Vebreltinib Plus Furmonertinib in Patients With EGFR-mutated Advanced Non-small Cell Lung Cancer and High PD-L1 Expression (DUAL-THRUST)
A Single-arm, Phase I/II Trial Aimed to Evaluate the Efficacy and Safety of Vebreltinib Plus Furmonertinb as First-line Treatment for Patients With Locally Advanced or Metastatic Non-small Cell Lung Cancer Harboring EGFR Mutations and High PD-L1 Expression
This is a single-arm, exploratory phase Ib/II study with a seamless design to evaluate the safety and efficacy of Vebreltinib combined with furmonertinib as first-line treatment in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring EGFR-sensitive mutations (exon 19 deletion or L858R) and PD-L1 TPS ≥50%.
In the phase Ib part, 12-16 patients will be enrolled to compare the safety and early efficacy of Vebreltinib 100mg BID versus 150mg BID in combination with furmonertinib 80mg QD, and to determine the recommended phase II dose (RP2D).
In the phase II part, 37 patients (including evaluable patients from the RP2D cohort in phase Ib) will receive treatment at the RP2D. The primary endpoint is investigator-assessed median progression-free survival (PFS). Secondary endpoints include objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Exploratory endpoints will analyze the correlation between baseline MET abnormalities and treatment efficacy.
研究概览
详细说明
Patients with advanced NSCLC harboring EGFR mutations and high PD-L1 expression (TPS ≥50%) have primary resistance to third-generation EGFR-TKI monotherapy, with a median PFS of only 3.8-5.0 months, representing an unmet clinical need.
Basic research has shown that PD-L1 can inhibit protein tyrosine phosphatase through a non-immune pathway, leading to sustained MET phosphorylation and induction of MET amplification, which mediates EGFR-TKI resistance.
This study aims to overcome primary resistance by simultaneously blocking the EGFR and MET pathways through the combination of the MET inhibitor Vebreltinib and the third-generation EGFR-TKI furmonertinib.
The study is divided into two phases: the phase Ib dose-escalation phase adopts a parallel cohort design, enrolling two dose groups simultaneously. Each group initially enrolls 3 patients for a 28-day DLT observation period. If DLT ≤1 case, the cohort will be expanded to at least 6 evaluable patients; if DLT ≥2 cases, the cohort will be terminated. The RP2D will be determined comprehensively based on DLT incidence, incidence of grade ≥2 AEs, dose adjustment rate, and 8-week ORR.
The phase II efficacy-expansion phase will use the RP2D, with the primary endpoint being median PFS. It is expected that combination therapy will prolong the median PFS from 4 months in historical data to 8.5 months.
Patients will receive treatment until disease progression, death, withdrawal of informed consent, or intolerable toxicity. Imaging assessments will be performed every 8 weeks, with an additional tumor assessment on day 28 of cycle 1 for phase Ib patients. Safety assessments include adverse events, laboratory tests, electrocardiograms, and echocardiograms, graded according to NCI-CTCAE v5.0.
研究类型
注册 (估计的)
阶段
- 阶段2
- 阶段1
联系人和位置
学习联系方式
- 姓名:Jing Cai, MD, PhD
- 电话号码:+86+0791-86297662
- 邮箱:cjdl879@163.com
研究联系人备份
- 姓名:Liangqian Lv, MD
- 电话号码:+86+0791-86297662
- 邮箱:369848857@qq.com
学习地点
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Jianxi
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Nanchang、Jianxi、中国、330006
- 招聘中
- The Second Affiliated Hospital of Nanchang University
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接触:
- Jian Li, PhD
- 电话号码:+86-0791-86297662
- 邮箱:efyyjs@126.com
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接触:
- Jing Cai, MD
- 电话号码:+86-0791-86265873
- 邮箱:cjdl879@163.com
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首席研究员:
- Anwen Liu, PhD
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-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Voluntarily agree to participate in this study and sign a written informed consent form
- Age ≥18 years and ≤75 years, regardless of gender
- Histologically or cytologically confirmed locally advanced (stage IIIB-IIIC), metastatic, or recurrent (stage IV) non-small cell lung cancer, not amenable to surgical resection and definitive concurrent chemoradiotherapy
- No prior systemic antineoplastic therapy for advanced/metastatic disease Histologically or cytologically confirmed EGFR-sensitive mutations (exon 19 deletion or exon 21 L858R point mutation)
- Central laboratory-confirmed PD-L1 Tumor Proportion Score (TPS) ≥50%
- At least one measurable target lesion according to RECIST v1.1 criteria
- Asymptomatic or locally treated stable brain metastases are allowed.
- ECOG performance status 0-1
- Expected survival ≥3 months
- Adequate organ function
Exclusion Criteria:
- Histological type of small cell lung cancer or mixed small cell lung cancer
- Prior treatment with any EGFR-TKI or MET-TKI
- Presence of ALK fusion positive or ROS1 fusion positive
- Other active malignant tumors (except completely resected carcinoma in situ, basal cell or squamous cell skin cancer, or tumors with no recurrence for ≥3 years after curative treatment)
- Major surgery within 4 weeks before first dose (except brain metastasis resection, which requires ≥2 weeks); thoracoscopic biopsy or mediastinoscopy is excluded (requires ≥1 week)
- Require use of strong CYP3A4 inhibitors or inducers within 1 week before first dose or during the study
- Uncontrolled systemic diseases
- Cardiac dysfunction: QTcF >470ms (average of three ECGs) at screening; NYHA functional class ≥3 or LVEF <50%
- Dysphagia, active digestive system disease, or history of major gastrointestinal surgery that may affect drug absorption
- History of acute or chronic pancreatitis or pancreatic surgery
- Other conditions deemed unsuitable for participation by the investigator
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:Vebreltinib plus Furmonertinib
Participants with EGFR-sensitizing mutated, PD-L1-high locally advanced or metastatic non-small cell lung cancer (NSCLC) will receive Vebreltinib at the recommended phase 2 dose (RP2D) orally in combination with furmonertinib 80 mg orally once daily, until disease progression or unacceptable toxicity.
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Administered orally on an empty stomach, 100mg or 150mg twice daily, with an interval of 12±4 hours between morning and evening doses.
Dose adjustments are allowed based on toxicity, down to a minimum of 100mg BID
Administered orally on an empty stomach, 80mg once daily, taken concurrently with Vebreltinib.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Phase Ib: Incidence of Dose-Limiting Toxicities as assessed by protocol-defined criteria and CTCAE v5.0
大体时间:Up to 28 days from first dose
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Number of participants experiencing dose-limiting toxicities during the dose-escalation phase of the study, based on CTCAE v5.0 grading and protocol-specified DLT criteria
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Up to 28 days from first dose
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Phase Ib: Incidence of Grade ≥2 Treatment-Emergent Adverse Events as assessed by CTCAE v5.0
大体时间:Up to 8 weeks from first dose
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Number of participants experiencing Grade 2 or higher treatment-related adverse events
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Up to 8 weeks from first dose
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Phase Ib: Rate of dose reduction, interruption, or discontinuation due to treatment-related adverse events as assessed by CTCAE v5.0
大体时间:Up to 8 weeks from first dose
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Proportion of participants requiring dose reduction, interruption, or discontinuation due to treatment-related toxicity
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Up to 8 weeks from first dose
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Phase II: Investigator-Assessed Progression-Free Survival (PFS)
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Time from first dose to first documented disease progression or death from any cause, assessed according to RECIST v1.1
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Phase Ib: Objective Response Rate (ORR)
大体时间:Up to 8 weeks from first dose
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Proportion of participants achieving complete response (CR) or partial response (PR) per RECIST v1.1, assessed at 8 weeks after first dose
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Up to 8 weeks from first dose
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Phase II: Objective Response Rate (ORR)
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Proportion of participants achieving complete response (CR) or partial response (PR) per RECIST v1.1
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Phase II: Disease Control Rate (DCR)
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Proportion of participants achieving complete response (CR), partial response (PR), or stable disease (SD) per RECIST v1.1
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
|
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Phase II: Overall Survival (OS)
大体时间:From first dose until death from any cause, assessed up to 36 months
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Time from first dose to death from any cause
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From first dose until death from any cause, assessed up to 36 months
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Exploratory: Objective response rate by baseline MET aberration status as assessed by RECIST 1.1
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Proportion of participants achieving complete response (CR) or partial response (PR), stratified by presence or absence of baseline MET aberrations (MET amplification or MET overexpression)
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
|
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Exploratory: Objective response rate by MET overexpression level as assessed by RECIST 1.1
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Proportion of participants achieving CR or PR, stratified by MET overexpression level ( IHC 1+,2+, 3+) measured by immunohistochemistry
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
|
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Exploratory: Progression-free survival by baseline MET aberration status as assessed by RECIST 1.1
大体时间:From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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Time from first dose to first documented disease progression or death from any cause, whichever occurs first, stratified by presence or absence of baseline MET aberrations (MET amplification or MET overexpression)
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From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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合作者和调查者
调查人员
- 学习椅:Anwen Liu, PhD、Second Affiliated Hospital of Nanchang University
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- IIT-I-2026-021
- I-MRER[2026] No. 10 (其他标识符:Ethics Committee, The Second Affiliated Hospital of Nanchang University)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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