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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT05800015




Registration number
NCT05800015
Ethics application status
Date submitted
23/03/2023
Date registered
5/04/2023
Date last updated
29/05/2024

Titles & IDs
Public title
A Trial to Learn How the Combination of Fianlimab With Cemiplimab and Chemotherapy Works Compared With Cemiplimab and Chemotherapy for Treating Adult Patients With Advanced Non-small Cell Lung Cancer
Scientific title
A Randomized, Double-Blind Phase 2/3 Study of Fianlimab (Anti-LAG-3 Antibody), Cemiplimab (Anti-PD-1 Antibody), and Chemotherapy Versus Cemiplimab and Chemotherapy in First-Line Treatment of Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) Irrespective of PD-L1 Expression Levels
Secondary ID [1] 0 0
2022-501577-40-00
Secondary ID [2] 0 0
R3767-ONC-2236
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Non-small Cell Lung Cancer 0 0
Condition category
Condition code
Cancer 0 0 0 0
Lung - Mesothelioma
Cancer 0 0 0 0
Lung - Non small cell
Cancer 0 0 0 0
Lung - Small cell

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - fianlimab
Treatment: Drugs - cemiplimab
Treatment: Drugs - Pemetrexed
Treatment: Drugs - Paclitaxel
Treatment: Drugs - Carboplatin
Treatment: Drugs - Cisplatin
Treatment: Drugs - Placebo

Experimental: Phase 2 - Arm A - Randomized 1:1:1 fianlimab (higher dose) + cemiplimab + platinum-doublet chemotherapy

Experimental: Phase 2 - Arm B - Randomized 1:1:1 fianlimab (lower dose) + cemiplimab + platinum-doublet chemotherapy

Experimental: Phase 2 - Arm C - Randomized 1:1:1 cemiplimab + platinum-doublet chemotherapy + placebo

Experimental: Phase 3 - Arm A or B - Randomized 1:1 fianlimab (chosen dose) + cemiplimab + platinum-doublet chemotherapy

Experimental: Phase 3 - Arm C - Randomized 1:1 cemiplimab + platinum-doublet chemotherapy + placebo


Treatment: Drugs: fianlimab
Administered intravenously (IV) every 3 weeks (Q3W)

Treatment: Drugs: cemiplimab
Administered IV Q3W

Treatment: Drugs: Pemetrexed
IV Infusion, Q3W

Treatment: Drugs: Paclitaxel
IV Infusion, Q3W

Treatment: Drugs: Carboplatin
IV Infusion, Q3W

Treatment: Drugs: Cisplatin
IV infusion, Q3W

Treatment: Drugs: Placebo
IV infusion, Q3W
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Objective response rate (ORR) as assessed by blinded independent review committee (BICR) using RECIST 1.1
Timepoint [1] 0 0
Up to 136 Weeks
Primary outcome [2] 0 0
Overall Survival (OS)
Timepoint [2] 0 0
Up to 5 years
Secondary outcome [1] 0 0
Incidence of treatment-emergent adverse event (TEAEs)
Timepoint [1] 0 0
Up to 108 weeks
Secondary outcome [2] 0 0
Incidence of treatment-related TEAEs
Timepoint [2] 0 0
Up to 108 weeks
Secondary outcome [3] 0 0
Incidence of serious adverse events (SAEs)
Timepoint [3] 0 0
Up to 108 weeks
Secondary outcome [4] 0 0
Incidence of adverse events of special interest (AESIs)
Timepoint [4] 0 0
Up to 108 weeks
Secondary outcome [5] 0 0
Incidence of immune-mediated adverse events (imAEs)
Timepoint [5] 0 0
Up to 108 weeks
Secondary outcome [6] 0 0
Occurrence of interruption of study drug(s) due to AEs
Timepoint [6] 0 0
Up to 108 weeks
Secondary outcome [7] 0 0
Occurrence of discontinuation of study drug(s) due to AEs
Timepoint [7] 0 0
Up to 108 weeks
Secondary outcome [8] 0 0
Incidence of deaths due to TEAE
Timepoint [8] 0 0
Up to 108 weeks
Secondary outcome [9] 0 0
Incidence of grade 3-4 laboratory abnormalities
Timepoint [9] 0 0
Up to 108 weeks
Secondary outcome [10] 0 0
ORR by investigator assessment using RECIST 1.1
Timepoint [10] 0 0
Up to 136 Weeks
Secondary outcome [11] 0 0
Disease control rate (DCR) by BICR
Timepoint [11] 0 0
Up to 136 Weeks
Secondary outcome [12] 0 0
DCR by investigator assessment
Timepoint [12] 0 0
Up to 136 Weeks
Secondary outcome [13] 0 0
Time to tumor response (TTR) by BICR
Timepoint [13] 0 0
Up to 136 Weeks
Secondary outcome [14] 0 0
TTR by investigator assessment
Timepoint [14] 0 0
Up to 136 Weeks
Secondary outcome [15] 0 0
Duration of response (DOR) by BICR
Timepoint [15] 0 0
Up to 5 Years
Secondary outcome [16] 0 0
DOR by investigator assessment
Timepoint [16] 0 0
Up to 5 Years
Secondary outcome [17] 0 0
Progression free survival (PFS) by BICR
Timepoint [17] 0 0
Up to 5 Years
Secondary outcome [18] 0 0
PFS by investigator assessment
Timepoint [18] 0 0
Up to 5 Years
Secondary outcome [19] 0 0
OS
Timepoint [19] 0 0
Up to 5 Years
Secondary outcome [20] 0 0
Change from baseline in patient-reported global health status/quality of life (GHS/QoL) per European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
Timepoint [20] 0 0
Up to 108 weeks
Secondary outcome [21] 0 0
Change from baseline in physical functioning per EORTC QLQ-C30
Timepoint [21] 0 0
Up to 108 weeks
Secondary outcome [22] 0 0
Change from baseline in patient-reported chest pain per European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13)
Timepoint [22] 0 0
Up to 108 weeks
Secondary outcome [23] 0 0
Change from baseline in patient-reported dyspnea per EORTC QLQ-LC13
Timepoint [23] 0 0
Up to 108 weeks
Secondary outcome [24] 0 0
Change from baseline in patient-reported cough per EORTC QLQ-LC13
Timepoint [24] 0 0
Up to 108 weeks
Secondary outcome [25] 0 0
Time until definitive deterioration in patient-reported global health status/QoL per EORTC QLQ-C30
Timepoint [25] 0 0
Up to 108 weeks
Secondary outcome [26] 0 0
Time until definitive deterioration in patient-reported physical functioning per EORTC QLQ-C30
Timepoint [26] 0 0
Up to 108 weeks
Secondary outcome [27] 0 0
Time until definitive deterioration in patient-reported chest pain per EORTC QLQ-LC13
Timepoint [27] 0 0
Up to 108 weeks
Secondary outcome [28] 0 0
Time until definitive deterioration in patient-reported dyspnea per EORTC QLQ-LC13
Timepoint [28] 0 0
Up to 108 weeks
Secondary outcome [29] 0 0
Time until definitive deterioration in patient-reported cough per EORTC QLQ-LC13
Timepoint [29] 0 0
Up to 108 weeks
Secondary outcome [30] 0 0
Time until definitive deterioration in a composite of these three symptoms: patient-reported chest pain, dyspnea and cough per EORTC QLQ-LC13
Timepoint [30] 0 0
Up to 108 weeks
Secondary outcome [31] 0 0
Change from baseline in patient-reported general health status per EuroQoL 5-Dimensional 5-Level Scale (EQ-5D-5L) VAS
Timepoint [31] 0 0
Up to 108 weeks
Secondary outcome [32] 0 0
Change from baseline in patient-reported severity with usual or daily activities due to fatigue per the Patient Reported Outcomes for Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Timepoint [32] 0 0
Up to 108 weeks
Secondary outcome [33] 0 0
Change from baseline in patient-reported interference with usual or daily activities due to fatigue per the PRO-CTCAE
Timepoint [33] 0 0
Up to 108 weeks
Secondary outcome [34] 0 0
Concentrations of cemiplimab in serum
Timepoint [34] 0 0
Up to 136 weeks
Secondary outcome [35] 0 0
Concentrations of fianlimab in serum
Timepoint [35] 0 0
Up to 136 weeks
Secondary outcome [36] 0 0
Immunogenicity, as measured by anti-drug antibodies (ADA) to fianlimab
Timepoint [36] 0 0
Up to 136 weeks
Secondary outcome [37] 0 0
Immunogenicity, as measured by ADA to cemiplimab
Timepoint [37] 0 0
Up to 136 weeks
Secondary outcome [38] 0 0
Immunogenicity, as measured by neutralizing antibodies (NAb) to fianlimab
Timepoint [38] 0 0
Up to 136 weeks
Secondary outcome [39] 0 0
Immunogenicity, as measured by NAb to cemiplimab
Timepoint [39] 0 0
Up to 136 weeks

Eligibility
Key inclusion criteria
Key

1. Patients with non-squamous or squamous histology NSCLC with stage IIIB or stage IIIC
disease who are not candidates for surgical resection or definitive chemoradiation per
investigator assessment or stage IV (metastatic disease), who received no prior
systemic treatment for recurrent or metastatic NSCLC.

2. Availability of an archival or on-study formalin-fixed, paraffin-embedded (FFPE) tumor
tissue sample, without intervening therapy between biopsy collection and screening as
described in the protocol

3. For enrollment in phase 2, patients should have PD-L1, expression results (regardless
of expression level) determined by a College of American Pathologists (CAP)/Clinical
Laboratory Improvement Amendments (CLIA) (or equivalently licensed, according to local
regulations) accredited laboratory, as described in the protocol. For enrollment in
phase 3, patients should have a valid PD-L1 result, regardless of expression level,
using an assay as performed by a central laboratory, as described in the protocol.

4. At least 1 radiographically measurable lesion by computed tomography (CT) or magnetic
resonance imaging (MRI) per RECIST 1.1 criteria. Target lesions may be located in a
previously irradiated field if there is documented (radiographic) disease progression
in that site.

5. Eastern Cooperative Oncology Group (ECOG) performance status of =1.

6. Adequate organ and bone marrow function as defined in the protocol.

Key
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Active or untreated brain metastases or spinal cord compression. Patients are eligible
if central nervous system (CNS) metastases are adequately treated and patients have
neurologically returned to baseline (except for residual signs or symptoms related to
the CNS treatment) for at least 2 weeks prior to enrollment. Patients must be off
(immunosuppressive doses of) corticosteroid therapy.

2. Patients with tumors tested positive for actionable estimated glomerular filtration
rate (EGFR) gene mutations, anaplastic lymphoma kinase (ALK) gene translocations, or
ROS oncogene 1 (ROS1) fusions, as described in the protocol.

3. Encephalitis, meningitis, or uncontrolled seizures in the year prior to enrollment.

4. History of interstitial lung disease (eg, idiopathic pulmonary fibrosis or organizing
pneumonia), of active, noninfectious pneumonitis that required immune-suppressive
doses of glucocorticoids to assist with management, or of pneumonitis within the last
5 years. A history of radiation pneumonitis in the radiation field is permitted as
long as pneumonitis resolved =6 months prior to enrollment.

5. Known primary immunodeficiencies, either cellular (eg, DiGeorge syndrome,
T-cell-negative severe combined immunodeficiency [SCID]) or combined T- and B-cell
immunodeficiencies (eg, T- and B-cell negative SCID, Wiskott Aldrich syndrome, ataxia
telangiectasia, common variable immunodeficiency).

6. Ongoing or recent (within 2 years) evidence of significant autoimmune disease that
required treatment with systemic immunosuppressive treatments, which may suggest risk
of immune-mediated treatment-emergent adverse events (imTEAEs). Patients with
uncontrolled type 1 diabetes mellitus or with uncontrolled adrenal insufficiency are
excluded. The following are not exclusionary: vitiligo, childhood asthma that has
resolved, residual hypothyroidism that required only hormone replacement, or psoriasis
that does not require systemic treatment.

7. Patients with a condition requiring corticosteroid therapy (>10 mg prednisone/day or
equivalent) within 14 days of randomization. Physiologic replacement doses are allowed
even if they are >10 mg of prednisone/day or equivalent, as long as they are not being
administered for immunosuppressive intent. Patients with clinically relevant systemic
immune suppression within the last 3 months before trial enrollment are excluded.
Inhaled or topical steroids are permitted, provided that they are not for treatment of
an autoimmune disorder.

8. Patients who have received prior systemic therapies are excluded with the exception of
the following:

1. Adjuvant or neoadjuvant platinum-based doublet chemotherapy (after surgery and/or
radiation therapy) if recurrent or metastatic disease develops more than 6 months
after completing therapy as long as toxicities have resolved to CTCAE grade =1 or
baseline with the exception of alopecia and peripheral neuropathy.

2. Anti-PD-(L)1 with or without LAG-3 as an adjuvant or neoadjuvant therapy as long
as the last dose is >12 months prior to enrollment.

3. Prior exposure to other immunomodulatory or vaccine as an adjuvant or neoadjuvant
therapy such as Cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4)
antibodies as long as the last dose is >6 months prior to enrollment.
Immune-mediated AEs must be resolved to CTCAE grade =1 or baseline by the time of
enrollment. Endocrine immune-mediated AEs controlled with hormonal or other
non-immunosuppressive therapies without resolution prior to enrollment are
allowed.

