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NSCLCPhase 2NCT03318939

Phase 2 Study of Poziotinib in Participants With NSCLC Having EGFR or HER2 Exon 20 Insertion Mutation

A Phase 2 study testing Poziotinib in people with NSCLC, run by Spectrum Pharmaceuticals, Inc at 63 sites in 8 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a Phase 2, open-label, multi-center study to evaluate the efficacy and the safety/tolerability of poziotinib in seven participant cohorts for up to 603 previously treated and treatment-naïve NSCLC participant. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
NSCLC
What is being tested?
Poziotinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
648 participants
Where
63 sitesin 8 countries
Study dates
11 Oct 2017to 3 Apr 2023
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participant must be willing and capable of giving written Informed Consent, adhering to dosing and visit schedules, and meeting all study requirements
  • Participant has histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer (NSCLC) that is not amenable to treatment with curative intent
  • Prior treatment status:
  • Cohorts 1 and 2: Participant has had at least one prior systemic treatment for locally advanced or metastatic NSCLC
  • Cohorts 3 and 4: Participant is treatment-naïve for locally advanced or metastatic NSCLC and eligible to receive first-line treatment with poziotinib as determined by the Investigator. Adjuvant/neo-adjuvant therapies (chemotherapy, radiotherapy, or investigational agents) are permissible as long as they end at least 15 days prior to study entry.
  • Cohort 5: Participants who meet the criteria for enrollment in Cohorts 1 to 4, but the enrollment in the respective cohort has been closed
Show all 15Show fewer
  • Cohort 6: Participant with EGFR mutation-positive NSCLC who progressed while on treatment with first-line osimertinib
  • Cohort 7: Participant has had at least one prior systemic treatment for locally advanced or metastatic NSCLC
  • Specific mutations:
  • Cohort 1 and 3: Documented EGFR exon 20 insertion mutation
  • Cohort 2 and 4: Documented HER2 exon 20 insertion mutation
  • Cohort 5: Documented EGFR or HER2 exon 20 insertion mutations
  • Cohort 6: Documented acquired EGFR mutation (tested after osimertinib progression)
  • Cohort 7: Documented EGFR or HER2 activating mutations
  • Participant has adequate organ function at Baseline

Who cannot join

  • Participant has had previous treatment with poziotinib or any other EGFR or HER2 exon 20 insertion mutation-selective tyrosine kinase inhibitor (TKI) prior to study participation. The currently approved TKIs (ie, erlotinib, gefitinib, afatinib, osimertinib) are not considered to be exon 20 insertion-selective and are permissible (Cohorts 1 and 2).
  • Participant is concurrently receiving chemotherapy, biologics, immunotherapy for cancer treatment; systemic anti-cancer treatment or investigational treatment should not be used within 2 weeks or 5 half lives, whichever is longer; local radiation therapy for bone pain may be allowed
  • Participant has had other malignancies within the past 3 years, except for stable non-melanoma skin cancer, fully-treated and stable, early-stage prostate cancer, or carcinoma in situ of the cervix or breast without need of treatment
  • Participant is pregnant or breast-feeding

Trial locations and contacts

63 sites in 8 countries.

63 sites in 8 countries

United States43 sites
  • Oncology Physician's Network Inc./OPN Healthcare

    Arcadia, California, 91007

  • University Cancer & Blood Center, LLC

    Athens, Georgia, 30607

  • Texas Oncology- Austin

    Austin, Texas, 78745

  • Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

    Baltimore, Maryland, 21287

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Rocky Mountain Cancer Center

    Boulder, Colorado, 80303

  • Roswell Park Cancer Institute

    Buffalo, New York, 14263

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • The Ohio State University

    Columbus, Ohio, 43210

  • Karmanos Cancer Institute

    Detroit, Michigan, 48201

  • City of Hope

    Duarte, California, 91010

  • Duke University Medical Center

    Durham, North Carolina, 27710

  • Virginia Cancer Specialists, PC

    Fairfax, Virginia, 22031

  • Hattiesburg Clinic Hematology/Oncology

    Hattiesburg, Mississippi, 39401

  • MD Anderson Cancer Center

    Houston, Texas, 77030

  • UCSD -Moores Cancer Center

    La Jolla, California, 92093

  • Pacific Shores Medical Group

    Long Beach, California, 90813

  • Los Angeles Hematology Oncology Medical Group

    Los Angeles, California, 90017

  • USC/Norris Comprehensive Cancer Center

    Los Angeles, California, 90033

  • Baptist Cancer Center

    Memphis, Tennessee, 38120

  • Minnesota Oncology Hematology, P.A.

    Minneapolis, Minnesota, 55404

  • Yale University, Yale Cancer Center Smilow Cancer Hospital at Yale

    New Haven, Connecticut, 06510

  • NYU Langone Medical Center

    New York, New York, 10016

  • Weill Cornell Medical College

    New York, New York, 10065

  • CTCA - Southeastern Regional Medical Center

    Newnan, Georgia, 30265

  • Florida Hospital

    Orlando, Florida, 32804

  • CTCA - Eastern Regional Medical Center

    Philadelphia, Pennsylvania, 19124

  • Mayo Clinic Hospital

    Phoenix, Arizona, 85054

  • North Shore Hematology Oncology Associates P.C. DBA NY Cancer and Blood Specialists

    Port Jefferson Station, New York, 11776

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • UC Davis Comprehensive Cancer Center

    Sacramento, California, 95817

  • UCSF Helen Diller Comprehensive Cancer Center at Mt Zion

    San Francisco, California, 94115

  • UCLA Hematology/Oncology

    Santa Monica, California, 90404

  • Seattle Cancer Care Alliance

    Seattle, Washington, 98109

  • H. Lee Moffitt Cancer Center & Research Institute

    Tampa, Florida, 33612

  • Montefiore Einstein Medical Center for Cancer Care

    The Bronx, New York, 10461

  • North Shore Hematology Oncology Associates DBA New York Cancer and Blood Specialists

    The Bronx, New York, 10469

  • The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

    Torrance, California, 90502

  • Oklahoma Cancer Specialists and Research Institute, LLC

    Tulsa, Oklahoma, 74146

  • Kaiser Permanente Medical Center

    Vallejo, California, 94589

  • Georgetown University Medical Center

    Washington D.C., District of Columbia, 20007

  • The Bond & Steele Clinic, P.A. dba Bond Clinic, P.A.

    Winter Haven, Florida, 33881

  • CTCA - Midwestern Regional Medical Center

    Zion, Illinois, 60099

Other trials in United States

Belgium4 sites
  • Saint Luc University Hospital

    Brussels

  • University Hospitals Leuven

    Leuven

  • Ambroise Pare University Hospital Center

    Mons

  • General Hospital Delta

    Roeselare

Other trials in Belgium

Canada4 sites
  • Cross Cancer Institute

    Edmonton, Alberta, T6G 1Z2

  • London Regional Cancer Program

    London, Ontario, N6A 5W9

  • Princess Margaret Cancer Centre

    Toronto, Ontario, M5G 2M9

  • BC Cancer - Vancouver

    Vancouver, British Columbia, V5Z 4E6

Other trials in Canada

Israel4 sites
  • Soroka Medical Center

    Beersheba

  • Rambam Healthcare Campus

    Haifa

  • Hadassah Medical Center

    Jerusalem

  • Rabin Medical Center

    Petah Tikva

Other trials in Israel

Italy3 sites
  • National Cancer Institute, IRCCS, Department of Medical Oncology

    Milan

  • Santa Maria delle Croci Hospital

    Ravenna

  • National Cancer Institute Regina Elena, IRCCS, Operative Unit of Medical Oncology A 1

    Rome

Other trials in Italy

France2 sites
  • Hopital Larrey, CHU Toulouse, Unité d'Oncologie des Voies Respiratoires

    Toulouse

  • Gustave Roussy Oncology Institute, Department of Medical Oncology

    Villejuif

Other trials in France

Spain2 sites
  • University Hospital Germans Trias i Pujol, Department of Medical Oncology

    Barcelona

  • University Hospital 12 de Octubre

    Madrid

Other trials in Spain

Netherlands1 site
  • Erasmus Medical Center

    Rotterdam

Other trials in Netherlands

About this study

Official title: A Phase 2 Study of Poziotinib in Patients With Non-Small Cell Lung Cancer (NSCLC), Locally Advanced or Metastatic, With EGFR or HER2 Exon 20 Insertion Mutation (ZENITH20)

This is a Phase 2, open-label, multi-center study to evaluate the efficacy and the safety/tolerability of poziotinib in seven participant cohorts for up to 603 previously treated and treatment-naïve NSCLC participant. Cohorts 3 and 4 were added with Amendment 1 and three additional cohorts were added with Amendment 2 (Cohorts 5, 6 and 7).

Read the detailed description

The Screening period (Day -30 to Day -1) lasts up to approximately 30 days prior to Cycle 1, Day 1. Participant must meet all Inclusion/Exclusion Criteria to participate in the study. Eligible participants will provide written Informed Consent prior to undergoing any study procedures.

