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Vebreltinib Plus Furmonertinib in Patients With EGFR-mutated Advanced Non-small Cell Lung Cancer and High PD-L1 Expression (DUAL-THRUST)

2026年6月17日 更新者:Jing Cai、Second Affiliated Hospital of Nanchang University

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

介入性

注册 (估计的)

45

阶段

  • 阶段2
  • 阶段1

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

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

    • Jianxi
      • Nanchang、Jianxi、中国、330006
        • 招聘中
        • The Second Affiliated Hospital of Nanchang University
        • 接触:
          • Jian Li, PhD
          • 电话号码:+86-0791-86297662
          • 邮箱:efyyjs@126.com
        • 接触:
        • 首席研究员:
          • Anwen Liu, PhD

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

Inclusion Criteria:

  1. Voluntarily agree to participate in this study and sign a written informed consent form
  2. Age ≥18 years and ≤75 years, regardless of gender
  3. 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
  4. 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)
  5. Central laboratory-confirmed PD-L1 Tumor Proportion Score (TPS) ≥50%
  6. At least one measurable target lesion according to RECIST v1.1 criteria
  7. Asymptomatic or locally treated stable brain metastases are allowed.
  8. ECOG performance status 0-1
  9. Expected survival ≥3 months
  10. Adequate organ function

Exclusion Criteria:

  1. Histological type of small cell lung cancer or mixed small cell lung cancer
  2. Prior treatment with any EGFR-TKI or MET-TKI
  3. Presence of ALK fusion positive or ROS1 fusion positive
  4. 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)
  5. 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)
  6. Require use of strong CYP3A4 inhibitors or inducers within 1 week before first dose or during the study
  7. Uncontrolled systemic diseases
  8. Cardiac dysfunction: QTcF >470ms (average of three ECGs) at screening; NYHA functional class ≥3 or LVEF <50%
  9. Dysphagia, active digestive system disease, or history of major gastrointestinal surgery that may affect drug absorption
  10. History of acute or chronic pancreatitis or pancreatic surgery
  11. Other conditions deemed unsuitable for participation by the investigator

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

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
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.
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.

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
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
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
Up to 28 days from first dose
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
Number of participants experiencing Grade 2 or higher treatment-related adverse events
Up to 8 weeks from first dose
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
Proportion of participants requiring dose reduction, interruption, or discontinuation due to treatment-related toxicity
Up to 8 weeks from first dose
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
Time from first dose to first documented disease progression or death from any cause, assessed according to RECIST v1.1
From first dose until first documented disease progression or death from any cause, assessed up to 24 months

次要结果测量

结果测量
措施说明
大体时间
Phase Ib: Objective Response Rate (ORR)
大体时间:Up to 8 weeks from first dose
Proportion of participants achieving complete response (CR) or partial response (PR) per RECIST v1.1, assessed at 8 weeks after first dose
Up to 8 weeks from first dose
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
Proportion of participants achieving complete response (CR) or partial response (PR) per RECIST v1.1
From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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
Proportion of participants achieving complete response (CR), partial response (PR), or stable disease (SD) per RECIST v1.1
From first dose until first documented disease progression or death from any cause, assessed up to 24 months
Phase II: Overall Survival (OS)
大体时间:From first dose until death from any cause, assessed up to 36 months
Time from first dose to death from any cause
From first dose until death from any cause, assessed up to 36 months

其他结果措施

结果测量
措施说明
大体时间
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
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)
From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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
Proportion of participants achieving CR or PR, stratified by MET overexpression level ( IHC 1+,2+, 3+) measured by immunohistochemistry
From first dose until first documented disease progression or death from any cause, assessed up to 24 months
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
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)
From first dose until first documented disease progression or death from any cause, assessed up to 24 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:Anwen Liu, PhD、Second Affiliated Hospital of Nanchang University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年7月3日

初级完成 (估计的)

2027年12月3日

研究完成 (估计的)

2029年6月3日

研究注册日期

首次提交

2026年6月5日

首先提交符合 QC 标准的

2026年6月17日

首次发布 (实际的)

2026年6月18日

研究记录更新

最后更新发布 (实际的)

2026年6月18日

上次提交的符合 QC 标准的更新

2026年6月17日

最后验证

2026年6月1日

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)?

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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