At sponsor's discretion

This is a Phase I/IIa dose-finding (Phase I) followed by randomized, double-blind, placebo-controlled, parallel, add-on to cisplatin + docetaxel (Phase IIa) study to evaluate the safety, tolerability, and efficacy profiles of Careseng 1370 in subjects with advanced NSCLC.

Inclusion Criteria:

1. Of either gender aged at least 20 years old
2. Histologically or cytologically confirmed unresectable, locally advanced, metastatic untreated NSCLC and can be accurately assessed by computed tomography/magnetic resonance imaging (CT/MRI) scan (RECIST v1.1) for which regimen of cisplatin + docetaxel is arranged by the investigator; no prior chemotherapy treatment for this disease will be allowed.
3. ECOG performance status score ≤2 and life expectancy ≥12 months
4. Dated and signed informed consent

Exclusion Criteria:

1. Had chemotherapy, therapeutic radiotherapy, or other therapy for NSCLC within 6 weeks before Screening visit

2. Has undergone major surgery within 4 weeks before Screening visit

3. With contraindications to MRI

4. Has elective or planned surgery to be conducted during the trial

5. Has documented brain or leptomeningeal metastases or any cancer other than NSCLC

6. Inadequate hematologic function, as defined by: absolute neutrophil count (ANC) ≤ 1,500/µL; hemoglobin concentration < 10.0 g/dL; and platelet count ≤ 100,000/µL

7. Inadequate hepatic function, as defined by: total bilirubin level > ULN; AST or ALT > 1.5 x ULN; gamma-GT > 2.5 x ULN; ALP > 2.5 x ULN.

8. Inadequate renal function, as defined by: serum creatinine level > 1.5 x ULN; or calculated serum creatinine clearance (Cockcroft-Gault) < 50 mL/min

9. Urinary protein >1+ on dipstick, edema or serum albumin < lower level of normal

10. Any other ≥ grade 3 laboratory abnormality at baseline

11. Inadequate coagulation function, as defined by: INR > 1.5 x ULN or aPTT > 1.5 x ULN

12. Male subject with female spouse/partners who are of childbearing potential refuses to adopt highly effective contraceptives from Screening visit until 7 days after end of study treatment

13. Female subjects with childbearing potential who is pregnant (confirmed by urine or serum pregnancy test) or lactating, refuses to adopt highly effective contraceptives, if heterosexually active, from Screening visit until 7 days after end of study treatment

14. Requirement of anticoagulants, antiplatelet treatments (e.g., warfarin, heparins) from Screening visit until Final visit

15. History of human immunodeficiency virus (HIV) infection

16. Has experienced any grade 3 or 4 gastrointestinal bleeding within 12 weeks before Screening visit

17. Has a history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess <6 months before Screening visit, or the subject has a history of poorly controlled or recurrent inflammatory bowel disease (including Crohn's disease or ulcerative colitis)

18. Has participated in a clinical study within 4 weeks prior to Screening visit

19. Has a known allergy to investigational product Careseng 1370, matched placebo, cisplatin, docetaxel or their excipients. If there is suspicion that the subject may have an allergy, the subject should be excluded.

20. Has known alcohol or drug dependency

21. Requirement for ongoing immunosuppressive agents (including azathioprine, mycophenolate, cyclophosphamide, chlorambucil, methotrexate, cyclosporine) or systemic steroid with equivalent dosage higher than prednisolone 30 mg/day for more than 14 days

22. Significant cardiovascular disease, including:

    1. History of New York Heart Association (NYHA) class III or IV congestive heart failure
    2. Ongoing uncontrolled hypertension
    3. History of congenital long QT syndrome
    4. Ongoing prolonged corrected QT (QTc) interval defined as at least 450 msec
    5. History of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation)

23. Uncontrolled psychiatric disorder or altered mental status precluding informed consent or necessary testing per investigator's discretion

24. Consumption of herbal preparations/supplements (except for a daily multivitamin/mineral supplement not containing herbal components) within 2 weeks prior to the start of cisplatin + docetaxel or Careseng 1370/matched placebo administration

25. Is not considered to be suitable for this study, in the opinion of the investigator