Each treatment cycle is 28 calendar days in duration. There will be seven participant cohorts and eligible participants will be enrolled into each cohort in parallel based on epidermal growth factor receptor (EGFR) or human epidermal growth factor receptor 2 (HER2) exon 20 mutation status and prior treatment status:

  • Cohort 1: Previously treated participant with EGFR exon 20 insertion mutation positive NSCLC (complete)
  • Cohort 2: Previously treated participant with HER2 exon 20 insertion mutation positive NSCLC (complete)
  • Cohort 3: Treatment naïve participant with EGFR exon 20 insertion mutation positive NSCLC (complete)
  • Cohort 4: Treatment naïve participant with HER2 exon 20 insertion mutation positive NSCLC (fully enrolled)
  • Cohort 5: Participants who meet the criteria for enrollment in Cohort 1 to 4, but the enrollment in the respective cohort has been closed (closed to enrollment)
  • Cohort 6: Participants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib (closed to enrollment)
  • Cohort 7: Participants with EGFR or HER2 activating mutations (closed to enrollment)

Toxicity will be assessed based on the grade of the adverse events using CTCAE version 4.03.

On Day 1 of each 28-day cycle, the participant's absolute neutrophil count (ANC) must be ≥1.5×10^9/L and platelet count must be ≥100×10^9/L before administering poziotinib. All participants will be treated until disease progression (except for first progression in Cohort 5), death, intolerable adverse events (AEs), or other protocol-specified reasons for participant withdrawal.

Conditions
NSCLC
Being tested
Poziotinib
Keywords
EGFR, HER2, Exon 20 insertion mutation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PoziotinibDrug

    The poziotinib drug substance is a hydrochloride salt of poziotinib and is formulated as a tablet for oral administration.

Study groups in NCT03318939
Study groupRoleWhat they receive
Cohort 1: Poziotinib 16 mgExperimentalParticipants previously treated for epidermal growth factor receptor (EGFR) exon 20 insertion mutation-positive non-small cell lung cancer (NSCLC) received poziotinib, 16 milligrams (mg), orally, once daily (QD) in each 28-day cycle until disease progression, death, intolerable adverse events (AEs), or for up to a maximum of 35 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 2: Poziotinib 16 mgExperimentalParticipants previously treated for human epidermal growth factor receptor 2 (HER2) exon 20 insertion mutation-positive NSCLC received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 32 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 3: Poziotinib 16 mgExperimentalTreatment naïve participants with EGFR exon 20 insertion mutation-positive NSCLC received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 24 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 4: Poziotinib 8 mgExperimentalTreatment naïve participants with HER2 exon 20 insertion mutation-positive NSCLC received poziotinib, 8 mg, orally, twice daily (BID) in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 27 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 4: Poziotinib 16 mgExperimentalTreatment naïve participants with HER2 exon 20 insertion mutation-positive NSCLC received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 27 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 5: Poziotinib 6 mgExperimentalParticipants who met the criteria for enrollment in Cohort 1 to Cohort 4, but the enrollment in the respective cohort had been closed were enrolled in this cohort and received poziotinib, 6 mg, orally, BID in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 23 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 5: Poziotinib 8mgExperimentalParticipants who met the criteria for enrollment in Cohort 1 to Cohort 4, but the enrollment in the respective cohort had been closed were enrolled in this cohort and received poziotinib, 8 mg, orally, BID in each 28-day cycle until disease progression (except first progression), death, intolerable AEs, or for up to a maximum of 25 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 5: Poziotinib 10 mgExperimentalParticipants who met the criteria for enrollment in Cohort 1 to Cohort 4, but the enrollment in the respective cohort had been closed were enrolled in this cohort and received poziotinib, 10 mg, orally, QD in each 28-day cycle until disease progression (except first progression), death, intolerable AEs, or for up to a maximum of 15 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 5: Poziotinib 12 mgExperimentalParticipants who met the criteria for enrollment in Cohort 1 to Cohort 4, but the enrollment in the respective cohort had been closed were enrolled in this cohort and received poziotinib, 12 mg, orally, QD in each 28-day cycle until disease progression (except first progression), death, intolerable AEs, or for up to a maximum of 26 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 5: Poziotinib 16 mgExperimentalParticipants who met the criteria for enrollment in Cohort 1 to Cohort 4, but the enrollment in the respective cohort had been closed were enrolled in this cohort and received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression (except first progression), death, intolerable AEs, or for up to a maximum of 18 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 6: Poziotinib 8 mgExperimentalParticipants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib received poziotinib, 8 mg, orally, BID in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 29 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 6: Poziotinib 16 mgExperimentalParticipants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 7 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 7: Poziotinib 8 mgExperimentalParticipants with EGFR or HER2 activating mutations received poziotinib, 8 mg, orally, BID in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 20 months, whichever occurs first.
Receives: Drug: Poziotinib
Cohort 7: Poziotinib 16 mgExperimentalParticipants with EGFR or HER2 activating mutations received poziotinib, 16 mg, orally, QD in each 28-day cycle until disease progression, death, intolerable AEs, or for up to a maximum of 4 months, whichever occurs first.
Receives: Drug: Poziotinib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Objective Response Rate (ORR)

