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| Name | Class |
|---|---|
| Chinese Thoracic Oncology Group | UNKNOWN |
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This phase II, umbrella trial study directed by next generation sequencing (NGS) works in Chinese patients with advanced stage NSCLC who never received any anti-tumor treatment. The purpose of this study is to evaluate efficacy of targeted therapies or immunotherapy to NSCLC patients whose tumor harbors a genomic variant known to be a drug target or to predict sensitivity to a drug.
PRIMARY OBJECTIVES:
I. To evaluate the anti-tumor efficacy of targeted agents or checkpiont inhibitors in advanced stage NSCLC with genomic alteration.
SECONDARY OBJECTIVES:
I. To evaluate the clinical efficacy of targeted agents or checkpiont inhibitors in advanced stage NSCLC with genomic alteration.
II. To evaluate safty and tolerence of targeted agents or checkpiont inhibitors in advanced stage NSCLC with genomic alteration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm1: Avitinib Maleate | Experimental | Patients with EGFR de novo T790m mutation receive Avitinib 300mg orally (PO) twice daily (BID) on day 1-28. |
|
| Arm2: Chidamide plus Afatinib | Experimental | Patients with EGFR sensitive mutation with BIM deletion polymorphism receive Afatinib plus Chidamide. Chidamide will be administered 30mg orally twice weekly, 28 days as one cycle. Afatinib will be administered 40mg orally once a day, 28 days as one cycle. |
|
| Arm3: crizotinib | Experimental | Patients with MET 14 exon mutation receive crizotinib 250mg PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
|
| Arm4: X396 | Experimental | Patients with MET amplification receive X396 225mg PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
|
| Arm5: X396 | Experimental | Patients with ROS1 fusion receive X396 225mg PO QD on days 1-28. 28 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Avitinib Maleate | Drug | 300mg orally (PO) twice daily (BID) on day 1-28. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Response rate (RR) | RECIST version 1.1 | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | RECIST version 1.1 | 24 months |
| Overall survival (OS) | Overall Survival is defined as the time from first dose to death due to any cause. Through the follow-up within 30 days after study completion or termination of the last subject, death and date of death will be checked for subject alive during treatment period |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yi-Long Wu, Professor | Contact | 862083827812 | syylwu@live.cn | |
| Qing Zhou, Dr. | Contact | +8613544561166 | gzzhouqing@126.com |
| Name | Affiliation | Role |
|---|---|---|
| Yi-Long Wu | Guangdong Association of Clinical Trials | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology | Recruiting | Guangzhou | Guangdong | 510080 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37488286 | Derived | Liu SM, Tu HY, Wei XW, Yan HH, Dong XR, Cui JW, Zhou Z, Xu CR, Zheng MY, Li YS, Wang Z, Bai XY, Li AN, Sun YL, Huang J, Lin JX, Ke EE, Xu BF, Lu C, Du Y, Chen Y, Ma R, Wang BH, Cang SD, Wang BC, Chen HJ, Yang JJ, Li Y, Zhou Q, Wu YL. First-line pyrotinib in advanced HER2-mutant non-small-cell lung cancer: a patient-centric phase 2 trial. Nat Med. 2023 Aug;29(8):2079-2086. doi: 10.1038/s41591-023-02461-x. Epub 2023 Jul 24. | |
| 35659479 |
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|
| Arm6: X396 | Experimental | Patients with Ntrk1/2/3 fusion receive X396 225mg PO QD on days 1-28. 28 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm7: Pyrotinib Maleate | Experimental | Patients with HER2 mutation receive Pyrotinib Maleate 400mg PO QD on days 1-28. 28 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm8: AZD3759 | Experimental | EGFR sensitive mutation with brain/meningeal metastasis receive AZD3759 200mg PO BID on days 1-28. 28 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm9: Pirotinib | Experimental | Patients with EGFR20ins mutation positive receive Pirotinib. This arm was divided into three groups: Group 1, 60mg PO QD on days 1-28. 28 days as one cycle. Group 2, 40mg PO BID on days 1-28. 28 days as one cycle. Group 3, Dosage was determined according to the number of PR patients in Group 2. |
|
| Arm10: Nimotuzumab plus gemcitabine and carboplatin | Experimental | Lung squamous cell carcinoma with EGFR amplification. Nimotuzumab 400mg, iv gtt. on day 1,8,15. Gemcitabine 1250mg/m^2, iv gtt. on day 1,8. Carboplatin AUC5, iv gtt. Q3W on day 1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm11: Nimotuzumab plus pemetrexed and cisplatin | Experimental | Lung adenocarcinoma with EGFR amplification. Nimotuzumab 400mg, iv gtt. on day 1,8,15. pemetrexed 500mg/m^2, iv gtt. on day 1. Cisplatin 75mg/m^2, iv gtt. Q3W on day 1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm12: Pirotinib | Experimental | Patients with rare EGFR mutation receive Pirotinib. This arm was divided into two groups: Group 1, 40mg PO BID on days 1-28. 28 days as one cycle. Group 2, Dosage was determined according to the number of PR patients in Group 1. |
