This study is about a medicine called TAK-788, also known as mobocertinib, given to adults with non-small cell lung cancer. The main aims of this study are to check if there are any side effects from TAK-788, to learn how TAK-788 is processed by the body, and to determine the best dose of TAK-788 to treat this condition. Participants will take TAK-788 capsules with chemotherapy. Participants will continue to take TAK-788 unless they or their doctor decide they should stop this treatment. Participants will take TAK-788 capsules with or without chemotherapy under antidiarrhea prevention to determine the safety of TAK-788 treatment. Non-Asian, non-White participants will take TAK-788 to determine the safety and tolerability of TAK-788 treatment.
This phase 1/2 study will evaluate the safety, pharmacokinetics, and anti-tumor activity of oral EGFR/HER2 Inhibitor TAK-788 in participants with NSCLC and anti-tumor activity of TAK-788 in participants with solid tumors other than NSCLC with EGFR or HER2 mutations. The trial will be conducted in three parts: a dose escalation (Part 1), expansion phase (Part 2), followed by an extension phase (Part 3). The objectives of the dose escalation phase (Part 1), is to determine the safety profile of orally administered TAK-788, including the MTD, DLTs, RP2D, pharmacokinetic profile. The primary goal of the expansion component of the trial is to evaluate the anti-tumor activity of TAK-788 in seven histologically and molecularly defined cohorts at the RP2D (determined based on dose escalation phase of the trial). The seven expansion cohorts will be: 1. NSCLC participants with EGFR exon 20 activating insertions, who have either not received or not shown an objective response to an EGFR TKI, and who have no active, measurable CNS metastases; 2. NSCLC participants with HER2 exon 20 activating insertions or point mutations and no active, measurable CNS metastases; 3. NSCLC participants with EGFR exon 20 activating insertions or HER2 exon 20 activating insertions or point mutations and active, measurable CNS metastases; 4. NSCLC participants with other targets against which TAK-788 is active (examples include EGFR exon 19 deletions or exon 21 substitutions \[with or without T790M mutations\] and other uncommon EGFR activating mutations), without active CNS metastases; 5. NSCLC participants with EGFR exon 20 activating insertions, who have previously shown an objective response to an EGFR TKI and subsequently progressed, without active CNS metastases; 6. NSCLC participants with EGFR exon 20 activating insertions, who have not received prior systemic anticancer treatment for locally advanced or metastatic disease, without active CNS metastases; and 7. Participants with solid tumors other than NSCLC with EGFR/HER2 mutations against which TAK-788 is active, without active CNS metastases. The extension phase will evaluate efficacy of TAK-788 in participants with locally advanced or metastatic NSCLC whose tumors harbor EGFR exon 20 insertion mutations and who have been previously treated. The study enrolled 324 participants.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
334
TAK-788 capsules.
Brookwood Medical Center
Birmingham, Alabama, United States
Banner MD Anderson Cancer Center
Gilbert, Arizona, United States
The Oncology Institute of Hope and Innovation - West Tucson
Tucson, Arizona, United States
City of Hope Comprehensive Cancer Center - Duarte
Duarte, California, United States
Compassionate Cancer Care - Fountain Valley
Fountain Valley, California, United States
Part 1, Dose Escalation Component: Recommended Phase 2 Dose (RP2D) of Orally Administered TAK-788
Time frame: Cycle 1 (Cycle length is equal to [=] 28 days)
Part 2, Expansion Cohorts 1, 2, 4, 5 and 7: Confirmed Objective Response Rate (ORR) Assessed by the Investigator
Time frame: Up to 36 months after first dose
Part 2, Expansion Cohort 3: Intracranial ORR (iORR) Assessed by Independent Review Committee (IRC)
Time frame: Up to 36 months after first dose
Part 2, Expansion Cohort 6: Confirmed ORR Assessed by IRC
Time frame: Up to 36 months after first dose
Part 3, Extension Cohort: Confirmed ORR Assessed by IRC
Time frame: Up to 36 months after first dose
Part 1, Dose Escalation Component: Dose Limiting Toxicities (DLTs) of TAK-788
Time frame: Cycle 1 (Cycle length=28 days)
Part 1, Dose Escalation Component: Maximum Tolerated Dose (MTD) of TAK-788
Time frame: Cycle 1 (Cycle length=28 days)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: Cmax; Maximum Observed Concentration of TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: Tmax; Time of First Occurrence of Maximum Plasma Concentration (Cmax) of TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: AUC 24; Area Under the Concentration-time Curve from Time Zero to 24 hours for TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: AUCt: Area Under the Concentration-time Curve from Time Zero to Time t for TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: RAC (Cmax): Accumulation Ratio Based on Cmax of TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Parts 1 and 2, Dose Escalation and Expansion Cohorts: RAC (AUC): Accumulation Ratio Based on AUC of TAK-788 and its Metabolites
Time frame: Cycle 1 Day 1 and Cycle 2 Day 1 (cycle length=28 days for Parts 1 and 2)
Part 2, Expansion Cohorts 1, 2, 3, 4, 5, and 7: Confirmed ORR as Assessed by IRC
Time frame: Up to 36 months after first dose
Part 2, Expansion Cohorts: Best Overall Response as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Part 2, Expansion Cohorts: Best Target Lesion Response as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Parts 2 and 3, Expansion and Extension Cohorts: Duration of Response as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Parts 2 and 3, Expansion and Extension Cohorts: Disease Control Rate (DCR) as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Part 2 and 3, Expansion and Extension Cohorts: Time to Response as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Parts 2 and 3, Expansion and Extension Cohorts: Progression Free Survival (PFS) as Assessed by the Investigator and IRC
Time frame: Up to 36 months after first dose
Parts 2 and 3, Expansion and Extension Cohorts: Overall Survival (OS)
Time frame: Up to 36 months after first dose
Part 2, Expansion Cohort 3: Duration of Intracranial Response (iDOR)
Time frame: up to 36 months after first dose
Part 2, Expansion Cohort 3: Intracranial PFS (iPFS)
Time frame: up to 36 months after first dose
Part 2, Expansion Cohorts 6: Confirmed ORR as Assessed by the Investigator
Time frame: Up to 36 months after first dose
Part 3, Extension Cohort: Confirmed ORR as Assessed by the Investigator
Time frame: Up to 36 months after first dose
Part 3, Number of Participants With Patient-reported Symptoms (Lung Cancer), Functioning, and Health-related Quality of Life (HRQoL) Based on European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30 (EORTC QLQ-C30)
Time frame: Up to 30 days after last dose of drug (approximately up to 37 months)
Part 3, Extension Cohort: Number of Participants With Patient-reported Symptoms (Lung Cancer), Functioning, and health-related Global Quality of Life (HRQoL) Based on Quality of Life Questionnaire Lung Cancer Module-13 (QLQ-LC13)
Time frame: Up to 30 days after last dose of drug (approximately up to 37 months)
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University of California San Diego Moores Cancer Center
La Jolla, California, United States
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Long Beach, California, United States
Cancer and Blood Specialty Clinic
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University of California Irvine Health Chao Family Comprehensive Cancer Center
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