A Study of Lazertinib With Subcutaneous Amivantamab Compared With Intravenous Amivantamab in Participants With Epidermal Growth Factor Receptor (EGFR)-Mutated Advanced or Metastatic Non-small Cell Lung Cancer

Study Overview
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Brief Summary
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The purpose of the study is to simplify amivantamab intravenous administration and to reduce dose times, by assessing a new formulation of amivantamab, amivantamab subcutaneous and co-formulated with recombinant human hyaluronidase (SC-CF), for subcutaneous administration. This formulation has the potential to enhance both the patient and physician experience with amivantamab by providing easier and accelerated administration.

Official Title
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A Phase 3, Open-label, Randomized Study of Lazertinib With Subcutaneous Amivantamab Compared With Intravenous Amivantamab in Patients With EGFR-mutated Advanced or Metastatic Non-small Cell Lung Cancer After Progression on Osimertinib and Chemotherapy

Conditions
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Advanced or Metastatic Non-small Cell Lung Cancer

Intervention / Treatment
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* Drug: Lazertinib
* Drug: Amivantamab Subcutaneous and Co-Formulated with Recombinant Human Hyaluronidase (SC CF)
* Drug: Amivantamab Intravenous


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have histologically or cytologically confirmed, advanced or metastatic non-small cell lung cancer (NSCLC), characterized by either epidermal growth factor receptor (EGFR) Exon 19 deletion (Exon 19del) or Exon 21 leucine 858 to arginine substitution (Exon 21 L858R) mutation by an Food and Drug Administration (FDA)-approved or other validated test of either circulating tumor deoxyribonucleic acid (ctDNA) or tumor tissue in a clinical laboratory improvement amendments (CLIA) certified laboratory (sites in the United Started [US]) or an accredited local laboratory (sites outside of the US) Have progressed on or after osimertinib (or another approved 3rd generation epidermal growth factor receptor [EGFR] tyrosine kinase inhibitor [TKI]) and platinum-based chemotherapy (irrespective of order). a) The 3rd generation EGFR TKI must have been administered as the first EGFR TKI for metastatic disease or as the second TKI after prior treatment with first- or second-generation EGFR TKI in participants with metastatic EGFR T790M mutation positive NSCLC. b) Participants who decline or are otherwise ineligible for chemotherapy may be enrolled after discussion with the medical monitor. c) Any adjuvant or neoadjuvant treatment, whether with a 3rd generation EGFR TKI or platinum based chemotherapy, would count towards the prior treatment requirement if the participant experienced disease Have at least 1 measurable lesion, according to response evaluation criteria in solid tumors (RECIST) version 1.1 Have an eastern cooperative oncology group (ECOG) performance status of 0 to 1 Any toxicities from prior anticancer therapy must have resolved to common terminology criteria for adverse events (CTCAE) Version 5.0 Grade 1 or baseline level (except for alopecia [any grade], Grade less than or equal to (<=) 2 peripheral neuropathy, and Grade <=2 hypothyroidism stable on hormone replacement) Exclusion Criteria: Participant has received cytotoxic, investigational, or targeted therapies beyond one regimen of platinum-based chemotherapy and EGFR inhibitors Participant has received radiotherapy for palliative purposes less than 7 days prior to randomization Participant has symptomatic or progressive brain metastases Participant has leptomeningeal disease, or participant has spinal cord compression not definitively treated with surgery or radiation Participant has uncontrolled tumor-related pain Participant has a medical history of interstitial lung disease (ILD), including drug-induced ILD or radiation pneumonitis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm A: Lazertinib with Amivantamab SC-CF<br>Lazertinib 240 mg will be administered orally once daily. Participants will receive Amivantamab subcutaneous and co-formulated with recombinant human hyaluronidase (SC-CF), 1600 milligrams (mg)/ 2240 mg depending on the body weight by manual injection. | Drug: Lazertinib<br>* Lazertinib tablets will be administered orally.<br>* Other names: YH25448;Drug: Amivantamab Subcutaneous and Co-Formulated with Recombinant Human Hyaluronidase (SC CF)<br>* Amivantamab injection will be administered subcutaneously by manual injection<br>* Other names: JNJ-61186372;|
| Experimental: Arm B: Lazertinib with Amivantamab Intravenous (IV) Infusion<br>Lazertinib 240 mg will be administered orally once. Participants will receive amivantamab, 1050 mg or 1400 mg depending on the body weight as an IV infusion. | Drug: Lazertinib<br>* Lazertinib tablets will be administered orally.<br>* Other names: YH25448;Drug: Amivantamab Intravenous<br>* Amivantamab will be administered by IV infusion<br>* Other names: JNJ-61186372;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| For All Regions Other Than the European Union (EU) and Others Accepting Cycle 2 Day 1: Observed Serum Concentration (Ctrough) of Amivantamab at Steady State on Cycle 4 Day 1 | Ctrough is the observed serum concentration of Amivantamab at steady state on Cycle 4 Day 1 immediately prior to the next drug administration. | Cycle 4 Day 1 (28 days cycle) | 
| For EU and Any Applicable Region: Observed Serum Concentration (Ctrough) of Amivantamab at Pre-dose on Cycle 2 Day 1 | Ctrough is the observed serum concentration of Amivantamab at pre-dose on Cycle 2 Day 1 immediately prior to the next drug administration. | Cycle 2 Day 1 (28 days cycle) | 
| Area Under the Concentration Time Curve from Day 1 to Day 15 (AUC[Day 1-15]) of Amivantamab of Cycle 2 | AUC(Day 1-15) defined as area under the concentration time curve from Cycle 2 Day 1 to Day 15, will be reported. | Cycle 2 Day 1 to Cycle 2 Day 15 (28 days cycle) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Objective Response Rate (ORR) | ORR is defined as the percentage of participants who achieve either a CR or PR as per Response Evaluation Criteria In Solid Tumors Criteria (RECIST version 1.1). | Up to 1 year 11 months | 
| Progression-Free Survival (PFS) | PFS is defined as the time from randomization until the date of objective disease progression or death, whichever comes first, based on RECIST version 1.1. | Up to 1 year 11 months | 
| Duration of Response (DOR) | The DoR is defined as the time from the date of first documented response (PR or CR) until the date of documented progression or death, whichever comes first, for participants who have PR or CR. | Up to 1 year 11 months | 
| Time to Response (TTR) | Time to response (that is time to first response) is defined as the time from the date of randomization to the date of first documentation of a response (PR or CR) prior to any disease progression and subsequent anticancer therapy, as defined by BICR using RECIST version 1.1., for participants who have PR or CR as their best response. | Up to 1 year 11 months | 
| Number of Participants With Adverse Events (AEs) | An AE is any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product. An adverse event does not necessarily have a causal relationship with the intervention. | Up to 1 year 11 months | 
| Number of Participants with AEs by Severity | Severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Severity scale ranges from Grade 1 (Mild) to Grade 5 (Death). Grade 1= Mild, Grade 2= Moderate, Grade 3= Severe, Grade 4= Life-threatening and Grade 5= Death related to adverse event. | Up to 1 year 11 months | 
| Number of Participants with Clinical Laboratory Abnormalities | Number of participants with clinical laboratory abnormalities (serum Chemistry, hematology, coagulation, and urinalysis) will be reported. | Up to 1 year 11 months | 
| Number of Participants with Clinical Laboratory Abnormalities by Severity | Number of participants with clinical laboratory abnormalities by severity (serum Chemistry, hematology, coagulation, and urinalysis) will be reported. Severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Severity scale ranges from Grade 1 (Mild) to Grade 5 (Death). Grade 1= Mild, Grade 2= Moderate, Grade 3= Severe, Grade 4= Life-threatening and Grade 5= Death related to adverse event. | Up to 1 year 11 months | 
| Number of Participants Infusion Related Reactions (IRRs) | Number of participants with IRRs will be reported. | Up to 1 year 11 months | 
| Number of Participants with Infusion Related Reactions (IRRs) by Severity | Number of participants with IRRs by severity will be reported. | Up to 1 year 11 months | 
| For All Regions Other Than the EU and Others Accepting Cycle 2 Day 1: Observed Serum Concentration (Ctrough) of Amivantamab at Pre-dose on Cycle 2 Day 1 | The Ctrough is the observed serum concentration of Amivantamab at pre-dose on Cycle 2 Day 1 immediately prior to the next drug administration. | Cycle 2 Day 1 (28 days cycle) | 
| For EU and Any Applicable Region: Observed Serum Concentration (Ctrough) of Amivantamab at Steady State on Cycle 4 Day 1 | The Ctrough is the observed serum concentration of Amivantamab at steady state on Cycle 4 Day 1 immediately prior to the next drug administration. | Cycle 4 Day 1 (28 days cycle) | 
| Model-Predicted Area Under the Concentration Time Curve from Day 1 to Day 15 (AUC[Day 1-15]) of Amivantamab at Steady State of Cycle 4 | Model-predicted AUC(Day 1-15) defined as area under the concentration time curve from Cycle 4 Day 1 to Day 15, will be reported. | From Cycle 4 Day 1 to Cycle 4 Day 15 (28 days cycle) | 
| Percentage of Participants with Presence of Anti-amivantamab Antibodies and Anti-rHuPH20 Antibodies | Percentage of participants with presence of anti-amivantamab antibody anti-rHuPH20 antibodies will be reported. | Up to 1 year 11 months | 
| Percentage of Participants with Cancer Therapy Satisfaction as Assessed by Therapy Administration Satisfaction Questionnaire (TASQ) | Percentage of participants with cancer therapy satisfaction in will be assessed using the modified TASQ. The modified TASQ is an 11-item questionnaire measuring the impact of each mode of treatment administration on five domains: Physical Impact, Psychological Impact, Impact on Activities of Daily Living, Convenience, and Satisfaction. | Up to 1 year 11 months | 
| Change from Baseline in TASQ as Assessed Over Time | Change from baseline in TASQ as assessed Over time will be reported. The modified TASQ is an 11-item questionnaire measuring the impact of each mode of treatment administration on five domains: Physical Impact, Psychological Impact, Impact on Activities of Daily Living, Convenience, and Satisfaction. | Up to 1 year 11 months | 
| Participant Chair Time | Participant chair time will be assessed by time and motion analysis. | Up to 1 year 11 months | 
| Duration of Treatment Administration | Duration of treatment administration will be assessed by time and motion analysis. | Up to 1 year 11 months | 
| Active HCP Time For Drug Preparation, Treatment Administration and Posttreatment Monitoring | Active health care professional time for drug preparation, treatment administration, and posttreatment monitoring will be assessed by time and motion analysis. | Up to 1 year 11 months | 
| Participant Time in Treatment Room | Participant time in treatment room will be assessed by time and motion analysis. | Up to 1 year 11 months |