A Clinical Study to Evaluate Injection TQB2102 for the Treatment of Patients With HER2 IHC3+ Advanced Colorectal Cancer Who Progressed After Treatment With Oxaliplatin, Irinotecan and Fluoropyrimidine-Based Drugs

Официальное название

A Randomized, Open-Label, Active-Controlled, Multicenter Phase III Clinical Study to Evaluate Injection TQB2102 Versus Investigator's Choice of Treatment Regimens in Patients With HER2 IHC3+ Advanced Colorectal Cancer Who Progressed After Treatment With Oxaliplatin, Irinotecan and Fluoropyrimidine-Based Drugs

Обзор

This is a Phase III, randomized, open-label, active-controlled, multicenter study designed to evaluate the efficacy and safety of Injection TQB2102 compared with investigator's choice of treatment in subjects with Human Epidermal Growth Factor Receptor 2 (HER2) ImmunoHistoChemistry score 3 (IHC3+) advanced colorectal cancer who have failed prior treatment with oxaliplatin, irinotecan, and fluoropyrimidine-based regimens. The primary endpoint of this study is progression-free survival (PFS) as assessed by an Independent Review Committee (IRC). The key secondary endpoint is overall survival (OS). Other secondary endpoints include investigator-assessed PFS, objective response rate (ORR), duration of response (DOR), disease control rate (DCR), time to response (TTR), safety, and quality of life scores. Approximately 142 subjects are planned to be enrolled. Eligible subjects will be randomly assigned in a 1:1 ratio to the experimental group or the control group.

Вмешательства

• Препарат TQB2102 Injection
  TQB2102 Injection is a next-generation HER2 Antibody-Drug Conjugate (ADC) drug.
• Препарат Trifluridine /Tipiracil (TAS-102) tablets / Fruquintinib / Regorafenib tablets
  TAS-102 Tablets: Antimetabolite antitumor drug; trifluridine inhibits DNA synthesis by incorporating into tumor cell DNA, while tipiracil increases trifluridine bioavailability by inhibiting its degradation. Fruquintinib Tablets: Oral small-molecule VEGFR inhibitor; blocks VEGFR 1/2/3 signaling to inhibit tumor angiogenesis, cutting off tumor nutrient and oxygen supply. Regorafenib Tablets: Multikinase inhibitor; targets VEGFR, PDGFR, Fibroblast Growth Factor Receptor (FGFR), and Raf kinases t

Первичные конечные точки

• Progression-Free Survival (PFS) assessed by IRC based on RECIST v1.1 [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]

Вторичные конечные точки (11)

• Overall Survival (OS) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Objective Response Rate (ORR) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Duration of Response (DOR) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Disease Control Rate (DCR) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Time to Response (TTR) (assessed by both IRC and investigators) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Investigator-assessed PFS [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 33 months]
• Survival rates at 3 months, 6 months, 9 months, and 12 months [Срок оценки: Baseline, 3, 6, 9, 12 months]
• Quality of life scores at 3 months, 6 months, 9 months, and 12 months [Срок оценки: Baseline, 3, 6, 9, 12 months]
• The occurrence of all adverse events (AEs), serious adverse events (SAEs) and treatment-related adverse events (TEAEs) [Срок оценки: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 50 months]
• Pharmacokinetic (PK)-Ctrough [Срок оценки: Within 1 hour prior to the start of infusion for Cycle 1, Cycle 4, Cycle 7, and Cycle 12 (each cycle is 21 days)]
• Immunogenicity of TQB2102: ADA incidence [Срок оценки: Within 1 hour prior to the start of infusion for Cycle 1, 4, 7, and 12, and 90 days after last infusion. (Each cycle is 21 days)]

Критерии участия

Критерии включения

• The subject voluntarily participates in this study, signs the informed consent form, and has good compliance.
• Aged 18 to 75 years old (calculated as of the date of signing the informed consent form).
• Subjects with histologically or cytologically confirmed advanced colorectal cancer.
• The subject has confirmed HER2 IHC3+ status in tumor tissue, as determined by the central laboratory designated by the sponsor.
• The subject must provide a sufficient quantity of qualified tumor specimens (fresh or archived samples collected within the past 3 years from primary or metastatic lesions) for central laboratory testing of HER2 status.
• Advanced colorectal cancer that has progressed on or been intolerant to at least 2 prior lines of standard therapy (defined as disease progression or intolerable toxicity during or within 3 months after the last standard therapy).
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
• Expected survival of greater than 12 weeks.
• Presence of at least one measurable lesion as confirmed by RECIST 1.1 criteria.
• Laboratory tests must meet criteria
• Women of childbearing potential must agree to use effective contraception during the study and for 6 months after the study ends, and have a negative serum or urine pregnancy test within 7 days prior to study entry. Men must agree to use effective contraception during the study and for 6 months after the study ends.

