prior to first dose or planned during study. Pregnancy or breastfeeding.
- Known hypersensitivity to Adebrelimab, Trastuzumab Rezetecan, or any excipients.
- Known history of psychotropic substance abuse, alcohol abuse, or illicit drug use.
- Any condition that might impair the subject's ability to comply with study requirements.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Arm A (Combination Therapy)
Drug: Trastuzumab Rezetecan + Adebrelimab |
Trastuzumab Rezetecan (4.8mg/kg, iv, d1, Q3W) and Adebrelimab (1200mg, iv, d1, Q3W). Treatment will continue for up to 12 months or until disease progression, unacceptable toxicity, or other criteria for treatment discontinuation are met. |
|
Eksperimentel: Arm B (Targeted Monotherapy)
Drug: Trastuzumab Rezetecan |
Trastuzumab Rezetecan (4.8mg/kg, iv, d1, Q3W). Treatment will continue for up to 12 months or until disease progression, unacceptable toxicity, or other criteria for treatment discontinuation are met. |
|
Eksperimentel: Arm C (Immunotherapy Monotherapy)
Drug: Adebrelimab |
Adebrelimab (1200mg, iv, d1, Q3W). Treatment will continue for up to 12 months or until disease progression, unacceptable toxicity, or other criteria for treatment discontinuation are met. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Progression-Free Survival (PFS)
Tidsramme: Assessed up to approximately 36 months.
|
Defined as the time from randomization to disease progression or death from any cause, whichever occurs first. |
Assessed up to approximately 36 months.
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall Survival (OS)
Tidsramme: Assessed up to approximately 60 months.
|
Defined as the time from randomization to death from any cause. |
Assessed up to approximately 60 months.
|
|
Objective Response Rate (ORR)
Tidsramme: Assessed up to approximately 36 months.
|
Defined as the proportion of participants whose best overall response (BOR) is complete response (CR) or partial response (PR), as assessed according to RECIST v1.1. |
Assessed up to approximately 36 months.
|
|
Duration of Response (DoR)
Tidsramme: Assessed up to approximately 36 months.
|
Defined as the time from the first documented response (CR or PR) to the first documented disease progression (PD) or death from any cause, whichever occurs first. |
Assessed up to approximately 36 months.
|
|
Disease Control Rate (DCR)
Tidsramme: Assessed up to approximately 36 months.
|
Defined as the proportion of participants who achieve complete response (CR), partial response (PR), or stable disease (SD) following treatment, as assessed according to RECIST v1.1. |
Assessed up to approximately 36 months.
|
|
Time to Death or Distant Metastasis (TTDM)
Tidsramme: Assessed up to approximately 36 months.
|
Defined as the time from randomization to the first occurrence of distant metastasis or death from any cause. |
Assessed up to approximately 36 months.
|
|
Progression-Free Survival Rate at 6 Months
Tidsramme: 6 months after randomization.
|
Kaplan-Meier estimate of the percentage of participants alive without disease progression at 6 months after randomization. |
6 months after randomization.
|
|
Progression-Free Survival Rate at 12 Months
Tidsramme: 12 months after randomization.
|
Kaplan-Meier estimate of the percentage of participants alive without disease progression at 12 months after randomization. |
12 months after randomization.
|
|
Overall Survival Rate at 12 Months
Tidsramme: 12 months after randomization.
|
Kaplan-Meier estimate of the percentage of participants alive at 12 months after randomization. |
12 months after randomization.
|
|
Overall Survival Rate at 24 Months
Tidsramme: 24 months after randomization.
|
Kaplan-Meier estimate of the percentage of participants alive at 24 months after randomization. |
24 months after randomization.
|
|
Incidence of Adverse Events (AEs)
Tidsramme: Assessed up to approximately 36 months.
|
AEs graded by CTCAE version 6.0 |
Assessed up to approximately 36 months.
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Patients reported disease-related symptoms and HRQoL by the EORTC QLQ-C30 questionnaires
Tidsramme: Assessed up to approximately 36 months.
|
Assessed up to approximately 36 months.
|
|
Patients reported disease-related symptoms and HRQoL by the EORTC QLQ-LC13 questionnaires
Tidsramme: Assessed up to approximately 36 months.
|
Assessed up to approximately 36 months.
|
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
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MA-NSCLC-II-064
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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