a phase i/ii, multicenter, open-label study of egfrmut-tki egf816, administered orally in adult patients with egfrmut solid malignancies

Conditions: Advanced Non-small Cell Lung Cancer

Summary: this is a phase i/ii, multi-center, open-label study, composed with a phase i part (dose-escalation phase) followed by a phase ii part (expansion phase). the dose escalation phase was designed to determine as primary objective the maximum tolerated dose (mtd) or recommended phase ii dose (rp2d) of egf816 monotherapy in adult subjects with locally advanced (stage iiib) or metastatic (stage iv) nsclc harboring specific egfr mutations. patients may have or not have received prior lines of antineoplastic therapy. an adaptive bayesian logistic regression model (blrm) employing the escalation with overdose control (ewoc) principle will be used during the dose escalation part for dose level selection and mtd recommendation. the primary objective of the phase ii part is to estimate antitumor activity of egf816 as measured by overall response rate (orr) determined by blinded independent review committee (birc) assessment in accordance to recist 1.1.

following completion of screening procedures and confirmation of patient eligibility, the participants are enrolled in the study. the study treatment begin on cycle 1, day 1 with the first administration of egf816. a treatment cycle is defined as 28 days. oral egf816 is administered once daily on a continuous schedule until patient experiences unacceptable toxicity, progressive disease (pd), and/or treatment is discontinued at the discretion of the investigator, patient withdrawal of consent, or due to any other reasons. treatment with egf816 may be continued beyond recist 1.1 defined pd, if, in the judgment of the investigator, there is evidence of clinical benefit and the patient wishes to continue with the study treatment.

Eligibility criteria:
inclusion criteria: (for all patients unless otherwise specified) * histologically or cytologically confirmed locally advanced (stage iiib not amenable to definitive multi-modality therapy including surgery) or metastatic (stage iv) egfr mutant nsclc. * patients with controlled brain metastases * ecog performance status: phase i part: 0, 1, or 2; phase ii part: 0 or 1 * presence of at least one measurable lesion according to recist 1.1 per investigator assessment * patients who are either hepatitis b surface antigen (hbsag) positive or hepatitis b virus (hbv)-dna positive must be willing and able to take antiviral therapy 1-2 weeks prior to 1st dose of egf816 treatment and continue on antiviral therapy for at least 4 weeks after the last dose of egf816 * patients must have negative hepatitis c antibody (hcv-ab) or positive hcv-ab but undetectable level of hcv-rna. note: patients with detectable hcv-rna are not eligible for the study. * for phase i: patients must have failed no more than 3 lines of any systemic antineoplastic therapy for advanced nsclc, including egfr-tki * for phase ii: patients must be naïve from any systemic antineoplastic therapy in the advanced setting. patients who have failed no more than 1 cycle of systemic antineoplastic therapy in the advanced setting are allowed. exclusion criteria: (for all patients unless otherwise specified) * patients with a history or presence of interstitial lung disease (ild) or interstitial pneumonitis, including clinically significant radiation pneumonitis (i.e. affecting activities of daily living or requiring therapeutic intervention) * presence or history of another malignancy * undergone a bone marrow or solid organ transplant * known history of human immunodeficiency virus (hiv) seropositivity * patients receiving concomitant immunosuppressive agents or chronic corticosteroids use at the time of study entry except for control of brain metastases, topical applications, inhaled sprays, eye drops or local injections * patients with clinically significant, uncontrolled heart disease * any prior therapies ≤ 4 weeks prior to the first dose of study treatment * patients who are receiving treatment with medications that are known to be strong inhibitors or inducers of cyp3a4/5 and cannot be discontinued 1 week prior to the start of egf816 treatment and for the duration of the study. * patients who have impairment of gastrointestinal (gi) function or gi disease that may significantly alter the absorption of egf816 * patients who are receiving treatment with any enzyme-inducing anticonvulsant that cannot be discontinued at least 1 week before first dose of study treatment, and for the duration of the study * women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception * sexually active males unless they use a condom during intercourse while taking drug and for 3 months after stopping treatment other protocol-defined inclusion and exclusion criteria may apply.

Keywords: nsclc non-small cell lung cancer egfrmut egfr tkis (egf816) acquired t790m mutation de novo t790m mutation egfr tki activating mutation (i.e. l858r or ex19del) treatment naive advanced nsclc with egfr activating mutations locally advanced nsclc (stage iiib nsclc not amenable to definitive multi-modality therapy including surgery) metastatic nsclc refers to stage iv nsclc 1st line