Description:
This trial will evaluate the efficacy and safety of targeted therapies in participants with
resectable Stage IIA, IIB, IIIA, and select IIIB (T3N2) resectable and untreated non-small
cell lung cancer (NSCLC) tumors with selected molecular alterations.
Title
- Brief Title: A Study of Alectinib, Entrectinib, Vemurafenib Plus Cobimetinib, or Pralsetinib in Patients With Resectable Stages II-III Non-Small Cell Lung Cancer With ALK, ROS1, NTRK, BRAF V600, or RET Molecular Alterations
- Official Title: NAUTIKA1: Multicenter, Phase II, Neoadjuvant and Adjuvant Study of Alectinib, Entrectinib, Vemurafenib Plus Cobimetinib, or Pralsetinib in Patients With Resectable Stages II-III Non-Small Cell Lung Cancer With ALK, ROS1, NTRK, BRAF V600, or RET Molecular Alterations
Clinical Trial IDs
- ORG STUDY ID:
ML41591
- NCT ID:
NCT04302025
Conditions
- Non-small Cell Lung Cancer
Interventions
Drug | Synonyms | Arms |
---|
Alectinib | | ALK Cohort |
Entrectinib | | NTRK Cohort |
Vemurafenib | | BRAF Cohort |
Cobimetinib | | BRAF Cohort |
Chemotherapy | | ALK Cohort |
Pralsetinib | | RET Cohort |
Purpose
This trial will evaluate the efficacy and safety of targeted therapies in participants with
resectable Stage IIA, IIB, IIIA, and select IIIB (T3N2) resectable and untreated non-small
cell lung cancer (NSCLC) tumors with selected molecular alterations.
Trial Arms
Name | Type | Description | Interventions |
---|
ALK Cohort | Experimental | Participants will receive up to 8 weeks of alectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with alectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of alectinib. | |
ROS 1 Cohort | Experimental | Participants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib. | |
NTRK Cohort | Experimental | Participants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib. | |
BRAF Cohort | Experimental | Participants will receive up to 8 weeks of vemurafenib plus cobimetinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with vemurafenib plus cobimetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of of vemurafenib plus cobimetinib. | - Vemurafenib
- Cobimetinib
- Chemotherapy
|
RET Cohort | Experimental | Participants will receive up to 8 weeks of pralsetinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with pralsetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of pralsetinib. | |
Eligibility Criteria
Inclusion Criteria for Neoadjuvant Therapy:
- Pathologically documented NSCLC: Stage IIA, IIB, IIIA, or selected IIIB, including
T3N2, or T4 (by size criteria, not by mediastinal invasion) NSCLC (based on the 8th
edition of the American Joint Committee on Cancer [AJCC] Non-Small Cell Lung Cancer
Staging system
- Molecular testing results from CLIA-certified laboratories and showing at least one of
the following abnormalities: ALK fusion, ROS1 fusion, NTRK1/2/3 fusion; BRAF V600
mutation; RET fusion
- Measurable disease, as defined by RECIST v1.1
- Evaluated by the attending surgeon prior to study enrollment to verify that the
primary tumor and any involved lymph nodes are technically completely resectable and
verify that the participant is medically operable
- Adequate pulmonary function to be eligible for surgical resection with curative intent
- Adequate cardiac function to be eligible for surgical resection with curative intent
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
- Male participants must be willing to use acceptable methods of contraception
- Female participants of childbearing potential must agree to use acceptable methods of
contraception
Inclusion Criteria for Adjuvant Therapy
- Participants whose tumors lack radiographic progression
- ECOG Performance Status of 0 or 1
- Adequate hematologic and end-organ function
Exclusion Criteria
- NSCLC that is clinically T4 by virtue of mediastinal organ invasion or Stage IIIB by
virtue of N3 disease
- Any prior therapy for lung cancer, including chemotherapy, targeted therapy,
immunotherapy, or radiotherapy, within 2 years
- Participants with prior lung cancer that have been in remission for <2 years with the
exception of minimally invasive adenocarcinoma or incidental typical carcinoid tumors
- Major surgical procedure within 28 days prior to Cycle 1, Day 1
- Participants known to be positive for HIV are excluded if they meet any of the
following criteria: CD4+ T-cell count of <350 cells/microliters; detectable HIV viral
load; history of an opportunistic infection within the past 12 months; on stable
antiretroviral therapy for <4 weeks
- Severe infection within 4 weeks prior to initiation of study treatment, including but
not limited to hospitalization for complications of infections, or any active
infection that, in the opinion of the investigator, could impact participant safety
- Pregnant or lactating, or intending to become pregnant during the study
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Proportion of Participants with Major Pathologic Response (MPR) |
Time Frame: | After surgical resection (approximately study Week 8) |
Safety Issue: | |
Description: | MPR is defined as </=10% residual viable tumor cells as scored by local pathologists |
Secondary Outcome Measures
Measure: | Proportion of Participants with MPR as Scored by a Central Pathology Committee |
Time Frame: | After surgical resection (approximately study Week 8) |
Safety Issue: | |
Description: | MPR is defined as </=10% residual viable tumor cells |
Measure: | Pathological Regression Based on Weighted % Viable Tumor Cell Assessment |
Time Frame: | After surgical resection (approximately study Week 8) |
Safety Issue: | |
Description: | |
Measure: | Investigator-Assessed Response Objective Response Rate (ORR) per RECIST v1.1 |
Time Frame: | After neoadjuvant treatment (after approximately study Week 8) |
Safety Issue: | |
Description: | |
Measure: | Pathological Complete Response (pCR) as Assessed by Local and Central Pathology Laboratories |
Time Frame: | At the time of surgical resection (approximately study Week 8) |
Safety Issue: | |
Description: | Defined as the absence of any viable tumor in main tumor bed at the time of surgical resection, as assessed by local and central pathology laboratories |
Measure: | Disease-Free Survival (DFS) |
Time Frame: | From the first date of no disease to local or distant recurrence or death from any cause, whichever occurs first, through the end of the study (up to 8 years) |
Safety Issue: | |
Description: | |
Measure: | Event-Free Survival (EFS) |
Time Frame: | From first dose of study treatment to first documented disease progression per RECIST v1.1, or local or distant disease recurrence as determined by investigator, or death from any cause, whichever occurs first, through the end of study (up to 8 years) |
Safety Issue: | |
Description: | |
Measure: | Overall Survival (OS) |
Time Frame: | From the first dose of study medication to death from any cause, through the end of the study (up to 8 years) |
Safety Issue: | |
Description: | |
Measure: | Percentage of Participants with Adverse Events (AEs) |
Time Frame: | Up to 8 years |
Safety Issue: | |
Description: | |
Measure: | ctDNA Clearance Rate |
Time Frame: | Prior to surgery (before study Week 8) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Genentech, Inc. |
Last Updated
August 20, 2021