Phase 2
N=88
Tepotinib With Gefitinib in Participants With Locally Advanced or Metastatic NSCLC (INSIGHT)
Non-small Cell Lung Cancer
Bottom Line
View on ClinicalTrials.gov: NCT01982955 ↗Enrolled (actual)
88
Serious AEs
42.5%
Results posted
Jul 2020
Primary outcome: Primary: Phase 1b: Number of Participants Experiencing at Least One Dose Limiting Toxicity (DLT) — 0; 0 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Tepotinib (Drug); Gefitinib (Drug); Pemetrexed (Drug); Cisplatin (Drug); Carboplatin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Merck KGaA, Darmstadt, Germany
- Primary completion
- Dec 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 1b: Number of Participants Experiencing at Least One Dose Limiting Toxicity (DLT) |
0; 0 | — |
| PRIMARY Phase 1b: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEs |
6; 12; 4; 7 | — |
| PRIMARY Phase 2 (Randomized Part Only): Progression-free Survival (PFS) Based on Tumor Assessment by the Investigator |
4.86; 4.37 | — |
| SECONDARY Phase 1b: Area Under the Plasma Concentration Versus Time Curve From Time Zero to the Last Sampling Time AUC (0-t) of Tepotinib, Its Metabolites and Gefitinib |
6280; 9210; 15600; 22200; 1680; 1770 | — |
| SECONDARY Phase 1b: Area Under the Plasma Concentration-Time Curve Within 1 Dosing Interval (AUC 0-tau) of Tepotinib, Its Metabolites and Gefitinib |
6280; 9210; 15600; 22200; 1680; 1770 | — |
| SECONDARY Phase 1b: Maximum Observed Plasma Concentration (Cmax) of Tepotinib, Its Metabolites and Gefitinib |
375; 575; 763; 1050; 132; 149 | — |
| SECONDARY Phase 1b: Average Observed Plasma Concentration (Cavg) of Tepotinib, Its Metabolites and Gefitinib |
654; 924; 185; 314; 36.4; 78.3 | — |
| SECONDARY Phase 1b: Minimum Observed Plasma Concentration (Cmin) of Tepotinib, Its Metabolites and Gefitinib |
534; 735; 156; 270; 32.8; 68.7 | — |
| SECONDARY Phase 1b: Time to Reach Maximum Plasma Concentration (Tmax) of Tepotinib, Its Metabolites and Gefitinib |
8.00; 9.01; 6.00; 9.00; 24.00; 24.00 | — |
| SECONDARY Phase 1b: Area Under the Plasma Concentration-Time Curve From Time Zero to Infinity (AUC 0-infinity) of Tepotinib, Its Metabolites and Gefitinib |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Phase 1b: Apparent Total Body Clearance From Plasma (CL/F) of Tepotinib and Gefitinib |
17.3; 20.3; 32.5; 35.3 | — |
| SECONDARY Phase 1b: Apparent Volume of Distribution (Vz/F) During the Terminal Phase of Tepotinib, Its Metabolites and Gefitinib |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Phase 1b: Apparent Volume of Distribution During the Steady State (Vss/F) of Tepotinib, Its Metabolites and Gefitinib |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Phase 1b: Apparent Terminal Elimination Rate Constant Lambda(z) of Tepotinib, Its Metabolites and Gefitinib |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Phase 1b: Apparent Terminal Half-Life (t1/2) of Tepotinib, Its Metabolites and Gefitinib |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Phase 1b: Percentage of Participants With Objective Response Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
33.3; 33.3 | — |
| SECONDARY Phase 1b: Percentage of Participants With Disease Control Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
50.0; 58.3 | — |
| SECONDARY Phase 1b: Number of Participants With Treatment-Related Treatment-Emergent Adverse Events (TEAEs) and Treatment-Related Serious TEAEs According to National Cancer Institute Common Toxicity Criteria for Adverse Events Version 4.03 |
6; 9; 5; 11; 0; 0 | — |
| SECONDARY Phase 1b: Number of Participants With Grade 3/4 Treatment-Emergent Adverse Events (TEAEs) and Grade 3/4 Treatment-Related TEAEs According to National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTCAE) Version 4.03 |
5; 9; 2; 4; 0; 0 | — |
| SECONDARY Phase 1b: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) Leading to Permanent Treatment Discontinuation |
0; 2; 0; 1 | — |
| SECONDARY Phase 1b: Number of Participants With Death and Reasons |
0; 3; 0; 0; 1; 0 | — |
| SECONDARY Phase 1b: Number of Participants With Laboratory Test Abnormalities of Grade 3 or Higher Severity Based on NCI-CTCAE Version 4.03 Reported as Treatment-Emergent Adverse Events (TEAEs) |
2; 2; 1; 2; 0; 1 | — |
| SECONDARY Phase 1b: Number of Participants With Clinically Significant Abnormalities in Vital Signs |
0; 0 | — |
| SECONDARY Phase 1b: Number of Participants With Clinically Significant Abnormalities in 12-Lead Electrocardiograms (ECG) Findings |
0; 0 | — |
| SECONDARY Phase 1b: Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score of 2 or Higher Than 2 |
1; 9 | — |
| SECONDARY Phase 2: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Treatment-Related TEAEs and Treatment-Related Serious TEAEs According to National Cancer Institute Common Toxicity Criteria for Adverse Events Version 4.03 |
31; 23; 13; 30; 23; 11 | — |
| SECONDARY Phase 2: Number of Participants With Greater Than or Equal to (>=) Grade 3 Treatment-Emergent Adverse Events (TEAEs) and >= Grade 3 Treatment-Related TEAEs According to National Cancer Institute Common Toxicity Criteria for Adverse Events Version 4.03 |
20; 14; 7; 16; 12; 1 | — |
| SECONDARY Phase 2: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) Leading to Permanent Treatment Discontinuation |
3; 1; 2 | — |
| SECONDARY Phase 2: Number of Participants With Death and Reasons |
21; 15; 8; 0; 0; 0 | — |
| SECONDARY Phase 2: Number of Participants With Laboratory Test Abnormalities of Grade 3 or Higher Severity Based on NCI-CTCAE Version 4.03 Reported as Treatment-Emergent Adverse Events (TEAEs) |
