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Sikkerheds- og effektivitetsundersøgelse af GEN1046 som enkeltstof eller i kombination med Pembrolizumab til behandling af tilbagevendende (ikke-småcellet) lungekræft

17. september 2026 opdateret af: Genmab

Et fase 2, multicenter, randomiseret, åbent forsøg med GEN1046 som monoterapi og i kombinationsbehandling med Pembrolizumab hos forsøgspersoner med recidiverende/refraktær metastatisk ikke-småcellet lungekræft efter behandling med standardbehandling med en immun checkpoint-hæmmer

The goal of this clinical trial is to compare the safety and efficacy (how well the drug works) of acasunlimab (also known as GEN1046) when it is used alone (monotherapy) versus when it is combined with a cancer drug (pembrolizumab) for participants with relapsed/refractory (disease has returned after treatment or did not respond to treatment) non-small cell lung cancer (NSCLC; the most common type of lung cancer).

This trial has 2 parts. The purpose of the first part is to find out if the combination of acasunlimab and pembrolizumab is safe and to find out the best doses to use. The purpose of the second part is to give acasunlimab and pembrolizumab to more participants to evaluate efficacy. In the second part of the trial, participants will be randomized to participate in 1 of the 3 arms of the trial. Randomized means that the participant will be randomly assigned to a treatment arm based on chance; no one chooses their treatment arm.

Participants will receive either acasunlimab alone (100 followed by 500 mg into the vein) or acasunlimab with pembrolizumab (200 or 400 mg into the vein) once every 3 or 6 weeks, depending on which arm the participant is randomized into. All participants will receive active drug; no one will receive placebo.

Trial details include:

  • The average trial duration for an individual participant will be about 10 months.
  • The average treatment duration for an individual participant will be about 6 months.
  • The visit frequency will be weekly at first and lessening over time until visits are only once every 3 weeks.

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

125

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Cheltenham, Det Forenede Kongerige
        • Cheltenham General Hospital
      • Manchester, Det Forenede Kongerige
        • The Christie Hospital
    • California
      • Santa Rosa, California, Forenede Stater, 95403
        • St. Joseph Heritage Healthcare
    • Florida
      • Fort Myers, Florida, Forenede Stater, 33901
        • Florida Cancer Specialists - FCS South
      • St. Petersburg, Florida, Forenede Stater, 33705
        • Florida Cancer Center
    • Michigan
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Cancer Institute
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Cancer & Hematology Centers of Western Michigan CHCWM P.C.
    • Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Medical College of Wisconsin
      • Bordeaux, Frankrig
        • Institut Bergonie
      • Brest, Frankrig
        • Hopital Morvan CHU de Brest
      • Rouen, Frankrig
        • Hopital Charles Nicolle Chu Rouen
      • Saint-Mandé, Frankrig
        • Hopital dInstruction Des Armees Begin
      • Strasbourg, Frankrig
        • Institut de Cancerologie Strasbourg Europe (ICANS)
      • Suresnes, Frankrig
        • Hôpital Foch
      • Villejuif, Frankrig
        • Gustave Roussy
      • Amsterdam, Holland
        • VU University Medical Center
      • Amsterdam, Holland
        • Netherlands Cancer Institute
      • Leiden, Holland
        • Leids Universitair Medisch Centrum
      • Rotterdam, Holland
        • Erasmus MC
      • Catania, Italien
        • Azienda Ospedaliera Universitaria Policlinico G Rodolico San Marco
      • Milan, Italien
        • IRCCS Istituto Europeo di Oncologia
      • Naples, Italien
        • UOC Oncoematologia AOU L.Vanvitelli
      • Palermo, Italien
        • La Maddalena SPA
      • Roma, Italien
        • IFO Regina Elena
      • Olsztyn, Polen
        • Samodzielny Publiczny Zespol Gruzlicy i Chorob Pluc
      • Warsaw, Polen
        • Maria Sklodowska-Curie National Research Institute of Oncology
      • Lisbon, Portugal
        • Centro Clinico Champalimaud
      • Porto, Portugal
        • Centro Hospitalar Universitário do Porto - Hospital de Santo Antonio
      • Barcelona, Spanien
        • Hospital Universitari Vall dHebron
      • Madrid, Spanien
        • Hospital Universitario 12 de Octubre
      • Madrid, Spanien
        • MD Anderson Cancer Center
      • Madrid, Spanien
        • Clinica Universidad de Navarra CUN
      • Madrid, Spanien
        • Hospital Universitario Fundacion Jimenez Diaz
      • Málaga, Spanien
        • Hospital Universitario Virgen de la Victoria
      • Pamplona, Spanien
        • Clinica Universidad de Navarra
      • Valencia, Spanien
        • Fundacion Instituto Valenciano de Oncologia
      • Hanover, Tyskland
        • Med.Hochschule Hannover Klinik für Pneumologie
      • Hessen, Tyskland
        • Universitatsklinik Giessen und Marburg Standort Giessen
      • Immenhausen, Tyskland
        • LKI Lungenfachklinik Immenhausen
      • Regensburg, Tyskland
        • Department of Internal Medicine II

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Key Inclusion Criteria:

  • Have signed an informed consent form (ICF)
  • Be at least 18 years of age.
  • Have histologically or cytologically confirmed diagnosis of stage 4 NSCLC with at least 1 prior line of systemic therapy containing an anti-PD-1/PD-L1 mAb for metastatic disease
  • Have a tumor PD-L1 expression result available prior to first treatment demonstrating PD-L1 expression in ≥1% of tumor cells as assessed by a central or local laboratory during screening.
  • Have measurable disease per RECIST v1.1.
  • Have Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤1.
  • Have life expectancy of at least 3 months.
  • Have adequate organ and bone marrow function as defined in the protocol.

Key Exclusion Criteria:

  • Documentation of known EGFR, KRAS, RET, ROS1, BRAF mutations, NTRK gene infusions, RET arrangement, ALK gene rearrangements, high-level MET amplification, or METex 14 skipping. Note: Subjects harboring such mutations, gene rearrangements or amplifications may be enrolled in the trial, if subjects have received prior approved targeted therapy for such mutations, the subject may still be eligible for this trial.

  • Treatment with an anti-cancer agent within 28 days prior to acasunlimab administration.

  • Any investigational agent (including investigational vaccines).

  • Radiotherapy within 14 days prior to first dose of acasunlimab. Note: palliative radiotherapy will be allowed for local pain control under certain conditions.

  • Chronic systemic immunosuppressive corticosteroid doses, ie, prednisone >10 mg daily or a cumulative dose >150 mg prednisone within 14 days before the first acasunlimab administration.

  • Subject has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients.

  • Subject has contraindications to the use of pembrolizumab per local prescribing information.

  • Subject has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis (interstitial lung disease).

  • Ongoing or active infection requiring intravenous treatment with anti-infective therapy or any ongoing systemic inflammatory condition requiring further diagnostic work-up or management during screening.

  • Symptomatic congestive heart failure (grade III or IV as classified by the New York Heart Association), unstable angina pectoris, or cardiac arrhythmia.

  • Uncontrolled hypertension defined as systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg, despite optimal medical management.

  • Ongoing or recent (within 6 months) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for irAEs.

  • Subject has a known history of any of the following:

    1. Grade 3 or higher irAEs that led to treatment discontinuation of a prior immunotherapy treatment.
    2. Myositis, Guillain-Barré syndrome, or myasthenia gravis of any grade.
    3. Liver disease (eg, alcoholic hepatitis or non-alcoholic steatohepatitis, drug-related or autoimmune hepatitis, or evidence of hepatic cirrhosis).
    4. Organ allograft (except for corneal transplant) or autologous or allogeneic bone marrow transplant, or stem cell rescue within 3 months prior to the first dose of acasunlimab.
    5. Grade 3 or higher allergic reactions to monoclonal antibody therapy as well as known or suspected allergy or intolerance to any agent given in the course of this trial.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm A

