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A Study of Anti-PD-1 AK105 in Patients With Metastatic Nonsquamous Non-small Cell Lung Cancer

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ClinicalTrials.gov Identifier: NCT03866980
Recruitment Status : Recruiting
First Posted : March 7, 2019
Last Update Posted : March 7, 2019
Sponsor:
Collaborator:
Akeso Tiancheng, Inc
Information provided by (Responsible Party):
Akeso

Brief Summary:
This is a phase III , randomized, double-blinded, multicenter clinical study to compare efficacy and safety of AK105 (Anti-PD1 antibody) combined with Carboplatin and Pemetrexed vs Placebo combined with Carboplatin and Pemetrexed as first-line therapy in patients with EGFR and ALK wild type metastatic nonsquamous non-small cell lung cancer.

Condition or disease Intervention/treatment Phase
Lung Cancer Non-small Cell Stage IV Biological: AK105 Drug: carboplatin Drug: pemetrexed Drug: placebo Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 360 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase III, Randomized, Double-blinded, Multicenter Study of AK105 Combined With Carboplatin and Pemetrexed vs Placebo Combined With Carboplatin and Pemetrexed as First-line Therapy in Patients With Metastatic Nonsquamous Non-small Cell Lung Cancer
Actual Study Start Date : November 27, 2018
Estimated Primary Completion Date : November 30, 2020
Estimated Study Completion Date : November 30, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lung Cancer

Arm Intervention/treatment
Experimental: AK105 plus Carboplatin and Pemetrexed
Subjects receive AK105 200 mg intravenously (IV) plus pemetrexed 500 mg/m^2 IV and carboplatin area under the curve (AUC) 5 IV on Day 1 of every 3-week cycle (Q3W) for 4 cycles followed by AK105 200 mg IV plus pemetrexed 500 mg/m^2 IV Q3W until progression.
Biological: AK105
IV infusion

Drug: carboplatin
IV infusion

Drug: pemetrexed
IV infusion

Placebo Comparator: Placebo plus Carboplatin and Pemetrexed
Subjects receive placebo intravenously (IV) plus pemetrexed 500 mg/m^2 IV and carboplatin area under the curve (AUC) 5 IV on Day 1 of every 3-week cycle (Q3W) for 4 cycles followed by AK105 200 mg IV plus pemetrexed 500 mg/m^2 IV Q3W until progression.
Drug: carboplatin
IV infusion

Drug: pemetrexed
IV infusion

Drug: placebo
IV infusion




Primary Outcome Measures :
  1. Progression-free survival (PFS) in intent-to-treat (ITT) population, assessed by Independent Radiologist Review Committee(IRRC) in accordance with RECIST v1.1 [ Time Frame: up to 2 years ]
    PFS is defined as the time from the date of randomization till the first documentation of disease progression (per RECIST v1.1 criteria) assessed by IRRC or death due to any cause (whichever occurs first).

  2. PFS in PD-L1-selected population, assessed by IRRC in accordance with RECIST v1.1 [ Time Frame: up to 2 years ]
    PFS is defined as the time from the date of randomization till the first documentation of disease progression (per RECIST v1.1 criteria) assessed by IRRC or death due to any cause (whichever occurs first).


Secondary Outcome Measures :
  1. Overall survival (OS) in ITT population [ Time Frame: Up to 2 years ]
    OS is the time from the date of randomization to death due to any cause.

  2. Overall survival (OS) in PD-L1-selected population [ Time Frame: Up to 2 years ]
    OS is the time from the date of randomization to death due to any cause.

  3. PFS assessed by the investigator in accordance with RECIST v1.1 [ Time Frame: Up to 2 years ]
    PFS is defined as the time from the date of randomization till the first documentation of disease progression (per RECIST v1.1 criteria) assessed by the investigator or death due to any cause (whichever occurs first).

  4. Objective response rate (ORR) [ Time Frame: Up to 2 years ]
    ORR is the proportion of subjects with CR or PR based on RECIST v1.1.

  5. Duration of response (DoR) [ Time Frame: Up to 2 years ]
    DoR is defined as the duration from the first documentation of objective response to the first documented disease progression or death due to any cause, whichever occurs first.

