This study is an open-label, randomized, controlled, multicenter Phase IIIb clinical study, aiming to evaluate the efficacy, safety, and tolerability of Vebreltinib Enteric Capsule combined with platinum-based doublet chemotherapy compared with platinum-based doublet chemotherapy in treating subjects with locally advanced or metastatic non-squamous NSCLC who have not received previous systemic treatment and MET-positive. The target population of this study is subjects with histologically confirmed locally advanced or metastatic non-squamous NSCLC who have not received previous systemic anti-tumor treatment and MET-positive( MET Amplification or Overexpression). This study adopts an enrichment design. The enriched population is those with MET GCN ≥ 6, and the overall population is those with MET GCN ≥ 4. This study consists of two parts: the lead-in period (Part 1) and the randomized controlled period (Part 2). Both the lead-in period (Part 1) and the randomized controlled period (Part 2) will include a screening period (from Day -28 to Day -1), a treatment period (until the termination of treatment), and a follow-up period (including safety follow-up and survival follow-up).
Part 1 (Lead-in Period): The lead-in period is set before the randomized controlled period, aiming to evaluate the safety, tolerability, and preliminary efficacy of Vebreltinib Enteric Capsule combined with platinum-based doublet chemotherapy, and to determine the recommended dose of Vebreltinib Enteric Capsule combined with platinum-based doublet chemotherapy. Initially, it is planned to set up 2 dose groups in the lead-in period. After the screening period, eligible subjects will be assigned to the 2 dose cohorts in chronological order, and the subjects will receive oral treatment of Vebreltinib Enteric Capsule at different doses combined with intravenous chemotherapy of standard-dose platinum-based doublet according to the cohort assignment. Vebreltinib Enteric Capsule: Each cycle is 3 weeks (21 days), administered orally twice a day (BID), and the dose level depends on the cohort assignment. Platinum-based doublet chemotherapy: Each cycle is 3 weeks (21 days), and it is administered once on Day 1 (D1) of each cycle. Pemetrexed 500 mg/m² + platinum (carboplatin AUC5 or cisplatin 75 mg/m²) is given by intravenous infusion for 4 to 6 cycles as the initial treatment, and then it is switched to pemetrexed (500 mg/m²) by intravenous infusion as the maintenance treatment. In this part, the "3+3" dose escalation design will be adopted to determine the maximum tolerated dose (MTD) and/or the recommended dose of the combination of Vebreltinib Enteric Capsule and platinum-based doublet treatment in subjects with locally advanced or metastatic non-squamous NSCLC. Part 2 (Randomized Controlled Period): After completing the lead-in period study in Part 1, once the investigator and the sponsor have determined the recommended dose of the combination of Vebreltinib Enteric Capsule, the randomized controlled study in Part 2 will be carried out to evaluate the efficacy of Vebreltinib Enteric Capsule combined with platinum-based doublet chemotherapy compared with platinum-based doublet chemotherapy in subjects with locally advanced or metastatic non-squamous NSCLC carrying MET amplification. After the screening period, eligible subjects will be stratified according to the stratification factors (baseline brain metastasis status \[yes vs no\], MET gene copy number \[GCN\] \[≥4 and \<6 vs ≥6 and \<10 vs ≥10\]) and randomly assigned to the experimental group or the control group at a 1:1 allocation ratio using the stratified block randomization method. The experimental group will receive the treatment regimen of Vebreltinib Enteric Capsule combined with platinum-based doublet chemotherapy, and the control group will receive the platinum-based doublet chemotherapy regimen. Subjects randomly assigned to the control group will have the opportunity to choose to receive single-agent treatment with Vebreltinib Enteric Capsule (200 mg BID) after the disease progression is evaluated by the investigator and confirmed by the blinded independent central review (BICR). Receiving single-agent treatment with Vebreltinib Enteric Capsule after progression is not mandatory and is determined by the investigator at his/her own discretion (subject to the approval of the sponsor). Number of subjects: It is expected to enroll 6-18 subjects in the dose escalation stage of the lead-in period, and about 20-40 subjects in the cohort expansion stage, with a total of about 26-58 subjects to be enrolled (the final number will depend on the number of dose levels). The planned sample size of the enriched population with GCN≥6 in the randomized controlled period is 182 cases. Considering that the proportion of the enriched population with GCN≥6 in the general population is approximately 75%, the estimated sample size of the total population is 242. Independent Data Monitoring Committee (IDMC): During the interim analysis, the independent statistical team of the IDMC will conduct the interim analysis, which will be evaluated by the IDMC experts, and the IDMC will give its recommendations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
300
Vebreltinib: Each cycle is 3 weeks (21 days). It is administered orally twice a day (BID), and the dosage level depends on the cohort assignment. Platinum-based doublet chemotherapy: Each cycle is 3 weeks (21 days), and it is administered once on the first day (D1) of each cycle. Pemetrexed at a dose of 500 mg/m² plus a platinum agent (carboplatin with an area under the curve (AUC) of 5 or cisplatin at a dose of 75 mg/m²) is given by intravenous infusion for 4 to 6 cycles as the initial treatment. After that, it is switched to pemetrexed (500 mg/m²) given by intravenous infusion as the maintenance treatment.