|
| Arm13: Avitinib | Experimental | Patients with EGFR sensitive mutation receive Avitinib 300mg PO BID on days 1-28. 28 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm14: Sintilimab | Experimental | Patients with PD-L1(TPS)≥50% without EGFR mutation or ALK rearrangement. Sintilimab 200mg iv gtt. Q3W on day1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm15: Sintilimab | Experimental | Patients with TMB≥10 mut/Mb,1%≦PD-L1<50% without EGFR mutation or ALK rearrangement. Sintilimab 200mg iv gtt. Q3W on day1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm16: Sintilimab | Experimental | Patients with KRAS and TP53 mutation, 1%≦PD-L1<50%, TMB<10 mut/Mb without EGFR mutation or ALK rearrangement. Sintilimab 200mg iv gtt. Q3W on day1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm17: Sintilimab plus pemetrexed and cisplatin | Experimental | Patients with PD-L1<1%, TMB<10 mut/mb without EGFR mutation, ALK rearrangement, KRAS or TP53 mutation. Sintilimab 200mg iv gtt. Q3W on day1. Pemetrexedb 500mg/m^2 iv gtt. Q3W on day1. Cisplatin 75mg/m^2 iv gtt. Q3W on day1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Arm18: Sintilimab plus Gemcitabine and carboplatin | Experimental | Patients with PD-L1<1%, TMB<10 mut/mb without EGFR mutation, ALK rearrangement, KRAS or TP53 mutation. Sintilimab 200mg iv gtt. Q3W on day1. Gemcitabine 1g/m^2 iv gtt. on day1,8. Carboplatin AUC5 iv gtt. Q3W on day1. 21 days as one cycle. Courses repeat every 2 cycles in the absence of disease progression or unacceptable toxicity. |
|
| Afatinib | Drug | 40mg orally once a day, 28 days as one cycle. |
|
|
| Crizotinib | Drug | 250mg PO QD on days 1-28. 28 days as one cycle. |
|
|
| X-396 | Drug | 225mg PO QD on days 1-28. 28 days as one cycle. |
|
|
| Chidamide | Drug | 30mg orally twice weekly, 28 days as one cycle. |
|
|
| Pyrotinib Maleate | Drug | 400mg PO QD on days 1-28. 28 days as one cycle. |
|
|
| AZD3759 | Drug | 200mg PO BID on days 1-28. 28 days as one cycle. |
|
| Pirotinib | Drug | 60mg PO QD/40mg PO BID on days 1-28. 28 days as one cycle. |
|
|
| Nimotuzumab | Drug | 400mg, iv gtt. on day 1,8,15. 21 days as one cycle. |
|
| Pemetrexed | Drug | 500mg/m^2, iv gtt. Q3W. 21 days as one cycle. |
|
|
| Cisplatin | Drug | 75mg/m^2, iv gtt. Q3W on day1. 21 days as one cycle. |
|
|
| Sintilimab | Drug | 200mg iv gtt. Q3W on day1. 21 days as one cycle. |
|
| Gemcitabine | Drug | 1g/m^2 iv gtt. on day1,8. 21 days as one cycle. |
|
|
| Gemcitabine | Drug | 1.25g/m^2 iv gtt. on day1,8. 21 days as one cycle. |
|
|
| Carboplatin | Drug | AUC5 iv gtt. Q3W on day1. 21 days as one cycle. |
|
|
| 48 months |
| Disease control rate(DCR) | RECIST version 1.1 | 24 months |
| Duration of response (DOR) | RECIST version 1.1 | 24 months |
| Toxicity (number of patients with treatment-related AE as assessed by CTCAE v4.03) | number of patients with treatment-related AE as assessed by CTCAE v4.03 | 24 months |
| Health-Related Quality of Life (HRQOL) | EORTC-LC13 | 24 months |
| To explore the mechanism of drug resistance in the treatment of specific gene mutation | 24 months |
|
| Derived |
| Liu SM, Yan HH, Wei XW, Lu C, Dong XR, Du Y, Cui JW, Chen Y, Ma R, Wang BH, Zhou Z, Cang SD, Yang JJ, Tu HY, Zhang XC, Zhong WZ, Zhou Q, Wu YL. Biomarker-Driven Studies With Multi-targets and Multi-drugs by Next-Generation Sequencing for Patients With Non-Small-Cell Lung Cancer: An Open-Label, Multi-center, Phase II Adaptive Umbrella Trial and a Real-World Observational Study (CTONG1702&CTONG1705). Clin Lung Cancer. 2022 Nov;23(7):e395-e399. doi: 10.1016/j.cllc.2022.05.009. Epub 2022 May 11. |
| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C000630672 | abivertinib |
| D000077716 | Afatinib |
| D000077547 | Crizotinib |
| C000629294 | ensartinib |
| C547816 | N-(2-amino-5-fluorobenzyl)-4-(N-(pyridine-3-acrylyl)aminomethyl)benzamide |
| C000604577 | AZD3759 |
| C501466 | nimotuzumab |
| D000068437 | Pemetrexed |
| D002945 | Cisplatin |
| C000632826 | sintilimab |
| D000093542 | Gemcitabine |
| D016190 | Carboplatin |
| ID | Term |
|---|---|
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D000631 | Aminopyridines |
| D011725 | Pyridines |
| D006147 | Guanine |
| D007042 | Hypoxanthines |
| D011688 | Purinones |
| D011687 | Purines |
| D005971 | Glutamates |
| D024342 | Amino Acids, Acidic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000600 | Amino Acids, Dicarboxylic |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D056831 | Coordination Complexes |
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