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 2/Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
8/08/2023
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
23/12/2031
Actual
Sample size
Target
950
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
Recruitment hospital [1] 0 0
Macquarie University Health Science Center (MQ Health) - Macquarie Park
Recruitment hospital [2] 0 0
Southern Medical Day Care Centre - Wollongong
Recruitment hospital [3] 0 0
Ballarat Regional Integrated Cancer Centre (BRICC) - Ballarat
Recruitment hospital [4] 0 0
Bendigo Hospital - Bendigo
Recruitment hospital [5] 0 0
St Vincents Hospital - Fitzroy
Recruitment hospital [6] 0 0
St John of God Murdoch Hospital - Murdoch
Recruitment postcode(s) [1] 0 0
2109 - Macquarie Park
Recruitment postcode(s) [2] 0 0
NSW 2500 - Wollongong
Recruitment postcode(s) [3] 0 0
3350 - Ballarat
Recruitment postcode(s) [4] 0 0
3550 - Bendigo
Recruitment postcode(s) [5] 0 0
3065 - Fitzroy
Recruitment postcode(s) [6] 0 0
6150 - Murdoch
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Arizona
Country [2] 0 0
United States of America
State/province [2] 0 0
California
Country [3] 0 0
United States of America
State/province [3] 0 0
Florida
Country [4] 0 0
United States of America
State/province [4] 0 0
Illinois
Country [5] 0 0
United States of America
State/province [5] 0 0
Louisiana
Country [6] 0 0
United States of America
State/province [6] 0 0
Mississippi
Country [7] 0 0
United States of America
State/province [7] 0 0
New Jersey
Country [8] 0 0
United States of America
State/province [8] 0 0
New Mexico
Country [9] 0 0
United States of America
State/province [9] 0 0
New York
Country [10] 0 0
United States of America
State/province [10] 0 0
Ohio
Country [11] 0 0
United States of America
State/province [11] 0 0
Tennessee
Country [12] 0 0
United States of America
State/province [12] 0 0
Virginia
Country [13] 0 0
Canada
State/province [13] 0 0
British Columbia
Country [14] 0 0
Georgia
State/province [14] 0 0
Adjaria
Country [15] 0 0
Georgia
State/province [15] 0 0
Tbilisi
Country [16] 0 0
Israel
State/province [16] 0 0
Hamerkaz
Country [17] 0 0
Israel
State/province [17] 0 0
Tel Aviv
Country [18] 0 0
Korea, Republic of
State/province [18] 0 0
Chungbuk
Country [19] 0 0
Korea, Republic of
State/province [19] 0 0
Gyeonggi Do
Country [20] 0 0
Korea, Republic of
State/province [20] 0 0
Gyeonggi
Country [21] 0 0
Korea, Republic of
State/province [21] 0 0
Jeollabuk-do
Country [22] 0 0
Korea, Republic of
State/province [22] 0 0
Seoul Teugbyeolsi
Country [23] 0 0
Korea, Republic of
State/province [23] 0 0
Daejeon
Country [24] 0 0
Korea, Republic of
State/province [24] 0 0
Incheon
Country [25] 0 0
Korea, Republic of
State/province [25] 0 0
Seoul
Country [26] 0 0
Korea, Republic of
State/province [26] 0 0
Ulsan
Country [27] 0 0
Malaysia
State/province [27] 0 0
Johor
Country [28] 0 0
Malaysia
State/province [28] 0 0
Pahang
Country [29] 0 0
Malaysia
State/province [29] 0 0
Penang
Country [30] 0 0
Malaysia
State/province [30] 0 0
Sarawak
Country [31] 0 0
Malaysia
State/province [31] 0 0
Wilayah Persekutuan
Country [32] 0 0
Malaysia
State/province [32] 0 0
Pulau Pinang

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Regeneron Pharmaceuticals
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This study is researching an investigational drug called fianlimab (also called REGN3767)
with two other medications called cemiplimab and chemotherapy, individually called a "study
drug" or collectively called "study drugs". 'Investigational' means that the study drug is
not approved for use outside of this study by any Health Authority. Examples of chemotherapy
drugs include the following: Paclitaxel plus carboplatin, and Pemetrexed plus cisplatin. The
study is being conducted in patients who have advanced non-small cell lung cancer (NSCLC).

The aim of the study is to see how effective the combination of fianlimab, cemiplimab, and
chemotherapy is for treating advanced NSCLC, in comparison with cemiplimab and chemotherapy.

The study is looking at several other research questions, including:

- What side effects may happen from taking the study drugs

- How much of each study drug is in your blood at different times

- Whether the body makes antibodies against the study drugs (which could make the drug
less effective or could lead to side effects)

- How administering the study drugs might improve your quality of life
Trial website
https://clinicaltrials.gov/ct2/show/NCT05800015
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Clinical Trial Management
Address 0 0
Regeneron Pharmaceuticals
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Clinical Trials Administrator
Address 0 0
Country 0 0
Phone 0 0
844-734-6643
Fax 0 0
Email 0 0
clinicaltrials@regeneron.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05800015