Platinum-based doublet chemotherapy: Each cycle is 3 weeks (21 days), and it is administered once on the first day (D1) of each cycle. Pemetrexed at a dose of 500 mg/m² plus a platinum agent (carboplatin with an area under the curve (AUC) of 5 or cisplatin at a dose of 75 mg/m²) is given by intravenous infusion for 4 to 6 cycles as the initial treatment. After that, it is switched to pemetrexed (500 mg/m²) given by intravenous infusion as the maintenance treatment.
Cancer Hospital Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, China
NOT_YET_RECRUITINGGuangdong Provincial People's Hospital
Guangzhou, Guangdong, China
RECRUITINGIntroductory phase-Dose-limiting toxicity (DLT) Incidence of DLT events during the observation period
laboratory tests, vital signs, physical examination, electrocardiogram (ECG), and the Eastern United States Collaborative Oncology Group (ECOG) clinically significant abnormal values in physical status (PS).To evaluated DLT events during the observation period.
Time frame: 1 year
Incidence and severity of adverse events (AEs) .
laboratory tests, vital signs, physical examination, electrocardiogram (ECG), and the Eastern United States Collaborative Oncology Group (ECOG) clinically significant abnormal values in physical status (PS).
Time frame: 1 year
Introductory phase-Recommended dosage for MTD and/or co-administration.
Confirm Recommended dosage for MTD and/or co-administration.
Time frame: 1 year
Randomized control period-Progression-free survival (PFS) as assessed by the Blinded Independent Center Review Board (BICR) according to RECIST V1.1 in the MET GCN ≥6-enriched population.
Progression Free Survival is defined as the time (in months) from the first administration of trial treatment to the date of the first documentation of PD or death due to any cause.
Time frame: 4 years
Randomized control period-Progression-free survival (PFS) as assessed by BICR according to the criteria for evaluating the efficacy of solid tumors (RECIST V1.1) in the full MET GCN ≥4 population.
Progression Free Survival is defined as the time (in months) from the first administration of trial treatment to the date of the first documentation of PD or death due to any cause.
Time frame: 4 years
Introductory phase-Objective Response Rate (ORR) as assessed by the investigator according to RECIST V1.1.
Objective response rate is defined as the percentage of patients who experienced either a complete response (CR) or partial response (PR) from first administration of trial treatment to first observation of progressive disease (PD).
Time frame: 2 years
Introductory phase-Duration of Remission (DoR) as assessed by the investigator according to RECIST V1.1.
Duration of remission is defined as the time from the first tumor assessment as CR or PR to the first assessment of PD (Progressive Disease) or death from any cause.
Time frame: 2 years
Introductory phase-Disease control rate (DCR) as assessed by the investigator according to RECIST V1.1.
Disease Control Rate according to RECIST 1.1 is the percentage of patients who experienced either a complete response (CR), partial response (PR) or stable disease (SD).
Time frame: 2 years
Introductory phase-Progression-free survival (PFS), 6-month PFS rate as assessed by the investigator according to RECIST V1.1.
Progression Free Survival is defined as the time (in months) from the first administration of trial treatment to the date of the first documentation of PD or death due to any cause.
