Non Small Cell Lung CancerPhase 1/2REZILIENT1NCT04036682
A Phase 1/2 Trial of CLN-081 in Patients With Non-Small Cell Lung Cancer
A Phase 1/2 study testing CLN-081 in people with Non Small Cell Lung Cancer and EGFR Exon 20 Mutation, run by Cullinan Therapeutics Inc. at 64 sites in 9 countries.
Trial summary
CLN-081-001 is a Phase 1/2, open label, multi-center study of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring EGFR (epidermal growth factor receptor) exon 20 insertion mutations, to characterize the safety, determine the recommended Phase 2 dose (RP2D), and evaluate efficacy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non Small Cell Lung Cancer, EGFR Exon 20 Mutation
- What is being tested?
- CLN-081
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 284 participants
- Where
- 64 sitesin 9 countries
- Study dates
- 31 Oct 2019to 31 Mar 2028
- Phase
- Phase 1/2
- Are there results?
- Not yet: the study is under way
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 confirmed locally advanced or metastatic NSCLC (all patients).
- Documented EGFR ex20ins mutation demonstrated by a validated test listed in Section 9.7 and performed in a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalent laboratory (all patients other than Module A Food Effect PK Assessment Module). Institutions that don't have access to these tests should contact the sponsor for assistance.
- Prior treatment in the recurrent/metastatic disease setting including:
- A platinum-based chemotherapy regiment (or other chemotherapy regimen if platinum-based chemotherapy is contra-indicated)
- Any other approved standard therapy that is available to the patient, unless this therapy is contraindicated, intolerable to the patient, or is declined by the patient. In the case of a patient declining such therapy, documentation that the patient has been informed and declined should be documented in the medical record.
- No prior therapy is required for patients enrolled on Module A.
Show all 21Show fewer
- Prior therapy with an agent approved by the local regulatory authorities for the treatment of EGFR ex20ins mutant NSCLC (Module C only).
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) (except for patients enrolled on Module A).
- Age ≥ 18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
- Ability to take pills by mouth.
- Have the following laboratory values:
- Serum creatinine < 1.5 × upper limit of normal (ULN) or calculated creatinine clearance (CrCl) must be ≥ 50 mL/min/1.73 m2 (if calculated by Cockroft-Gault formula, the actual body weight must be used for CrCl unless body mass index [BMI] >30 kg/m2 then lean body weight must be used).
- Total bilirubin ≤ 1.5 × ULN unless prior history of Gilbert's syndrome.
- AST and ALT ≤ 2.5 × ULN, or ≤ 5 × ULN if due to liver involvement by tumor.
- Hemoglobin ≥ 9.0 g/dL in the absence of transfusion ≤ 14 days prior to the first dose of study drug on C1D1.
- Platelets ≥ 100 × 109 cells/L in the absence of transfusion <14 days prior to the first dose of study drug on Cycle 1 Day 1 (C1D1).
- Absolute neutrophil count ≥ 1.5 ×109 cells/L.
- For Module A patients only: patients must have a negative coronavirus disease 2019 (COVID-19) polymerase chain reaction test prior to enrolment.
- For Module B and Module C patients only: verification of suitable archived tumor tissue available at the participating center for biomarker analysis. A fresh biopsy is required if an archived sample is not available.
- Ability to understand and the willingness to sign a written informed consent document.
Who cannot join
- R6, Phase 1 Expansion, Phase 2a, Module A and Module B Patients Only
- Prior treatment with an EGFR ex20ins -targeting drug (eg, including, but not limited to poziotinib, mobocertinib, amivantamab, DZD9008, BDTX-189).
- Note: enrolment of patients treated previously with EGFR ex20ins-targeting drugs allowed selectively during accelerated titration dose escalation and Module C only.
- Module A Food Effect PK Assessment Module patients only
- Conditions that compromise esophageal or gastrointestinal (GI) function, including esophageal, gastric, pancreatic, hepatobiliary, or small bowel carcinomas, or history of gastric resection.
