The aim is to determine the recommended phase 2 dose (RP2D) of binimetinib in combination with pemetrexed and cisplatin, and to demonstrate that the combination is feasible and has preliminary activity in previously untreated patients with advanced NSCLC and documented KRAS mutations.
There is a need for more effective therapies for patients with advanced NSCLC driven by the RAS/MEK/ERK pathway. These tumors are generally aggressive, are almost exclusively of non-squamous histology, and represent the largest group of patients with advanced NSCLC harboring specific driver mutations in Western populations. Based on recent preclinical and clinical evidence, mitogen-activated protein kinase kinase (MEK)-inhibition plus first-line chemotherapy is a promising new treatment for patients with NSCLC and KRAS \[v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog\] mutations. Binimetinib is a medication without marketing authorization. Pemetrexed and cisplatin have marketing authorization in Switzerland and in EU for the treatment of non-small cell lung cancer (NSCLC) and will be administered as standard backbone treatment according to their Swissmedic-approved indication, dose and route of administration. Binimetinib, pemetrexed and cisplatin are IMP in the context of this phase I trial.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Binimetinib will be administered in combination with pemetrexed and cisplatin (induction therapy), and with pemetrexed only (maintenance therapy), during the first 2 weeks of each cycle. Cycles will be repeated every 21 days.
Pemetrexed 500 mg/m2 i.v. is applied on day 1 of each cycle, before cisplatin administration
Cisplatin 75 mg/m2 i.v. is applied on day 1 of each induction therapy cycle. The drug must be administered after pemetrexed infusion
Universitaetsspital Basel
Basel, Switzerland
IOSI Ospedale Regionale di Bellinzona e Valli
Bellinzona, Switzerland
Kantonsspital Graubuenden
Chur, Switzerland
Kantonsspital St. Gallen
Sankt Gallen, Switzerland
Dose-limiting toxicities (DLTs)
A DLT is defined as an AE or abnormal laboratory value assessed as at least possibly related to trial treatment (binimetinib in combination with pemetrexed and cisplatin), which occurs ≤ 21 days following the first dose of trial treatment during cycle 1.
Time frame: within 21 days from the first dose
Objective response (OR)
OR will include complete and partial responses based on RECIST 1.1 criteria. Best response will be the best result by investigator and RECIST 1.1 in the planned follow-up CT scans.
Time frame: at 30 months after start of trial
Progression-free survival (PFS)
PFS will be calculated from registration until documented tumor progression according to RECIST 1.1 or death due to any reason, whichever occurs first.
Time frame: at 30 months after start of trial
Overall survival (OS)
OS will be calculated from registration until death due to any reason.
Time frame: at 30 months after start of trial
Adverse events (AEs)
AEs will be assessed according to NCI CTCAE V.4.03.
Time frame: at 30 months after start of trial
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