Patient case: 54-year-old female with non-small cell lung cancer; genetic feature: EGFR (D770N)

Clinical trial: Safety, Tolerability and Pharmacokinetic Profile of BPI-15086 in EGFR T790M Mutation-positive NSCLC Patients

Summary: The main objective of this study is to evaluate the safety and tolerability of BPI-15086.

Detailed description: The main objective of this study is to evaluate the safety and tolerability of BPI-15086. In addition, the anti-cancer effect of BPI-15086 in EGFR T790M mutation-positive advanced NSCLC patients who have progressed on a previous EGFR tyrosine kinase inhibitor therapy will also be evaluated. Biomarkers related to the efficacy of BPI-15086 will be investigated.

Eligibility: Inclusion Criteria:
  -  Histologically or cytologically confirmed, locally advanced or metastatic NSCLC patients, who is not suitable for surgery or radiotherapy
  -  Radiological documentation of disease progression while on a previous continuous EGFR TKI (e.g. icotinib, gefitinib, afatinib, neratinib, dacomitnib, or erlotinib) treatment
  -  Patients must fulfil one of the following:
  -  Confirmation that the tumour harbours EGFR sensitivity mutation (exon 19 deletion, L858R and L861R, G719X)
  -  Must have experienced clinical benefit from EGFR TKIs, according to the Jackman criteria
  -  Confirmation of T790M mutation positive after disease progression on EGFR TKIs
  -  Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 and estimated life expectancy of at least 12 weeks
  -  Measurable lesion per Response Evaluation Criteria in Solid Tumors(RECIST1.1)
  -  Adequate bone marrow, hepatic, and renal function
  -  Have signed Informed Consent Form
  Exclusion Criteria:
  -  Any other malignancy within 5 years of the first dose of study treatment
  -  Radiotherapy for target lesion within 4 weeks of the first dose of study treatment.
  -  Investigational agents or anticancer drugs (Including cytotoxic chemotherapy) from a previous treatment regimen or clinical study within 14 days of the first dose of study treatment
  -  Prior treatment with other third generation EGFR TKIs, including osimertinib, rociletinib, EGF816, olmutinib, ASP8273 and avitinib
  -  Brain/meninges metastases unless asymptomatic, stable and not requiring steroids for at least 4 weeks prior to start of study treatment
  -  History of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease, radiological documentation of idiopathic pulmonary fibrosis at baseline; uncontrolled pleural effusion/pericardial effusion
  -  Any evidence of severe or uncontrolled systemic diseases, including CTCAE 2 or higher active infection, uncontrolled hypertension, unstable angina pectoris, congestive cardiac failure and severe liver/renal or metabolic disease
  -  Active infection including hepatitis B, hepatitis C and human immunodeficiency virus (HIV)
  -  History of organ transplant; had surgery or severe injury within 4 weeks
  -  Any clinically important abnormalities in rhythm, conduction or morphology of resting ECG eg, complete left bundle branch block, third degree heart block, second degree heart block, PR interval >240msec, or QRS> 110 msec
  -  Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, hypokalaemia, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age in first degree relatives or any concomitant medication known to prolong the QT interval
  -  Poorly controlled hyperglycemia(fasting blood glucose level ≥7.0 mmol/L).
  -  Any unresolved toxicities from prior therapy greater than Common Terminology Criteria for Adverse Events (CTCAE) grade 1 at the time of starting study treatment with the exception of alopecia
  -  Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of BPI-15086

Relevance to patient case: possibly relevant