- Recurrent diarrhea, nausea, or vomiting.
Show all 36Show fewer
- Unable to refrain from or anticipates the use of:
- Any drug, including prescription and non-prescription medications, including drugs that change gastrointestinal motility (eg, loperamide) or gastric pH (eg, antacids, H2 antagonists, proton pump inhibitors), herbal remedies, or vitamin supplements within 14 days prior to the first dosing on Day 1 to follow-up.
- Any drugs known to be inhibitors or inducers of CYP3A enzymes and/or P-glycoprotein (P-gp), including St. John's Wort and grape fruit juice, within 28 days prior to the first dosing and throughout the PK assessment.
- Any allergies to the composition of the high fat meal.
- Patients who use tobacco products.
- All Patients
- History of COVID-19-related pneumonitis requiring hospitalization.
- History of COVID-19 infection within 4 weeks prior to enrolment, or clinically significant pulmonary symptoms related to prior COVID-19 pneumonitis.
- Treatment with any of the following:
- An EGFR TKI ≤ 8 days or 5 × the terminal phase t1/2, whichever is longer, prior to the first dose of study drug on C1D1.
- Systemic anticancer treatment (excluding EGFR-TKIs as described above) within 14 days prior to the first dose of study drug on C1D1.
- Immunotherapy ≤ 28 days prior to the first dose of study drug on C1D1.
- Radiotherapy < 28 days and palliative radiation ≤ 14 days prior to the first dose of study drug on C1D1. If irradiated, lesions must have demonstrated clear-cut progression prior to being eligible for evaluation as target lesions.
- Major surgery (excluding placement of vascular access) ≤ 28 days of the first dose of study drug on C1D1.
- Have any unresolved toxicity of Grade ≥ 2 from previous anti-cancer treatment, except for alopecia and skin pigmentation. Patients with chronic but stable Grade 2 toxicities may be allowed to enroll after agreement between the Investigator and Sponsor.
- Have known or suspected leptomeningeal metastasis. Have known or suspected brain metastases or spinal cord compression, unless the condition has been asymptomatic, treated with surgery and/or radiation (if clinically indicated), and has been stable without requiring escalating corticosteroids or anti-convulsant medications for at least four weeks prior to the first dose of study drug on C1D1.
- Prior therapy with CLN-081.
- Known hypersensitivity to CLN-081 or any drugs similar in structure or class.
- Past medical history of interstitial lung disease, drug-induced interstitial lung disease, treatment-related pneumonitis, or any evidence of clinically active interstitial lung disease.
- Cardiac conditions as follows: Patient has a history of congestive heart failure (CHF) Class III/IV according to the New York Heart Association (NYHA) Functional Classification or serious cardiac arrhythmias requiring treatment.
- Resting QTcF > 470 msec.
- Patient is unable to take drugs po due to disorders or diseases that may affect GI function, including but not limited to inflammatory bowel diseases (eg, Crohn's disease, ulcerative colitis) or malabsorption syndrome, or procedures that may affect gastrointestinal function, such as gastrectomy, enterectomy, or colectomy.
- Have any condition or illness that, in the opinion of the Investigator, might compromise patient safety or interfere with the evaluation of the safety of the drug.
- Pregnant or lactating females; females of child-bearing potential (FOCBP) must have a negative serum pregnancy test at within seven days prior to receiving study drug on C1D1. FOCBP and males with partners of child-bearing potential must agree to use adequate birth control (Section 16.3) throughout their participation and for six months following the last dose of study treatment.
- History of another primary malignancy within 2 years prior to starting study drug on C1D1, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ.
- Uncontrolled intercurrent illness including, but not limited to, uncompensated respiratory, cardiac, hepatic, or renal disease, active infection (including human immunodeficiency virus (HIV) and active clinical tuberculosis), or renal transplant; ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, or psychiatric illness/social situations that would limit compliance with study requirements.
