Patritumab Deruxtecan (Fixed dose): Patritumab deruxtecan will be dosed at 5.6 mg/kg as an intravenous (IV) infusion administered on Day 1 of each 21-day cycle.
Patritumab Deruxtecan (Up-Titration): Patritumab deruxtecan will be dosed as an intravenous (IV) infusion administered at Cycle 1, 3.2 mg/kg; Cycle 2, 4.8 mg/kg; Cycle 3 and subsequent cycles, 6.4 mg/kg administered on Day 1 of each 21-day cycle.
Study summary
This study is designed to evaluate the antitumor activity of patritumab deruxtecan in participants with metastatic or locally advanced NSCLC with an activating EGFR mutation (exon 19 deletion or L858R) who have received and progressed on or after at least 1 EGFR TKI and 1 platinum-based chemotherapy-containing regimen.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
Participants must meet all of the following criteria to be eligible for inclusion in this study.
* Sign and date the tissue informed consent form (ICF) and the main ICF, prior to the start of any study-specific qualification procedures.
* Male or female participants aged ≥18 years (follow local regulatory requirements if the legal age of consent for study participation is \>18 years old).
* Histologically or cytologically documented locally advanced or metastatic NSCLC not amenable to curative surgery or radiation.
* Documentation of radiological disease progression while on/after receiving most recent treatment regimen for locally advanced or metastatic disease. Participants must have received both of the following:
* Prior treatment with osimertinib. Participants receiving an EGFR TKI at the time of signing informed consent should continue to take the EGFR TKI until 5 days prior to Cycle 1 Day 1. Participants in South Korea known to harbor a clinically actionable genomic alteration in addition to EGFR mutation (e.g., anaplastic lymphoma kinase \[ALK\] or ROS1 protocol oncogene 1 \[ROS1\] fusion) for which treatment is available must have also received prior treatment with at least 1 approved genotype-directed therapy, unless unable (i.e., if contraindicated). No new testing for these genomic alterations (e.g., ALK or ROS1 fusion) is required for Screening.
* Systemic therapy with at least 1 platinum-based chemotherapy regimen.
* Documentation of an EGFR-activating mutation detected from tumor tissue or blood sample: exon 19 deletion or L858R.
* At least 1 measurable lesion confirmed by BICR as per RECIST v1.1
* Consented and willing to provide required tumor tissue of sufficient quantity and of adequate tumor tissue content. Required tumor tissue can be provided as either:
* Pretreatment tumor biopsy from at least 1 lesion not previously irradiated and amenable to core biopsy OR
* Archival tumor tissue collected from a biopsy performed within 3 months prior to signing of the tissue consent and since progression while on or after treatment with the most recent cancer therapy regimen.
* Eastern Cooperative Oncology Group Performance Standard of 0 or 1 at Screening.
* Has adequate bone marrow reserve and organ function based on local laboratory data within 14 days prior to Cycle 1 Day 1:
* Platelet count : ≥100,000/mm\^3 or ≥100 × 10\^9/L (platelet transfusions are not allowed up to 14 days prior to Cycle 1 Day 1 to meet eligibility)
* Hemoglobin: ≥9.0 g/dL (transfusion and/or growth factor support is allowed)
* Absolute neutrophil count: ≥1500/mm\^3 or ≥1.5 × 10\^9/L
* Serum creatinine (SCr) or creatinine clearance (CrCl): SCr ≤1.5 × upper limit of normal (ULN), OR CrCl ≥30 mL/min as calculated using the Cockcroft-Gault equation or measured CrCl
* Aspartate aminotransferase/alanine aminotransferase: ≤3 × ULN (if liver metastases are present, ≤5 × ULN)
* Total bilirubin: ≤1.5 × ULN if no liver metastases (\<3 × ULN in the presence of documented Gilbert's syndrome \[unconjugated hyperbilirubinemia\] or liver metastases)
* Serum albumin: ≥2.5 g/dL
* Prothrombin time (PT) or PT-International normalized ratio (INR) and activated partial thromboplastin time (aPTT)/PTT: ≤1.5 × ULN, except for subjects on coumarin-derivative anticoagulants or other similar anticoagulant therapy, who must have PT-INR within therapeutic range as deemed appropriate by the Investigator
Exclusion Criteria:
Participants meeting any exclusion criteria for this study will be excluded from this study.
* Any previous histologic or cytologic evidence of small cell OR combined small cell/non-small cell disease in the archival tumor tissue or pretreatment tumor biopsy.
* Any history of interstitial lung disease (including pulmonary fibrosis or radiation pneumonitis), has current interstitial lung disease (ILD), or is suspected to have such disease by imaging during screening.
* Clinically severe respiratory compromise (based on Investigator's assessment) resulting from intercurrent pulmonary illnesses including, but not limited to:
* Any underlying pulmonary disorder (eg, pulmonary emboli within 3 months prior to the study enrollment, severe asthma, severe chronic obstructive pulmonary disease \[COPD\]), restrictive lung disease, pleural effusion);
* Any autoimmune, connective tissue or inflammatory disorders with pulmonary involvement (eg, rheumatoid arthritis, Sjogren's syndrome, sarcoidosis); OR prior complete pneumonectomy.
* Is receiving chronic systemic corticosteroids dosed at \>10 mg prednisone or equivalent anti-inflammatory or any form of immunosuppressive therapy prior to enrollment. Participants who require use of bronchodilators, inhaled or topical steroids, or local steroid injections may be included in the study.
* Evidence of any leptomeningeal disease.
* Evidence of clinically active spinal cord compression or brain metastases.
* Inadequate washout period prior to Cycle 1 Day 1, defined as:
* Whole brain radiation therapy \<14 days or stereotactic brain radiation therapy \<7 days;
* Any cytotoxic chemotherapy, investigational agent or other anticancer drug(s) from a previous cancer treatment regimen or clinical study (other than EGFR TKI), \<14 days or 5 half-lives, whichever is longer;
* Monoclonal antibodies, other than immune checkpoint inhibitors, such as bevacizumab (anti-VEGF) and cetuximab (anti-EGFR) \<28 days;
* Immune checkpoint inhibitor therapy \<21 days;
* Major surgery (excluding placement of vascular access) \<28 days;
* Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of radiation \<28 days or palliative radiation therapy \<14 days; or
* Chloroquine or hydroxychloroquine \<14 days.
* Prior treatment with an anti-human epidermal growth factor receptor 3 (HER3) antibody or single-agent topoisomerase I inhibitor.
* Prior treatment with an antibody drug conjugate (ADC) that consists of any topoisomerase I inhibitor
* Has unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0, Grade ≤1 or baseline. Participants with chronic Grade 2 toxicities may be eligible at the discretion of the Investigator after consultation with the Sponsor Medical Monitor or designee.
* Has history of other active malignancy within 3 years prior to enrollment, except:
* Adequately treated non-melanoma skin cancer;
* Superficial bladder tumors (Ta, Tis, T1);
* Adequately treated intraepithelial carcinoma of the cervix uteri;
* Low risk non-metastatic prostate cancer (with Gleason score \<7, and following local treatment or ongoing active surveillance);
* Any other curatively treated in situ disease.
* Uncontrolled or significant cardiovascular disease prior to Cycle 1 Day 1
* Active hepatitis B and/or hepatitis C infection, such as those with serologic evidence of viral infection within 28 days of Cycle 1 Day 1.
* Participant with any human immunodeficiency virus (HIV) infection.
Primary outcome measure(s)
Objective Response Rate (ORR) as Assessed by Blinded Independent Central Review (BICR) — Data collected from screening until time of disease progression by BICR, death, lost to follow up, study discontinuation, whichever occurs first, assessed up to approximately 21 months ORR is defined as the proportion of participants with a best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) as assessed by BICR per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions based on RECIST v1.1.
Trial sites (123)
Facility
City
Region
Status
Banner MD Anderson Cancer Center
Gilbert
Arizona
City of Hope
Duarte
California
Moores Cancer Center at the UC San Diego Health
La Jolla
California
Pacific Shores Medical Group
Long Beach
California
USC Norris Comprehensive Cancer Center
Los Angeles
California
University of California at Irvine
Orange
California
Cedars Sinai
West Hollywood
California
University of Colorado Denver - Anschutz Medical Campus
Aurora
Colorado
Florida Cancer Specialists - South
Fort Myers
Florida
AdventHealth Orlando
Orlando
Florida
Memorial Healthcare System
Pembroke Pines
Florida
Florida Cancer Specialist-North
St. Petersburg
Florida
Florida Cancer Specialists-Panhandle
Tallahassee
Florida
H. Lee Moffitt Cancer Center & Research Institute
Tampa
Florida
Florida Cancer Specialists-East
West Palm Beach
Florida
Emory University
Dunwoody
Georgia
Northwestern University
Chicago
Illinois
University of Maryland - Marlene and Stewart Greenebaum Cancer Center
Baltimore
Maryland
Massachusetts General Hospital (MGH) - Hematology/Oncology
Boston
Massachusetts
Beth Israel Deaconess Medical Center, Harvard Medical School
Boston
Massachusetts
Dana-Farber Cancer Institute
Boston
Massachusetts
Henry Ford Cancer Institute/Henry Ford Hospital
Detroit
Michigan
Mount Sinai Hospital
New York
New York
Memorial Sloan Kettering Cancer Center
New York
New York
Montefiore Medical Center
The Bronx
New York
Levine Cancer Institute
Charlotte
North Carolina
Cleveland Clinic - Main Campus
Cleveland
Ohio
Providence Portland Medical Center
Portland
Oregon
Sarah Cannon Research Institute at Tennessee Oncology - Chattanooga
Chattanooga
Tennessee
Sarah Cannon Research Institute
Nashville
Tennessee
University of Virginia Cancer Center - Emily Couric Clinical Cancer Center
Charlottesville
Virginia
Virginia Cancer Specialist, PC
Fairfax
Virginia
University of Washington/Seattle Cancer Care Alliance
Seattle
Washington
Blacktown Hospital
Blacktown
New South Wales
The Chris O'Brien Lifehouse
Camperdown
New South Wales
St George Public Hospital
Kogarah
New South Wales
Peter MacCallum Cancer Centre
Melbourne
Victoria
St John of God Subiaco Hospital
Subiaco
Western Australia
Princess Alexandra Hospital
Woolloongabba
Australia
Karl Landsteiner Institut für Lungenforschung und pneumologische Onkologie c/o Klinik Floridsdorf
Vienna
Austria
+ 83 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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