| Eligibility |
Inclusion Criteria:
- Inclusion Criteria:
1. Male or female aged 18-75 (inclusive) at the time of signing the informed
consent;
2. Patients with locally advanced or metastatic stage IIIb, IIIc, or IV NSCLC
(according to the AJCC Eighth Edition TNM staging system for lung cancer) who are
confirmed by histopathology/cytology and cannot be resected by surgery can be
included in the group without or after systemic treatment;
3. At baseline, genetic testing reports of BRAF V600E mutation can be provided;
4. The time interval between the end of the last anti-tumor therapy and the first
administration of the study drug meets the following requirements: =4 weeks for
cytotoxic drugs and cellular immunotherapy; PD-1/PD-L1/CTLA-4=6 weeks;
Small-molecule targeted drugs =2 weeks or 5 half-lives of drugs (whichever is
longer); Mitomycin/nitrosourea =6 weeks; End time of radiotherapy =4 weeks
(palliative local radiotherapy for pain relief =2 weeks), radiotherapy related
adverse reactions recovered;
5. ECOG PS score 0-1;
6. Expected survival > 3 months;
7. At least one measurable lesion in line with the RECIST v1.1 definition at
baseline (if the lesion at the site of previous radiotherapy is selected as the
target lesion, this lesion has obvious evidence of progression);
8. The level of organ function and related laboratory indicators must meet the
following requirements:
- Neutrophil count absolute value (ANC) = 1.5×109/L; Platelet count =
100×109/L; Hemoglobin = 90g/L;
- Blood biochemistry: serum total bilirubin =1.5 times the upper limit of
normal value (ULN); For Gilbert syndrome patients, TBIL=3×ULN; AST/ALT=3 ULN
(Allow AST/ALT=5 ULN when liver metastasis occurs); Serum creatinine =1.5
ULN; Albumin =30 g/L;
- Coagulation: prothrombin time (PT) = 1.5x ULN or activated partial thrombin
time (APTT) = 1.5x ULN;
- Creatine phosphokinase (CPK) and (hypersensitive) troponin (cTnI/T) are
within normal ranges;
9. The serum pregnancy test results of fertile women must be negative within 7 days
prior to the first dosing, and female subjects are willing to use adequate
contraception during the trial and for at least 6 months after the last dosing of
the study drug. Male subjects must consent to use contraception (non-drug or tool
contraception) for at least 6 months from the start of the study until the final
dose;
10. The subjects voluntarily participated in the study and signed the informed
consent. The subjects had good compliance and could cooperate with the follow-up.
Exclusion Criteria:
- Exclusion Criteria:
1. Patients who are known to have an allergic reaction to any BRAF and/or MEK
inhibitors and their excipients or have an allergic predisposition;
2. Patients with EGFR mutation, ALK fusion and other positive driver genes;
3. Previous history of antitumor and surgical treatment conforms to any of the
following:
- Being in the treatment phase of another clinical study within 4 weeks prior
to initial dosing (except for patients participating in overall survival
follow-up);
- Has undergone major surgery or has not fully recovered from previous
invasive procedures within 4 weeks prior to initial dosing (other than
baseline tumor biopsy);
- Previous use of MEK inhibitors, including but not limited to trametinib,
smeitinib, caubitinib, pimetinib, and/or BRAF inhibitors, including but not
limited to vermofinib, dalafenib, and Conefenib;
4. Symptomatic or untreated brain metastases, meninges, or spinal cord compression
(imaging instability, symptomatic lesion, need for hormonal or dehydration
treatment); Subjects with asymptomatic and stable brain metastases (brain lesions
=4 weeks stable without progression) could be enrolled;
5. Pleural effusion, pericardial effusion and abdominal effusion that still cannot
be controlled after clinical intervention;
6. Patients with malignancies other than the type of tumor studied within 3 years
prior to initial administration, except local cancers that have been apparently
cured or have been free of disease for at least 3 years, such as basal or
squamous cell skin cancer, superficial bladder cancer, prostate cancer in situ,
cervical cancer in situ, or ductal carcinoma in situ of the breast;
7. Patients who have previously received allogeneic bone marrow transplantation or
organ transplantation;
8. Previous or current retinal diseases, such as retinal venous obstruction (RVO),
retinal arterial obstruction (RAO), retinal vasculitis, diabetic retinopathy,
hypertensive retinopathy, retinal telangiectasis (Costs disease), retinal pigment
epithelium detachment (RPED), etc.;
9. Patients with past or current interstitial lung disease, including clinically
significant radiation pneumonia (i.e. affecting activities of daily living or
requiring intervention);
10. Past or current neuromuscular diseases associated with elevated CPK (e.g.,
inflammatory myopathy, muscular dystrophy, amyotrophic lateral sclerosis, spinal
muscular atrophy, rhabdomyolysis syndrome);
11. Bleeding symptoms = Grade 3 as defined in NCI CTCAE v5.0 occurred within 4 weeks
prior to initial administration;
12. Subjects with impaired heart function or clinically significant cardiovascular
and cerebrovascular diseases, including any of the following:
- Acute myocardial infarction, unstable angina, or acute cerebral infarction
- Stent implantation during coronary angioplasty or within 6 months prior to
initial administration
- Clinically significant unstable arrhythmias (atrial fibrillation, etc.)
- Congestive heart failure of grade II or higher as defined by New York Heart
Society (NYHA) standards; Note: Subjects with grade 1 abnormal heart valve
morphology recorded by ECHO (= Grade 2) were admitted, but subjects with
moderate valve thickening were excluded;
- QT interval (QTcF) = 480 msec corrected using the Fridericia formula;
- Left ventricular ejection fraction (LVEF) < 55%;
- Implantable defibrillators;
- Refractory hypertension (at least 3 consecutive months of use of at least 3
antihypertensive drugs, still unable to control blood pressure within the
normal range);
13. Inability to swallow capsules or refractory nausea and vomiting, malabsorption,
extracorporeal bile shunt, or any significant small intestine resection that
might prevent full absorption of the study drug; Chronic atrophic gastritis and
gastroduodenal ulcer with bleeding risk;
14. Human immunodeficiency virus (HIV) antibody positive, syphilis antibody (Anti-TP)
positive, hepatitis C virus (HCV) antibody positive and HCV-RNA positive,
hepatitis B virus surface antigen (HBsAg) positive and HBV-DNA positive (HBsAg
positive requires further HBV DNA testing, HBV DNA=200 IU/ml, or =103 copy number
/ml);
15. Strong inducers that affect cytochrome P450 (CYP) isoenzymes (CYP2C9, CYP3A4)
that are prohibited by protocol, strong inhibitors or drugs with a narrow
therapeutic window through CYP1A2 metabolism should continue to be used within 7
days prior to initial administration or during the study period;
16. There was > grade 1 unmitigated toxicity associated with prior antitumor therapy
prior to initial administration. Alopecia, skin pigmentation, grade 2
neurotoxicity due to prior platinum therapy, asymptomatic hypothyroidism due to
immune checkpoint inhibitors requiring hormone replacement therapy, and medicated
hyperglycemia were excluded;
17. The presence of any serious and/or unstable pre-existing condition, mental
illness, or other condition that may interfere with the subject's safety,
obtaining informed consent, or complying with study procedures. Including, but
not limited to, severe diabetes (fasting blood glucose =13.9mmol/L), active
infections (such as active tuberculosis), active bleeding, or other serious
diseases requiring systematic treatment;
18. lactating women;
19. The investigator determined that the subjects had a serious or uncontrolled
systemic disease that would make them unfit to participate in the study or would
affect protocol compliance or significantly interfere with the correct assessment
of the safety, toxicity, or efficacy of the study drug.
|
