Tyrosine Kinase Inhibitor (TKI) that targets Epidermal Growth Factor Receptor (EGFR) mutations. Unfortunately, despite the benefit observed for patients treated with EGFR-TKI, the vast majority of cancers are expected to develop resistance to the drug over time. The exact reasons why resistance develops are not fully understood but based upon clinical research it is hoped that combining PLB1004 with another type of anti-cancer therapy known as chemotherapy will delay the onset of resistance and the worsening of a patient's cancer. In recent years, clinical studies on the combination of EGFR-TKI and chemotherapy have made important progress, suggesting that the combination of EGFR-TKI and chemotherapy further enhances the therapeutic benefit in EGFR-mutant positive NSCLC. Both preclinical and clinical data indicate that PLB1004 exhibit good antitumor activity and relatively durable efficacy in NSCLC patients with EGFR mutations. They can reduce tumor burden, control tumor progression, and improve the survival benefit of patients, which is expected to provide an effective treatment option for such patients.
This study is a multicenter, open-label, dose-escalation and dose-expansion Ib/II phase study, aiming to evaluate the clinical safety, tolerability, PK and preliminary efficacy of PLB1004 combined with platinum-based doublet chemotherapy in NSCLC patients with EGFR mutations. The study consists of two parts: the phase Ib dose-escalation study and dose-expansion study, as well as the phase II clinical study. The target population of the phase Ib study is patients with confirmed locally advanced or metastatic NSCLC harboring EGFR mutations who have received or not received systemic antitumor therapy. The II phase clinical study sets up two cohorts. Cohort 1: patients with confirmed locally advanced or metastatic NSCLC harboring EGFR mutations who have received or not received systemic antitumor therapy; Cohort 2: patients with newly diagnosed resectable stage II-III NSCLC harboring EGFR mutations who have not received systemic antitumor therapy. A total of 79-108 patients are planned to be enrolled in the study, which is divided into a screening period, a treatment period and a follow-up period. During the administration of the study drug, follow-up will be conducted every 6 weeks in the first year and every 12 weeks from the second year onwards.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
108
For non-squamous NSCLC patients:Pemetrexed (500 mg/m2) plus carboplatin (AUC5) or cisplatin(75 mg/m²)on Day 1 of 21day cycles (every 3 weeks) , followed by PLB1004 80mg/160mg/240mg oral once daily。 For squamous NSCLC subjects: Docetaxel(75 mg/m² )or paclitaxel(175 mg/mg) plus carboplatin (AUC5) or cisplatin(75 mg/m²)on Day 1 of 21day cycles (every 3 weeks) , followed by PLB1004 80mg/160mg/240mg oral once daily.
Multiple doses of PLB1004 for oral administration. Platinum-based chemotherapy is combined and administered on Day 1 of 21days(every 3 weeks).
RP2D of PLB1004 as determined during Phase Ib . Platinum-based chemotherapy is combined and administered on Day 1 of 21days(every 3 weeks).
RP2D of PLB1004 as determined during Phase Ib,patients will undergo surgical treatment after 3 cycles of combination therapy with platinum-based chemotherapy. Post-surgery, they will receive an additional cycle of platinum-based chemotherapy followed by 13 cycles of maintenance therapy with PLB1004.
Shanghai Chest hospital
Shanghai, China
Phase Ib: Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability])
To evaluate the tolerability and safety of PLB1004 combined with platinum-based doublet chemotherapy in patients with epidermal growth factor receptor (EGFR) mutation positive NSCLC
Time frame: 12 months
Phase Ib: Incidence of dose-limiting toxicities (DLT) as defined in the protocol
To determine the maximum tolerated dose (MTD) and/or dose-limiting toxicities (DLT) of combination therapy of PLB1004 combined with platinum-based doublet chemotherapy in patients with EGFR mutation positive NSCLC
Time frame: 12 months
Phase Ib: Recommended Phase II Dose (RP2D)
To determine the recommended phase II dose (RP2D) of PLB1004 in combination with platinum-based doublet chemotherapy in subjects with EGFR mutation positive NSCLC
Time frame: 12 months
Phase Ib: Overall Response Rate (ORR)
ORR is defined as the proportion of subjects with confirmed best overall response of complete response (CR) or partial response (PR) according to RECIST 1.1
Time frame: 24 months
Phase II: To evaluate the efficacy of PLB1004 in combination with platinum-based doublet chemotherapy at the RP2D in subjects with EGFR mutation positive locally advanced or metastatic NSCLC
Objective response rate (ORR) as evaluated by the investigator according to RECIST v1.1
Time frame: 36 months
Phase II: To evaluate the efficacy of PLB1004 in combination with platinum-based doublet chemotherapy at the RP2D RP2D in newly diagnosed resectable stage II-III NSCLC subjects with EGFR mutation positive
Major pathological response (MPR) evaluated by the blinded independent pathology review committee (BIPR)
Time frame: 12 months
Cmax
Single-dose PK parameters: Peak concentration (Cmax)
Time frame: 12 months
DOR
Duration of response (DoR)
Time frame: 36 months
PFS
Progression-Free Survival
Time frame: 36 months
Tmax
Time to peak concentration (Tmax)
Time frame: 12 months
(AUC0-t)
Evaluation of the area under the concentration-time curve (AUC0-t)
Time frame: 12 months
T 1/2
Assessment of the first dose elimination half-life (T 1/2)
Time frame: 12 months
CL/F
Assessment of apparent clearance rate of the first dose (CL/F)
Time frame: 12 months
Vz/F
Apparent volume of distribution
Time frame: 12 months
DCR
Disease Control Rate
Time frame: 36 months
OS
Overall Survival
Time frame: 36 months
EFS
Event-Free Survival
Time frame: 36 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
pCR
pathological Complete Response
Time frame: 36 months
DFS
Disease-Free Survival
Time frame: 36 months