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Non-small Cell Lung CancerPhase 2ALERT-lungNCT03445000

ALEctinib for the Treatment of Pretreated RET-rearranged Advanced Non-small Cell Lung Cancer

A Phase 2 study testing Alectinib in people with Non-small Cell Lung Cancer and Non-small Cell Lung Cancer Metastatic, run by ETOP IBCSG Partners Foundation at 19 sites in 6 countries.

Terminated

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

Official record
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Trial summary

A research study to evaluate the activity of alectinib for the Treatment of pretreated patients with advanced NSCLC that have confirmed RETrearrangement. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Alectinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
14 participants
Where
19 sitesin 6 countries
Study dates
6 Nov 2018to 31 Mar 2021
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

  • Histologically or cytologically documented non-small cell lung carcinoma
  • Advanced disease defined as recurrent stage IV (according to 8th TNM classification) or recurrent or progressive disease following multimodal therapy (radiation therapy, surgical resection, or definitive chemo-radiation therapy for locally advanced disease)
  • At least one prior platinum-based systemic regimen: Adjuvant or neoadjuvant or definitive platinum-based chemo-radiotherapy treatments are considered as a line of treatment only if completed less than 6 months before enrolment. Maintenance therapy following platinum doublet-based chemotherapy is not considered a separate regimen of therapy.
  • RET rearrangement detected by FISH, Nanostring or by parallel-sequencing on FFPE tumour tissue assessed locally.
  • Availability of FFPE tumour material for central confirmation of RETrearrangement
  • Measurable or non-measurable, but radiologically evaluable (except for skin lesions) disease according to RECIST v1.1 criteria
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  • Age ≥18 years
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
  • Life expectancy >3 months
  • Adequate haematological function:
  • Haemoglobin ≥9 g/dL
  • Neutrophil count ≥1.5 ×109/L
  • Platelet count ≥100 × 109/L
  • WBC ≥2 ×109/L
  • Adequate renal function: Calculated creatinine clearance ≥45 mL/min (according to Cockcroft-Gault formula)
  • Adequate liver function:
  • Total bilirubin ≤2x ULN (except patients with Gilbert Syndrome, who can have total bilirubin ≤3.0 mg/dL)
  • ALT and AST ≤3x ULN (≤5x ULN for patients with concurrent liver ¨ metastasis)
  • Patient capable of proper therapeutic compliance, and accessible to correct followup.
  • Women of childbearing potential, including women who had their last menstrual period in the last 2 years, must have a negative serum or urine beta HCG pregnancy test within 7 days before enrolment into the trial and within 3 days before alectinib treatment start.
  • Sexually active men and women of childbearing potential must use an effective contraceptive method (intrauterine devices without hormones, bilateral tubal occlusion, vasectomized partner or total abstinence) during the trial treatment and for a period of at least 3 months following the last dose of alectinib.
  • Recovered from any previous therapy related toxicity to Grade ≤1 at date of enrolment (except for recovery to Grade ≤2 of alopecia, fatigue, creatinine increased, lack of appetite or peripheral neuropathy)
  • Written Informed Consent (IC) for trial treatment must be signed and dated by the patient and the investigator prior to any trial-related intervention.

Who cannot join

  • Untreated, active CNS metastases
  • Carcinomatous meningitis
  • Any previous (in the past 3 years) or concomitant malignancy EXCEPT adequately treated basal or squamous cell carcinoma of the skin, in situ carcinoma of the cervix or bladder, in situ ductal carcinoma of the breast
  • Any serious diseases or clinical conditions, including but not limited to uncontrolled active infection and any other serious underlying medical processes, that could affect the patient's capacity to participate in the trial
  • Liver disease characterized by:
  • ALT or AST >3 × ULN (>5 × ULN for patients with concurrent liver metastasis) confirmed on two consecutive measurements or
Show all 16Show fewer
  • Impaired excretory function (e.g., hyperbilirubinaemia) or synthetic function or other conditions of decompensated liver disease such as coagulopathy, hepatic encephalopathy, hypoalbuminaemia, ascites, and bleeding from oesophageal varices or
  • Acute viral or active autoimmune, alcoholic, or other types of acute hepatitis
  • Patients with baseline symptomatic bradycardia
  • Previous treatment with any RET TKI or RET targeted therapy.
  • Known EGFR, ALK, ROS, and BRAF mutation (in addition to RET rearrangement)
  • Any concurrent systemic anticancer therapy.
  • Any GI disorder that may affect absorption of oral medications, such as malabsorption syndrome or status post major bowel resection.
  • History of hypersensitivity to any of the additives in the alectinib drug formulation.
  • Known HIV positivity or AIDS-related illness.
  • Women who are pregnant or in the period of lactation.

Trial locations and contacts

19 sites in 6 countries.

19 sites in 6 countries

Spain8 sites
  • Hospital Teresa Herrara

    A Coruña

  • Hospital general de Alicante

    Alicante

  • Vall d'Hebron University Hospital

    Barcelona, 08035

  • Hospital Quirón Dexeus

    Barcelona

  • Hospital Sant Pau

    Barcelona

  • Hospital Puerta de Hierro

    Madrid

  • Hospital Universitario 12 de Octubre

    Madrid

  • Hospital Regional Universitario Carlos Haya

    Málaga

Other trials in Spain

Italy4 sites
  • IRCCS Instituto Tumori Giovanni Paolo II

    Bari

  • Instituto Europeo di Oncologia (IEO)

    Milan

  • University Hospital of Turin

    Turin

  • Universita di Verona

    Verona

Other trials in Italy

Switzerland3 sites
  • HFR Fribourg

    Fribourg

  • Hôpital Universitaire de Genève

    Geneva

  • UniversitatSpital Zurich

    Zurich

Other trials in Switzerland

Netherlands2 sites
  • The Netherlands Cancer Institute Amsterdam

    Amsterdam

  • University Medical Center Maastricht

    Maastricht

Other trials in Netherlands

Belgium1 site
  • Institut Jules Bordet

    Brussels

Other trials in Belgium

Ireland1 site
  • St. James Hospital

    Dublin

Other trials in Ireland

About this study

Official title: A Single Arm Phase II Trial Evaluating the Activity of Alectinib for the Treatment of Pretreated RET-rearranged Advanced NSCLC

A research study to evaluate the activity of alectinib for the Treatment of pretreated patients with advanced NSCLC that have confirmed RETrearrangement.

Read the detailed description

The trial is investigating the efficacy of alectinib in patients with advanced stage RET-rearranged NSCLC, treated with at least one platinum based systemic chemotherapy regimen. Preclinical studies have shown that alectinib, a highly selective next generation ALK inhibitor, has potent anti-tumour activity in RET-rearranged NSCLC. Therapeutically, several multiple kinases inhibitors, are potentially able to inhibit RET kinase function, which has been tested in several unselected NCSLC trials. However, those result were negative and none of the tested drugs was approved for lung cancer treatment.

The ALERT-lung trial is a single arm, phase II trial with the primary objective to assess the efficacy of alectinib in terms of best overall response (OR) assessed by RECIST v1.1 in selected NSCLC patients with RET rearrangement. The secondary objectives are to evaluate secondary measures of clinical efficacy including disease control, progression-free survival (PFS), and overall survival (OS) as well as to assess safety and tolerability of the treatment and to describe the association of primary and secondary outcomes with tumour characteristics.

Alectinib is administered orally, 600 mg, twice per day, until progression, refusal or unacceptable toxicity. Trial treatment may also continue beyond progression, with physician and patient agreement, for as long as the patient may still derive clinical benefit. A total sample size of 44 patients is required.

Being tested
Alectinib
Keywords
RET-rearrangement, advanced NSCLC
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

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

  • AlectinibDrug

    Also called Alecensa

    Alectinib is administered orally 600mg (4x150mg capsules), twice per day (8 capsules, total 1200mg daily). The appropriate number of alectinib capsules will be provided to patients to be self-administered at home.

    Alectinib capsules must be taken at the same time each day with food. If a planned dose of alectinib is missed, patients can take the missed dose up until 6 hours before the next dose.

Study groups in NCT03445000
Study groupRoleWhat they receive
Trial treatmentExperimentalAlectinib is administered orally, 600 mg, twice per day (1200 mg per day) until progression, refusal or unacceptable toxicity. Trial treatment may also continue beyond progression, with physician and patient agreement, for as long as the patient may still derive clinical benefit as per investigator decision.
Receives: Drug: Alectinib

What is being measured

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

  1. Best Overall Response (BOR)

    Best overall response (OR = CR or PR), per investigator assessment. OR was determined using the Response Evaluation Criteria in Solid Tumors (RECIST v1.1). OR is defined as the best overall response [Complete Response (disappearance of all target and non-target lesions, no new lesions) or Partial Response (at least a 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum of diameters, no measurable increase in a non-target lesion, no new lesions)] across all assessment points. Radiological tumour assessments were performed using CT scans.

    Measured: Evaluated from enrollment through study completion, up to a maximum of 28 months.

Secondary outcomes (4)
  1. Disease Control at 24-weeks

    Best overall response of CR or PR, or SD (or non-CR/non-PD in the case of non-measurable disease only) by RECIST v1.1 criteria. Complete Response (CR): disappearance of all target and non-target lesions and no new lesions detected; Partial Response (PR): at least 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum of diameters (no measurable increase in a non-target lesion and no new lesion detected); Stable disease (SD): at most 20% increase or at most 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum of diameters (no measurable increase in a non-target lesion and no new lesion detected). Radiological tumour assessments were performed using CT scans.

    Measured: From first documented response (CR, PR, SD, non-CR/non-PD) to 24 weeks or first documented progression or death from any cause, whichever came first, assessed every 8 weeks (±4 days).

  2. Progression-free Survival (PFS)

    Progression-free survival time was measured from the date of enrolment until documented progression or death from any cause, whichever came first. PFS is assessed according to RECIST 1.1 criteria. Progressive disease: at least a 20% increase in the sum of the longest diameter of target lesions taking as reference the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions.

    Measured: Evaluated from enrollment through study completion, up to a maximum of 28 months.

  3. Overall Survival (OS)

    Overall survival time is measured from the date of enrolment until death from any cause.

    Measured: Evaluated from enrollment through study completion, up to a maximum of 28 months.

  4. Number of Patients Experienced Adverse Events

    The safety and tolerability of alectinib treatment is assessed through analysis of the worst grade of toxicity/adverse events according to CTCAE v4.0 criteria observed over the whole treatment period.

    Measured: Evaluated from enrollment through study completion, up to a maximum of 28 months.

Timeline

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

  1. First posted26 Feb 2018
  2. Study start6 Nov 2018
  3. Primary completion31 Mar 2021
  4. Study completion31 Mar 2021

Why it stopped: Low recruitment rate

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
14 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03445000
Sponsor's protocol ID
ETOP 12-17
Other IDs
2017-002063-17, MO30176, 2017
Acronym
ALERT-lung
Status last verified
Mar 2025
First submitted
5 Jan 2018
Last updated
21 Jul 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Gainor JF, Shaw AT. Novel targets in non-small cell lung cancer: ROS1 and RET fusions. Oncologist. 2013;18(7):865-75. doi: 10.1634/theoncologist.2013-0095. Epub 2013 Jun 28.

    PubMed 23814043
  • Takeuchi K, Soda M, Togashi Y, Suzuki R, Sakata S, Hatano S, Asaka R, Hamanaka W, Ninomiya H, Uehara H, Lim Choi Y, Satoh Y, Okumura S, Nakagawa K, Mano H, Ishikawa Y. RET, ROS1 and ALK fusions in lung cancer. Nat Med. 2012 Feb 12;18(3):378-81. doi: 10.1038/nm.2658.

    PubMed 22327623
  • Lin JJ, Kennedy E, Sequist LV, Brastianos PK, Goodwin KE, Stevens S, Wanat AC, Stober LL, Digumarthy SR, Engelman JA, Shaw AT, Gainor JF. Clinical Activity of Alectinib in Advanced RET-Rearranged Non-Small Cell Lung Cancer. J Thorac Oncol. 2016 Nov;11(11):2027-2032. doi: 10.1016/j.jtho.2016.08.126. Epub 2016 Aug 17.

    PubMed 27544060
  • Gautschi O, Milia J, Filleron T, Wolf J, Carbone DP, Owen D, Camidge R, Narayanan V, Doebele RC, Besse B, Remon-Masip J, Janne PA, Awad MM, Peled N, Byoung CC, Karp DD, Van Den Heuvel M, Wakelee HA, Neal JW, Mok TSK, Yang JCH, Ou SI, Pall G, Froesch P, Zalcman G, Gandara DR, Riess JW, Velcheti V, Zeidler K, Diebold J, Fruh M, Michels S, Monnet I, Popat S, Rosell R, Karachaliou N, Rothschild SI, Shih JY, Warth A, Muley T, Cabillic F, Mazieres J, Drilon A. Targeting RET in Patients With RET-Rearranged Lung Cancers: Results From the Global, Multicenter RET Registry. J Clin Oncol. 2017 May 1;35(13):1403-1410. doi: 10.1200/JCO.2016.70.9352. Epub 2017 Mar 13.

    PubMed 28447912
  • Kodama T, Tsukaguchi T, Satoh Y, Yoshida M, Watanabe Y, Kondoh O, Sakamoto H. Alectinib shows potent antitumor activity against RET-rearranged non-small cell lung cancer. Mol Cancer Ther. 2014 Dec;13(12):2910-8. doi: 10.1158/1535-7163.MCT-14-0274. Epub 2014 Oct 27.

    PubMed 25349307

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Alectinib in people with Non-small Cell Lung Cancer and Non-small Cell Lung Cancer Metastatic, run by ETOP IBCSG Partners Foundation at 19 sites in 6 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 23 inclusion and 16 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 21 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Spain, Italy, Switzerland, Netherlands, Belgium and 1 more country. 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 26 Mar 2025). 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?

Best Overall Response (BOR) (time frame: Evaluated from enrollment through study completion, up to a maximum of 28 months.). 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 NCT03445000, which also lists 5 linked publications.

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 21 Jul 2026.

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