EGFR Mutant Advanced Non-small Cell Lung Cancer Clinical Trial
Official title:
A Phase 1/2, Open-label, Multi-center Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Anti-tumor Activity of JIN-A02 in Patients With EGFR Mutant Advanced Non-small Cell Lung Cancer
This study is a Phase I/II open-label, multi-center study to evaluate the safety, tolerability, PK, and an anti-tumor activity of JIN-A02, a 4th generation EGFR-TKI agent for oral administration, in EGFR mutant-positive, advanced NSCLC subjects who showed disease progression after receiving standard anticancer therapy, including approved EGFR-TKI therapy and/or no more than a single platinum-based anticancer chemotherapy. In Part A of the study, dose escalation is carried out where MTD is evaluated using Bayesian Optimal Interval (BOIN) design in subjects with advanced NSCLC harboring EGFR-mutation of C797S or T790M. In Part B, dose exploration is carried out to further evaluate the safety of JIN-A02 and to determine the RP2D using 2 preliminary effective dose levels and with the help of a safety review committee (SRC) in advanced NSCLC subjects harboring EGFR mutant C797S or T790M. In Part C dose expansion study, subjects with EGFR mutant who show disease progression after receiving standard anticancer therapy, including approved EGFR-TKI therapy with activity against T790M such as Osimertinib and/or no more than one platinum-based anticancer chemotherapy, are divided into 5 different cohorts based on the EGFR mutation and the anti-tumor activity of JIN-A02 is evaluated. Before enrollment in the study, the EGFR mutant profile is determined using either tumor tissue and/or plasma ctDNA. The profile is determined locally through a test method approved by the sponsor. The sponsor reviews and approves each potential subject for enrollment. Study eligibility evaluation will utilize local test(s).
<Part A: Dose Escalation Study> This part of the study evaluates MTD using the BOIN design in advanced or metastatic NSCLC subjects with EGFR mutant C797S or T790M. The target DLT rate for determination of MTD in this study is 30%. The administration cycle is defined as 28 days and JIN-A02 is administered QD. The DLT period for each subject is 21 days. When a subject receives at least 75% of his or her assigned daily dose during the DLT period or shows DLT during the DLT period, the subject is considered evaluable for DLT. The first cohort starts with 12.5 mg QD, and at least 3 subjects will be recruited per cohort. Dose escalation between cohorts is made at up to twice the prior dose level. At any dose level, if DLT occurs to 1 subject or if 2 subjects experience a grade 2 or higher AE considered related to JIN-A02 during the first Cycle after administration, subsequent dose escalation shall be made at no more than 50%. Before proceeding with a subsequent cohort, the SRC will convene and conducts a review meeting at a time point when subject DLT evaluation is available and then determines a subsequent dose level. In the Part A dose escalation study, the estimated sample size is 30 subjects, and if an additional dose cohort is added, the maximum sample size can be increased by 6 subjects per dose level. If there is no DLT or disease progression in subjects after Cycle 1 (28 days), the dose level can be maintained or escalated as determined by the investigator though it must not exceed the MTD determined, or the level reviewed by SRC at that time. If there is a subject who withdraws from the study before completion of Cycle 1 due to reasons other than DLT, the subject can be replaced for MTD determination. The total number of subjects for a given dose level must not exceed 12. If 12 subjects are evaluable for DLT at a given dose level, it is considered that the dose escalation has been completed. Additionally, if a dose level has not exceeded the level approved by SRC and a subject has completed administration for 8 weeks or longer without experiencing a grade 3/4 AE or DLT, dose escalation is permitted for these subjects who were enrolled to the earlier lower dose levels. <Part B: Dose Exploration Study> This part of the study is to determine the optimal RP2D by further investigating safety, tolerability, PK and efficacy of JIN-A02. SRC will select 2 preliminary effective dose levels based on the results of Part A and additionally enrolls 3 to 6 subjects to each of the 2 dose levels. Up to 12 evaluable subjects are expected per dose level, including those previously enrolled in Part A of the study. If data for the 12 subjects have been collected at a dose level during the dose escalation phase, an exploratory cohort may not be required at the same dose level. SRC will determines the RP2D based on the dose escalation phase and dose exploration phase of this study. <Part C: Dose Expansion Study> This part of the study will utilize the RP2D. A total of 5 cohorts will be selected based on the type of EGFR mutation identified in the tumor tissue or through plasma ctDNA test. Cohort 1 with both EGFR C797S and T790M mutations and Cohort 2 with EGFR-C797S but not T790M, will enroll around 36 subjects each according to the single-stage design in order to evaluate the feasibility for further studies of the anti-tumor activity of JIN-A02. Cohort 3 will enroll subjects with EGFR T790M but not C797S, Cohort 4 subjects with any EGFR mutation and stable brain metastasis and Cohort 5 with any EGFR dependent mutation other than C797S or T790M, will enroll 12 subjects each in order to explore the anti-tumor activity of JIN-A02 in these settings. Data will be collected regularly and will be evaluated by SRC for safety and benefit/risk assessment. ;