Критерии исключения

• A history of other malignant tumors within 3 years prior to the first dose, or concurrent malignant tumors at screening. Subjects are eligible for enrollment if they meet one of the following two conditions:

• Other malignant tumors treated with curative intent via a single surgical procedure, with disease-free survival (DFS) maintained for 5 consecutive years;
• A history of cured carcinoma in situ of the cervix, non-melanoma skin cancer, or superficial bladder tumors \[Ta (non-invasive tumor), Tis (carcinoma in situ), and T1 (tumor invading the basement membrane)\].
• Presence of diseases that affect intravenous injection or venous blood collection, or factors that impair oral drug administration (e.g., dysphagia, chronic diarrhea, intestinal obstruction, etc.).
• Failure of adverse reactions from prior treatments to resolve to ≤ Grade 1 per CTCAE v5.0, with the following exceptions: Grade 2 alopecia, Grade 2 peripheral neurotoxicity, Grade 2 anemia, non-clinically significant and asymptomatic laboratory abnormalities, type 1 diabetes mellitus and hypothyroidism stabilized with hormone replacement therapy, and other toxicities judged by the investigator to pose no safety risks.
• Receipt of major surgical treatment, significant traumatic injury within 4 weeks prior to the first dose; or planned major surgery during the study period (excluding surgeries specified in the protocol); or presence of unhealed wounds or fractures for a prolonged period.
• Clinically significant tumor bleeding or perforation within 1 month prior to the first dose; or any bleeding event ≥ Grade 3 per CTCAE v5.0; or subjects with bleeding or coagulation disorders receiving warfarin, aspirin, or other antiplatelet agents (excluding maintenance doses: aspirin ≤ 100 mg/day, clopidogrel ≤ 75 mg/day); or subjects with a history or signs of bleeding deemed ineligible by the investigator.
• A history of thrombotic or embolic events within 6 months prior to the first dose, such as cerebrovascular accident (including transient ischemic attack, cerebral hemorrhage, cerebral infarction), deep vein thrombosis (DVT) \[excluding subjects with isolated calf vein thrombosis ≤ 7 mm in diameter, ≤ 5 cm in length, not involving ≥ 2 veins, and assessed by the investigator as having no risk of thrombus progression\], and pulmonary embolism, etc.
• Presence of major cardiovascular diseases.
• A history of decompensated liver cirrhosis or hepatic encephalopathy.
• Subjects with active chronic hepatitis B or active chronic hepatitis C. Subjects positive for hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) antibody at screening must undergo additional testing for Hepatitis B Virus (HBV) DNA titer or HCV RNA quantification.
• Active syphilis infection requiring treatment.
• A history of (non-infectious) pneumonitis/interstitial lung disease requiring corticosteroid therapy; or current diagnosis of non-infectious pneumonitis/interstitial lung disease; or hospitalization for any active infection or receipt of therapeutic antibiotics within 4 weeks prior to the start of study treatment, including but not limited to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• Active or uncontrolled severe infection (≥ Grade 2 infection per CTCAE v5.0).
• A history of psychoactive substance abuse with inability to abstain, or presence of mental disorders.
• A history of immunodeficiency, including HIV positivity, other acquired or congenital immunodeficiency diseases, or a history of organ transplantation.
• Tumor-related symptoms and treatments.
• Known hypersensitivity or allergic reaction to any study drug or its excipients.
• Prior receipt of anti-HER2 antibody-drug conjugate (ADC) therapy.
• Receipt of any anticancer therapy (including chemotherapy, targeted therapy, immunotherapy, etc.) or any other investigational drug therapy within 4 weeks or 5 half-lives prior to the first dose of this study, whichever is shorter.
• Pregnant or lactating subjects.
• Vaccination with live-attenuated vaccines within 28 days prior to the start of study treatment, or inactivated vaccines within 7 days prior; or planned vaccination during the study period.
• Any other condition judged by the investigator to pose a serious risk to subject safety or interfere with the subject's completion of the study.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Китай · 48 центров

• Anhui Provincial Cancer Hospital — Хэфэй
• Anhui Provincial Cancer Hospital — Хэфэй
• Beijing Friendship Hospital, Capital Medical University — Пекин
• The First Affiliated Hospital of Chongqing Medical University — Чунцин
• Fujian Cancer Hospital — Фучжоу
• The First Affiliated Hospital of Xiamen University — Xiamen
• Gansu Provincial Cancer Hospital — Lanzhou
• The first affiliated hostpital of guangzhou medical university (national center for respir — Гуанчжоу
• … и ещё 40 центров

Идентификаторы

NCT: NCT07483684 · TQB2102-III-03

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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