    ORR was defined as the percentage of participants whose best overall response (BOR) was confirmed to be complete response (CR) or partial response (PR) from the first dose of poziotinib until the last tumor assessment on study. ORR was assessed by the Independent Radiologic Review Committee according to Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1). CR was defined as the disappearance of all non-nodal target lesions. Any pathological lymph nodes must have become normal (i.e., decrease in the short axis to less than (<) 10 millimeters (mm). PR was defined as at least a 30 percent (%) decrease in the sum of diameters (SOD) of all target lesions, taking as reference the baseline SOD. Additionally, progression of target lesions must not have been present.

    Measured: Up to 3 years

Secondary outcomes (3)
  1. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. TEAEs were defined as AEs that occur from the first dose of study treatment until 35 (±5) days after the last dose of study treatment.

    Measured: Up to 5 years

  2. Disease Control Rate (DCR)

    DCR was defined as percentage of participants with best response of CR, PR, or stable disease (SD) from the first dose of poziotinib to the last tumor assessment on study. CR was defined as the disappearance of all non-nodal target lesion. Any pathological lymph nodes must have become normal (i.e., decrease in the short axis to <10 millimeters (mm). PR was defined as at least a 30% decrease in the SOD of all target lesions, taking as reference the baseline SOD. Additionally, progression of target lesions must not have been present. SD was defined as neither sufficient shrinkage of target lesions to qualify for PR nor sufficient increase to qualify for progressive disease (PD).

    Measured: Up to 3 years

  3. Duration of Response (DoR)

    DoR was evaluated only for participants who had CR or PR and was defined as the time from the date that response evaluation criteria were first met for CR or PR (whichever status was recorded first) until the first subsequent date that PD or death was documented. CR was defined as the disappearance of all non-nodal target lesion. Any pathological lymph nodes must have become normal (i.e., decrease in the short axis to <10 millimeters (mm). PR was defined as at least a 30% decrease in the SOD of all target lesions, taking as reference the baseline SOD. Additionally, progression of target lesions must not have been present. Disease progression was defined as greater than or equal to (≥) 20% increase in the SOD of target lesions taking as reference the nadir SOD (or the baseline, if the baseline is the nadir value). In addition to the relative increase of 20% in SOD, the SOD must also have demonstrated an absolute increase of ≥ 5 mm.

    Measured: Up to 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Oct 2017
  2. Study start11 Oct 2017
  3. Primary completion3 Apr 2023
  4. Study completion3 Apr 2023

Why it stopped: Strategic business decision (unrelated to safety)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Each treatment cycle is 28 calendar days in duration. There will be seven participant cohorts and eligible participants will be enrolled into each cohort in parallel based on EGFR or HER2 exon 20 mutation status and prior treatment status: * Cohort 1: Previously treated participants with EGFR exon 20 insertion mutant positive NSCLC (closed to enrollment) * Cohort 2: Previously treated participants with HER2 exon 20 insertion mutant positive NSCLC (closed to enrollment) * Cohort 3: Treatment naïve participants with EGFR exon 20 insertion mutant positive NSCLC (fully enrolled) * Cohort 4: Treatment naïve participants with HER2 exon 20 insertion mutant positive NSCLC * Cohort 5: Participants who meet the criteria for enrollment in Cohort 1 to 4, but the enrollment in the respective cohort has been closed * Cohort 6: Participants with acquired EGFR mutation who progressed while on treatment with first-line osimertinib * Cohort 7: Participants with EGFR or HER2 activating mutations
Masking
None (open label)
Enrolment
648 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03318939
Sponsor's protocol ID
SPI-POZ-202
Status last verified
Jun 2026
First submitted
10 Oct 2017
Last updated
12 Jun 2026
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Le X, Cornelissen R, Garassino M, Clarke JM, Tchekmedyian N, Goldman JW, Leu SY, Bhat G, Lebel F, Heymach JV, Socinski MA. Poziotinib in Non-Small-Cell Lung Cancer Harboring HER2 Exon 20 Insertion Mutations After Prior Therapies: ZENITH20-2 Trial. J Clin Oncol. 2022 Mar 1;40(7):710-718. doi: 10.1200/JCO.21.01323. Epub 2021 Nov 29.

    PubMed 34843401

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Poziotinib in people with NSCLC, run by Spectrum Pharmaceuticals, Inc at 63 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 12 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 63 sites in United States, Belgium, Canada, Israel, Italy and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 Jun 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (ORR) (time frame: Up to 3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03318939, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jun 2026.

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