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This is a phase Ib, multi-center, open label study evaluating the safety and efficacy of CT053PTSA in combination with gefitinib in patients with EGFR mutation, T790M negative NSCLC who have progressed after EGFR TKI treatment.
This study is being carried out in two parts, part 1 and part 2.
Part 1: This is the dose-escalation part. The primary purpose of the part 1 portion is to determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD), and recommend the appropriate doses of CT053PTSA in combination with gefitinib for further studies.
Part 2: This is the expansion part. The part 2 portion of this study will continue to evaluate the safety and efficacy of the combination of CT053PTSA and gefitinib , at the appropriate doses recommended in Part 1, in patients with EGFR mutation, T790M negative NSCLC.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CT053PTSA +Gefitinib | Experimental | Patients will receive CT053PTSA and gefitinib over a 28-day cycle until progressive disease, intolerable toxicity or subject's withdrawal from treatment. CT053PTSA will be administered daily, at a dose of 30 mg/40mg/60mg orally . Gefitinib will be administered daily, at a dose of 250 mg orally . |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CT053PTSA | Drug |
|
| |
| Gefitinib |
| Measure | Description | Time Frame |
|---|---|---|
| Part 1(dose-escalation part): Maximum Tolerated Dose (MTD) | The maximum tolerated dose (MTD) of the CT053PTSA and gefitinib combination will be determined according to incidence of dose-limiting toxicity (DLT) assessed by NCI CTCAE v4.03 | Cycle 1 Day 1 to Cycle 1 Day 28 |
| Part 2(expansion part): Overall Response Rate | Overall response rate (ORR), defined as a partial response (PR) or complete response (CR) occurring at any point post-treatment according to Response Evaluation Criteria in Solid Tumors as assessed by RECIST v1.1 | up to approximately 36 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with adverse events (AEs) as a measure of safety and tolerability | Safety and tolerability will be assessed through AEs, via monitoring changes in physical examination, clinical laboratory parameters, vital signs and ECGs | up to approximately 36 months |
| Disease Control Rate (DCR) |
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Inclusion Criteria:
Exclusion Criteria:
Prior treatments
Symptomatic, untreated or unstable central nervous system metastases
Spinal cord compression, carcinomatous meningitis or leptomeningeal diseaseonly (patient are only permitted if treated, asymptomatic and stable for at least 4 weeks prior to start of study treatment)
Interstitial pneumonia or radiation pneumonitis
Uncontrolled hypertension that require more than two anti-hypertensive agents to control, or systolic blood pressure (BP) >140mmHg or diastolic BP >90 mmHg before the first administration (BP is the mean blood pressure of two measures that 1 hours interval or above)
Doppler ultrasound evaluation:Left ventricular ejection fraction < 50%
Grade ≥ 2 of arrhythmia (assessed by NCI CTCAE 4.03), or symptomatic bradycardia, or male with QTCF > 450 ms or female with QTCF > 470 ms, or patients with a history of torsion or congenital QT prolonged syndrome long QT syndrome
Certain factors that would preclude adequate absorption of CT053PTSA and gefitinib (eg. unable to swallow, chronic diarrhea, intestinal obstruction)
Significant hemoptysis within 2 months prior to enrollment, or a daily hemoptysis volume is 2.5 ml or above
Patients with evidence of bleeding tendency, including the following cases: gastrointestinal bleeding, hemorrhagic gastric ulcer, fecal occult blood ++ and above; or melena or hematemesis within 2 months; or visceral bleeding that may occur considered by investigator
History of immunodeficiency, or other acquired or congenital immunodeficiency, or history of organ transplantation
Any disease of the following bellowed within 12 months prior to administration: Myocardial infarction, severe angina, or unstable angina, coronary or peripheral artery bypass graft, congestive heart failure, or cerebrovascular events (including transient ischemic attack)
Pulmonary embolism within 6 months prior to administration
Active infection of hepatitis B, or infection of HIV
Other malignancies within 5 years prior to enrollment, with the exception of carcinoma in situ of the cervix, basal or squamous cell skin cancer
History of thyroid dysfunction, and the thyroid function cannot be maintained at the normal range with drugs.
Serious electrolyte imbalance in the investigator's judgment
Pregnant or lactating woman
Any other reason the investigator considers the patient is not suitable to participate in the study
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| Name | Affiliation | Role |
|---|---|---|
| Li Zhang, MD | Sun Yat-Sen University Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sun Yat-sen University Cancer Center | Guangzhou | Guangdong | 510060 | China |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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| ID | Term |
|---|---|
| D000077156 | Gefitinib |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| Drug |
|
|
DCR, proportion of patients with best overall response of CR, PR or SD |
| up to approximately 36 months |
| Progression-free Survival (PFS) | PFS, defined as time from date of treatment to disease progression or death due to any cause | up to approximately 36 months |
| Duration of Response (DOR) | DOR, defined as time from the first documented CR or PR to first documented progression or death due to any cause | up to approximately 36 months |
| Overall Survival (OS) | OS, defined as time from date of treatment to death due to any cause | up to approximately 60 months |
| Maximum observed plasma concentration (Cmax) | to assess the pharmacokinetic profile | Cycle 1 Day1 and Day 28 |
| Time of maximum observed plasma concentration (Tmax) | to assess the pharmacokinetic profile | Cycle 1 Day1 and Day 28 |
| Area under the plasma concentration time curve (AUC) | to assess the pharmacokinetic profile | Cycle 1 Day1 and Day 28 |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |