Clinical trial NCT04402008: Study of Poziotinib in Japanese Patients With NSCLC
Official title: A Phase 1/2 Dose Finding Study of Poziotinib in Japanese Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC)
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
PHASE2
Conditions: NSCLC
Keywords: EGFR
HER2
Exon 20 insertion mutation
Lead sponsor: Spectrum Pharmaceuticals, Inc
Sponsor class: INDUSTRY
First posted: 2020-05-26
Enrollment: 42
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Phase 1 will have two randomized, parallel dose groups comparing daily dosing and twice daily dosing at 3 dose levels.

Phase 2 will be a single dose group evaluating the safety and efficacy of the dose determined in Phase 1 in 2 Cohorts. Cohort 1: EGFR exon 20 insertion mutations and Cohort 2: HER2 exon 20 insertion mutations.
Primary purpose: TREATMENT

Brief summary: A Phase 1/2, open-label, multicenter study to determine dose, tolerability, safety and efficacy of poziotinib in Japanese patients non-small cell lung cancer (NSCLC).

Detailed description: This is a Phase 1/2, open-label, multicenter study in Japanese patients with locally advanced or metastatic NSCLC. This study will be conducted in two parts. Phase 1 is designed to observe the maximum tolerated dose (MTD) or maximum administered dose (MAD) of poziotinib when administered once daily or twice daily. Phase 2 will evaluate the safety and efficacy of the dose determined in Phase 1. Study participation includes a 30 day screening period, up to 24 months of treatment, and long-term follow-up for a maximum of 24 months after discontinuation of study treatment.

Phase 1 will enroll up to 36 patients into a dose finding study with two parallel, randomized dose groups. Each group will undergo a dose-finding scheme using a 3+3 design with the assessment of dose-limiting toxicities (DLTs) at up to three dose levels. Patients will be randomized into once daily (QD) or twice daily (BID) dose groups. The DLT assessment will be conducted in the first cycle of treatment and therefore, poziotinib dose modifications are not permitted during this cycle. Patients will be hospitalized for the first 2 weeks.

Phase 2 will enroll 40 additional NSCLC patients with epidermal growth factor receptor (EGFR) (20 patients) or human epidermal growth factor 2 (HER2) (20 patients) exon 20 insertion mutations. Efficacy and safety of the dose and dosing regimen determined in Phase 1 will be evaluated. All patients will be treated in 28-day cycles for up to 24 months.

Eligibility criteria: Key Inclusion Criteria:

* Patient must be willing and capable of giving written Informed Consent, adhering to dosing and visit schedules, and meeting all study requirements
* Previously treated patient with histologically or cytologically confirmed (archival tissue accepted) locally advanced or metastatic non-small cell lung cancer (NSCLC) and is not a candidate for definitive therapy

  * Phase 1: No test for mutational status is required
  * Phase 2: Documented EGFR or HER2 exon 20 insertion mutations (including duplication mutations) in NSCLC patients
* Prior treatment status:

  * Phase 1: Patient with refractory NSCLC to available standard therapies
  * Phase 2: Progression after at least one systemic therapy for locally advanced or metastatic disease
* Patient has measurable NSCLC disease, as per the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1). Metastatic lesions in bone, central nervous system (CNS), or in brain cannot be used for target lesions.
* Patient has recovered from prior systemic therapy for metastatic disease to Grade ≤1 for non-hematologic toxicities (except for Grade ≤2 peripheral neuropathy) and has adequate hematologic, hepatic, and renal function at Baseline

Key Exclusion Criteria:

* Patient is concurrently receiving chemotherapy, biologics, immunotherapy for cancer treatment; systemic anti-cancer treatment or investigational treatment should not be used within 2 weeks prior to Cycle 1, Day 1; local radiation therapy for bone pain may be allowed
* Patient has used strong inhibitors/inducers of CYP3A4 and CYP2D6 within 1 month prior to Cycle 1, Day 1
* Patient has had another primary malignancy within 3 years prior to starting study treatment, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ
* Patient is pregnant or breastfeeding
* Phase 2 : Patient has had previous treatment with poziotinib. The currently approved tyrosine kinase inhibitors (TKIs) that are not considered to be exon 20 insertion-selective are permissible

Primary outcomes:
measure: Phase 1: Number of Participants With Dose Limiting Toxicities (DLTs)
timeFrame: Cycle 1 (Day 1-28)
measure: Phase 2: Objective Response Rate (ORR)
timeFrame: Up to 461 days
Secondary outcomes:
measure: Phase 2: Disease Control Rate (DCR)
timeFrame: Up to 461 days
measure: Phase 2: Duration of Response (DoR)
timeFrame: Up to 461 days
measure: Phase 2: Progression Free Survival (PFS)
timeFrame: Up to 461 days
measure: Phase 1: Plasma Concentration of Poziotinib and M1, M2 Metabolites
timeFrame: Cycle 1, Day 1 and Day 13
measure: Phase 1 and 2: Percentage of Participants With Treatment Emergent Adverse Events (TEAE)
timeFrame: Up to 40 days after the last dose of the study drug (Up to 461 days)
Other outcomes:
measure: Phase 2: Exploratory - Overall Survival
timeFrame: 2 years
Locations:
city: Kashiwa
country: Japan
facility: National Cancer Center East
state: Chiba
city: Miyakojima-ku
country: Japan
facility: Osaka City General Hospital
state: Osaka
city: Sunto District
country: Japan
facility: Shizuoka Cancer Center
state: Shizuoka
Study officials:
References: