E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced Non-Small Cell Lung Cancer |
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E.1.1.1 | Medical condition in easily understood language |
Advanced Non-Small Cell Lung Cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Phase 2: To evaluate the efficacy and safety of adagrasib monotherapy and in combination with pembrolizumab in cohorts of patients with advanced NSCLC with KRAS G12C mutation and any PD-L1 TPS and who are candidates for first-line treatment.
Phase 3: To compare the efficacy of adagrasib in combination with pembrolizumab versus pembrolizumab alone in patients with unresectable, locally advanced or metastatic nonsquamous NSCLC with KRAS G12C mutation and PD-L1 TPS ≥ 50% and who are candidates for first line treatment. |
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E.2.2 | Secondary objectives of the trial |
Phase2: •To characterize the safety and tolerability of the monotherapy and the combination regimen in the selected population. •To evaluate secondary efficacy endpoints using monotherapy and the combination regimen in the selected population. •To evaluate the pharmacokinetics (PK) of adagrasib administered as monotherapy and in combination with pembrolizumab.
Phase 3: •To evaluate secondary efficacy endpoints in the study population •To evaluate the safety and tolerability in the study population •To evaluate the pharmacokinetics (PK) of adagrasib administered in the study population •To evaluate health-related quality of life (HRQOL) and lung cancer specific symptoms in the study population
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Phase 2: Histologically confirmed diagnosis of unresectable or metastatic NSCLC with KRAS G12C mutation and any PD-L1 TPS
Phase 3: Histologically confirmed diagnosis of unresectable or metastatic NSCLC (squamous or nonsquamous) with KRAS G12C mutation and PD-L1 TPS ≥ 50% confirmed (qualifying results using Qiagen therascreen KRAS RGQ PCR kit and PharmDx 22C3 must be obtained either locally or centrally).
Phase 3: Presence of evaluable or measurable disease per RECIST version 1.1.
Phase 3: CNS Inclusion–- Based on screening brain imaging, patients must have one of the following: 1. No evidence of brain metastases 2. Untreated brain metastases not needing immediate local therapy 3. Previously treated brain metastases not needing immediate local therapy
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E.4 | Principal exclusion criteria |
Phase 2 and Phase 3: Prior systemic treatment for locally advanced or metastatic NSCLC including chemotherapy, immune checkpoint inhibitor therapy, or a therapy targeting KRAS G12C mutation (e.g., sotorasib)
Phase 2 and Phase 3: Radiation to the lung > 30Gy within 6 months prior to the first dose of study treatment
Phase 2: Active brain metastases.
Phase 3: Patients with known central nervous system (CNS) lesions must not have any of the following: 1. Any untreated brain lesions > 1.0 cm in size 2. Any brainstem lesions 3. Ongoing use of systemic corticosteroids for control of symptoms of brain lesions at a total daily dose of > 10 mg of prednisone (or equivalent) prior to randomization. 4. Have poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression due to brain lesions notwithstanding CNS-directed therapy
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E.5 End points |
E.5.1 | Primary end point(s) |
Phase 2: Objective Response Rate (ORR) as defined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1)
Phase 3: Dual primary endpoints: •PFS (RECIST 1.1) by BICR •OS
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Phase 2: 22 months
Phase 3: 36 months |
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E.5.2 | Secondary end point(s) |
Phase 2: -Safety characterized by type, incidence, severity, timing, seriousness and relationship to study treatment of adverse events and laboratory abnormalities -Duration of Response (DOR), Progression - Free Survival (PFS) , 1-Year Survival rate, Overall Survival (OS) -Pharmacokinetics (PK) Blood Plasma adagrasib and potential metabolite concentrations
Phase 3: •PFS, ORR, DOR per RECIST 1.1 by investigator and BICR •Safety characterized by type, incidence, severity, timing, seriousness and relationship to study treatment of AEs, laboratory abnormalities, and number of patients discontinuing study treatment due to an AE •Population PK parameters of adagrasib •Patient-reported outcome (PRO) to measure quality of life
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Phase 2: 22 months Phase 3: 36 months |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
TPS ≥1% open: MRTX849 + Pembro/ TPS <1% randomized 1:1 : MRTX849 monotherapy OR MRTX849 + Pembro |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 5 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 88 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Taiwan |
Australia |
Canada |
China |
Georgia |
Israel |
Korea, Republic of |
United Kingdom |
United States |
Austria |
Belgium |
Bulgaria |
Czechia |
Germany |
Hungary |
Ireland |
Italy |
Netherlands |
Poland |
Portugal |
Spain |
Türkiye |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 6 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 6 |
E.8.9.2 | In all countries concerned by the trial months | 7 |