Recruiting NCT06758401

This is a Study to Learn About How the Combination of the Study Medicines Sigvotatug Vedotin Plus Pembrolizumab Works in People With Non-small Cell Lung Cancer With High Levels of PD-L1.

Phase III Interventional Non-Small Cell Lung Cancer Carcinoma, Non-Small-Cell Lung Carcinoma, Non-Small-Cell Lung (NSCLC)

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied: The protocol lists: Sigvotatug Vedotin, Pembrolizumab.
Who it may be relevant to: Registry conditions: Non-Small Cell Lung Cancer, Carcinoma, Non-Small-Cell Lung, Carcinoma, Non-Small-Cell Lung (NSCLC). Basic parameters: from 18 years · All.
What needs checking: Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place: United States, Argentina, Australia, Austria, Belgium +26
Next step: Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

AN OPEN-LABEL, RANDOMIZED, CONTROLLED PHASE 3 STUDY OF SIGVOTATUG VEDOTIN IN COMBINATION WITH PEMBROLIZUMAB COMPARED WITH PEMBROLIZUMAB MONOTHERAPY AS FIRST-LINE TREATMENT IN PARTICIPANTS WITH PD-L1 HIGH (≥50% OF TUMOR CELLS EXPRESSING PD-L1), LOCALLY ADVANCED, UNRESECTABLE, OR METASTATIC NON-SMALL CELL LUNG CANCER (BE6A LUNG-02)

Overview

The purpose of the study is to compare how the new combination treatment (Sigvotatug Vedotin plus pembrolizumab) works compared to pembrolizumab alone in patients with non-small cell lung cancer (NSCLC) with high levels of PD-L1. This is a protein that acts as a kind of "brake" to keep the body's immune responses under control. The study is seeking for participants who: * Are confirmed to have NSCLC (Stage 3 or 4). * Have PD-L1 levels in more than 50% of the cancer cells. All participants in this study will receive pembrolizumab at the study clinic once every 6 weeks as an intravenous (IV) infusion (give directly into a vein). In addition, half of the participants will also receive Sigvotatug Vedotin once every 2 weeks as an IV infusion in addition to receiving pembrolizumab. Participants may receive pembrolizumab for up to about two years. Those participants taking Sigvotatug Vedotin can continue until their NSCLC is no longer responding. The study team will monitorsee how each participant is doing with the study treatment during regular visits at the clinic.

Interventions

Drug Sigvotatug Vedotin
MMAE-Antibody Drug Conjugate targeting Integrin Beta-6
Drug Pembrolizumab
Anti-PD-(L)1

Primary outcome measures

Overall Survival [Time frame: Baseline to date of death from any cause (Approximately 2 years)]
Progression Free Survival (PFS) assessed by blinded independent central review (BICR) [Time frame: From Baseline to to date of first documentation of progression OR death (Approximately 2 year)]

Secondary outcome measures (11)

Progression Free Survival as assessed by Investigator [Time frame: From Baseline to date of first progression or death (Approximately 4 Years)]
Objective Response Rate as assessed by BICR [Time frame: From Baseline to to the date of progression OR death (approximately to 4 years)]
Objective Response Rate as assessed by Investigator [Time frame: From Baseline to to the date of progression OR death (approximately to 4 years)]
Duration of Response as assessed by BICR [Time frame: From the date of the first objective response to the date of disease progression or death (approximately to 4 years)]
Duration of Response as assessed by Investigator [Time frame: From the date of the first objective response to the date of disease progression or death (approximately to 4 years)]
Number of participants with adverse events (AEs) [Time frame: From Baseline to end of treatment (up to 4 years)]
Pharmacokinetics (PK) of antibody-conjugated monomethyl auristatin E (ac-MMAE) in plasma: Plasma concentration at end of infusion (CEOI) [Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1]
PK of ac-MMAE in plasma: Plasma predose concentration (Cpredose) [Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1]
PK of unconjugated monomethyl auristatin E (MMAE) in plasma: Plasma concentration at end of infusion (CEOI) [Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1]
PK of MMAE in plasma: Plasma predose concentration (Cpredose) [Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1]
Number of participants with antidrug antibodies (ADAs) [Time frame: Cycle 1 (up to Day 29), Cycle 3 Day 1, Cycle 5 Day 29, Cycle 8 Day 15 and Cycle 11 Day 1]

Eligibility criteria

Inclusion criteria

Participants must meet the following criteria:

Have pathologically confirmed Stage IIIB or IIIC NSCLC and not be a candidate for surgical resection or definitive chemoradiation, or Stage IV NSCLC per the AJCC Staging Manual (Version 8.0) and the UICC Staging System (Eighth edition).
Participants with non-squamous histology must have documented negative test results for EGFR, ALK, and ROS1 AGAs and no known AGAs in NTRK, BRAF, RET, MET, or other AGAs with approved front-line therapies per local standard of care.
Large cell neuroendocrine carcinoma is excluded.
Candidate for treatment with pembrolizumab monotherapy per local guidelines.
Tumor has PD-L1 expression in ≥50% of tumor cells (TPS ≥50%) as determined by local testing
Measurable disease based on RECIST v1.1 per investigator.
Resolution of acute effects of any prior therapy to either baseline severity or NCI CTCAE Grade 1 or less (except for AEs not constituting a safety risk in the investigator's judgment), unless otherwise excluded.

Exclusion criteria

Life expectancy of <3 months in the opinion of the investigator.
Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or make the participant inappropriate for the study.
Participants with any history of another malignancy within 3 years before the first dose of study intervention, or any evidence of residual disease from a previously diagnosed malignancy.
Known or suspected hypersensitivity, intolerance, or contraindication to any excipient contained in the drug formulation of sigvotatug vedotin or pembrolizumab.
Participants with any of the following respiratory conditions:

Evidence of noninfectious or drug-induced ILD or pneumonitis
Known DLCO (adjusted for hemoglobin) <50% predicted.
Grade ≥3 pulmonary disease unrelated to underlying malignancy
Known active CNS lesions are excluded. Participants with definitively treated brain metastases (surgery and/or radiotherapy) may be eligible. Clinically inactive brain metastases of longest diameter <0.5 cm are permitted.
Major surgery (defined as a surgery requiring inpatient hospitalization of at least 48 hours) within 21 days or minor surgery within 7 days prior to first dose of study intervention.
Receipt of a live vaccine within 30 days prior to first dose of study intervention.
Pre-existing peripheral neuropathy Grade ≥2 per NCI CTCAE v5.0.
Uncontrolled diabetes mellitus, defined as HbA1c ≥8.0% or HbA1c between 7.0% and 8.0% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained.
Prior immune-related AE that led to anti-PD-(L)1 treatment discontinuation, required a high-dose steroid taper (≥0.5 mg/kg prednisone or equivalent per day) for >2 weeks, or required treatment with systemic immunosuppressive therapy.
History of autoimmune disease that has required systemic treatment in the past 2 years
Participants with prior solid organ or bone marrow transplantation.
Currently receiving a high-dose steroid (>10 mg prednisone or equivalent per day) or other immune suppressant or has a condition requiring a chronic high-dose steroid or immune suppressant.
Prior and concomitant therapy:

Any prior treatment with MMAE-derived drugs or IB6 targeting agents.
Prior systemic therapy, including anti-PD-(L)1 therapy, for locally advanced, unresectable, or metastatic NSCLC.

(Neo)adjuvant anti-PD-(L)1 is allowed if recurrence or progression occurred ≥9 months after the last dose.
Other (neo)adjuvant or definitive therapy is allowed if recurrence or progression occurred ≥6 months after the last dose.
Prior radiotherapy to the lung within 6 months of first dose of study intervention, referencing the last date radiotherapy was received.
Chemotherapy, biologics, and/or other antitumor treatment with immunotherapy not specifically prohibited that is completed less than 4 weeks prior to first dose of study intervention, or 2 weeks for palliative radiotherapy.
Any prior therapy with an immune-oncology agent directed to a stimulatory or co-inhibitory T-cell receptor
History of or current ongoing infection, including participants positive for active HIV, HBV, or HCV.
Severe uncontrolled cardiac or cerebrovascular condition within the previous 6 months

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation: Randomized
Model: Parallel assignment
Masking: Single blind
Primary purpose: Treatment