Treatment with acasunlimab once every 21 days for the first 2 cycles and then every 42 days in subsequent cycles

Acasunlimab will be administered intravenously (IV)

Andre navne:
  • DuoBody®-PD-L1×4-1BB
  • GEN1046
Eksperimentel: Arm B

Treatment with acasunlimab + pembrolizumab once every 21 days

Acasunlimab will be administered intravenously (IV)

Andre navne:
  • DuoBody®-PD-L1×4-1BB
  • GEN1046

Pembrolizumab will be administered IV

Andre navne:
  • KEYTRUDA®
Eksperimentel: Arm C

Treatment with acasunlimab + pembrolizumab once every 42 days

Acasunlimab will be administered intravenously (IV)

Andre navne:
  • DuoBody®-PD-L1×4-1BB
  • GEN1046

Pembrolizumab will be administered IV

Andre navne:
  • KEYTRUDA®

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Objective response rate (ORR)
Tidsramme: From first treatment to approximately 27 weeks after last subject's first dose

ORR will be measured as the proportion of subjects with a confirmed response of complete response (CR) or partial response (PR) as per RECIST v1.1

From first treatment to approximately 27 weeks after last subject's first dose

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of response (DOR)
Tidsramme: From onset date of response until disease progression/death/lost to follow-up/start of new anticancer therapy or withdrawal of consent, whichever occurs first (an expected average of 6 months)

DOR will be measured as the time from initial onset of CR or PR to first radiographic progression as per RECIST v. 1.1 or death from any cause, whichever occurs first.

From onset date of response until disease progression/death/lost to follow-up/start of new anticancer therapy or withdrawal of consent, whichever occurs first (an expected average of 6 months)
Time to response (TTR)
Tidsramme: From first treatment to date of onset of initial response (CR or PR) as per RECIST v.1.1 (an expected average of 6 months)

TTR will be measured as the time from first treatment to onset of initial response (CR or PR) as per RECIST v.1.1

From first treatment to date of onset of initial response (CR or PR) as per RECIST v.1.1 (an expected average of 6 months)
Progression-free survival (PFS)
Tidsramme: From first treatment to first documented progression or death due to any cause (an expected average of 6 months)

PFS will be measured from date of first treatment until date of radiographic progression as per RECIST v.1.1 or until death from any cause, whichever occurs first

From first treatment to first documented progression or death due to any cause (an expected average of 6 months)
Overall survival (OS)
Tidsramme: From first treatment to date of death (assessed up to 3 years after the last participant's first dose in the trial)

Defined as time to death from of any cause

From first treatment to date of death (assessed up to 3 years after the last participant's first dose in the trial)
Incidence and severity of adverse events (AEs) and laboratory abnormalities
Tidsramme: Throughout the trial until end of safety follow-up period (60 days or 90 days after last dose)

Incidence of treatment-emergent AEs as assessed by CTCAE v5.0. Laboratory parameters graded by CTCAE v5.0

Throughout the trial until end of safety follow-up period (60 days or 90 days after last dose)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Studieleder: Study Official, Genmab

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

27. oktober 2021

Primær færdiggørelse (Faktiske)

2. december 2024

Studieafslutning (Faktiske)

31. august 2026

Datoer for studieregistrering

Først indsendt

1. november 2021

Først indsendt, der opfyldte QC-kriterier

10. november 2021

Først opslået (Faktiske)

11. november 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

21. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GCT1046-04
  • 2021-001928-17 (EudraCT nummer)
  • 1004314 (Anden identifikator: IRAS ID; UK Research Summaries Database)
  • NL-OMON54259 (Registry Identifier: CCMO (The Netherlands))
  • 2024-513770-22-00 (Anden identifikator: EU Trial (CTIS) Number)
  • RECF-005102 (Registry Identifier: National Institute of Cancer France)
  • 15582 (Registry Identifier: Portugal RNET)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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