Time frame: 2 years
Introductory phase-6-month overall survival (OS) rate as assessed by the investigator according to RECIST V1.1.
Overall Survival is defined as the length of time from the start of treatment (or diagnosis) until death from any cause.
Time frame: 2 years
Introductory phase-Blood drug concentration of Vebreltinib
Assess the area under the plasma concentration-time curve (AUC0-t, AUC0-∞) of Vebreltinib.
Time frame: 1 year
Introductory phase-Blood drug concentration of Vebreltinib
Assess the maximum plasma concentration (Cmax) of Vebreltinib.
Time frame: 1 year
Introductory phase-Blood drug concentration of Vebreltinib
Assess the time to reach peak concentration (Tmax) of Vebreltinib.
Time frame: 1 year
Introductory phase-Blood drug concentration of Vebreltinib
Assess the elimination half-life (t½) of Vebreltinib.
Time frame: 1 year
Introductory phase-Blood drug concentration of Vebreltinib
Assess the apparent systemic clearance (CL/F) of Vebreltinib.
Time frame: 1 year
Introductory phase-Companion Diagnostics, CDx
All subjects in the study are required to provide sufficient tumor tissues (either archived or fresh samples) and blood samples for testing and analysis, in order to support the development of companion diagnostic reagents for the marketing of Vebreltinib. MET gene copy number in patient tumor tissue detected by FISH and in patient blood detected by NGS.
Time frame: 4 years
Randomized control period-PFS as assessed by the investigator according to RECIST V 1.1.
Progression Free Survival is defined as the time (in months) from the first administration of trial treatment to the date of the first documentation of PD or death due to any cause.
Time frame: 4 years
Randomized control period-Objective remission rate (ORR) as assessed by the investigator according to RECIST V1.1.
Objective response rate is defined as the percentage of patients who experienced either a complete response (CR) or partial response (PR) from first administration of trial treatment to first observation of progressive disease (PD).
Time frame: 4 years
Randomized control period-Disease control rate (DCR) as assessed by the investigator according to RECIST V1.1.
Disease Control Rate according to RECIST 1.1 is the percentage of patients who experienced either a complete response (CR), partial response (PR) or stable disease (SD).
Time frame: 4 years
Randomized control period-Duration of remission (DoR) as assessed by BICR and by the investigator according to RECIST V1.1.
Duration of remission is defined as the time from the first tumor assessment as CR or PR to the first assessment of PD (Progressive Disease) or death from any cause.
Time frame: 4 years
Randomized control period-Overall survival (OS) as assessed by BICR and by the investigator according to RECIST V1.1.
Overall Survival is defined as the length of time from the start of treatment (or diagnosis) until death from any cause.
Time frame: 4 years
Randomized control period-Incidence and severity of adverse events (AEs) (based on NCI-CTCAE V5.0);
clinically significant abnormal values seen in laboratory tests, vital signs, physical examination, electrocardiogram (ECG), and Eastern US Collaborative Oncology Group (ECOG) physical status (PS).
Time frame: 4 years
Randomized control period-Blood drug concentration of Vebreltinib.
Assess the area under the plasma concentration-time curve (AUC0-t, AUC0-∞) of Vebreltinib.
Time frame: 1 year
Randomized control period-Blood drug concentration of Vebreltinib.
Assess the maximum plasma concentration (Cmax) of Vebreltinib.
Time frame: 1 year
Randomized control period-Blood drug concentration of Vebreltinib.
Assess the time to reach peak concentration (Tmax) of Vebreltinib.
Time frame: 1 year
Randomized control period-Blood drug concentration of Vebreltinib.
Assess the elimination half-life (t½) of Vebreltinib.
Time frame: 1 year
Randomized control period-Blood drug concentration of Vebreltinib.
Assess the apparent systemic clearance (CL/F) of Vebreltinib.
Time frame: 1 year
Randomized control period-Companion Diagnostics, CDx
All subjects in the study are required to provide sufficient tumor tissues (either archived or fresh samples) and blood samples for testing and analysis, in order to support the development of companion diagnostic reagents for the marketing of Vebreltinib. MET gene copy number in patient tumor tissue detected by FISH and in patient blood detected by NGS.
Time frame: 4 years
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