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Recruiting Phase 3

Study to Evaluate Efficacy and Safety of Firmonertinib Compared With Investigator's Choice of EGFR Inhibitor as First-Line Treatment in Participants Who Have Locally Advanced or Metastatic NSCLC With EGFR P-Loop and Alpha C-Helix Compressing (PACC) Uncommon Mutations

NCT07185997 · tracked via the Priya Life Science UK tracker
Phase
Phase 3
Started
2025-12-17
Last updated
2026-10-14

Condition(s) studied

Non-Small-Cell Lung CancerMetastatic Non-Small-Cell Lung CancerAdvanced Non-Small-Cell Lung CancerEGFR P-Loop and Alpha C-Helix CompressingEGFR PACCEGFR Uncommon Mutations

Investigational drug(s) / intervention(s)

Firmonertinib →EGFR-TKI inhibitor based on investigator's choice

Firmonertinib: 240 mg oral, daily firmonertinib tablet

EGFR-TKI inhibitor based on investigator's choice: osimertinib 80 mg oral, daily tablet OR afatinib 40 mg oral, daily tablet

Study summary

Global, Phase 3, randomized, multicenter, open-label study evaluating the efficacy and safety of firmonertinib at a dose level of 240 mg QD compared to investigator's choice of osimertinib (80 mg QD) or afatinib (40 mg QD) in participants who have locally advanced or metastatic NSCLC with EGFR PACC mutations, and who have not received any prior therapy for advanced disease. Participants will be randomized in a 1:1 ratio to treatment with firmonertinib or osimertinib or afatinib and will take the assigned dose daily.

Eligibility

Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Key Eligibility Criteria: * Histologically or cytologically documented, locally advanced or metastatic Non-Small Cell Lung Cancer (NSCLC) not amenable to curative surgery or radiotherapy. * Documented results of the presence of an Epidermal Growth Factor Receptor (EGFR) PACC mutation in tumor tissue or blood from local testing. * No prior systemic anticancer therapy regimens received for locally advanced or metastatic Non-Small Cell Lung Cancer (NSCLC) including prior treatment with any Epidermal Growth Factor Receptor (EGFR)-targeting agents (e.g., previous (EGFR) TKIs, monoclonal antibodies, or bispecific antibodies). * Patients who have received prior neo-adjuvant and/or adjuvant chemotherapy, immunotherapy, or chemo radiotherapy for non-metastatic disease must have experienced a treatment free interval of at least 12 months. * Patients with asymptomatic CNS metastases are eligible. * List of eligible PACC mutations: E709X, E709A, E709H, E709V, E709K E709\_T710delinsD, E709\_T710delinsA, E709\_T710delinsG, L718M, L718P, L718Q, L718V, G719X, G719A, G719C, G719D, G719S, G724S, E736K, I740\_K745dup, I740\_K745dupIPVAIK, I744\_K745insKIPVAI, L747P, L747S, K757M, K757R, V765L, S768I, S768\_V769delinsIL, S768\_V769delinsIM, S768\_V769delinsPL, V769L, V769M, N771G, H773\_V774delinsLM, V774M, R776C, R776H, G779F, L792H, G796S, T854A, T854S, T854I, A647T, R675W, S768C, A755D, A750\_I759delinsPN, T751\_I759delinsN

Primary outcome measure(s)

  • Progression Free Survival (PFS) determined by blinded independent central review (BICR) — Until progression or death, assessed up to approximately 4 years
    PFS is defined as the time from randomization to the first occurrence of disease progression as determined by BICR using RECIST v1.1, or death from any cause, whichever occurs first.
  • Confirmed overall response rate (ORR) as determined by BICR — Until progression or death, assessed up to approximately 3 years
    Confirmed ORR is defined as the percentage of participants with a confirmed CR or PR based on BICR assessment relative to the total number of participants.

Trial sites (139)

FacilityCityRegionStatus
St. Jude Medical Center Fullerton California Recruiting
USC/Norris Comprehensive Cancer Center Los Angeles California Recruiting
Providence St. Joseph Hospital Orange California Recruiting
University of California Davis Comprehensive Cancer Center Sacramento California Recruiting
UCSF Medical Center-Mission Bay San Francisco California Recruiting
Kaiser Permanente Medical Center Vallejo California Recruiting
University of Colorado Health Aurora Colorado Recruiting
Illinois Cancer Specialists Arlington Heights Illinois Recruiting
University of Illinois Hospital and Health Sciences Systems Chicago Illinois Recruiting
Henry Ford Cancer Institute Detroit Michigan Recruiting
Northwell Health/R.J. Zuckerberg Cancer Center Lake Success New York Recruiting
Laura & Isaac Perlmutter Cancer Center at NYU Langone Health New York New York Recruiting
Columbia University Medical Center New York New York Recruiting
Ohio State University Hospitals Columbus Ohio Recruiting
Fox Chase Cancer Center Philadelphia Pennsylvania Recruiting
Texas Oncology Dallas Texas Recruiting
The University of Texas MD Anderson Cancer Center Houston Texas Recruiting
University of Virginia Charlottesville Virginia Recruiting
Virginia Cancer Specialists Fairfax Virginia Recruiting
Shenandoah Oncology, P.C. Winchester Virginia Recruiting
Swedish Cancer Institute Edmonds Washington Recruiting
Blacktown Cancer and Haematology Centre Blacktown New South Wales Recruiting
Chris O'Brien Lifehouse Camperdown New South Wales Recruiting
GenesisCare North Shore Health Hub St Leonards New South Wales Recruiting
Austin Health Heidelberg Victoria Recruiting
Alberta Health Services, Tom Baker Cancer Centre Calgary Alberta Recruiting
University of Alberta - Cross Cancer Institute (CCI) Edmonton Alberta Recruiting
BC Cancer Vancouver Centre Vancouver British Columbia Recruiting
Brampton Civic Hospital, William Osler Health Centre Brampton Ontario Recruiting
The Ottawa Hospital Cancer Centre Ottawa Ontario Recruiting
Sunnybrook Research Institute Toronto Ontario Recruiting
Princess Margaret Cancer Centre - University Health Network Toronto Ontario Recruiting
Anhui Provincial Hospital Hefei Anhui Recruiting
Peking University People's Hospital Beijing Beijing Municipality Recruiting
Peking University Cancer Hospital (PKUCH)/Beijing Cancer Hospital Beijing Beijing Municipality Recruiting
Beijing Chest Hospital, Capital Medical University Beijing Beijing Municipality Recruiting
The First Affiliated Hospital of Chongqing Medical University Chongqing Chongqing Municipality Recruiting
Fujian Cancer Hospital Fuzhou Fujian Recruiting
Zhongshan Hospital Xiamen University Xiamen Fujian Recruiting
The First People's Hospital of Foshan Foshan Guangdong Recruiting

+ 99 more sites — see the full list on the official registry below.

Official registry record

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.

View NCT07185997 on ClinicalTrials.gov ↗ ← All trials in the UK