Phase II study of MRTX849 monotherapy and in combination with pembrolizumab in patients with advanced non-small-cell lung cancer with KRAS G12C mutation

ISRCTN ISRCTN13464104
DOI https://doi.org/10.1186/ISRCTN13464104
EudraCT/CTIS number 2020-003101-58
IRAS number 1004279
ClinicalTrials.gov number NCT04613596
Secondary identifying numbers 849-007, IRAS 1004279, CPMS 51494
Submission date
24/02/2022
Registration date
03/05/2022
Last edited
09/11/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
The aim of this study is to evaluate the effectiveness of the investigational medication MRTX849, given alone or in combination with the cancer therapy pembrolizumab, in patients with non-small cell lung cancer (NSCLC) who have a specific change in a tumour gene (KRAS G12C mutation). This evaluation will include looking at how effective this treatment is in reducing and controlling the cancer. Other aims of the study include assessing what side effects occur and how often they occur, how quickly MRTX849 is absorbed into the bloodstream, and how fast it is removed by the body. Several laboratory tests will be performed using samples of tumour tissue or blood to understand how and why the combination of medications may work.

Who can participate?
Patients with advanced non-small-cell lung cancer with KRAS G12C mutation

What does the study involve?
Participants will be randomly allocated to one of three treatment groups that will receive either MRTX849 and pembrolizumab or MRTX849 alone. Study treatment will be administered in 21-day cycles until one of the indications for stopping treatment is identified such as disease progression, unacceptable adverse reaction(s) or receipt of the maximum number of cycles per local standard-of-care.

What are the possible benefits and risks of participating?
The potential risks and burdens for this study are provided in the participant information sheet and informed consent forms. The participants will therefore know about these risks and burdens before taking part in the study. Study staff will be trained on the expected side effects associated with the study drugs. They will also be trained on how to report unexpected reactions and given the contact details for the appropriate contact to discuss management and treatment of these side effects. Female participants are advised not to become pregnant during the study or within 6 months of completing treatment. Pregnancy tests will be performed before the administration of the study drugs. Both male and female participants are advised to use contraception for the duration of participation in the study. Should a partner of a participant become pregnant during this study they will be advised on the risks and will be invited to consent to additional assessment of the mother and child by the study team during and after the pregnancy.

Where is the study run from?
Mirati Therapeutics (USA)

When is the study starting and how long is it expected to run for?
February 2022 to August 2024

Who is funding the study?
Mirati Therapeutics (USA)

Who is the main contact?
Vicky Kang
miratistudylocator@emergingmed.com

Contact information

Ms Vicky Kang
Scientific

Senior Medical Director, Clinical Development
Mirati Therapeutics, Inc.
3545 Cray Court
San Diego
CA 92121
United Kingdom

Phone +1 844 893 5530
Email miratistudylocator@emergingmed.com
Dr Colin Lindsay
Principal Investigator

Wilmslow Road
Manchester
M20 4BX
United Kingdom

Phone +44 (0)161 9182514
Email colin.lindsay@manchester.ac.uk

Study information

Study designRandomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a participant information sheet
Scientific titleA Phase II trial of MRTX849 monotherapy and in combination with pembrolizumab in patients with advanced non-small-cell lung cancer with KRAS G12C mutation
Study objectives1. To evaluate the efficacy of MRTX849 monotherapy and in combination with pembrolizumab administered in the first-line treatment setting to patients having non-small-cell lung cancer (NSCLC) with KRAS G12C mutation
2. To characterize the safety and tolerability of the monotherapy and the combination regimen in the selected population
3. To evaluate secondary efficacy endpoints using monotherapy and the combination regimen in the selected population
4. To evaluate the pharmacokinetics (PK) of MRTX849 administered as monotherapy and in combination with pembrolizumab
Ethics approval(s)Approval pending, REC ref: 22/EE/0062
Health condition(s) or problem(s) studiedAdvanced non-small cell lung cancer
InterventionThis is a study involving an investigational (experimental) medication called MRTX849, being developed by Mirati Therapeutics, Inc.

In this study, participants will be administered MRTX849 monotherapy (alone) or MRTX849 in combination with pembrolizumab, an immunotherapy that has not yet been approved by the regulatory authorities such as the Medicines & Healthcare products Regulatory Agency (MHRA) in the UK for the treatment of lung cancer in several settings.

The study will include participants with locally advanced or metastatic NSCLC harbouring the KRAS-G12C mutation. Participants will be enrolled and treated in three cohorts (groups) as defined by their tumour proportion score (TPS) determined through assessment of extra signal molecules (PD-L1 molecules) found on the surface of the tumour cells. Up to 250 participants across approximately 110 study sites globally are expected to participate in this study.

Participants in this study will receive treatment based on the results of their PD-L1 testing (a marker that looks at how the immune system is involved in a cancer).