  6. Disease control rate (DCR) [ Time Frame: Up to 2 years ]
    DCR is defined as the proportion of subjects with CR, PR, or SD based on RECIST v1.1.

  7. Incidence and severity of treatment-emergent adverse events (TEAEs) [ Time Frame: From the time of informed consent signed through 90 days after last dose of AK105 ]
    An adverse event (AE) is any untoward medical occurrence or the deterioration of existing medical event in a clinical study subject administered an investigational drug, which does not necessarily have an unequivocal causal relationship with the investigational product.

  8. Observed concentrations of AK105 [ Time Frame: From first dose of AK105 through 90 days after last dose of AK105 ]
    The endpoints for assessment of PK of AK105 include serum concentrations of AK105 at different timepoints after AK105 administration.

  9. Number of subjects who develop detectable anti-drug antibodies (ADAs) [ Time Frame: From first dose of AK105 through 90 days after last dose of AK105 ]
    The immunogenicity of AK105 will be assessed by summarizing the number of subjects who develop detectable anti-drug antibodies (ADAs).



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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Signed written informed consent form voluntarily.
  • Age over 18 years old (inclusive) and not more than 75 years old (inclusive), when signing the ICF.
  • Eastern Cooperative Oncology Group (ECOG) performance score 0 or 1.
  • Expected life expectance ≥ 3 months.
  • Histologically or cytologically confirmed diagnosis of stage IV nonsquamous NSCLC.
  • No prior systemic chemotherapy for advanced or metastatic NSCLC. Subjects who have received prior adjuvant chemotherapy or neoadjuvant chemotherapy with curative intent, or definitive chemoradiotherapy for advanced disease, will be eligible provided that progression has occurred >6 months from last treatment.
  • At least one measurable tumor lesion per RECIST 1.1 criteria. A lesion previously irradiated will not be considered a target lesion.
  • Subjects must provide an available tumor tissue sample taken < 6 months prior to first dose of study treatment.
  • Subjects must provide wild-type EGFR and ALK reported by tissue-based tests. For subjects without documented wild-type EGFR/ALK, archival or fresh tumor tissues are required for EGFR/ALK assessment prior to enrollment.
  • Adequate organ function.
  • Females of childbearing potential who are sexually active with a nonsterilized male partner must use at least one highly effective method of contraception.
  • Nonsterilized males who are sexually active with a female partner of childbearing potential must use highly effective method of contraception from Day 1 and for 120 days after the last dose of investigational product.

Exclusion Criteria:

  • Subjects who are diagnosed as NSCLC that harbors an EGFR-sensitizing mutation or ALK gene translocation.
  • Subjects with other histological types of NSCLC, including mixed squamous cell carcinoma and adenocarcinoma, and mixed carcinoma containing small cell lung carcinoma or neuroendocrine carcinoma.
  • Received prior treatment with EGFR inhibitors or ALK inhibitors.
  • Receipt of last radiotherapy or any anti-tumor treatment [chemotherapy, targeted therapy, immunotherapy, Chinese patent drugs with antitumor indications, or immunomodulators or tumor embolization] within 3 weeks prior to the first dose of study treatment.
  • Prior exposure to any anti-PD-1, anti-PD-L1, anti-CTLA-4 antibody, or any other antibody or drug therapy for T cell co-stimulatory or checkpoint pathways, such as ICOS or agonists (e.g. CD40, CD137, GITR and OX40 etc).
  • Other invasive malignancies within 5 years, except for locally treatable (manifested as cured) malignancies, such as basal or skin squamous cell carcinoma, superficial bladder cancer, cervical or breast carcinoma in situ.
  • Subjects with active, known or suspected autoimmune disease, or a medical history of autoimmune disease, with the exceptions of the following: vitiligo, alopecia, Grave disease, psoriasis or eczema not requiring systemic treatment within the last 2 years, hypothyroidism (caused by autoimmune thyroiditis) only requiring steady doses of hormone replacement therapy and type I diabetes only requiring steady doses of insulin replacement therapy, or completely relieved childhood asthma that requires no intervention in adulthood, or primary diseases that will not relapse unless triggered by external factors.
  • Active or previously documented inflammatory bowel disease (e.g. Crohn's disease, ulcerative colitis or chronic diarrhea).
  • Subjects who require systemic corticosteroids (a dose equivalent to >10 mg/day prednisone) or other immunosuppressive drugs within 14 days prior to the first dose of study drug.
  • Major surgery (as defined by the investigator) within 28 days prior to the first dose of study drug.
  • Subjects who received non-thoracic radiotherapy >30 Gy within 4 weeks prior to the first dose, or thoracic radiotherapy >30 Gy within 24 weeks prior to the first dose study drug.
  • History of gastrointestinal perforation and/ or fistula within 6 months prior to the first dose of study drug.
  • Known history of primary immunodeficiency virus infection.
  • Known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
  • Known history of interstitial lung disease.
  • Known history of active tuberculosis (TB).
  • Serious infections within 4 weeks prior to the first dose of study drug, including but not limited to complications requiring hospitalization, sepsis or severe pneumonia.
  • An active infection requiring systemic therapy.
  • Subjects with untreated chronic hepatitis B or chronic hepatitis B virus (HBV) DNA exceeding 500 IU/ mL or active hepatitis C virus (HCV) should be excluded. Subjects with non-active HBsAg carriers, treated and stable hepatitis B (HBV DNA <500 IU/ mL) , and cured hepatitis C can be enrolled. Subjects with positive HCV antibodies are eligible only if the HCV RNA test results are negative.
  • Known history of testing positive for human immunodeficiency virus (HIV).
  • Presence of meningeal metastasis, spinal cord compression, leptomeningeal disease or active brain metastasis.
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage.
  • Clinically active hemoptysis, active diverticulitis, peritoneal abscess, or gastrointestinal obstruction.
  • Clinically significant bleeding symptoms or significant bleeding tendency such as gastrointestinal bleeding, hemorrhagic gastric ulcer or vasculitis within 1 month prior to the first dose of study treatment.
  • Unresolved toxicities from prior anticancer therapy, defined as having not resolved to NCI CTCAE v4.03 Grade 0 or 1, or to levels dictated in the inclusion/exclusion criteria, with the exception of alopecia.
  • Receipt of live or attenuated vaccination within 30 days prior to the first dose of study treatment, or plan to receive live or attenuated vaccine during the study.
  • Known history of server hypersensitivity to other monoclonal antibodies.
  • Known severe allergic reactions to pemetrexed, carboplatin or platinum-containing component, or their preventive medications.
  • Known allergic reactions to any ingredients of AK105.
  • Pregnant or lactating women.
  • Any conditions that, in the investigator's opinion, may put subjects treated with the study drug at risks, or interfere with the evaluation of study drug or subject safety, or the interpretation of study results.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03866980


Contacts
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Contact: Xiaoping Jin 86 (0760) 8987 3999 clinicaltrials@akesobio.com

Locations
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China, Beijing
Chinese PLA General Hospital Recruiting
Beijing, Beijing, China, 100853
Contact: Fangfang Jing, MD    86-010-66937003      
Principal Investigator: Shunchang Jiao, MD         
China, Shanghai
Shanghai Chest Hospital Not yet recruiting
Shanghai, Shanghai, China, 200025
Principal Investigator: Baohui Han, MD         
Sponsors and Collaborators
Akeso
Akeso Tiancheng, Inc
Investigators
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Study Chair: Shunchang Jiao, MD Chinese PLA General Hospital
Study Chair: Baohui Han, MD Shanghai Chest Hospital

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Responsible Party: Akeso
ClinicalTrials.gov Identifier: NCT03866980     History of Changes
Other Study ID Numbers: AK105-301
First Posted: March 7, 2019    Key Record Dates
Last Update Posted: March 7, 2019
Last Verified: March 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Akeso:
immunotherapy,immuno-oncology, non-small cell lung cancer
Anti-PD-1 antibody

Additional relevant MeSH terms:
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Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Carboplatin
Pemetrexed
Antineoplastic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors