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According to the 2024 edition of the NCCN guidelines and the 2023 edition of the CSCO guidelines, perioperative treatment is recommended for patients with stage IIIA and IIIB (T3N2) non-small cell lung cancer (NSCLC). Targeted therapies for NSCLC, such as EGFR inhibitors and ALK inhibitors, have been explored in the neoadjuvant setting. For patients with MET alterations, some have undergone preoperative MET inhibitor treatment, achieving pathological downstaging followed by surgery, resulting in R0 resection. Therefore, this is a prospective, cohort, single-center phase II clinical study to evaluate the efficacy and safety of Vebreltinib as a neoadjuvant treatment for patients with MET-altered stage IIIA-IIIB (N2) NSCLC.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vebreltinib | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vebreltinib | Drug | Neoadjuvant treatment stage: Vebreltinib 200mg, bid, po, 2-4 months in total; Surgical treatment stage: CR + PR patients and SD + PD patients who could still undergo surgery will receive radical surgery; Adjuvant treatment stage: CR, PR and SD patients who have been treated surgically: Vebreltinib 200mg, bid, po, up to 2 years/until the disease progressed. PD patients: transferred into medical oncology or/and radiation oncology and receive comprehensive therapy. |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response (ORR) rate | ORR is defined according to the RECIST v1.1 criteria. | up to 30 months |
| Measure | Description | Time Frame |
|---|---|---|
| Disease control rate (DCR) | DCR Rate is defined as the proportion of patients who achieve stable disease (SD), partial response (PR), or complete response (CR) among all patients. | up to 30 months |
| Major pathologic response (MPR) rate |
| Measure | Description | Time Frame |
|---|---|---|
| The correlation between stratification factors such as disease stage, smoking history, and treatment efficacy | The correlation between stratification factors such as disease stage, smoking history, and treatment efficacy. | Up to 30 months |
Inclusion Criteria:
1. The patient shall sign the Informed Consent Form. 2.Aged 18 ≥ years. 3.Histological or cytological diagnosis of NSCLC by needle biopsy, and evaluated by researchers as stage III-IVA.
4.NGS gene testing confirmed MET alterations, which include the following two types: Cohort 1: MET exon 14 skipping mutations (NGS results from tissue or blood samples certified by CLIA or CAP-approved laboratories); Cohort 2: Primary MET amplification (NGS results or FISH results from tissue or blood samples certified by CLIA or CAP-approved laboratories)..
5.Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1. 6. According to the MDT evaluation (which should include a thoracic surgeon specializing in tumor surgery), it is considered that the primary NSCLC is potentially completely resectable; 7. At least 1 measurable lesion according to RECIST 1.1. 8.Patients with good function of other main organs (liver, kidney, blood system, etc.) 9.Patients with lung function can tolerate surgery; 10.Fertile female patients must voluntarily use effective contraceptives not less than 120 days after chemotherapy or the last dose of toripalimab (whichever is later) during the study period, and urine or serum pregnancy test results within 7 days prior to enrollment are negative. 11. Unsterilized male patients must voluntarily use effective contraception during the study period not less than 120 d
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Peng Zhang, PhD | Contact | 021-65115006 | zhangpeng1121@tongji.edu.cn |
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The researchers will consider whether IPD is available to other researchers only after the paper is published.
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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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All enrolled patients received Vebreltinib neoadjuvant therapy.
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|
MPR rate is defined as the proportion of participants who have achieved major pathologic response (on routine hematoxylin and eosin staining, tumors with no more than 10% viable tumor cells) in all participants.
| Up to 30 months |
| Pathologic complete response (PCR) rate | PCR rate is defined as the proportion of participants who have achieved pathologic complete response (on routine hematoxylin and eosin staining, no tumor cell can be found in tumor bed or lymph node) in all participants. | Up to 30 months |
| Event-free survival (EFS) | Event-free survival (EFS) is defined as the length of time (months) from randomization to any of the following events: any progression of disease precluding surgery, progression or recurrence disease based on response evaluation criteria in solid tumors (RECIST) 1.1 after surgery, or death due to any cause. Participants who don't undergo surgery for reason other than progression will be considered to have an event at progression or death. Progression is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression). | up to 60 months |
| 3-year overall survival (OS) | OS is defined as the time (months) from enrollment to death of participant due to any cause. In the case of a patient who still survives at the time of analysis, the date of last contact will be taken as the censoring date. | Up to 36 months |
| Overall survival (OS) | It is defined as the time (months) from enrollment to death of participant due to any cause. In the case of a patient who still survives at the time of analysis, the date of last contact will be taken as the censoring date. | up to 60 months |
| Treatment-related adverse event (TRAE) | TRAE is defined and classified according to NCI-CTCAE v5.0 in all participants. | Up to 30 months |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |