Description:
The purpose of this study is to confirm the tolerability of recommended Phase 2 dose (RP2D)
of Lazertinib (Phase 1), to determine the tolerability and identify the recommended Phase 2
combination dose of Lazertinib when combined with Amivantamab (Phase 1b), to characterize the
safety and tolerability of Lazertinib and Amivantamab combinations at the RP2CD in
participants with advanced non-small cell lung cancer (NSCLC) with documented advanced or
metastatic epidermal growth factor receptor (EGFR) mutation (Phase 1b expansion cohorts A, B
and C), to estimate the antitumor activity of Lazertinib and Amivantamab combinations at the
RP2CD in participants with advanced NSCLC with documented advanced or metastatic EGFR
mutation (Phase 1b expansion cohorts A, B and C), to identify the recommended Phase 2 dose
(RP2ChD) of Lazertinib when combined with Amivantamab and standard of care chemotherapy and
to determine the tolerability of the Lazertinib, Amivantamab, and platinum-doublet
chemotherapy (LACP) combination (Phase 1b LACP combination cohort) and to characterize the
safety and tolerability of Lazertinib at the RP2ChD and Amivantamab and standard of care
chemotherapy in participants with advanced or metastatic EGFR-mutated NSCLC (Phase 1b LACP
combination cohort), to assess 2 potential biomarker strategies to identify participants at
increased, or decreased, probability of tumor response with JNJ-61186372 and lazertinib
combination in participants with EGFR Exon19del or L858R mutated NSCLC progressed on or after
osimertinib (Phase 1b expansion Cohort D).
Title
- Brief Title: A Study of Lazertinib as Monotherapy or in Combination With Amivantamab in Participants With Advanced Non-small Cell Lung Cancer
- Official Title: An Open-label Phase 1/1b Study to Evaluate the Safety and Pharmacokinetics of JNJ-73841937 (Lazertinib), a Third Generation EGFR-TKI, as Monotherapy or in Combinations With JNJ-61186372, a Human Bispecific EGFR and cMet Antibody in Participants With Advanced Non-Small Cell Lung Cancer
Clinical Trial IDs
- ORG STUDY ID:
CR108656
- SECONDARY ID:
73841937NSC1001
- SECONDARY ID:
2020-000747-31
- NCT ID:
NCT04077463
Conditions
- Carcinoma, Non-Small-Cell Lung
Interventions
Drug | Synonyms | Arms |
---|
Lazertinib | JNJ-73841937 | Phase 1 (monotherapy dose escalation): Lazertinib |
Amivantamab | JNJ-61186372 | Phase 1b (combination): Lazertinib and Amivantamab |
Carboplatin | | Phase 1b (combination): Lazertinib, Amivantamab and Platinum-doublet Chemotherapy (LACP) |
Pemetrexed | | Phase 1b (combination): Lazertinib, Amivantamab and Platinum-doublet Chemotherapy (LACP) |
Purpose
The purpose of this study is to confirm the tolerability of recommended Phase 2 dose (RP2D)
of Lazertinib (Phase 1), to determine the tolerability and identify the recommended Phase 2
combination dose of Lazertinib when combined with Amivantamab (Phase 1b), to characterize the
safety and tolerability of Lazertinib and Amivantamab combinations at the RP2CD in
participants with advanced non-small cell lung cancer (NSCLC) with documented advanced or
metastatic epidermal growth factor receptor (EGFR) mutation (Phase 1b expansion cohorts A, B
and C), to estimate the antitumor activity of Lazertinib and Amivantamab combinations at the
RP2CD in participants with advanced NSCLC with documented advanced or metastatic EGFR
mutation (Phase 1b expansion cohorts A, B and C), to identify the recommended Phase 2 dose
(RP2ChD) of Lazertinib when combined with Amivantamab and standard of care chemotherapy and
to determine the tolerability of the Lazertinib, Amivantamab, and platinum-doublet
chemotherapy (LACP) combination (Phase 1b LACP combination cohort) and to characterize the
safety and tolerability of Lazertinib at the RP2ChD and Amivantamab and standard of care
chemotherapy in participants with advanced or metastatic EGFR-mutated NSCLC (Phase 1b LACP
combination cohort), to assess 2 potential biomarker strategies to identify participants at
increased, or decreased, probability of tumor response with JNJ-61186372 and lazertinib
combination in participants with EGFR Exon19del or L858R mutated NSCLC progressed on or after
osimertinib (Phase 1b expansion Cohort D).
