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RecruitingInterventionalPhase 3

A Phase 3 Study of the Selective Anaplastic Lymphoma Kinase (ALK) Inhibitor NVL-655 Compared to Alectinib in First-Line Treatment of Patients With ALK-Positive Advanced Non-Small Cell Lung Cancer (ALKAZAR)

NCT ID: NCT06765109Sponsor: Nuvalent Inc.Last updated: 2026-06-02

Summary

Multicenter, randomized, controlled, open-label, Phase 3 study designed to demonstrate that neladalkib (NVL-655) is superior to alectinib in prolonging progression-free survival (PFS) in patients with treatment-naïve, Anaplastic Lymphoma Kinase (ALK) positive, advanced Non-Small Cell Lung Cancer (NSCLC).

Detailed description

Patients will be randomized in a 1:1 ratio (approximately 225 in each arm) to receive either neladalkib (NVL-655) or alectinib.

Arms & interventions

  • DrugNeladalkib (NVL-655)

    Oral tablet of Neladalkib (NVL-655)

  • DrugAlectinib

    Oral capsule of alectinib

Outcome measures

Primary

  • Progression-free survival (PFS) per blinded independent central review (BICR)

    Time from randomization to BICR-assessed radiographic disease progression or death

    Time frame: Up to 5 years after first patient dosed

Secondary

  • Overall survival (OS)

    Time frame: Up to 5 years after first patient dosed

  • Progression-free survival (PFS) per investigator assessment

    Time frame: Up to 5 years after first patient dosed

  • Time to intracranial progression per BICR

    Time frame: Up to 5 years after first patient dosed

  • Intracranial objective response rate (IC-ORR)

    Time frame: Up to 5 years after first patient dosed

  • Intracranial duration of response (IC-DOR)

    Time frame: Up to 5 years after first patient dosed

  • Objective response rate (ORR)

    Time frame: Up to 5 years after first patient dosed

  • Duration of response (DOR)

    Time frame: Up to 5 years after first patient dosed

  • Intracranial progression per investigator assessment

    Time frame: Up to 5 years after first patient dosed

  • Treatment-emergent adverse events (TEAEs) and changes in clinically relevant laboratory parameters

    Time frame: Up to 5 years after first patient dosed

  • Patient-reported measures in health-related quality of life (QoL)

    Time frame: Up to 5 years after first patient dosed

  • Patient-reported measures in lung cancer symptoms and side effects of treatment

    Time frame: Up to 5 years after first patient dosed

  • Patient-reported measures in patient functioning

    Time frame: Up to 5 years after first patient dosed

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: 1. Histologically or cytologically confirmed locally advanced (not amenable for multimodality treatment) or metastatic Non-small Cell Lung Cancer (NSCLC) 2. Documented Anaplastic Lymphoma Kinase (ALK) rearrangement via testing of tissue or blood 3. No prior systemic anticancer treatment for NSCLC (adjuvant/neoadjuvant chemotherapy allowed if 12 months prior to randomization; prior ALK tyrosine kinase inhibitor \[TKI\] such as alectinib is not allowed in any setting) 4. Measurable disease (1 or more target lesions per Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1) 5. Pretreatment tumor tissue Exclusion Criteria: 1. Patient's cancer has a known oncogenic driver alteration other than ALK. 2. Known allergy/hypersensitivity to excipients of neladalkib or alectinib. 3. Ongoing or recent radiotherapy as per protocol-specified timeframes prior to randomization 4. Major surgery within 4 weeks prior to randomization 5. Uncontrolled clinically relevant infection requiring systemic therapy 6. Known active tuberculosis, or active Hepatitis B or C 7. QT corrected for heart rate by Fridericia's formula (QTcF) \> 470 msec on repeated assessments 8. Clinically significant cardiovascular disease 9. Brain metastases associated with progressive neurological symptoms or requiring increasing doses of corticosteroids to control CNS disease 10. Active malignancy requiring therapy within 2 years prior to randomization

Study locations (22)

Palo Verde Hematology Oncology

Glendale, Arizona, 85304

Recruiting
Amol Nanak Singh Rakkar, M.D. · Principal Investigator

Hoag Hospital Newport Beach

Newport Beach, California, 92663

Recruiting
Yaser Homsi, MD · Principal Investigator

University of California, Irvine Health

Orange, California, 92868

Recruiting
Misako Nagasaka, M.D., Ph.D. · Principal Investigator

Rocky Mountain Cancer Centers

Boulder, Colorado, 80218

Recruiting
Robert Jotte, MD, PhD · Principal Investigator

Sylvester Comprehensive Cancer Center Miami

Miami, Florida, 33136

Recruiting
Gilberto de Lima Lopes, Jr., M.D. · Principal Investigator

AdventHealth Cancer Institute

Orlando, Florida, 32804

Recruiting
Mark Socinski, M.D. · Principal Investigator

H Lee Moffitt Cancer Center and Research Institute

Tampa, Florida, 33612

Recruiting
Ben Creelan, M.D. · Principal Investigator

Winship Cancer Institute of Emory University

Atlanta, Georgia, 30322

Recruiting
Ticiana Leal, M.D. · Principal Investigator

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Recruiting
Alice Shaw, M.D., Ph.D. · Principal Investigator

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, 48201

Withdrawn

Washington University Center for Advanced Medicine

St Louis, Missouri, 63110

Recruiting
Ayse Ece Cali Daylan, M.D. · Principal Investigator

NYU Langone's Perlmutter Cancer Center

New York, New York, 10016

Recruiting
Elaine Shum, MD · Principal Investigator

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting
Alexander Drilon, M.D. · Principal Investigator

Optum Medical Care, PC

Westbury, New York, 11590

Recruiting
Jonathan S. Goldberg, M.D. · Principal Investigator

Carolinas Medical Center

Charlotte, North Carolina, 28203

Recruiting
Daniel Haggstrom, MD · Principal Investigator

Duke Cancer Center

Durham, North Carolina, 27710

Recruiting
Thomas Stinchcombe, M.D. · Principal Investigator

University of Cincinnati Cancer Center

Cincinnati, Ohio, 45267

Recruiting
Jennifer Leddon, M.D., Ph.D. · Principal Investigator

The Ohio State University

Columbus, Ohio, 43210

Recruiting
Logan Roof, M.D., MSCR · Principal Investigator

Alliance Cancer Specialists

Sellersville, Pennsylvania, 18960

Recruiting
Howard Zipin, MD · Principal Investigator

SCRI Oncology Partners

Nashville, Tennessee, 37203

Recruiting
Melissa Johnson, M.D. · Principal Investigator

Virginia Cancer Specialists

Fairfax, Virginia, 22031

Recruiting
Alexander Spira, M.D., Ph.D. · Principal Investigator

University of Washington - Fred Hutchinson Cancer Center

Seattle, Washington, 98109

Recruiting
Christina Baik, MD · Principal Investigator