- For patients with a history of hepatitis B (HBV), negative PCR test is required. Patients with active hepatitis B (HBV) infection [as defined by a positive hepatitis B serum antigen (HBsAg) test and detectable HBV deoxyribonucleic acid (DNA)]. Patients ineligible due to detectable levels of HBV DNA at baseline may be rescreened for enrolment if their HBV DNA levels become undetectable after treatment with antiviral agents, and upon agreement between the Investigator and Sponsor.
- For patients with a history of hepatitis C, active infection as defined by a reactive hepatitis C virus (HCV) antibody test and detectable HCV ribonucleic acid (RNA).
- Active bleeding disorders.
- The patient is, in the Investigator's opinion, unable or unwilling to comply with the trial procedures.
Trial locations and contacts
64 sites in 9 countries.
64 sites in 9 countries
United States18 sites
Pacific Cancer Medical Center, Inc
Anaheim, California, 92801
University of Michigan Health System - University Hospital
Ann Arbor, Michigan, 48109
Massachusetts General Hospital
Boston, Massachusetts, 02114
Gabrail Cancer Center Research
Canton, Ohio, 44701
Medical University of South Carolina
Charleston, South Carolina, 29425
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Virginia Cancer Specialists
Fairfax, Virginia, 22031
Summit Medical Group PA
Florham Park, New Jersey, 07932
City of Hope at Irvine Lennar
Irvine, California, 92618
Pacific Shores Medical Group
Long Beach, California, 90813
Perlmutter Cancer Center at NYU Langone Hospital - Long Island
Mineola, New York, 11501
New York University Langone Health
New York, New York, 10016
Columbia University Irving Medical Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
AdventHealth
Orlando, Florida, 32804
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Providence Cancer Center
Portland, Oregon, 97213
Providence Oncology & Hematology Care Clinic-Westside
Portland, Oregon, 97225
Spain13 sites
University Hospital A Coruna
A Coruña
Hospital Clinic i Provincial de Barcelona
Barcelona
Hospital Parc Tauli
Barcelona
Hospital Universitario Vall d'Hebron
Barcelona
Institut Catala d'Oncologia l'Hospitalet
Barcelona
START Barcelona
Barcelona
Complejo Hospitalario Universitario Insular Materno Infantil
Las Palmas
Hospital General Universitario Gregorio Maranon (HGUGM)
Madrid
Hospital Universitario Puerta de Hierro de Majadahonda
Madrid
University Hospital Quironsalud Madrid
Madrid
Hospital Regional Universitario de Malaga
Málaga
Clinica Universidad de Navarra
Pamplona
Universitat de Valencia - Hospital Universitari i Politecnic La Fe de Valencia (Hospital La Fe Bulevar Sur)
Valencia
South Korea9 sites
National Cancer Center
Goyang-si
Seoul National University Bundang Hospital (SNUBH)
Gyeonggi-do
Gachon University Gil Medical Center
Incheon
Inha University Hospital
Incheon
Samsung Medical Center
Seoul
Asan Medical Center (AMC)
Soeul
Korea University Guro Hospital
Soeul
Ajou University Hospital
Suwon
The Catholic University Of Korea St. Vincent's Hospital
Suwon
Italy7 sites
Azienda Ospedaliero Universitaria Careggi
Careggi
Azienda Ospedaliero Universitaria Ospedali Riuniti Umberto I
Marche
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS
Meldola
IRCCS-Istituto Europeo di Oncologia
Milan
Azienda Ospedaliero Universitaria Modena
Modena
San Gerardo Hospital
Monza
Ospedale Santa Maria delle Croci
Ravenna
Japan7 sites
National Cancer Center Hospital East
Chiba
Niigata Cancer Center
Niigata
Osaka City General Hospital
Osaka
Osaka International Cancer Institute
Osaka
Shizuoka Cancer Center
Shizuoka
National Cancer Center Hospital
Tokyo
The Cancer Institute Hospital of Japanese Foundation for Cancer Research
Tokyo
Taiwan5 sites
Chang Gung Medical Foundation Chiayi Chang Gung Memorial Hospital
Chiayi City
Chung Shan Medical University Hospital
Taichung
Taichung Veterans General Hospital
Taichung
National Taiwan University Hospital
Taipei, 10002
Taipei Medical University Hospital
Taipei
Netherlands2 sites
The Netherlands Cancer Institute (NKI)
Amsterdam, 1066 CX
Leiden University Medical Center
Leiden, 2333 ZA
Singapore2 sites
Singapore Clinical Research Institute
Singapore, 138669
National Cancer Centre Singapore
Singapore, 169610
About this study
Official title: A Phase 1/2, Open-Label, Multi-Center Trial to Assess Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Efficacy of CLN-081 in Patients With Locally-Advanced or Metastatic Non-Small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations Who Have Previously Received Platinum-Based Systemic Chemotherapy
CLN-081-001 is a Phase 1/2, open label, multi-center study of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring EGFR (epidermal growth factor receptor) exon 20 insertion mutations, to characterize the safety, determine the recommended Phase 2 dose (RP2D), and evaluate efficacy.