Detailed Description
Lung cancer is one of the most common types of cancer and is also the most common cause of
death from cancer. NSCLC accounts for 85 percent (%) to 90% of lung cancers. Lazertinib is an
oral, highly potent, mutant-selective, and irreversible EGFR-tyrosine kinase inhibitor (TKI)
targeting both, the T790M mutation and activating EGFR mutations while sparing wild type
EGFR. JNJ-61186372 (also referred to as amivantamab), is a low fucose, fully human
immunoglobulin G1(IgG1)-based bispecific antibody. As a third generation EGFR-TKI targeting
activating EGFR mutations, lazertinib has a distinct mechanism of action from JNJ-61186372,
which targets the extracellular domains of both the EGFR and cMet proteins. The distinct
mechanisms of action of lazertinib and JNJ-61186372 suggests potential to improve clinical
outcomes through the combination of these two molecules. Phase 1 and 1b lazertinib +
amivantamab, and Phase 1b LACP combination cohort are divided into 2 periods: screening and
treatment period whereas Phase 1b expansion cohorts are divided into 3 periods: screening,
treatment, and post-treatment follow up period. Safety assessment will include adverse events
(AEs), serious adverse events (SAEs), physical examinations, Eastern Cooperative Oncology
Group (ECOG) criteria for performance status, laboratory tests, vital signs,
electrocardiograms, chest x-ray, baseline ophthalmologic examination (Phase 1b Expansion
Cohorts), echocardiography or multigated acquisition, and concomitant medication usage. The
overall duration of the study will be up to 5 years and 2 months.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase 1 (monotherapy dose escalation): Lazertinib | Experimental | Participants will receive Lazertinib monotherapy orally once daily (QD) in 21-day cycles until documented evidence of disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent, or the investigator decides to discontinue treatment, whichever comes first. The subsequent doses of Lazertinib will be assigned by the Study Evaluation Team (SET) according to the dose escalation strategy by Bayesian logistic regression model (BLRM). | |
Phase 1b (combination): Lazertinib and Amivantamab | Experimental | Participants will receive Lazertinib and Amivantamab, after the safety of RP2D of Lazertinib is confirmed in the Phase 1, in 28-day cycles until documented evidence of disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent, or the investigator decides to discontinue treatment, whichever comes first. This phase will start enrolling participants after the safety of Amivantamab is confirmed in Japanese participants in Study 61186372EDI1001 (NCT02609776). | |
Phase 1b (combination): Lazertinib, Amivantamab and Platinum-doublet Chemotherapy (LACP) | Experimental | Participants will receive Lazertinib starting dose administered orally once daily (QD) in combination with Amivantamab, and doses of platinum-based chemotherapy (carboplatin and pemetrexed) per standard of care according to local guidance in a 21-day cycle for 4 cycles followed by maintenance with Lazertinib, Amivantamab and pemetrexed until disease progression or unacceptable toxicities. | - Lazertinib
- Amivantamab
- Carboplatin
- Pemetrexed
|
Phase 1b (expansion) Cohort A: Lazertinib and Amivantamab | Experimental | This cohort A will further characterize the safety, tolerability, and preliminary antitumor activity of Lazertinib and Amivantamab based combinations within specific NSCLC population "who have progressed after osimertinib and subsequent platinum-based chemotherapy, and platinum-based chemotherapy regimen as the last line of therapy prior to study enrollment. Prior use of first or second generation EGFR TKI is allowed if administered prior to osimertinib. Participants will receive at the RP2CD of Lazertinib orally QD and Amivantamab, every 7 days for the first 28 days cycle and every 2 weeks thereafter. | |
Phase 1b (expansion) Cohort B: Lazertinib and Amivantamab | Experimental | This Cohort B will further characterize the safety, tolerability and preliminary antitumor activity of Lazertinib and JNJ-61186372 combination in participants previously treated with advanced or metastatic NSCLC with documented primary EGFR Exon 20ins activating mutation. Participants will receive at the RP2CD of Lazertinib orally QD and Amivantamab, every 7 days for the first 28 days cycle and every 2 weeks thereafter. | |
Phase 1b (expansion) Cohort C: Lazertinib and Amivantamab | Experimental | This Cohort C will further characterize the safety, tolerability and preliminary antitumor activity of Lazertinib and JNJ-61186372 combination in participants with uncommon EGFR mutations. Participants will receive at the RP2CD of Lazertinib orally QD and Amivantamab, every 7 days for the first 28 days cycle and every 2 weeks thereafter. | |
Phase 1b (expansion) Cohort D: Lazertinib and Amivantamab | Experimental | Cohort D will seek to validate one or both potential biomarker strategies (next generation sequencing [NGS] and Immunohistochemical [IHC]), previously identified in Cohort E of Study 61186372EDI1001, in participants with osimertinib-relapsed, but chemotherapy-naive, EGFR Exon19del or L858R mutated NSCLC. Participants will receive at the RP2CD of Lazertinib orally QD and Amivantamab, every 7 days for the first 28 days cycle and every 2 weeks thereafter. | |
Eligibility Criteria
Inclusion Criteria:
- Phase 1 and Phase 1b lazertinib+Amivantamab combination cohorts: Histologically or
cytologically confirmed non-small cell lung cancer (NSCLC) with previously epidermal
growth factor receptor (EGFR) mutation (identified locally in a Clinical Laboratory
Improvement Amendments [CLIA]-certified laboratory [or equivalent]) that is metastatic
or unresectable, and have progressed after standard of care front-line therapy, and
exhausted available options with targeted therapy. A participant who has refused all
other currently available therapeutic options is allowed to enroll
- For the Phase 1b Lazertinib, Amivantamab and Platinum-doublet Chemotherapy (LACP)
combination cohort: histologically or cytologically confirmed advanced or metastatic
EGFR-mutated NSCLC who have progressed on or after an EGFR-TKI as the most recent line
of treatment with a maximum of 3 prior lines of therapy in the metastatic setting
allowed
- For all expansion cohorts, the EGFR mutation must have been previously histologically
or cytologically characterized, as performed by a CLIA-certified (US sites) or an
accredited (outside of US) local laboratory, with a copy of the mutation analysis
being submitted during screening (Phase 1b expansion Cohort B, C and D)
1. Expansion Cohort A: Participant must have advanced or metastatic EGFR-mutated
non-small cell lung cancer (NSCLC) that has progressed on prior treatment with
osimertinib in the first or second line, followed by progression on a
platinum-based chemotherapy regimen as the last line of therapy prior to study
enrollment. Prior use of first or second generation EGFR tyrosine kinase
inhibitor (TKI) is allowed if administered prior to osimertinib
2. Expansion Cohort B: Participant must have previously treated, advanced or
metastatic NSCLC with documented primary EGFR Exon 20ins activating mutation.
Participants should have been treated with standard of care, platinum-based
chemotherapy regimens, but may have treated with approved EGFR TKI,
investigational EGFR, or immunotherapy agents if refusing front line
platinum-based chemotherapy standard of care. Up to 3 lines of prior systemic
anti-cancer treatment are allowed
3. Expansion Cohort C: Participant must have advanced or metastatic NSCLC
characterized by an uncommon activating mutation Additional uncommon EGFR
mutations/alterations, beyond those listed above, may be considered for
enrollment after agreement with the medical monitor. Participants may be
treatment naïve or have been treated with one prior line of therapy which must be
a first or second generation TKI (that is gefitinib, erlotinib, afatinib) in the
most recent line of therapy. Prior chemotherapy is allowed if administered prior
to EGFR TKI therapy, or as the only systemic anti-cancer therapy prior to study
enrollment. Up to 2 lines of prior systemic anti-cancer treatment are allowed
4. Expansion Cohort D: Participant must have advanced or metastatic EGFR-mutated
NSCLC (EGFR Exon19 deletion or L858R) that has progressed on prior treatment with
osimertinib in the first or second line (after first- or second-generation EGFR
TKI), as the immediate prior line of therapy. Only previous treatment in the
metastatic setting with a first, second, or third generation EGFR TKI is allowed
- Evaluable disease
- Eastern Cooperative Oncology Group (ECOG) performance status grade of 0 or 1
- Participants must meet the study protocol defined laboratory criteria without having a
history of red blood cell transfusion, platelet transfusion, or granulocyte-colony
stimulating factor support within 7 days prior to the date of the test
- A woman of childbearing potential: Must have a negative serum beta human chorionic
gonadotropin at screening; Must agree not to breast-feed during the study and for 6
months after the last dose of study intervention. (Enrollment is not allowed even if a
woman who is breast-feeding stops breast-feeding); Must agree not to donate eggs (ova,
oocytes) for the purposes of assisted reproduction during the study and for 6 months
after receiving the last dose of study intervention
Exclusion Criteria:
- Participant has an uncontrolled illness, including but not limited uncontrolled
diabetes, ongoing or active infection (includes infection requiring treatment with
antimicrobial therapy [participants will be required to complete antibiotics week
prior to study treatment] or diagnosed or suspected viral infection); active bleeding
diathesis; Impaired oxygenation requiring continuous oxygen supplementation;
Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to
swallow the formulated product, or previous significant bowel resection that would
preclude adequate absorption of study treatment; or psychiatric illness or any other
circumstances including (social circumstances) that would limit compliance with study
requirements. Any ophthalmologic condition that is either clinically unstable or
requires treatment
- Prior treatment with antiPD-1 or anti Programmed death-ligand 1 (PD-L1) antibody
within 6 weeks of planned first dose of study intervention
- Untreated brain or other central nervous system (CNS) metastases whether symptomatic
or asymptomatic. Participants who have completed definitive therapy, are not on
steroids, and have a stable clinical status for at least 2 weeks prior to study
treatment may be eligible for Phase 1b expansion cohorts. If brain metastases are
diagnosed on Screening imaging, the participant may be enrolled, or rescreened for
eligibility, after definitive treatment if above criteria are met
- 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 <=2 peripheral neuropathy, and Grade <=2 hypothyroidism
stable on hormone replacement therapy)
- Allergies, hypersensitivity, or intolerance to Lazertinib or JNJ-61186372 or their
excipients. For the LACP combination cohort: participant has a contraindication for
the use of carboplatin or pemetrexed (refer to local prescribing information for each
agent). Participant has a history of hypersensitivity to, or cannot take, vitamin B12
or folic acid
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Percentage of Participants with Dose-Limiting Toxicity (DLT) (Phase 1) |
Time Frame: | Until the end of first cycle (21 days for Phase 1) |
Safety Issue: | |
Description: | DLTs are defined as certain non-hematologic and hematologic toxicities of Grade 3 or higher. |
Secondary Outcome Measures
Measure: | Number of Participants with Adverse Events (AEs) as a Measure of Safety and Tolerability (Phase 1 and Phase 1b) |
Time Frame: | Up to 1.8 years |
Safety Issue: | |
Description: | An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study. |
Measure: | Plasma Concentration of Lazertinib (Phase 1 and Phase 1b) |
Time Frame: | Up to End of Treatment [EOT]) (30 days after last dose) (up to 1.8 years) |
Safety Issue: | |
Description: | Plasma samples will be analyzed to determine concentrations of Lazertinib. |
Measure: | Serum Concentration of Amivantamab (Phase 1b) |
Time Frame: | Up to EOT (30 days after last dose) (up to 1.8 years) |
Safety Issue: | |
Description: | Serum samples will be analyzed to determine concentrations of Amivantamab. |
Measure: | Number of Participants with Anti-drug Antibodies Against Amivantamab (Phase 1b) |
Time Frame: | Up to EOT (30 days after last dose) (up to 1.8 years) |
Safety Issue: | |
Description: | Number of participants with anti-drug antibodies against Amivantamab will be reported. |
Measure: | Progression free survival (PFS) (Phase 1b Expansion) |
Time Frame: | Up to 1.8 years (end of treatment) |
Safety Issue: | |
Description: | PFS is defined as the time from first infusion of study intervention to PD or death due to any cause. |
Measure: | Time to Treatment Failure (TTF) (Phase 1b Expansion) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | TTF is defined as the time from the first administration of the study intervention to discontinuation of treatment for any reason, including disease progression, treatment toxicity, death, and will be utilized to capture clinical benefit for patients continuing treatment beyond as determined by the investigator using RECIST 1.1 criteria. |
Measure: | Overall Survival (OS) (Phase 1b Expansion) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | OS is defined as the time from first infusion of study intervention to death due to any cause as determined by the investigator using RECIST 1.1 criteria. |
Measure: | Duration of Response (DOR) (Phase 1b expansion) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | DOR will be calculated as time from initial response of CR or PR to progressive disease (PD) or death due to any cause, whichever comes first, only for participants who achieve CR or PR as determined by the investigator using RECIST 1.1 criteria. |
Measure: | Clinical Benefit Rate (CBR) (Phase 1b expansion) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | CBR is defined as the percentage of participants achieving complete or partial response, or durable stable disease (duration of at least 11 weeks) as determined by the investigator using RECIST 1.1 criteria. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Janssen Research & Development, LLC |
Last Updated
August 3, 2021