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RecruitingInterventionalPhase 3

AN OPEN-LABEL, RANDOMIZED, CONTROLLED PHASE 3 STUDY OF SIGVOTATUG VEDOTIN IN COMBINATION WITH PEMBROLIZUMAB COMPARED WITH PEMBROLIZUMAB MONOTHERAPY AS FIRST-LINE TREATMENT IN PARTICIPANTS WITH PD-L1 HIGH (≥50% OF TUMOR CELLS EXPRESSING PD-L1), LOCALLY ADVANCED, UNRESECTABLE, OR METASTATIC NON-SMALL CELL LUNG CANCER (BE6A LUNG-02)

NCT ID: NCT06758401Sponsor: PfizerLast updated: 2026-04-20

Summary

The purpose of the study is to compare how the new combination treatment (Sigvotatug Vedotin plus pembrolizumab) works compared to pembrolizumab alone in patients with non-small cell lung cancer (NSCLC) with high levels of PD-L1. This is a protein that acts as a kind of "brake" to keep the body's immune responses under control. The study is seeking for participants who: * Are confirmed to have NSCLC (Stage 3 or 4). * Have PD-L1 levels in more than 50% of the cancer cells. All participants in this study will receive pembrolizumab at the study clinic once every 6 weeks as an intravenous (IV) infusion (give directly into a vein). In addition, half of the participants will also receive Sigvotatug Vedotin once every 2 weeks as an IV infusion in addition to receiving pembrolizumab. Participants may receive pembrolizumab for up to about two years. Those participants taking Sigvotatug Vedotin can continue until their NSCLC is no longer responding. The study team will monitorsee how each participant is doing with the study treatment during regular visits at the clinic.

Arms & interventions

  • DrugSigvotatug Vedotin

    MMAE-Antibody Drug Conjugate targeting Integrin Beta-6

  • DrugPembrolizumab

    Anti-PD-(L)1

Outcome measures

Primary

  • Overall Survival

    Overall survival defined as the duration from enrollment to death.

    Time frame: Baseline to date of death from any cause (Approximately 2 years)

  • Progression Free Survival (PFS) assessed by blinded independent central review (BICR)

    Progression-free survival is defined as the time interval from the date of randomization to the date of first documented tumor progression determined by blinded independent central review (BICR) assessment as per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) or death due to any cause, whichever come first.

    Time frame: From Baseline to to date of first documentation of progression OR death (Approximately 2 year)

Secondary

  • Progression Free Survival as assessed by Investigator

    Time frame: From Baseline to date of first progression or death (Approximately 4 Years)

  • Objective Response Rate as assessed by BICR

    Time frame: From Baseline to to the date of progression OR death (approximately to 4 years)

  • Objective Response Rate as assessed by Investigator

    Time frame: From Baseline to to the date of progression OR death (approximately to 4 years)

  • Duration of Response as assessed by BICR

    Time frame: From the date of the first objective response to the date of disease progression or death (approximately to 4 years)

  • Duration of Response as assessed by Investigator

    Time frame: From the date of the first objective response to the date of disease progression or death (approximately to 4 years)

  • Number of participants with adverse events (AEs)

    Time frame: From Baseline to end of treatment (up to 4 years)

  • Pharmacokinetics (PK) of antibody-conjugated monomethyl auristatin E (ac-MMAE) in plasma: Plasma concentration at end of infusion (CEOI)

    Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1

  • PK of ac-MMAE in plasma: Plasma predose concentration (Cpredose)

    Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1

  • PK of unconjugated monomethyl auristatin E (MMAE) in plasma: Plasma concentration at end of infusion (CEOI)

    Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1

  • PK of MMAE in plasma: Plasma predose concentration (Cpredose)

    Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1

  • Number of participants with antidrug antibodies (ADAs)

    Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: 1. Participants must meet the following criteria: 1. Have pathologically confirmed Stage IIIB or IIIC NSCLC and not be a candidate for surgical resection or definitive chemoradiation, or Stage IV NSCLC per the AJCC Staging Manual (Version 8.0) and the UICC Staging System (Eighth edition). 2. Participants with non-squamous histology must have documented negative test results for EGFR, ALK, and ROS1 AGAs and no known AGAs in NTRK, BRAF, RET, MET, or other AGAs with approved front-line therapies per local standard of care. 3. Large cell neuroendocrine carcinoma is excluded. 4. Candidate for treatment with pembrolizumab monotherapy per local guidelines. 2. Tumor has PD-L1 expression in ≥50% of tumor cells (TPS ≥50%) as determined by local testing 3. Measurable disease based on RECIST v1.1 per investigator. 4. Resolution of acute effects of any prior therapy to either baseline severity or NCI CTCAE Grade 1 or less (except for AEs not constituting a safety risk in the investigator's judgment), unless otherwise excluded. Exclusion Criteria: 1. Life expectancy of \<3 months in the opinion of the investigator. 2. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or make the participant inappropriate for the study. 3. Participants with any history of another malignancy within 3 years before the first dose of study intervention, or any evidence of residual disease from a previously diagnosed malignancy. 4. Known or suspected hypersensitivity, intolerance, or contraindication to any excipient contained in the drug formulation of sigvotatug vedotin or pembrolizumab. 5. Participants with any of the following respiratory conditions: 1. Evidence of noninfectious or drug-induced ILD or pneumonitis 2. Known DLCO (adjusted for hemoglobin) \<50% predicted. 3. Grade ≥3 pulmonary disease unrelated to underlying malignancy 6. Known active CNS lesions are excluded. Participants with definitively treated brain metastases (surgery and/or radiotherapy) may be eligible. Clinically inactive brain metastases of longest diameter \<0.5 cm are permitted. 7. Major surgery (defined as a surgery requiring inpatient hospitalization of at least 48 hours) within 21 days or minor surgery within 7 days prior to first dose of study intervention. 8. Receipt of a live vaccine within 30 days prior to first dose of study intervention. 9. Pre-existing peripheral neuropathy Grade ≥2 per NCI CTCAE v5.0. 10. Uncontrolled diabetes mellitus, defined as HbA1c ≥8.0% or HbA1c between 7.0% and 8.0% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained. 11. Prior immune-related AE that led to anti-PD-(L)1 treatment discontinuation, required a high-dose steroid taper (≥0.5 mg/kg prednisone or equivalent per day) for \>2 weeks, or required treatment with systemic immunosuppressive therapy. 12. History of autoimmune disease that has required systemic treatment in the past 2 years 13. Participants with prior solid organ or bone marrow transplantation. 14. Currently receiving a high-dose steroid (\>10 mg prednisone or equivalent per day) or other immune suppressant or has a condition requiring a chronic high-dose steroid or immune suppressant. 15. Prior and concomitant therapy: 1. Any prior treatment with MMAE-derived drugs or IB6 targeting agents. 2. Prior systemic therapy, including anti-PD-(L)1 therapy, for locally advanced, unresectable, or metastatic NSCLC. * (Neo)adjuvant anti-PD-(L)1 is allowed if recurrence or progression occurred ≥9 months after the last dose. * Other (neo)adjuvant or definitive therapy is allowed if recurrence or progression occurred ≥6 months after the last dose. 3. Prior radiotherapy to the lung within 6 months of first dose of study intervention, referencing the last date radiotherapy was received. 4. Chemotherapy, biologics, and/or other antitumor treatment with immunotherapy not specifically prohibited that is completed less than 4 weeks prior to first dose of study intervention, or 2 weeks for palliative radiotherapy. 5. Any prior therapy with an immune-oncology agent directed to a stimulatory or co-inhibitory T-cell receptor 16. History of or current ongoing infection, including participants positive for active HIV, HBV, or HCV. 17. Severe uncontrolled cardiac or cerebrovascular condition within the previous 6 months

Study locations (58)

Providence St. Jude Medical Center Virginia K. Crosson Cancer Center and Infusion Center

Fullerton, California, 92835

Recruiting

Providence St. Jude Medical Center

Fullerton, California, 92835

Recruiting

St. Jude Heritage Medical Group - Fullerton Plaza Multi-Specialty Clinic (Pulmonary Function Test)

Fullerton, California, 92835

Recruiting

Intermountain Health Cancer Center Lutheran Hospital

Golden, Colorado, 80401

Recruiting

Cancer Centers of Colorado St. Mary's Regional Hospital

Grand Junction, Colorado, 81501

Recruiting

Intermountain Health St. Mary's Regional Hospital

Grand Junction, Colorado, 81501

Recruiting

Intermountain Health

Grand Junction, Colorado, 81505

Recruiting

Intermountain Health Lutheran Hospital

Wheat Ridge, Colorado, 80401

Recruiting

Washington DC Veterans Affairs Medical Center

Washington D.C., District of Columbia, 20422

Recruiting

Mid Florida Hematology and Oncology Center

Orange City, Florida, 32763

Recruiting

BRCR Global

Plantation, Florida, 33322

Recruiting

Endeavor Health

Elmhurst, Illinois, 60126

Recruiting

Hope and Healing Cancer Services

Hinsdale, Illinois, 60521

Recruiting

Endeavor Health

Naperville, Illinois, 60540

Recruiting

Hope and Healing Cancer Services

New Lenox, Illinois, 60451

Recruiting

Maine Medical Center

Portland, Maine, 04102

Recruiting

MaineHealth Cancer Care - Scarborough

Scarborough, Maine, 04074

Recruiting

MaineHealth Cancer Care and IV Therapy - South Portland

South Portland, Maine, 04106

Recruiting

Minnesota Oncology Hematology, PA

Burnsville, Minnesota, 55337

Recruiting

Minnesota Oncology Hematology PA

Coon Rapids, Minnesota, 55433

Recruiting

M Health Fairview Cancer Clinic-Edina

Edina, Minnesota, 55435

Recruiting

Minnesota Oncology Hematology PA

Edina, Minnesota, 55435

Recruiting

Minnesota Oncology Hematology PA

Maple Grove, Minnesota, 55369

Recruiting

M Health Fairview St. John's Hospital

Maplewood, Minnesota, 55109

Recruiting

Minnesota Oncology Hematology PA

Maplewood, Minnesota, 55109

Recruiting

Hennepin County Medical Center

Minneapolis, Minnesota, 55415

Recruiting

North Memorial Health Cancer Center

Robbinsdale, Minnesota, 55422

Recruiting

Metro Minnesota Community Oncology Research Consortium (MMCORC)

Saint Louis Park, Minnesota, 55426

Recruiting

Park Nicollet Frauenshuh Cancer Center

Saint Louis Park, Minnesota, 55426

Recruiting

Regions Hospital

Saint Paul, Minnesota, 55101

Recruiting

Minnesota Oncology Hematology, P.A. Cornerstone Medical Specialty Center

Woodbury, Minnesota, 55125

Recruiting

Jackson Oncology Associates, PLLC

Jackson, Mississippi, 39202

Recruiting

Jackson Oncology Associates, PLLC

Jackson, Mississippi, 39216

Recruiting

Oncology Hematology West, PC dba Nebraska Cancer Specialists - Fremont

Fremont, Nebraska, 68025

Recruiting

Oncology Hematology West, PC dba Nebraska Cancer Specialists - Grand Island

Grand Island, Nebraska, 68803

Recruiting

Oncology Hematology West, PC dba Nebraska Cancer Specialists - Regional

Grand Island, Nebraska, 68803

Recruiting

Cancer Partners of Nebraska - April Sampson Cancer Center

Lincoln, Nebraska, 68516

Recruiting

Oncology Hematology West P.C. dba Nebraska Cancer Specialists - Methodist

Omaha, Nebraska, 68114

Recruiting

Oncology Hematology West, PC dba Nebraska Cancer Specialists - Bergan

Omaha, Nebraska, 68124

Recruiting

Oncology Hematology West P.C. dba Nebraska Cancer Specialists

Omaha, Nebraska, 68130

Recruiting

Hematology Oncology Associates of Rockland

Nyack, New York, 10960

Recruiting

Carolina Cancer Research Center

Wilson, North Carolina, 27893

Recruiting

Gabrail Cancer Center Research

Canton, Ohio, 44718

Recruiting

The University of Texas, MD Anderson Cancer Center - Woodlands

Conroe, Texas, 77384

Recruiting

Renovatio Clinical - El Paso

El Paso, Texas, 79915

Recruiting

The University of Texas MD Anderson Cancer Center Diagnostic Imaging

Houston, Texas, 77030

Recruiting

The University of Texas MD Anderson Cancer Center Investigational Pharmacy Services

Houston, Texas, 77030

Recruiting

The University of Texas, MD Anderson Cancer Center- Interventional Radiology

Houston, Texas, 77030

Recruiting

University of Texas MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting

The University of Texas MD Anderson Cancer Center Clinical Research Imaging

Houston, Texas, 77054

Recruiting

The University of Texas, MD Anderson Cancer Center - West Houston

Houston, Texas, 77079

Recruiting

Community Clinical Trials

Kingwood, Texas, 77339

Recruiting

The University of Texas, MD Anderson Cancer Center - League City

League City, Texas, 77573

Recruiting

The University of Texas, MD Anderson Cancer Center - Sugar Land

Sugar Land, Texas, 77478

Recruiting

Renovatio Clinical

The Woodlands, Texas, 77380

Recruiting

Woodlands Radiology

The Woodlands, Texas, 77381

Recruiting

American Oncology Network Vista Oncology Division-West office

Olympia, Washington, 98502

Recruiting

American Oncology Network Vista Oncology Division-East office

Olympia, Washington, 98506

Recruiting

References

  • Reck M, Lu S, O'Byrne KJ, Barrios C, Pavlov D, Tay F, Negrao MV. Frontline sigvotatug vedotin plus pembrolizumab vs pembrolizumab for non-small cell lung cancer with PD-L1 tumor proportion score >/=50%: phase III study design. Future Oncol. 2025 Dec;21(30):3891-3901. doi: 10.1080/14796694.2025.2596228. Epub 2025 Dec 13.(PubMed)