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Brief Title: Comparing Combinations of Targeted Drugs for Advanced Non-Small Cell Lung Cancer That Has EGFR and MET Gene Changes (A Lung-MAP Treatment Trial)
Official Title: A Randomized Phase II Study of INC280 (Capmatinib) Plus Osimertinib With or Without Ramucirumab in Participants With EGFR-Mutant, MET-Amplified Stage IV or Recurrent Non-Small Cell Lung Cancer (Lung-MAP Sub-Study)
Study ID: NCT05642572
Brief Summary: This phase II Lung-MAP treatment trial test the combination of targeted drugs (capmatinib, osimertinib, and/or ramucirumab) in treating patients with non-small cell lung cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) and that has EGFR and MET gene changes. Capmatinib and osimertinib are in a class of medications called kinase inhibitors. They work by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells and may help shrink tumors. Ramucirumab is a monoclonal antibody that may prevent the growth of new blood vessels that tumors need to grow. Giving capmatinib, osimertinib, and/or ramucirumab and targeting abnormal gene changes in tumor cells may be effective in shrinking or stabilizing advanced non-small cell lung cancer.
Detailed Description: PRIMARY OBJECTIVE: I. To compare investigator-assessed progression-free survival (IA-PFS) between participants with EGFR mutated, MET amplified non-small cell lung cancer (NSCLC) randomized to INC280 (capmatinib) and osimertinib with or without ramucirumab. SECONDARY OBJECTIVES: I. To evaluate if the combination of INC280 (capmatinib), osimertinib and ramucirumab or INC280 (capmatinib) and osimertinib during the first cycle of treatment has an acceptable toxicity rate. II. To evaluate the frequency and severity of toxicities within the arms. III. To compare IA-PFS between the arms, in the subset of participants with centrally-confirmed MET amplification in tissue. IV. To compare IA-PFS between the arms, in the subset of participants with centrally-confirmed MET amplification based on circulating tumor deoxyribonucleic acid (ctDNA). V. To compare IA-PFS between the randomized arms in the subsets of participants with and without history of brain metastases. VI. To compare the objective response rate (ORR) (confirmed and unconfirmed, complete and partial) between the arms among participants with measurable disease at baseline. VII. To compare overall survival between the arms. VIII. To compare IA-PFS between the randomized arms in the subsets of patients who have received only 1 prior line of therapy and those who have received 2 or more prior lines of therapy. IX. To evaluate duration of response among responders within each arm. TRANSLATIONAL MEDICINE OBJECTIVES: I. To collect, process, and bank cell-free deoxyribonucleic acid (ctDNA) prior to treatment (Cycle 1 Day 1), Cycle 1 Day 15, Cycle 3 Day 1, and first progression for future development of a proposal to evaluate comprehensive next-generation sequencing of circulating tumor deoxyribonucleic acid (ctDNA). II. To establish a tissue/blood repository from participants with refractory non-small cell lung cancer (NSCLC). OUTLINE: Patients are randomized to 1 of 2 arms. ARM A: Patients receive capmatinib orally (PO), osimertinib PO, and ramucirumab intravenously (IV) on study. Patients also undergo computed tomography (CT) scan or magnetic resonance imaging (MRI) and collection of blood samples throughout the trial. ARM B: Patients receive capmatinib PO and osimertinib PO on study. Patients also undergo CT scan or MRI and collection of blood samples throughout the trial.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Cancer Center at Saint Joseph's, Phoenix, Arizona, United States
Mission Hope Medical Oncology - Arroyo Grande, Arroyo Grande, California, United States
Mercy Cancer Center �� Carmichael, Carmichael, California, United States
Mercy San Juan Medical Center, Carmichael, California, United States
Mercy Cancer Center - Elk Grove, Elk Grove, California, United States
Memorial Medical Center, Modesto, California, United States
Palo Alto Medical Foundation Health Care, Palo Alto, California, United States
Mercy Cancer Center - Rocklin, Rocklin, California, United States
Mercy Cancer Center - Sacramento, Sacramento, California, United States