Read the detailed description
This is a Phase 1/2, open-label, multicenter, first-in-human trial to evaluate the safety and tolerability, PK, PD, and efficacy of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) exon 20 insertion mutations.
This trial is divided into multiple parts: Phase 1 Dose Escalation, Phase 2a Dose Expansion, Module A, Module B, and Module C.
The objectives of the dose escalation and dose expansion parts are to determine the safety, tolerability, recommended Phase 2 dose (RP2D), and preliminary anti-tumor activity of orally administered CLN-081 monotherapy.
The objective of Module A is to preliminarily assess the effect of food on the PK profile of CLN-081.
The objective of Module B is to further characterize the safety and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior systemic anti-cancer treatment for locally advanced or metastatic disease.
The objective of Module C is to explore the safety, tolerability, and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior treatment with an agent approved for EGFR exon 20 insertion mutant NSCLC
CLN-081 will be dosed twice daily (BID).
- Conditions
- Non Small Cell Lung Cancer, EGFR Exon 20 Mutation
- Being tested
- CLN-081
- Keywords
- NSCLC, EGFR, Exon 20 insertions, CLN-081, TAS6417, zipalertinib
- 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.
CLN-081Drug
Also called TAS6417; zipalertinib
CLN-081 tablets
| Study group | Role | What they receive |
|---|---|---|
| Phase 1 Dose Escalation (Accelerated Titration) | Experimental | CLN-081 BID in single patient dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations that either have received or never received prior EGFR TKIs. Receives: Drug: CLN-081 |
| Phase 1 Dose Escalation (Rolling Six) | Experimental | CLN-081 BID in Rolling Six dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations. Receives: Drug: CLN-081 |
| Phase 2a Dose Expansion(s) | Experimental | CLN-081 BID in expansion cohorts that may be opened at doses that meet pre-specified efficacy and safety criteria. Receives: Drug: CLN-081 |
| Module A Food Affect | Experimental | Single-dose CLN-081 150 mg with and without high fat food intake. Receives: Drug: CLN-081 |
| Module B | Experimental | CLN-081 BID in NSCLC patients with EGFR exon 20 insertion mutations that have received prior systemic therapy for locally advanced or metastatic disease. Receives: Drug: CLN-081 |
| Module C | Experimental | CLN-081 BID to patients with EGFR exon 20 insertion mutant NSCLC after prior therapy with an agent approved for the treatment of ex20ins mutant NSCLC. Receives: Drug: CLN-081 |
What is being measured
The primary outcome is the main question the study is designed to answer.
All Cohorts: The rate and severity of treatment emergent AEs.
Measured: 24 months
All Cohorts: The rate and severity of DLTs.
Measured: 24 months
Phase 2 Dose Expansion Cohorts: Overall response rate (ORR)
Measured: 24 months
Module A: Pharmacokinetic (PK) parameter
Maximum Plasma Concentration [Cmax]
Measured: 24 months
Module A: Pharmacokinetic (PK) parameter
Area Under Curve [AUC]
Measured: 24 months
Module B and C: Confirmed overall response rate (ORR) and duration of response (DOR) by independent review committee (IRC)
Measured: 24 months
Secondary outcomes (9)
Phase 1 Dose Escalation and Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: ORR by Investigator assessment
Measured: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: DOR (duration of response).
