A Study Evaluates the Safety and Efficacy of WX-0593 in ALK -Positive, or ROS1-positive Non-small Cell Lung Cancer

Non-small Cell Lung Cancer Clinical Trial

Official title:

Phase II Clinical Study to Evaluate the Efficacy and Safety of WX-0593 in Patients With Crizotinib-resistant ALK -Positive, or Crizotinib-resistant/Crizotinib-naive ROS1-positive Non-small Cell Lung Cancer (NSCLC)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04641754
• Other study ID #: WX0593-003
• Status: Recruiting
• Phase: Phase 2
• Start date: March 7, 2019
• Est. completion date: March 2021

Study information

• Verified date: November 2020
• Source: Qilu Pharmaceutical Co., Ltd.
• Contact: Shunjiang Yu, CMO
• Phone: 0531-83129659
• Email: shunjiang.yu[@]qilu-pharma.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to evaluate safety and efficacy of WX-0593 oral tablets in ALK -positive, or ROS1-positive non-small cell lung cancer (NSCLC)

Description:

The clinical study is a single-arm, phase II, open label, multicenter design in patients with crizotinib-resistant ALK -positive, or crizotinib-resistant/crizotinib-naive ROS1-positive NSCLC.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 176
• Est. completion date: March 2021
• Est. primary completion date: December 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. =18 years.

2. Female or male;

3. Eastern Cooperative Oncology Group (ECOG) performance status = 2.

4. Expected survival no less than 12 weeks.

5. Patient should have at least one measurable lesion (RECIST 1.1); Lesions previously treated with radiotherapy can be considered target lesions only if there is a clear evidence of progression after radiotherapy.

6. Histologically or cytologically confirmed advanced ALK-positive NSCLC in upper first-class hospitals,or histologically or cytologically confirmed advanced ROS1-positive NSCLC in a central laboratory. Admission of ROS1-positive patients will be based on the positive test results confirmed by the central laboratory or by the local-approved method.

1. Patients with ALK-positive NSCLC who had been progressive disease after at least 12 weeks of continuous treatment with crizotinib .

2. Patients with ROS1-positive NSCLC who failed in standard treatment (eg.resistant /intolerance of crizotinib or chemotherapy).

3. Patients with ROS1-positive NSCLC who cannot accept chemotherapy.

4. ROS1-positive NSCLC patients who could not afford crizotinib treatment.

7. Patients with or without asymptomatic CNS metastases, or symptomatic brain metastasis after treatment stabilized for more than 4 weeks, and with stopping systemic sex hormone therapy for more than 2 weeks.

8. Organ functions should meet the following requirements (Blood components, cell growth factors, drugs that stimulate the growth of WBC or platelets, or drugs used to correct anemia are not permitted within 14 days prior to the laboratory examination): ANC=1.5*10^9/L PLT=90*10^9/L,Hb=90 g/L, Total Bilirubin (TBIL)=1.5*Upper Limit of Normal(ULN) ( Gilbert's Syndrome TBIL =3.0*ULN and DBIL=1.5*ULN ),Alanine Transaminase (ALT)and Aspartate Aminotransferase (AST)=2.5*ULN. For liver metastasis patients, ALT and AST=5*ULN, Cr=1.5*ULN, LVEF=50%.

9. Any surgery, prior radiotherapy (except for palliative radiotherapy)/procedures must be completed at least 4 weeks prior to starting the treatment with study drug. Palliative radiotherapy must be completed within 48 hours prior to starting treatment.

10. Subject understands and voluntarily provides informed consent.

Exclusion Criteria:

1. Received any prior ALK inhibitors other than crizotinib.

2. Patients with brain meningeal metastasis.

3. Any clinically significant cardiovascular disease within 6 months prior to the first dose of the investigational drug, including but not limited to: myocardial infarction, severe/unstable angina, coronary artery/peripheral artery bypass graft, congestive heart failure, cerebrovascular accident (including transient ischemic attack).

4. Two consecutive corrected QT interval (QTc) > 480 ms through ECG examination during screening, patients with NCI-CTCAE v4.03 Grade =2 arrhythmia, Grade =2 heart failure, atrial fibrillation and ventricular fibrillation of any grade, or clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention.

5. Concomitant use of medications that may cause QTc prolongation or induce Torsades de pointes within 14 days prior to the first dose of the investigational drug or during treatment.

