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Trial record 1 of 1 for:    NCT04036682
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A Phase 1/2 Trial of CLN-081 in Patients With Non-Small Cell Lung Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04036682
Recruitment Status : Recruiting
First Posted : July 30, 2019
Last Update Posted : November 15, 2022
Sponsor:
Information provided by (Responsible Party):
Cullinan Oncology, LLC

Brief Summary:
CLN-081-101 is a Phase 1/2, open label, multi-center study of CLN-081 in patients with NSCLC (non-small cell lung cancer) harboring EGFR (epidermal growth factor receptor) exon 20 insertion mutations, to characterize the safety, determine the recommended Phase 2 dose (RP2D), and evaluate efficacy.

Condition or disease Intervention/treatment Phase
Non Small Cell Lung Cancer EGFR Exon 20 Mutation Drug: CLN-081 Phase 1 Phase 2

Detailed Description:

This is a Phase 1/2, open-label, multicenter, first-in-human trial to evaluate the safety and tolerability, PK, PD, and efficacy of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) exon 20 insertion mutations.

This trial is divided into multiple parts: Phase 1 Dose Escalation, Phase 2a Dose Expansion, Module A, Module B, and Module C.

The objectives of the dose escalation and dose expansion parts are to determine the safety, tolerability, recommended Phase 2 dose (RP2D), and preliminary anti-tumor activity of orally administered CLN-081 monotherapy.

The objective of Module A is to preliminarily assess the effect of food on the PK profile of CLN-081.

The objective of Module B is to further characterize the safety and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior systemic anti-cancer treatment for locally advanced or metastatic disease.

The objective of Module C is to explore the safety, tolerability, and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior treatment with an agent approved for EGFR exon 20 insertion mutant NSCLC

CLN-081 will be dosed twice daily (BID).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 284 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2, Open-Label, Multi-Center Trial to Assess Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Efficacy of CLN-081 in Patients With Locally-Advanced or Metastatic Non-Small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations Who Have Previously Received Platinum-Based Systemic Chemotherapy
Actual Study Start Date : October 31, 2019
Estimated Primary Completion Date : December 31, 2024
Estimated Study Completion Date : December 31, 2024

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lung Cancer

Arm Intervention/treatment
Experimental: Phase 1 Dose Escalation (Accelerated Titration)
CLN-081 BID in single patient dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations that either have received or never received prior EGFR TKIs.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib

Experimental: Phase 1 Dose Escalation (Rolling Six)
CLN-081 BID in Rolling Six dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib

Experimental: Phase 2a Dose Expansion(s)
CLN-081 BID in expansion cohorts that may be opened at doses that meet pre-specified efficacy and safety criteria in Rolling Six cohorts.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib

Experimental: Module A Food Affect
Single-dose CLN-081 150 mg with and without high fat food intake.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib

Experimental: Module B
CLN-081 BID in NSCLC patients with EGFR exon 20 insertion mutations that have received prior systemic therapy for locally advanced or metastatic disease.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib

Experimental: Module C
CLN-081 BID to patients with EGFR exon 20 insertion mutant NSCLC after prior therapy with an agent approved for the treatment of ex20ins mutant NSCLC.
Drug: CLN-081
CLN-081 tablets
Other Name: TAS6417; zipalertinib




Primary Outcome Measures :
  1. All Cohorts: The rate and severity of treatment emergent AEs. [ Time Frame: 24 months ]
  2. All Cohorts: The rate and severity of DLTs. [ Time Frame: 24 months ]
  3. Phase 2 Dose Expansion Cohorts: Overall response rate (ORR) [ Time Frame: 24 months ]
  4. Module A: Pharmacokinetic (PK) parameter [ Time Frame: 24 months ]
    Maximum Plasma Concentration [Cmax]

