A Study to Compare the Efficacy and Safety of Entrectinib and Crizotinib in Participants With Advanced or Metastatic ROS1 Non-small Cell Lung Cancer (NSCLC) With and Without Central Nervous System (CNS) Metastases
Entrectinib: Entrectinib will be self-administered orally at a dose of 600 mg (three 200 mg capsules per day) once daily with or without food.
Crizotinib: Crizotinib will be self-administered orally at a dose of 250 mg twice daily with or without food.
Study summary
The study will compare the efficacy and safety of entrectinib with crizotinib in participants with advanced or metastatic ROS1 non-small cell lung cancer (NSCLC). The participants will self-administer oral entrectinib or crizotinib as described in the protocol and local prescribing information. Treatments will continue until progressive disease, unacceptable toxicity, death, or withdrawal from the study, whichever occurs first.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Histologically or cytologically-confirmed diagnosis of advanced or recurrent (Stage IIIB/C not amenable for radical treatment) or metastatic (Stage IV) NSCLC that harbors a documented ROS1 gene rearrangement.
* No prior treatment with a ROS1 tyrosine kinase inhibitor, chemotherapy or other systemic therapy for advanced or recurrent (Stage IIIB/C not amenable for radical treatment) or metastatic (Stage IV) NSCLC
* Prior radiotherapy is allowed if more than 14 days have elapsed between the end of treatment and randomization
* Measurable systemic disease according to RECIST v1.1
* Participants with measurable and non-measurable CNS lesions per RECIST v1.1, including leptomeningeal carcinomatosis
* Life expectancy of at least 12 weeks
* Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
* Adequate hematologic, renal, liver functions
* Participants must have recovered from effects of any major surgery or significant traumatic injury at least 28 days before the first dose of study treatment
* Ability to swallow entrectinib and crizotinib intact without chewing, crushing, or opening the capsules
* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods with a failure rate of \<1% per year during the treatment period and for up to 5 weeks after the last dose of entrectinib or for at least 90 days after the last dose of crizotinib
* For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating sperm.
Exclusion Criteria:
* Prior treatment with a ROS1 tyrosine kinase inhibitor, chemotherapy or other systemic therapy for advanced or recurrent (Stage IIIB/C not amenable for radical treatment) or metastatic (Stage IV) NSCLC
* NCI-CTCAE v5.0 Grade 3 or higher toxicities due to any prior therapy (excluding alopecia, fatigue, nausea and lack of appetite), which have not shown improvement and are strictly considered to interfere with current study drug
* History of recent (within the past 3 months) symptomatic congestive heart failure or ejection fraction ≤ 50% observed during screening for the study
* History of prolonged corrected QTc interval
* Peripheral sensory neuropathy ≥ Grade 2
* Known interstitial lung disease, interstitial fibrosis, or history of tyrosine kinase inhibitor-induced pneumonitis
* Previous malignancy within the past 3 years
* Incomplete recovery from any surgery prior to the start of study treatment
* Active GI disease (e.g., Crohn's disease, ulcerative colitis or short gut syndrome) or other malabsorption syndrome that would reasonably impact drug absorption
* History of prior therapy-induced pneumonitis
* Any condition (in the past 3 months) e.g., myocardial infarction, unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, stroke, symptomatic bradycardia, or uncontrolled arrhythmias requiring medication
* Known active infections (bacterial, fungal or viral, including human immunodeficiency virus positive)
* History of hypersensitivity to any of the additives in the entrectinib and/or crizotinib drug formulations
* Pregnant or lactating women
* Known human immunodeficiency virus (HIV) positivity or acquired immunodeficiency syndrome (AIDS)-related illness
* Any clinically significant concomitant disease or condition that could interfere with, or for which the treatment might interfere with, the conduct of the study or the absorption of oral medications.
Primary outcome measure(s)
Progression-free survival (PFS) in participants with central nervous system (CNS) metastases at baseline — Up to 7 years PFS is defined as the time from randomization to the first documented disease progression (extracranial or intracranial) or death from any cause whichever occurs first determined by a blinded independent review committee (BIRC) using Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1).
Trial sites (61)
Facility
City
Region
Status
Oncocentro Serviços Médicos e Hospitalares Ltda
Fortaleza
Ceará
Hospital Sao Rafael - HSR
Salvador
Estado de Bahia
Hospitais Integrados da Gavea S/A
Brasília
Federal District
Centro de Pesquisa e Ensino em Oncologia de Santa Catarina - CEPEN
Florianópolis
Santa Catarina
Hospital de Cancer de Barretos
Barretos
São Paulo
Instituto do Cancer do Estado de Sao Paulo - ICESP
São Paulo
São Paulo
Oncoclinicas Rio de Janeiro S.A.
Rio de Janeiro
Brazil
Jilin Cancer Hospital
Changchun
China
The Second Xiangya Hospital of Central South University
Changsha
China
Hunan Cancer Hospital
Changsha
China
West China Hospital, Sichuan University
Chengdu
China
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou
China
Harbin Medical University Cancer Hospital
Harbin
China
Affiliated Hospital of Jining Medical University
Jining
China
Guangxi Cancer Hospital of Guangxi Medical University
Nanning
China
Shanghai Pulmonary Hospital
Shanghai
China
Taihe Hospital of Hubei University of Medicine
Shiyan
China
Union Hospital Tongji Medical College Huazhong University of Science and Technology
Wuhan
China
Clinical Hospital Centre Zagreb
Zagreb
Croatia
Institut Bergonie
Bordeaux
France
CHRU Lille
Lille
France
Centre Leon Berard
Lyon
France
Hopital Nord AP-HM
Marseille
France
CHU Rennes - Hopital Pontchaillou
Rennes
France
Hopital Larrey
Toulouse
France
Hopital Robert Schuman
Vantoux
France
HELIOS Klinikum Emil von Behring Klinik f.Pneumologie Onkologie u.Infektiologie
Berlin
Germany
Pius-Hospital
Oldenburg
Germany
Metropolitan Hospital
Athens
Greece
MVR Cancer Centre and Research Institute
Kozhikode
Kerala
MOC Cancer Care & Research Centre (Unit of Cellcure Cancer Centre Pvt Ltd)
Mumbai
Maharashtra
All India Institute Of Medical Sciences (AIIMS)
New Delhi
National Capital Territory of Delhi
Mahamana Pandit Madan Mohan Malaviya Cancer Centre-TMC
Varanasi
Uttar Pradesh
Tata Medical Center
Kolkata
West Bengal
Azienda Ospedaliera San Camillo Forlanini
Rome
Lazio
IRCCS Istituto Nazionale Per La Ricerca Sul Cancro (IST)
Genoa
Liguria
Azienda Sanitaria Ospedaliera S Luigi Gonzaga
Orbassano
Piedmont
IRCCS Istituto Oncologico Veneto (IOV)
Padova
Veneto
King Hussein Cancer Center
Amman
Jordan
Hotel Dieu de France
Beirut
Lebanon
+ 21 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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