Measured: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: DCR (disease control rate)
Measured: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: PFS (progression free survival)
Measured: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: OS (overall survival)
Measured: 24 months
All Cohorts: Assessment of maximum concentration (Cmax)
Measured: 24 months
All Cohorts: Assessment of area under curve (AUC)
Measured: 24 months
All Cohorts: Assessment of time to maximum concentration (tmax)
Measured: 24 months
All Cohorts: Assessment of terminal half-life (t1/2)
Measured: 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jul 2019
- Study start31 Oct 2019
- Primary completion13 Oct 2025
- Study completion31 Mar 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Non Small Cell Lung CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 284 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cullinan Therapeutics Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Taiho Oncology, Inc.
- Responsible party
- Sponsor
- Investigators
- Zosia Piotrowska, MD, Study chair, Massachusetts General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04036682
- Sponsor's protocol ID
- CLN-081-001
- Acronym
- REZILIENT1
- Status last verified
- Jun 2026
- First submitted
- 23 Jul 2019
- Last updated
- 17 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Piotrowska Z, Passaro A, Nguyen D, Ruiter G, Soo RA, Ho-Fun Lee V, Velcheti V, Tan DS, Lee SH, Kim SH, Wrangle J, Yang JC, Daga H, Juan Vidal OJ, Spira AI, Fernandez-Hinojal G, Kim SW, Umemura S, Provencio Pulla M, Keeton EK, Yang ZS, Li S, Xu ZC, Jones JA, Yu HA; REZILIENT1 Investigators. Zipalertinib in Patients With Epidermal Growth Factor Receptor Exon 20 Insertion-Positive Non-Small Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy With or Without Amivantamab. J Clin Oncol. 2025 Jul 20;43(21):2387-2397. doi: 10.1200/JCO-25-00763. Epub 2025 Jun 1.
PubMed 40450572Piotrowska Z, Tan DS, Smit EF, Spira AI, Soo RA, Nguyen D, Lee VH, Yang JC, Velcheti V, Wrangle JM, Socinski MA, Koczywas M, Janik JE, Jones J, Yu HA. Safety, Tolerability, and Antitumor Activity of Zipalertinib Among Patients With Non-Small-Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Exon 20 Insertions. J Clin Oncol. 2023 Sep 10;41(26):4218-4225. doi: 10.1200/JCO.23.00152. Epub 2023 Jun 29.
PubMed 37384848Ye L, Chen X, Zhou F. EGFR-mutant NSCLC: emerging novel drugs. Curr Opin Oncol. 2021 Jan;33(1):87-94. doi: 10.1097/CCO.0000000000000701.
PubMed 33122578
Study at a glance
From the registry record, last updated by the sponsor on 17 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1/2, Open-Label, Multi-Center Trial to Assess Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Efficacy of CLN-081 in Patients With Locally-Advanced or Metastatic Non-Small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations Who Have Previously Received Platinum-Based Systemic Chemotherapy
- ClinicalTrials.gov ID
- NCT04036682
- Acronym / sponsor ID
- REZILIENT1 / CLN-081-001
- Conditions
- Non Small Cell Lung Cancer, EGFR Exon 20 Mutation
- Keywords
- NSCLC, EGFR, Exon 20 insertions, CLN-081, TAS6417, zipalertinib
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 284 participants (estimated)
- Lead sponsor
- Cullinan Therapeutics Inc.Industry (pharma, biotech, devices)
- Collaborators
- Taiho Oncology, Inc.
- Study start
- 31 Oct 2019 (actual)
- Primary completion
- 13 Oct 2025 (actual)
- Study completion
- 31 Mar 2028 (estimated)
- First posted
- 30 Jul 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
CLN-081-001 is a Phase 1/2, open label, multi-center study of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring EGFR (epidermal growth factor receptor) exon 20 insertion mutations, to characterize the safety, determine the recommended Phase 2 dose (RP2D), and evaluate efficacy.