  5. Module A: Pharmacokinetic (PK) parameter [ Time Frame: 24 months ]
    Area Under Curve [AUC]

  6. Module B: Confirmed overall response rate (ORR) by independent review committee (IRC) [ Time Frame: 24 months ]

Secondary Outcome Measures :
  1. Phase 1 Dose Escalation and Dose Expansion Cohorts: ORR [ Time Frame: 24 months ]
  2. Phase 1 Dose Escalation and Dose Expansion Cohorts: DOR (duration of response). [ Time Frame: 24 months ]
  3. Phase 1 Dose Escalation and Dose Expansion Cohorts: DCR (disease control rate) [ Time Frame: 24 months ]
  4. Phase 1 Dose Escalation and Dose Expansion Cohorts: PFS (progression free survival) [ Time Frame: 24 months ]
  5. Phase 1 Dose Escalation and Dose Expansion Cohorts: OS (overall survival) [ Time Frame: 24 months ]
  6. All Cohorts: Assessment of maximum concentration (Cmax) [ Time Frame: 24 months ]
  7. All Cohorts: Assessment of area under curve (AUC) [ Time Frame: 24 months ]
  8. All Cohorts: Assessment of time to maximum concentration (tmax) [ Time Frame: 24 months ]
  9. All Cohorts: Assessment of terminal half-life (t1/2) [ Time Frame: 24 months ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria
  1. Histologically or cytologically confirmed locally advanced or metastatic NSCLC (all patients). For module A only, histologically or cytologically confirmed solid tumor with the exception of esophageal, gastric, pancreatic, hepatobiliary, or small bowel carcinomas, or history of gastric resection.
  2. Documented EGFR ex20ins mutation demonstrated by a validated test listed in Section 9.7 and performed in a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalent laboratory (all patients other than Module A Food Effect PK Assessment Module). Institutions that don't have access to these tests should contact the sponsor for assistance.
  3. Prior treatment in the recurrent/metastatic disease setting including:

    1. A platinum-based chemotherapy regiment (or other chemotherapy regimen if platinum-based chemotherapy is contra-indicated)
    2. Any other approved standard therapy that is available to the patient, unless this therapy is contraindicated, intolerable to the patient, or is declined by the patient. In the case of a patient declining such therapy, documentation that the patient has been informed and declined should be documented in the medical record.
    3. No prior therapy is required for patients enrolled on Module A.
    4. Prior therapy with an agent approved by the local regulatory authorities for the treatment of EGFR ex20ins mutant NSCLC (Module C only).
  4. Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) (except for patients enrolled on Module A).
  5. Age ≥ 18 years.
  6. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  7. Ability to take pills by mouth.
  8. Have the following laboratory values:

    1. Serum creatinine < 1.5 × upper limit of normal (ULN) or if higher than normal range, calculated creatinine clearance (CrCl) must be ≥ 50 mL/min/1.73 m2 (by Cockroft-Gault formula); actual body weight must be used for CrCl unless body mass index (BMI) >30 kg/m2 then lean body weight must be used.
    2. Total bilirubin ≤ 1.5 × ULN unless prior history of Gilbert's syndrome.
    3. AST and ALT ≤ 2.5 × ULN, or ≤ 5 × ULN if due to liver involvement by tumor.
    4. Hemoglobin ≥ 9.0 g/dL in the absence of transfusion ≤ 14 days prior to the first dose of study drug on C1D1.
    5. Platelets ≥ 100 × 109 cells/L in the absence of transfusion <14 days prior to the first dose of study drug on Cycle 1 Day 1 (C1D1).
    6. Absolute neutrophil count ≥ 1.5 ×109 cells/L.
  9. For Module A patients only: patients must have a negative coronavirus disease 2019 (COVID 19) polymerase chain reaction test prior to enrolment.
  10. For Module B and Module C patients only: verification of suitable archived tumor tissue available at the participating center for biomarker analysis. A fresh biopsy is required if an archived sample is not available.
  11. Ability to understand and the willingness to sign a written informed consent document.

5.2 Exclusion Criteria

A patient who meets any of the following exclusion criteria will be ineligible to participate in this study:

R6, Phase 1 Expansion, Phase 2a, Module A and Module B Patients Only

  1. Prior treatment with an EGFR ex20ins -targeting drug (eg, including, but not limited to poziotinib, mobocertinib, amivantamab, DZD9008, BDTX-189).

    Note: enrolment of patients treated previously with EGFR ex20ins targeting drugs allowed selectively during accelerated titration dose escalation and Module C only.

    Module A Food Effect PK Assessment Module patients only

  2. Conditions that compromise esophageal or gastrointestinal (GI) function, including esophageal, gastric, pancreatic, hepatobiliary, or small bowel carcinomas, or history of gastric resection.
  3. Recurrent diarrhea, nausea, or vomiting.
  4. Unable to refrain from or anticipates the use of:

    1. Any drug, including prescription and non-prescription medications, including drugs that change gastrointestinal motility (eg, loperamide) or gastric pH (eg, antacids, H2 antagonists, proton pump inhibitors), herbal remedies, or vitamin supplements within 14 days prior to the first dosing on Day 1 to follow-up.
    2. Any drugs known to be inhibitors or inducers of CYP3A enzymes and/or P glycoprotein (P-gp), including St. John's Wort and grape fruit juice, within 28 days prior to the first dosing and throughout the PK assessment.
  5. Any allergies to the composition of the high fat meal.
  6. Patients who use tobacco products. All Patients
  7. History of COVID-19-related pneumonitis requiring hospitalization.
  8. History of COVID-19 infection within 4 weeks prior to enrolment, or clinically significant pulmonary symptoms related to prior COVID-19 pneumonitis.
  9. Treatment with any of the following:

    c. An EGFR TKI ≤ 8 days or 5 × the terminal phase t1/2, whichever is longer, prior to the first dose of study drug on C1D1.

    d. Systemic anticancer treatment (excluding EGFR-TKIs as described above) within 14 days prior to the first dose of study drug on C1D1.

    e. Immunotherapy ≤ 28 days prior to the first dose of study drug on C1D1. f. Radiotherapy < 28 days and palliative radiation ≤ 14 days prior to the first dose of study drug on C1D1. If irradiated, lesions must have demonstrated clear-cut progression prior to being eligible for evaluation as target lesions.

    g. Major surgery (excluding placement of vascular access) ≤ 28 days of the first dose of study drug on C1D1.

  10. Have any unresolved toxicity of Grade ≥ 2 from previous anti-cancer treatment, except for alopecia and skin pigmentation. Patients with chronic but stable Grade 2 toxicities may be allowed to enrol after agreement between the Investigator and Sponsor.
  11. Have known or suspected brain metastases or spinal cord compression, unless the condition has been asymptomatic, treated with surgery and/or radiation, and has been stable without requiring escalating corticosteroids or anti-convulsant medications for at least four weeks prior to the first dose of study drug on C1D1.
  12. Prior therapy with CLN-081.
  13. Known hypersensitivity to CLN-081 or any drugs similar in structure or class.
  14. Past medical history of interstitial lung disease, drug-induced interstitial lung disease, treatment-related pneumonitis, or any evidence of clinically active interstitial lung disease.
  15. Cardiac conditions as follows: Patient has a history of congestive heart failure (CHF) Class III/IV according to the New York Heart Association (NYHA) Functional Classification or serious cardiac arrhythmias requiring treatment.
  16. Resting QTc > 470 msec.
  17. Patient is unable to take drugs po due to disorders or diseases that may affect GI function, including but not limited to inflammatory bowel diseases (eg, Crohn's disease, ulcerative colitis) or malabsorption syndrome, or procedures that may affect gastrointestinal function, such as gastrectomy, enterectomy, or colectomy.
  18. Have any condition or illness that, in the opinion of the Investigator, might compromise patient safety or interfere with the evaluation of the safety of the drug.
  19. Pregnant or lactating women; women of child-bearing potential (WOCBP) must have a negative serum pregnancy test at within seven days prior to receiving study drug on C1D1. WOCBP and males with partners of child-bearing potential must agree to use adequate birth control (Section 15.3) throughout their participation and for six months following the last dose of study treatment.
  20. History of another primary malignancy within 2 years prior to starting study drug on C1D1, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ.
  21. Uncontrolled intercurrent illness including, but not limited to, uncompensated respiratory, cardiac, hepatic, or renal disease, active infection (including human immunodeficiency virus (HIV) and active clinical tuberculosis), or renal transplant; ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, or psychiatric illness/social situations that would limit compliance with study requirements.
  22. For patients with a history of hepatitis B (HBV), active infection as defined by a positive hepatitis B serum antigen (HBsAg) test and detectable HBV deoxyribonucleic acid (DNA). Patients ineligible due to detectable levels of HBV DNA at baseline may be rescreened for enrolment if their HBV DNA levels become undetectable after treatment with antiviral agents, and upon agreement between the Investigator and Sponsor.
  23. For patients with a history of hepatitis C, active infection as defined by a reactive hepatitis C virus (HCV) antibody test and detectable HCV ribonucleic acid (RNA).
  24. Active bleeding disorders.
  25. The patient is, in the Investigator's opinion, unable or unwilling to comply with the trial procedures.

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): NCT04036682


Contacts
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Contact: John Janik, MD (803) 634-3255 CLN081001trial@cullinanoncology.com
Contact: Ann Christensen, MSHA (619) 647-5750 amchristensen@cullinanoncology.com

Locations
Show Show 19 study locations
Sponsors and Collaborators
Cullinan Oncology, LLC
Investigators
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Study Chair: Zosia Piotrowska, MD Massachusetts General Hospital
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Cullinan Oncology, LLC
ClinicalTrials.gov Identifier: NCT04036682    
Other Study ID Numbers: CLN-081-001
First Posted: July 30, 2019    Key Record Dates
Last Update Posted: November 15, 2022
Last Verified: November 2022
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 Cullinan Oncology, LLC:
NSCLC
EGFR
Exon 20 insertions
CLN-081
TAS6417
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