0; 7; 0; 0; 1; 0 | — |
| SECONDARY Phase 2: Number of Participants With Clinically Significant Abnormalities in Vital Signs |
0; 0; 0 | — |
| SECONDARY Phase 2: Number of Participants With Clinically Significant Abnormalities in 12-Lead Electrocardiograms (ECG) Findings |
2; 1; 0 | — |
| SECONDARY Phase 2: Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score of 2 or Higher Than 2 |
6; 1; 1 | — |
| SECONDARY Phase 2 (Randomized Part Only): Progression-free Survival (PFS) Based on Tumor Assessment by Independent Review Committee (IRC) |
10.15; 4.34 | — |
| SECONDARY Phase 2: (Randomized Part Only): Overall Survival (OS) Time |
17.25; 19.48 | — |
| SECONDARY Phase 2 (Randomized Part Only): Percentage of Participants With Objective Response Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
45.2; 33.3 | — |
| SECONDARY Phase 2 (Randomized Part Only): Percentage of Participants With Disease Control Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
83.9; 70.8 | — |
| SECONDARY Phase 2 (Non-Randomized Part Only): Progression-free Survival (PFS) Based on Tumor Assessment by Investigator |
1.41 | — |
| SECONDARY Phase 2 (Non-Randomized Part Only): Progression-free Survival (PFS) Based on Tumor Assessment by Independent Review Committee (IRC) |
2.63 | — |
| SECONDARY Phase 2: (Non-Randomized Part Only): Overall Survival (OS) Time |
25.86 | — |
| SECONDARY Phase 2 (Non-Randomized Part Only): Percentage of Participants With Objective Response Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
— | — |
| SECONDARY Phase 2 (Non-Randomized Part Only): Percentage of Participants With Disease Control Based on Tumor Response Assessment According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Criteria |
40 | — |
| SECONDARY Phase 2: Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) Global Health Status Scale Score at End of Treatment (EOT) |
-16.29; -2.78; -24.19 | — |
| SECONDARY Phase 2: Time-to-Symptom Progression (TTSP) |
5.75; 7.95; 2.63 | — |
Summary
This is a multi-center, open-label, randomized, Phase 1b/2 study to determine the recommended phase 2 dose (RP2D) and to evaluate the efficacy in terms of progression free survival (PFS) of Tepotinib when used in combination with gefitinib in partcipants with T790M negative, MET positive locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation and having acquired resistance to Prior EGFR-Tyrosine Kinase Inhibitor (EGFR-TKI) Therapy. This study has 2:1 randomization (Tepotinib/Gefitinib arm versus Chemotherapy arm).
Eligibility Criteria
Phase Ib
Inclusion Criteria
- Histologically or cytologically confirmed advanced non-small cell lung cancer (NSCLC), regardless of histology subtype, which failed on gefitinib for reasons other than toxicity or compliance;
- Availability of a fresh or archived pre treatment tumor biopsy (excluding fine needle aspiration and cytology samples). For participants who have had at least 1 prior anticancer treatment, a biopsy obtained between failure of the most recent anticancer treatment and enrolment is mandatory;
- Mesenchymal-epithelial transition diagnostic-positive (status) (MET+ status), as determined by the central laboratory
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1
- Other protocol defined inclusion criteria could apply.
Phase II
Inclusion criteria
- Locally advanced or metastatic NSCLC other than predominantly squamous histology (confirmed by either histology or cytology);
- Activating mutation of the epidermal growth factor (EGFR) receptor (documented, or as determined by the central laboratory)
- Acquired resistance on first-line EGFR-Tyrosine Kinase Inhibitors (EGFR-TKI) therapy including gefitinib, erlotinib, icotinib, or afatinib
- EGFR T790M status after acquired resistance to first line EGFR-TKI therapy including gefitinib, erlotinib, icotinib, or afatinib treatment (as determined by the central laboratory, using a validated PCR test);
- T790M negative status for the randomized part
- T790M positive status for the single-arm cohort (mainland China sites only)
- Availability of a fresh or archived tumor tissue (excluding fine needle aspiration and cytology samples) obtained between documentation of acquired resistance to gefitinib, erlotinib, icotinib, or afatinib and enrollment is mandatory
- MET+ status, as determined by the central laboratory i.e. c-Met overexpression as determined by IHC (i.e., IHC 2+ or IHC 3+) and/or c-Met amplification and/or increased c-Met gene copy number (GCN), both determined by ISH;
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Other protocol defined inclusion criteria could apply
Exclusion Criteria (Phase I and II):
- Estimated life expectancy less than (<) 3 months
- Inadequate bone marrow, liver or renal functions
- Prior chemotherapy, biological therapy, radiation therapy, or other investigational anticancer therapy (not including palliative radiotherapy at focal sites) within 21 days prior to the first dose of study treatment (Phase 1b only)
- Prior systemic anticancer treatment with chemotherapy or other agents targeting the EGFR pathway excluding gefitinib, erlotinib, icotinib, and afatinib for advanced NSCLC (one course of chemotherapy regimen for [neo] adjuvant purpose, or one course of chemoradiation for Stage IIIa disease is allowed) (Phase 2 only)
- Other protocol defined exclusion criteria could apply.
Data sourced from ClinicalTrials.gov (NCT01982955). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.