6. Continuous use of corticosteroids for more than 30 days, or require chronic use of corticosteroids or other immunosuppressants.

7. Past history of a large area of diffuse/interstitial pulmonary fibrosis, or known history of Grade 3 or 4 interstitial pulmonary fibrosis or interstitial lung disease, including a history of pneumonitis, hypersensitivity pneumonitis, interstitial pneumonitis, interstitial lung disease, obliterative bronchiolitis, or pulmonary fibrosis, but does not include local radiation pneumonitis or radiation-induced pulmonary fibrosis.

8. Patients with Grade > 1 nausea, vomiting, or diarrhea (CTCAE 4.03), other GI dysfunction or GI disease that may potentially affect drug absorption (such as ulcerative disease or malabsorption syndrome).

9. Subject received other clinical trial treatment within 1 month prior to the first dose of the investigational drug (if the medication received is a marketed drug, then refer to exclusion criteria #11).

10. Patients who are HBsAg-positive and/or HBcAb positive and HBV DNA >10^3 copies/mL, or HCV antibody-positive, or syphilis antibody- positive or known HIV infected.

11. No more than 2 weeks between the most recent use of another anti-cancer treatment (half life =3 days) and the first dose of the investigational drug, or the most recent use of another anti-cancer treatment (half life > 3 days) is less than 4 weeks. Patients previously treated with crizotinib could take WX-0593 tables after 1 week from the last dose.

12. Patients who cannot suspend the use of a strong CYP3A4 inducer or inhibitor at least 1 weeks prior to this study and during the study. These drugs include but are not limited to carbamazepine, phenobarbital, phenytoin, rifabutin, rifampicin, rifapentine, tipranavir, ritonavir, St. John's wart, and ketoconazole.

13. Patients who cannot suspend the use of a CYP3A4 substrate at least 1 weeks prior to this study and during the study, and the therapeutic index is low.

14. Pregnant or lactating female patients or a positive pregnancy test at baseline for females of childbearing potential.

15. Childbearing potential female patients who are unwilling to use effective contraceptive measures during the entire course of the study and within 6 months after the end of the study, or male patients who plan to have children.

16. Concurrent diseases that may seriously affect patient safety or impact patient completion of the study as determined by the investigator (such as clinically uncontrolled hypertension (blood pressure > 160/110 mmHg), severe diabetes, or thyroid disease).

17. Drug or alcohol abuse. Alcohol abuse refers to drinking 14 units of alcohol per week:

1 unit = 285mL of beer, or 25mL of spirits, or 100mL of wine.

18. History of definitive neurological or mental disorder, including epilepsy or dementia.

19. Patients with other malignant tumors within 3 years prior to screening (except for cured basal cell carcinoma of the skin, cervical carcinoma in situ, thyroid carcinoma in situ, and papillary thyroid carcinoma).

20. Patients with added risks associated with the study or may interfere with the interpretation of study results as determined by the investigator, or deemed unsuitable by the investigator and/or sponsor.

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung
• Lung Neoplasms
• Non-small Cell Lung Cancer

Intervention

Drug:
• WX-0593 Tablets
tablets, 60 mg?180mg, quaque die(QD)

Locations

Country	Name	City	State
China	Beijing Chest Hospital	Beijing	Beijing
China	Cancer Institute and Hospital, Chinese Academy of Medical Sciences	Beijing	Beijing
China	Chinese PLA General Hospital	Beijing	Beijing
China	General Department, Beijing Chest Hospital, Capital Medical University	Beijing	Beijing
China	Peking Union Medical College Hospital	Beijing	Beijing
China	Thoracic Oncology I Department, Beijing Cancer Hospital	Beijing	Beijing
China	Thoracic Oncology II Department, Beijing Cancer Hospital	Beijing	Beijing
China	Jilin Cancer Hospital	Changchun	Jilin
China	The First Hospital of Jilin University	Changchun	Jilin
China	Hunan Tumor Hospital	Changsha	Hunan
China	Army Medical Center of PLA	Chongqing	Chongqing
China	Fujian Cancer Hospital	Fuzhou	Fujian
China	Cancer Center of Guangzhou Medical University	Guangzhou	Guangdong
China	Hangzhou first people's Hospital	Hangzhou	Zhejiang
China	Zhejiang Cancer Hospital	Hangzhou	Zhejiang
China	Harbin Medical University Cancer Hospital	Harbin	Heilongjiang
China	Oncology Department, Anhui Cancer Hospital	Hefei	Anhui
China	Respiratory Department, Anhui Cancer Hospital	Hefei	Anhui
China	The First Affiliated Hospital of Anhui Medical University	Hefei	Anhui
China	The Affiliated Hospital of Inner Mongolia Medical University	Hohhot	Inner Mongolia
China	Jinan Central Hospital	Jinan	Shandong
China	Qilu Hospital of Shandong University	Jinan	Shandong
China	Shandong Cancer Hospital	Jinan	Shandong
China	Yunnan Cancer Hospital	Kunming	Yunnan
China	Gansu Cancer Hospital	Lanzhou	Gansu
China	Liuzhou People's Hospital	Liuzhou	Guangxi
China	Affiliated Hospital of North Sichuan Medical College	Nanchong	Sichuan
China	Nanjing Chest Hospital	Nanjing	Jiangsu
China	The Affiliated Hospital of Qingdao University	Qingdao	Shandong
China	The First Hospital of China Medical University	Shenyang	Liaoning
China	The Fourth Hospital of Hebei Medical University	Shijiangzhuang	Hebei
China	The First Affiliated Hospital of Soochow University	Suzhou	Jiangsu
China	Shanxi Cancer Hospital	Taiyuan	Shanxi
China	Tianjin Cancer Hospital	Tianjin	Tianjin
China	Cancer Hospital Affiliated to Xinjiang Medical University	Ürümqi	Xinjiang
China	Hubei Cancer Hospital	Wuhan	Hubei
China	The Affiliated Hospital of Jiangnan University	Wuxi	Jiangsu
China	Tangdu Hospital	Xi'an	Shanxi
China	Xuzhou Central Hospital	Xuzhou	Jiangsu
China	Yantai Yuhuangding Hospital	Yantai	Shandong
China	Henan Cancer Hospital	Zhengzhou	Henan

Sponsors (1)

Lead Sponsor	Collaborator
Qilu Pharmaceutical Co., Ltd.

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Confirmed Objective Response Rate (ORR) Assessed By An Independent Review Committee	ORR is defined the percentage of the participants who are confirmed to have achieved complete response (CR) or partial response (PR) per an Independent Review Committee (IRC) using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks.
Secondary	Confirmed Objective Response Rate (ORR) Assessed By Investigators	ORR is defined the percentage of the participants who are confirmed to have achieved complete response (CR) or partial response (PR) per Investigators using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 after the initiation of study treatment.	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks.
Secondary	Progression-free survival (PFS)	PFS defined as the time from baseline to first observed disease progression or death from any cause.	From frist administration of WX-0593 until firstly recorded disease progression or death (whichever occurs earlier), or to the date that the last patients observed for 18 weeks.
Secondary	Disease Control Rate (DCR)	DCR is the percentage of patients with best response of CR, PR or Stable Disease (SD).	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks.
Secondary	Duration of Response (DOR)	The DOR is defined as the time from the date of the first response CR/PR (whichever is first recorded) to the date on which progressive disease (PD) is first noted or date of death.	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks .
Secondary	Time to Progression (TTP)	Time to Progression	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks.
Secondary	Confirmed Intracranial Objective Response Rate (iORR)	Confirmed iORR is defined as the proportion of the participants who have achieved CR or PR in the brain per a modification of RECIST version 1.1, after the initiation of study treatment, in participants with intracranial brain metastases at baseline.	From frist administration of WX-0593 to the date that the last patients observed for 18 weeks.
Secondary	Overall Survival (OS)	OS is the time from the start of study treatment to the date of death.	From frist administration of WX-0593 until death due to any cause, withdraws informed consent, is lost to follow-up or refuses phone visits, or study completion(up to 2.5 years)
Secondary	Incidence of Adverse Events	Incidence of All Adverse Events, Serious Adverse Events and Treatment-Emergent Adverse Events by CTCAE v4.03	the date of written informed consent signed until at least 28 days after the last dose of study drug was administered.
Secondary	Cssmin	Minimum value of steady plasma-drug concentration for WX-0593	Pre-dose on Cycle 1 Day 1, Cycle 1 Day 7, Cycle 1 Day 21, Cycle 2 Day 21, and Cycle 4 Day 21 (each cycle is 21 days)