Global, Phase 3, randomized, multicenter, open-label study evaluating the efficacy and safety of firmonertinib at a dose level of 240 mg QD compared to investigator's choice of osimertinib (80 mg QD) or afatinib (40 mg QD) in participants who have locally advanced or metastatic NSCLC with EGFR PACC mutations, and who have not received any prior therapy for advanced disease. Participants will be randomized in a 1:1 ratio to treatment with firmonertinib or osimertinib or afatinib and will take the assigned dose daily.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
480
240 mg oral, daily firmonertinib tablet
osimertinib 80 mg oral, daily tablet OR afatinib 40 mg oral, daily tablet
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States
RECRUITINGUCSF Medical Center-Mission Bay
San Francisco, California, United States
RECRUITINGLaura & Isaac Perlmutter Cancer Center at NYU Langone Health
New York, New York, United States
RECRUITINGTexas Oncology
Dallas, Texas, United States
RECRUITINGThe University of Texas MD Anderson Cancer Center
Houston, Texas, United States
RECRUITINGUniversity of Virginia
Charlottesville, Virginia, United States
RECRUITINGVirginia Cancer Specialists
Fairfax, Virginia, United States
RECRUITINGShenandoah Oncology, P.C.
Winchester, Virginia, United States
RECRUITINGHumanity and Health Clinical Trial Centre
Central, Hong Kong
RECRUITINGAichi Cancer Center
Nagoya, Aichi-ken, Japan
RECRUITING...and 13 more locations
Progression Free Survival (PFS) determined by blinded independent central review (BICR)
PFS is defined as the time from randomization to the first occurrence of disease progression as determined by BICR using RECIST v1.1, or death from any cause, whichever occurs first.
Time frame: Until progression or death, assessed up to approximately 4 years
Confirmed overall response rate (ORR) as determined by BICR
Confirmed ORR is defined as the percentage of participants with a confirmed CR or PR based on BICR assessment relative to the total number of participants.
Time frame: Until progression or death, assessed up to approximately 3 years
Overall survival (OS)
OS is defined as the time from randomization to death from any cause.
Time frame: Until death, assessed up to approximately 5 years
Investigator-assessed PFS
Investigator-assessed PFS is defined as the time from randomization to the first documented disease progression or death, whichever occurs first, based on investigator assessment per RECIST v1.1.
Time frame: Until progression or death, assessed up to approximately 4 years
Investigator-assessed confirmed ORR
Investigator-assessed confirmed ORR is defined as the percentage of participants with a confirmed CR or PR based on investigator assessment relative to the total number of participants.
Time frame: Until progression or death, assessed up to approximately 3 years
Duration of response (DOR)
DOR is defined as the time from first documented evidence of CR or PR until the first documented evidence of disease progression or death, whichever occurs first.
Time frame: Until progression or death, assessed up to approximately 4 years
Time to second Progression-free survival (PFS2)
PFS2 is defined as the time from randomization to second progression (ie, earliest of the subsequent progression events after initiation of a new anti-cancer treatment), or death from any cause, whichever occurs first.
Time frame: Assessed up to approximately 5 years
Incidence and severity of adverse events (AEs), as a measure of safety and tolerability of firmonertinib
An AE is defined as any unfavorable or unintended medical occurrence in a trial participant administered a pharmaceutical product, regardless of causal attribution.
Time frame: Assessed up to approximately 5 years
Change from baseline in safety-related clinical laboratory test results
Safety-related laboratory parameters include absolute neutrophil count, hemoglobin, platelet count, albumin, blood urea nitrogen (BUN), chloride, creatinine, potassium, sodium, alkaline phosphatase (ALP), alanine aminotransferase (ALT); aspartate aminotransferase (AST), total bilirubin. Each parameter is measured using its standard unit. Changes in participants' laboratory test values are evaluated by comparing baseline (pre-treatment) results with those obtained at prespecified time points during or following the treatment.
Time frame: Assessed up to approximately 5 years
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