A Randomized, Open-label, Phase 3 Study of Setidegrasib (ASP3082) Versus Docetaxel in Participants With KRAS G12D-mutated Locally Advanced (Unresectable) or Metastatic Non-small Cell Lung Cancer (NSCLC) Who Have Progressed on or After Platinum Based Chemotherapy and Checkpoint Inhibitor Therapy (CPI)
Summary
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. The first treatment is usually chemotherapy, given with another treatment that targets specific proteins on cancer cells. If the cancer gets worse, the next main treatment is usually a medicine called docetaxel. This treatment doesn't stop most people's cancer from getting worse for very long. Other treatments are needed to improve outcomes in people with NSCLC. Genes give your body instructions on how to make proteins. Proteins are needed to keep the body working properly. Many types of cancer are caused by changes in certain genes, making them faulty. Many people with NSCLC have a faulty KRAS gene in their tumor. One such change in the KRAS gene is called a G12D mutation. Researchers are looking for ways to stop the actions of abnormal proteins made from the KRAS G12D mutation. Setidegrasib (ASP3082) is thought to remove some of the abnormal proteins made from the faulty KRAS gene. Before setidegrasib can become available as a treatment, studies need to be done. This study is for people with NSCLC with a faulty KRAS gene in their tumor. In this study, some people will be given setidegrasib and some people will be given docetaxel. The main aims are to learn how long people who are given setidegrasib live with cancer without it getting worse, compared to people who are given docetaxel, and if they live for longer. Other aims are to check tumor response, symptoms, how the body processes setidegrasib, and its safety, compared with docetaxel. The main aims of study are to learn how long people who are given setidegrasib live with cancer without it getting worse, compared to people who are given docetaxel and if people who are given setidegrasib live for longer compared to people who are given docetaxel. People in this study will be adults with locally advanced, unresectable or metastatic non-small cell lung cancer (NSCLC) with the G12D mutation in their KRAS gene. Locally advanced means the cancer has spread to nearby tissue. Unresectable means the cancer cannot be removed by surgery. Metastatic means the cancer has spread to other parts of the body. They have had no more than 2 previous treatments for their cancer. The key reasons people cannot take part are if they have different faulty genes in their tumor which can be targeted with other treatments, have symptomatic or untreated cancers that have spread from the lung into the brain or nervous system, their cancer has spread to the thin tissue that covers the brain and spinal cord (leptomeningeal disease), or they have recently had other active cancers that required treatment. In this study, people will either receive setidegrasib or docetaxel. Whether people receive setidegrasib or docetaxel is decided by chance, not by the study doctor. Both study treatments are given slowly through a tube into a vein (infusion). People will continue to receive study treatment until their cancer gets worse, they can't tolerate the study treatment, they start other cancer treatment, they or the doctor decides the person should stop receiving study treatment, or sadly, they pass away. Some people on docetaxel may be able to switch to setidegrasib during the study if their cancer becomes worse. There will be safety checks at each visit, and the doctors will continue to check for medical problems and people's wellbeing throughout the study. People will continue to have scans of their tumor every 6 weeks for the first year, then every 9 weeks until their cancer becomes worse. After people's cancer becomes worse, clinic staff will telephone people every 12 weeks to check on their cancer.
Arms & interventions
- DrugSetidegrasib
Intravenous infusion
- DrugDocetaxel
Intravenous infusion
Outcome measures
Primary
Progression-Free Survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. as assessed by blinded independent central review (BICR)
PFS is defined as the time from the date of randomization until the date of documented radiographic disease progression per RECIST v1.1, as assessed by BICR or until death due to any cause, whichever comes first.
Time frame: Up to 2.3 years
Overall Survival (OS)
OS is defined as the time from the date of randomization until the date of death from any cause.
Time frame: Up to 4.2 years
Secondary
Time to deterioration in NSCLC symptoms (TDLCS): cough evaluated via European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer Module (EORTC QLQ-LC13) items
Time frame: Up to 2.3 years
TDLCS: chest pain evaluated via EORTC QLQ-LC13
Time frame: Up to 2.3 years
TDLCS: dyspnea evaluated via EORTC QLQ-LC13
Time frame: Up to 2.3 years
Time to Worsening of Global Health Status/Quality of Life (GHS/QoL) (TWGQ) measured by European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)
Time frame: Up to 2.3 years
Objective Response Rate (ORR) per RECIST v1.1, as assessed by BICR
Time frame: Up to 2.3 years
Time to response (TTR) per RECIST v 1.1 as assessed as assessed by BICR
Time frame: Up to 2.3 years
Duration of Response (DOR) per RECIST v 1.1 as assessed by BICR
Time frame: Up to 2.3 years
Disease Control Rate (DCR) per RECIST v 1.1 as assessed by BICR
Time frame: Up to 2.3 years
PFS per RECIST v1.1. as assessed by the investigator
Time frame: Up to 2.3 years
ORR per RECIST v1.1. as assessed by the investigator
Time frame: Up to 2.3 years
TTR per RECIST v 1.1 as assessed by the investigator
Time frame: Up to 2.3 years
DOR per RECIST v 1.1 as assessed by the investigator
Time frame: Up to 2.3 years
DCR per RECIST v 1.1 as assessed by the investigator
Time frame: Up to 2.3 years
Number of Participants with Adverse Events (AEs)
Time frame: Up to 4.2 years
Number of Participants with Serious Adverse Events (SAEs)
Time frame: Up to 4.2 years
Number of Participants with laboratory value abnormalities and/or AEs
Time frame: Up to 4.2 years
Number of Participants with electrocardiogram (ECG) abnormalities and/or AEs
Time frame: Up to 4.2 years
Number of Participants with vital sign abnormalities and/or AEs
Time frame: Up to 4.2 years
Number of Participants with Eastern Cooperative Oncology Group (ECOG) performance status
Time frame: Up to 4.2 years
Pharmacokinetics (PK) of setidegrasib in plasma: End-of-Infusion (EOI) concentration
Time frame: Up to 23 days
PK of setidegrasib in plasma: concentration immediately prior to dosing at multiple dosing (Ctrough)
Time frame: Up to 197 days
Change from baseline in EORTC QLQ-C30
Time frame: Baseline and up to 12 weeks
Change from baseline in EORTC QLQ-LC13
Time frame: Baseline and up to 12 weeks
Change from baseline in EuroQol 5-dimensional 5-level version (EQ-5D-5L) Visual Analog Scale
Time frame: Baseline and up to 12 weeks
Change from baseline until week 12 in Patient Global Impression of Change (PGIC)
Time frame: Baseline and up to 12 weeks
Change from baseline until week 12 in Patient Global Impression of Severity (PGIS)
Time frame: Baseline and up to 12 weeks
Patient reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) responses over time
Time frame: Up to 2.3 years
Functional Assessment of Cancer Therapy - General Item 5 (FACT-GP5) responses over time
Time frame: Up to 2.3 years
Eligibility criteria
Study locations (2)
Oncura Health d.b.a.Los Angeles Cancer Network
Glendale, California, 91204
Virginia Cancer Specialists
Arlington, Virginia, 22201