A Randomized, Phase 2/3 Study to Evaluate the Optimal Dose, Safety, and Efficacy of Livmoniplimab in Combination With Budigalimab Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy in Untreated Metastatic Non-Squamous Non-Small Cell Lung Cancer (NSCLC)
Summary
Non-Squamous Non-Small Cell Lung Cancer (NSCLC) remains a leading cause of cancer mortality worldwide, with poor survival prospects for metastatic disease. The purpose of this study is to evaluate the optimized dose, adverse events, and efficacy of livmoniplimab in combination with budigalimab plus chemotherapy versus pembrolizumab plus chemotherapy in participants with untreated metastatic non-squamous non-small cell lung cancer. Livmoniplimab is an investigational drug being developed for the treatment of NSCLC. There are 2 stages to this study. In Stage 1, there are 4 treatment arms. Participants will either receive livmoniplimab (at different doses) in combination with budigalimab (another investigational drug) + chemotherapy, budigalimab +chemotherapy, or pembrolizumab +chemotherapy. In Stage 2, there are 2 treatments arms. Participants will either receive livmoniplimab (optimized dose) in combination with budigalimab +chemotherapy or placebo in combination with pembrolizumab +chemotherapy. Chemotherapy consists of IV Infused pemetrexed + IV infused cisplatin or IV infused or injected carboplatin. Approximately 840 adult participants will be enrolled in the study across 200 sites worldwide. Stage 1: In cohort 1, participants will receive intravenously (IV) infused livmoniplimab (dose A)+ IV infused budigalimab, + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + IV Infused pemetrexed. In cohort 2, participants will receive livmoniplimab (dose B) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed. In cohort 3, participants will receive budigalimab + chemotherapy for 4 cycles followed by budigalimab + pemetrexed . In cohort 4, participants will receive IV Infused pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed. Stage 2: In arm 1, participants will receive livmoniplimab (dose optimized) + budigalimab + chemotherapy for 4 cycles followed by livmoniplimab + budigalimab + pemetrexed. In arm 2, participants will receive IV Infused placebo + pembrolizumab + chemotherapy for 4 cycles followed by pembrolizumab + pemetrexed. The estimated study duration is 55 months. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic and may require frequent medical assessments, blood tests, questionnaires, and scans.
Arms & interventions
- DrugLivmoniplimab
Intravenously (IV) Infusion
- DrugBudigalimab
IV Infusion
- DrugPembrolizumab
IV Infusion
- DrugPemetrexed
IV Infusion
- DrugCisplatin
IV Infusion
- DrugCarboplatin
IV Injection
- DrugCarboplatin
IV Infusion
Outcome measures
Primary
Stage 1: Best Overall Response (BOR) of Complete Response (CR)/Partial Response (PR)
BOR of CR/PR is defined as achieving CR or PR according to response evaluation criteria in solid tumors (RECIST) v1.1 as determined by investigators at any time prior to subsequent anticancer therapy. Objective response rate (ORR), defined as the percentage of participants with a BOR of CR/PR, will be summarized.
Time frame: Up to 21 Months
Stage 2: Overall Survival (OS)
OS is defined as the time measured from randomization until death from any cause.
Time frame: Up to 55 Months
Secondary
Stage 1: Progression Free Survival (PFS)
Time frame: Up to 21 Months
Stage 1: Duration of Response (DOR)
Time frame: Up to 21 Months
Stage 1: OS
Time frame: Up to 21 Months
Stage 2: PFS
Time frame: Up to 55 Months
Stage 2: BOR of CR/PR
Time frame: Up to 55 Months
Stage 2: Change from Baseline in Physical Functioning (PF) as measured by the PF domain of European Organization for Research Treatment of Cancer Quality of Life Questionnaire 17 (EORTC QLQ-F17)
Time frame: Up to 55 Months
Stage 2: Change from Baseline in Non-Small Cell Lung Cancer Symptom Assessment Questionnaire (NSCLC-SAQ)
Time frame: Up to 55 Months
Stage 2: Change from Baseline in Quality of Life as Measured by the Global Health Status/Quality of Life Domain of the EORTC QLQ-F17
Time frame: Up to 55 Months
Stage 2: PFS per Investigator
Time frame: Up to 55 Months
Stage 1: BOR of CR/PR per Investigator
Time frame: Up to 21 Months
Stage 2: DOR
Time frame: Up to 55 Months
Stage 2: DOR per investigator
Time frame: Up to 55 Months
Eligibility criteria
Study locations (19)
Moores Cancer Center /ID# 267782
La Jolla, California, 92037
Memorial Hospital West /ID# 262221
Pembroke Pines, Florida, 33028
Bond Clinic /ID# 262611
Winter Haven, Florida, 33880
University Cancer & Blood Cent /ID# 261824
Athens, Georgia, 30607
The University of Chicago Medical Center /ID# 262259
Chicago, Illinois, 60637-1443
University of Kansas Medical Center /ID# 263196
Westwood, Kansas, 66205
Baptist Health Lexington /ID# 261823
Lexington, Kentucky, 40503
Cancer & Hematology Centers of Western Michigan - East /ID# 261826
Grand Rapids, Michigan, 49546-7062
Washington University-School of Medicine /ID# 262759
St Louis, Missouri, 63110
Stony Brook Cancer Center /ID# 261954
Stony Brook, New York, 11794-0001
Cone Health Cancer Center /ID# 262583
Greensboro, North Carolina, 27403-1109
Oncology Hematology Care, Inc - Blue Ash /ID# 262733
Cincinnati, Ohio, 45252
Guthrie Robert Packer Hospital /ID# 262758
Sayre, Pennsylvania, 18840
Renovatio clinical /ID# 262000
El Paso, Texas, 79915-1803
Houston Methodist Hospital /ID# 262722
Houston, Texas, 77030
Texas Oncology - Plano East /ID# 264356
Plano, Texas, 75075
Texas Oncology - San Antonio Medical Center - Research Drive /ID# 264311
San Antonio, Texas, 78240
Renovatio Clinical /ID# 261999
The Woodlands, Texas, 77380-3181
Vista Oncology - East Olympia /ID# 262303
Olympia, Washington, 98506-5028