Pacific Central Coast Health Center-San Luis Obispo, San Luis Obispo, California, United States
Mission Hope Medical Oncology - Santa Maria, Santa Maria, California, United States
Palo Alto Medical Foundation-Sunnyvale, Sunnyvale, California, United States
Woodland Memorial Hospital, Woodland, California, United States
Penrose-Saint Francis Healthcare, Colorado Springs, Colorado, United States
Rocky Mountain Cancer Centers-Penrose, Colorado Springs, Colorado, United States
Saint Francis Cancer Center, Colorado Springs, Colorado, United States
Porter Adventist Hospital, Denver, Colorado, United States
Mercy Medical Center, Durango, Colorado, United States
Southwest Oncology PC, Durango, Colorado, United States
Saint Anthony Hospital, Lakewood, Colorado, United States
Littleton Adventist Hospital, Littleton, Colorado, United States
Longmont United Hospital, Longmont, Colorado, United States
Parker Adventist Hospital, Parker, Colorado, United States
Saint Mary Corwin Medical Center, Pueblo, Colorado, United States
Northeast Georgia Medical Center-Gainesville, Gainesville, Georgia, United States
Illinois CancerCare-Bloomington, Bloomington, Illinois, United States
Illinois CancerCare-Canton, Canton, Illinois, United States
Illinois CancerCare-Carthage, Carthage, Illinois, United States
Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois, United States
Decatur Memorial Hospital, Decatur, Illinois, United States
Illinois CancerCare-Dixon, Dixon, Illinois, United States
Crossroads Cancer Center, Effingham, Illinois, United States
Illinois CancerCare-Eureka, Eureka, Illinois, United States
Illinois CancerCare-Galesburg, Galesburg, Illinois, United States
Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois, United States
Illinois CancerCare-Macomb, Macomb, Illinois, United States
Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois, United States
Illinois CancerCare-Pekin, Pekin, Illinois, United States
Illinois CancerCare-Peoria, Peoria, Illinois, United States
Illinois CancerCare-Peru, Peru, Illinois, United States
Illinois CancerCare-Princeton, Princeton, Illinois, United States
Southern Illinois University School of Medicine, Springfield, Illinois, United States
Illinois CancerCare - Washington, Washington, Illinois, United States
Alegent Health Mercy Hospital, Council Bluffs, Iowa, United States
Flaget Memorial Hospital, Bardstown, Kentucky, United States
Commonwealth Cancer Center-Corbin, Corbin, Kentucky, United States
Saint Joseph Hospital, Lexington, Kentucky, United States
Saint Joseph Radiation Oncology Resource Center, Lexington, Kentucky, United States
Saint Joseph Hospital East, Lexington, Kentucky, United States
Saint Joseph London, London, Kentucky, United States
Saint Joseph Mount Sterling, Mount Sterling, Kentucky, United States
Lafayette Family Cancer Center-EMMC, Brewer, Maine, United States
Saint Francis Medical Center, Cape Girardeau, Missouri, United States
CHI Health Good Samaritan, Kearney, Nebraska, United States
Saint Elizabeth Regional Medical Center, Lincoln, Nebraska, United States
Alegent Health Immanuel Medical Center, Omaha, Nebraska, United States
Alegent Health Bergan Mercy Medical Center, Omaha, Nebraska, United States
Alegent Health Lakeside Hospital, Omaha, Nebraska, United States
Creighton University Medical Center, Omaha, Nebraska, United States
Midlands Community Hospital, Papillion, Nebraska, United States
Virtua Samson Cancer Center, Moorestown, New Jersey, United States
Virtua Voorhees, Voorhees, New Jersey, United States
Good Samaritan Hospital - Cincinnati, Cincinnati, Ohio, United States
Bethesda North Hospital, Cincinnati, Ohio, United States
TriHealth Cancer Institute-Westside, Cincinnati, Ohio, United States
TriHealth Cancer Institute-Anderson, Cincinnati, Ohio, United States
ProMedica Flower Hospital, Sylvania, Ohio, United States
Langlade Hospital and Cancer Center, Antigo, Wisconsin, United States
Aspirus Medford Hospital, Medford, Wisconsin, United States
Ascension Saint Mary's Hospital, Rhinelander, Wisconsin, United States
Ascension Saint Michael's Hospital, Stevens Point, Wisconsin, United States
Aspirus Regional Cancer Center, Wausau, Wisconsin, United States
Aspirus Cancer Care - Wisconsin Rapids, Wisconsin Rapids, Wisconsin, United States
Name: Sarah B Goldberg
Affiliation: SWOG Cancer Research Network
Role: PRINCIPAL_INVESTIGATOR