If the PD-L1 result is “negative” (less than (<) 1%), the participants will be randomly assigned to one of two groups through an online tool called IRT, to receive the following treatments listed below:

Cohort 1a: MRTX849 (400 mg dose) twice daily in combination with a standard treatment for lung cancer (pembrolizumab)
OR
Cohort 1b: MRTX849 (600 mg dose) twice daily

If the PD-L1 result is “positive” (1% or (>) greater), the participant will receive the following treatment listed below:

Cohort 2: MRTX849 (400 mg dose) twice daily in combination with (pembrolizumab) which is the standard treatment for lung cancer.

Participants may remain on the study treatment for as long as their disease doesn’t get worse such that the study doctor feels they should stop study treatment, and as long as they tolerate the medication (the side effects are not typically severe), and they wish to continue.

All participants will be followed for adverse events (AEs) for at least 28 days after the last dose of study treatment. All participants will be followed for serious adverse events (SAEs) for 90 days following the last dose of study treatment or, if subsequent therapy is begun, at least 28 days following the last dose of study treatment.

For participants who discontinue study treatment for a reason other than objective disease progression, disease assessment should continue until objective disease progression is documented by the investigator or start of subsequent anti-cancer therapy, whichever is sooner. Survival status and subsequent anti-cancer therapies will be collected during long term follow-up until death or lost to follow-up.
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase II
Drug / device / biological / vaccine name(s)MRTX849, pembrolizumab
Primary outcome measureObjective Response Rate (ORR) assessed using Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 at 22 months
Secondary outcome measures1. Safety characterized by type, incidence, severity, timing, seriousness and relationship to study treatment of adverse events and laboratory abnormalities at 22 months
2. Duration of response (DOR) estimated using the Kaplan-Meier method at 22 months
3. Pharmacokinetics (PK) of MRTX849 administered as monotherapy and in combination with pembrolizumab by measuring blood plasma MRTX849 and potential metabolite concentrations at 22 months
Overall study start date21/02/2022
Completion date31/08/2024

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants250
Key inclusion criteria1. Histologically confirmed diagnosis of NSCLC (squamous or nonsquamous) with KRAS G12C mutation and known PD-L1 Tumor Proportion Score (TPS) score
2. Unresectable or metastatic disease
Key exclusion criteria1. Prior systemic treatment for locally advanced or metastatic NSCLC including chemotherapy, immune checkpoint inhibitor therapy, or a therapy targeting KRAS G12C mutation (e.g., AMG 510)
2. Active brain metastases
Date of first enrolment23/11/2020
Date of final enrolment31/08/2023

Locations

Countries of recruitment

  • Australia
  • Austria
  • Belgium
  • Canada
  • China
  • England
  • Germany
  • Hungary
  • Ireland
  • Israel
  • Italy
  • Netherlands
  • New Zealand
  • Poland
  • Portugal
  • Scotland
  • Singapore
  • Spain
  • Taiwan
  • United Kingdom

Study participating centres

The Christie
550 Wilmslow Road
Withington
Manchester
M20 4BX
United Kingdom
Leicester Royal Infirmary
Infirmary Square
Leicester
LE1 5WW
United Kingdom
Queen Elizabeth Hospital Birmingham
Mindelsohn Way
Edgbaston
Birmingham
B15 2GW
United Kingdom
Western General Hospital
Crewe Road South
Edinburgh
Lothian
EH4 2XU
United Kingdom
Guys Hospital
Great Maze Pond
London
SE1 9RT
United Kingdom
Royal Surrey County Hospital
Egerton Road
Guildford
GU2 7XX
United Kingdom

Sponsor information

Mirati Therapeutics (United States)
Industry

3545 Cray Court
San Diego
CA 92121
United States of America

Phone +1 (0)844 647 2841
Email miratistudylocator@emergingmed.com
Website https://www.mirati.com/
ROR logo "ROR" https://ror.org/01by01460

Funders

Funder type

Industry

Mirati Therapeutics
Government organisation / For-profit companies (industry)
Alternative name(s)
Mirati Therapeutics Inc, Mirati Therapeutics, Inc.
Location
United States of America

Results and Publications

Intention to publish date31/12/2026
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryPublished as a supplement to the results publication
Publication and dissemination plan1. Peer-reviewed scientific journals
2. Internal report
3. Conference presentation
4. Publication on website
5. Other publication
6. Submission to regulatory authorities
7. Fully anonymised and aggregated data will be used. Participants will have the option for their data to be used for future research which will not directly identify the participants. The sponsor may share anonymised data collected during this study with others. The data provided to others will not include information that identifies the participant.
IPD sharing planThe datasets generated and/or analysed during the current study will be included in the subsequent results publication

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
HRA research summary 28/06/2023 No No

Editorial Notes

09/11/2022: The scientific contact was changed and the plain English summary was updated accordingly.
07/06/2022: Internal review.
30/04/2022: ISRCTN received notification of combined HRA/MHRA approval for this trial on 30/04/2022.
24/02/2022: Trial's existence confirmed by the HRA.