Phase Ib Study of the Safety of T-DXd and Immunotherapy Agents With and Without Chemotherapy in Advanced or Metastatic HER2+, Non-squamous NSCLC
Start Date
3/9/2021
Completion Date
6/30/2027
Summary
DESTINY-Lung03 will investigate the safety and tolerability of trastuzumab deruxtecan in combination with Immunotherapy Agents with and without chemotherapy in patients with HER2 over-expressing non-small cell lung cancer. The efficacy will be also analyzed as a secondary endpoint.
Detailed Description
Part 1 is a dose escalation study by design, allowing the assessment of safety, tolerability, and recommended dose levels of the combination of T-DXd and durvalumab plus cisplatin, carboplatin, or pemetrexed. No more patients will be enrolled in this part of the study. Part 2, expansions in the treatment-naïve setting on any recommended dose level, will not be initiated. The evaluation of T-DXd combination treatment with immunotherapy continues in Part 3, Part 4, and Part 5. In Part 3, T-DXd is assessed in combination with volrustomig, with carboplatin (Arm 3B) or without carboplatin (Arm 3A). Part 4 examines T-DXd with rilvegostomig, either with carboplatin (Arm 4B) or without carboplatin (Arm 4A). In Part 5, T-DXd is evaluated with volrustomig, given with or without a priming dose followed by a fixed dose in Arm 5A. There is also an optional Arm 5B at the Sponsor's discretion. These parts focus on further dose optimization for first-line HER2-overexpressing NSCLC. For Part 3, patients will be randomized to Arms 3A and 3B, beginning with the cohorts receiving the volrustomig starting dose (SD). A total of 6 DLT-evaluable patients will be enrolled to the SD cohorts in each arm. If the combination of T-DXd with volrustomig at the starting dose is deemed safe, a dose escalation (E1) cohort will be opened for 6 DLT-evaluable patients. Once all open dose confirmation cohorts have 6 DLT-evaluable patients, the SRC will convene to select the volrustomig RP2D to be used in the dose-expansion (DE) cohorts of each arm (n=34). Part 3 is now permanently closed to recruitment; no further patients will be enrolled. In Part 4, once a total of 6 DLT-evaluable patients/arm have been enrolled into Arm 4A and Arm 4B safety-run in (SR) cohorts and deemed safe, an additional 34 patients per arm will be enrolled in Arms 4A and 4B in dose expansion cohorts. Part 5 involves additional dosing regimens of T-DXd in combination with volrustomig. The objective of Part 5 is to evaluate the safety and efficacy of priming and flat dosing regimens in 2 different cohorts of up to 30 patients per arm. The target population of interest (for Part 3, 4 and 5) are patients with advanced or metastatic non-small cell lung cancer measurable disease by RECIST 1.1 criteria, HER2 overexpression, ECOG PS of 0 to 1, patients who are treatment naïve for recurrent, unresectable or metastatic disease. Patients with tumors that harbor a known genomic alteration or driver for which approved therapies are available are excluded.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
T-DXd
Durvalumab
Cisplatin
Carboplatin
Pemetrexed
Volrustomig
Rilvegostomig
Conditions
Locations
Research Site
Duarte, California 91010
United States
Research Site
Newport Beach, California 92663
United States
Research Site
Orange, California 92868
United States
Research Site
Santa Rosa, California 95403
United States
Research Site
Westwood, Kansas 66205
United States
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Baltimore, Maryland 21287
United States
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Detroit, Michigan 48201
United States
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Buffalo, New York 14263
United States
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New York, New York 10029
United States
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The Bronx, New York 10461
United States
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Houston, Texas 77030
United States
Research Site
Fairfax, Virginia 22031
United States
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Tacoma, Washington 98405
United States
Research Site
Adelaide, 5000
Australia
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Heidelberg, 3084
Australia
Research Site
Nedlands, 6009
Australia
Research Site
Edegem, 2650
Belgium
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Barretos, 14784-400
Brazil
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Porto Alegre, 90035-903
Brazil
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São Paulo, 05652-900
Brazil
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Winnipeg, Manitoba R3E 0V9
Canada
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London, Ontario N6A 5W9
Canada
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Montreal, Quebec H3T 1E2
Canada
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Changchun, 130000
China
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Chengdu, 610041
China
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Fuzhou, 350011
China
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Shandong,
China
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Shanghai, 200433
China
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Zhengzhou, 450000
China
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Bordeaux, 33075
France
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Dijon, 21079
France
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Pierre-Bénite, 69495
France
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Saint-Herblain, 44800
France
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Villejuif, 94805
France
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Kfar Saba, 4428164
Israel
Research Site
Tel Litwinsky, 52620
Israel
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Milan, 20133
Italy
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Milan, 20162
Italy
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Monza, 20052
Italy
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Naples, 80131
Italy
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Padova, 35128
Italy
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George Town, 10450
Malaysia
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Kuala Lumpur, 59100
Malaysia
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Kuala Selangor, 62250
Malaysia
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Kuching, 93586
Malaysia
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Amsterdam, 1066 CX
Netherlands
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Bacolod, 6100
Philippines
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Cebu City, 6000
Philippines
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City of Taguig, 1634
Philippines
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Davao City, PH-8000
Philippines
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Manila, 1000
Philippines
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Manila, 1015
Philippines
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Quezon City, 1100
Philippines
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Quezon City, 1112
Philippines
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San Juan City, 1500
Philippines
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Gdansk, 80-214
Poland
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Krakow, 30-727
Poland
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Olsztyn, 10-357
Poland
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Tomaszów Mazowiecki, 97-200
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Warsaw, 02-781
Poland
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Singapore, 119228
Singapore
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Singapore, 168583
Singapore
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Singapore, 308433
Singapore
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Cheongju-si, 28644
South Korea
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Goyang-si, 10408
South Korea
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Jinju, 52727
South Korea
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Seoul, 03722
South Korea
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Seoul, 05505
South Korea
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Seoul, 06351
South Korea
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Badalona, 08013
Spain
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Madrid, 28041
Spain
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Seville, 41013
Spain
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Valencia, 46010
Spain
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Kaohsiung City, 833
Taiwan
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Taichung, 402
Taiwan
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Taichung, 40705
Taiwan
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Tainan, 70403
Taiwan
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Taipei, 100
Taiwan
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Taipei, 11217
Taiwan
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Taipei, 235
Taiwan
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Taoyuan, 333
Taiwan
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Bangkok, 10300
Thailand
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Bangkok, 10330
Thailand
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Hat Yai, 90110
Thailand
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Khon Kaen, 40002
Thailand
Research Site
Muang, 22000
Thailand
Research Site
Muang, 50200
Thailand
Research Site
Ankara, 06800
Turkey (Türkiye)
Research Site
Ankara, 6200
Turkey (Türkiye)
Research Site
Bornova-Izmir, 35100
Turkey (Türkiye)
Research Site
Istanbul, 31755
Turkey (Türkiye)