Patient case: 50-year-old female with Lung cancer. Genetic variant: EGFR (L858R). Other conditions: Lupus.

Clinical trial: An Open-Label Phase 1/2 Study of INCB039110 in Combination With Osimertinib in Subjects With Non-Small Cell Lung Cancer

Summary: The purpose of this study is to evaluate the safety and tolerability of INCB039110 in combination with osimertinib in subjects with locally advanced or metastatic non-small cell lung cancer (NSCLC).


Eligibility: Inclusion Criteria:
  -  Histologically or cytologically confirmed unresectable locally advanced (Stage IIIB) or metastatic (Stage IV) NSCLC.
  -  Documented evidence of somatic activating mutation in EGFR (eg, G719X, exon 19 deletion, L858R, L861Q) in a tumor tissue sample. If a tissue sample is not available, then EGFR mutation status may be determined from circulating tumor DNA obtained from a blood sample using a validated or approved test kit.
  -  Phase 1: Subjects must have previously received and progressed on or after treatment with an EGFR tyrosine kinase inhibitor (TKI). Additional lines of systemic therapy including investigational agents for locally advanced or metastatic NSCLC are allowed.
  -  Phase 2: Subjects must not have received more than 1 prior line of therapy for locally advanced or metastatic NSCLC. First-line treatment must include an EGFR TKI, and subjects must have documented disease progression during or following treatment. Subjects with disease that progressed more than 6 months after completion of neoadjuvant/adjuvant chemotherapy or chemoradiation therapy are eligible if they received an EGFR TKI as first-line treatment for advanced NSCLC.
  -  Subjects must have evidence of a T790M mutation in tumor tissue or plasma obtained after disease progression during or after treatment with an EGFR TKI.
  -  Radiographically measurable or evaluable disease per RECIST v1.1.
  Exclusion Criteria:
  -  Known active central nervous system (CNS) metastases. Subjects with CNS metastases who have completed a course of therapy would be eligible provided that they are clinically stable for at least 4 weeks before study entry, defined as follows:
  -  No evidence of new or enlarging CNS metastasis or new neurological symptoms attributable to CNS metastases.
  -  Subjects who are receiving concomitant corticosteroids must be on a stable or decreasing dose for at least 4 weeks before first dose of study treatment and off anticonvulsants for at least 4 weeks before study entry.
  -  Laboratory parameters outside the protocol-defined range.
  -  Clinically significant abnormalities found on an ECG.
  -  Clinically significant or uncontrolled cardiac disease.
  -  Past history of interstitial lung disease (ILD), drug induced ILD, radiation pneumonitis that required steroid treatment, or any evidence of clinically active ILD.
  -  Current or previous other malignancy within 2 years of study entry, except cured basal or squamous cell skin cancer, superficial bladder cancer, prostate intraepithelial neoplasm, carcinoma in situ of the cervix, or other noninvasive malignancy.
  -  Concurrent anticancer therapy (eg, chemotherapy, radiation therapy, surgery, immunotherapy, biologic therapy, or hormonal therapy).
  -  Any previous use of Janus kinase (JAK) inhibitor, osimertinib, or other EGFR-directed therapy for T790M-mt NSCLC.

Relevance to patient case: definitely relevant