Description:
DESTINY-Lung03 will investigate the safety and tolerability of trastuzumab deruxtecan in
combination with chemotherapy in patients with HER2 positive advanced and metastatic
non-small lung cancer. The efficacy will be also analyzed as a secondary endpoint.
Title
- Brief Title: Phase Ib Study of the Safety of T-DXd and Durvalumab With Chemotherapy in Advanced or Metastatic HER2+ Non-squamous NSCLC
- Official Title: A Phase Ib Multicenter, Open-label Dose-escalation Study to Evaluate the Safety and Tolerability of Trastuzumab Deruxtecan (T-DXd) and Durvalumab in Combination With Cisplatin, Carboplatin or Pemetrexed in First-line Treatment of Patients With Advanced or Metastatic Non-squamous Non-small Cell Lung Cancer (NSCLC) and Human Epidermal Growth Factor Receptor 2 Overexpression (HER2+) (DESTINY-Lung03)
Clinical Trial IDs
- ORG STUDY ID:
D967YC00001
- NCT ID:
NCT04686305
Conditions
- Locally Advanced or Metastatic Non-Small Cell Lung Cancer
Interventions
Drug | Synonyms | Arms |
---|
Trastuzumab deruxtecan | DS-8201a, T-DXd | Arm 1: T-DXd, Durvalumab and Cisplatin |
Durvalumab | MEDI4736 | Arm 1: T-DXd, Durvalumab and Cisplatin |
Cisplatin | | Arm 1: T-DXd, Durvalumab and Cisplatin |
Carboplatin | | Arm 2: Arm 2: T-DXd, Durvalumab and Carboplatin |
Pemetrexed | | Arm 3: T-DXd, Durvalumab and Pemetrexed |
Purpose
DESTINY-Lung03 will investigate the safety and tolerability of trastuzumab deruxtecan in
combination with chemotherapy in patients with HER2 positive advanced and metastatic
non-small lung cancer. The efficacy will be also analyzed as a secondary endpoint.
Detailed Description
This is a dose escalation study by design, allowing the assessment of safety, tolerability
and recommended dose levels of the combination of T-DXd and durvalumab plus cisplatin,
carboplatin or pemetrexed. Expansions on any recommended dose level may take place to study
preliminary efficacy as well.
The target population of interest are patients with advanced or metastatic non-small cell
lung cancer and HER2 overexpression who are treatment naïve and have measurable disease by
RECIST criteria and ECOG PS of 0 to 1.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1: T-DXd, Durvalumab and Cisplatin | Experimental | T-DXd, Durvalumab and Cisplatin | - Trastuzumab deruxtecan
- Durvalumab
- Cisplatin
|
Arm 2: Arm 2: T-DXd, Durvalumab and Carboplatin | Experimental | T-DXd, Durvalumab and Carboplatin | - Trastuzumab deruxtecan
- Durvalumab
- Carboplatin
|
Arm 3: T-DXd, Durvalumab and Pemetrexed | Experimental | T-DXd, Durvalumab and Pemetrexed | - Trastuzumab deruxtecan
- Durvalumab
- Pemetrexed
|
Arm 4: T-DXd and Durvalumab | Experimental | T-DXd and Durvalumab | - Trastuzumab deruxtecan
- Durvalumab
|
Eligibility Criteria
Inclusion Criteria:
- Histologically documented locally advanced/metastatic non-squamous NSCLC
- Patients must have tumors that lack activating EGFR mutations, EML4-ALK fusion, and
ROS-1 mutation
- Patients must be treatment- naïve for locally advanced or mNSCLC and medically fit to
receive first-line treatment. Prior adjuvant, neo adjuvant therapies are permitted if
progression has occurred > 12 months from the end of last therapy
- HER2+ (IHC 3+ or IHC 2+) status as determined by central review of tumor tissue
- WHO / ECOG performance status of 0 or 1
- Has a measurable target disease assessed by the investigator using RECIST 1.1
- Has a protocol defined adequate organ and bone marrow functions
Exclusion criteria:
- Has a history of (non-infectious) ILD/pneumonitis that required steroids, has current
ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at
screening
- Lung-specific intercurrent clinically significant illnesses including, but not limited
to, any underlying pulmonary disorder and prior pneumonectomy
- Active primary immunodeficiency known HIV infection, or active hepatitis B or C
infection
- Active infection including tuberculosis and uncontrolled infection requiring IV
antibiotics, antivirals, or antifungals
- Spinal cord compression or clinically active central nervous system metastases,
defined as untreated and symptomatic, or requiring therapy with corticosteroids or
anticonvulsants to control associated symptoms
- Medical history of myocardial infarction within 6 months before treatment assignment,
symptomatic CHF (New York Heart Association Class II to IV), clinically important
cardiac arrhythmias, or a recent (< 6 months) cardiovascular event including stroke
- A pleural effusion, ascites or pericardial effusion that requires drainage, peritoneal
shunt, or CART
Maximum Eligible Age: | 120 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Frequency of AEs and SAEs |
Time Frame: | Safety will be assessed for approximately 20 months from informed consent |
Safety Issue: | |
Description: | Occurrence of AEs and SAEs graded according to NCI CTCAE v5.0 |
Secondary Outcome Measures
Measure: | Confirmed Objective Response Rate (ORR) |
Time Frame: | An average of approximately 12 months |
Safety Issue: | |
Description: | Confirmed ORR per RECIST 1.1 is the percentage of patients with Complete Response or Partial Response that is subsequently confirmed, based on investigator assessment |
Measure: | Duration of Response (DoR) |
Time Frame: | An average of approximately 12 months |
Safety Issue: | |
Description: | DOR is defined as the time from the date of first documented response until the date of documented progression or death, based on RECIST assessment |
Measure: | Disease Control Rate (DCR) |
Time Frame: | An average of approximately 12 months |
Safety Issue: | |
Description: | DCR is the percentage of patients who have a best overall response of complete response (CR) or partial response (PR) or stable disease (SD), based on RECIST assessment |
Measure: | Progression-free survival (PFS) |
Time Frame: | An average of approximately 12 months |
Safety Issue: | |
Description: | PFS is the time from first dose of study treatment until the date of objective disease progression or death, based on RECIST assessment |
Measure: | Overall survival (OS) |
Time Frame: | An average of approximately 20 months |
Safety Issue: | |
Description: | OS is the time form the date of first dose of study treatment until death due to any cause |
Measure: | Pharmacokinetics (PK) assessed by the serum concentration of T-DXd, total anti-HER2 antibody, and MAAA-1181 in all arms |
Time Frame: | An average of approximately 20 months |
Safety Issue: | |
Description: | Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for T-DXd, total anti-HER2 antibody and MAAA-1181a |
Measure: | Pharmacokinetics (PK) assessed by the serum concentration of durvalumab in study arms including T-DXd in combination with durvalumab |
Time Frame: | An average of approximately 20 months |
Safety Issue: | |
Description: | Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for durvalumab, including T-DXd in combination with durvalumab |
Measure: | The immunogenicity of T-DXd and durvalumab assessed by the presence of ADAs for T-DXd and durvalumab |
Time Frame: | An average of approximately 20 months |
Safety Issue: | |
Description: | Individual participant data and descriptive statistics will be provided for data at each time point for each dose level for T-DXd and durvalumab. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | AstraZeneca |
Trial Keywords
- HER2+
- DS-8201a
- T-DXd
- Trastuzumab Deruxtecan
- Locally advanced non-squamous NSCLC
- Metastatic non-squamous NSCLC
- Non-small cell lung cancer
Last Updated
March 26, 2021