Detailed description
This is a Phase 1/2, open-label, multicenter, first-in-human trial to evaluate the safety and tolerability, PK, PD, and efficacy of CLN-081 in patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) exon 20 insertion mutations.
This trial is divided into multiple parts: Phase 1 Dose Escalation, Phase 2a Dose Expansion, Module A, Module B, and Module C.
The objectives of the dose escalation and dose expansion parts are to determine the safety, tolerability, recommended Phase 2 dose (RP2D), and preliminary anti-tumor activity of orally administered CLN-081 monotherapy.
The objective of Module A is to preliminarily assess the effect of food on the PK profile of CLN-081.
The objective of Module B is to further characterize the safety and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior systemic anti-cancer treatment for locally advanced or metastatic disease.
The objective of Module C is to explore the safety, tolerability, and efficacy of CLN-081 monotherapy in patients with EGFR exon 20 insertion mutation NSCLC who have received prior treatment with an agent approved for EGFR exon 20 insertion mutant NSCLC
CLN-081 will be dosed twice daily (BID).
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| Phase 1 Dose Escalation (Accelerated Titration) | Experimental | Drug: CLN-081CLN-081 BID in single patient dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations that either have received or never received prior EGFR TKIs. |
| Phase 1 Dose Escalation (Rolling Six) | Experimental | Drug: CLN-081CLN-081 BID in Rolling Six dose escalation cohorts enrolling NSCLC patients with EGFR exon 20 insertion mutations. |
| Phase 2a Dose Expansion(s) | Experimental | Drug: CLN-081CLN-081 BID in expansion cohorts that may be opened at doses that meet pre-specified efficacy and safety criteria. |
| Module A Food Affect | Experimental | Drug: CLN-081Single-dose CLN-081 150 mg with and without high fat food intake. |
| Module B | Experimental | Drug: CLN-081CLN-081 BID in NSCLC patients with EGFR exon 20 insertion mutations that have received prior systemic therapy for locally advanced or metastatic disease. |
| Module C | Experimental | Drug: CLN-081CLN-081 BID to patients with EGFR exon 20 insertion mutant NSCLC after prior therapy with an agent approved for the treatment of ex20ins mutant NSCLC. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (21 listed)
- Histologically or cytologically confirmed locally advanced or metastatic NSCLC (all patients).
- Documented EGFR ex20ins mutation demonstrated by a validated test listed in Section 9.7 and performed in a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalent laboratory (all patients other than Module A Food Effect PK Assessment Module). Institutions that don't have access to these tests should contact the sponsor for assistance.
- Prior treatment in the recurrent/metastatic disease setting including:
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) (except for patients enrolled on Module A).
- Age ≥ 18 years.
Key exclusion criteria (36 listed)
- R6, Phase 1 Expansion, Phase 2a, Module A and Module B Patients Only
- Prior treatment with an EGFR ex20ins -targeting drug (eg, including, but not limited to poziotinib, mobocertinib, amivantamab, DZD9008, BDTX-189).
- Note: enrolment of patients treated previously with EGFR ex20ins-targeting drugs allowed selectively during accelerated titration dose escalation and Module C only.
- Module A Food Effect PK Assessment Module patients only
- Conditions that compromise esophageal or gastrointestinal (GI) function, including esophageal, gastric, pancreatic, hepatobiliary, or small bowel carcinomas, or history of gastric resection.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CLN-081Also: TAS6417; zipalertinibCLN-081 tablets | Drug | Module A Food Affect, Module B, Module C, Phase 1 Dose Escalation (Accelerated Titration), Phase 1 Dose Escalation (Rolling Six), Phase 2a Dose Expansion(s) |
Primary outcome
All Cohorts: The rate and severity of treatment emergent AEs.
Time frame: 24 months
All Cohorts: The rate and severity of DLTs.
Time frame: 24 months
Phase 2 Dose Expansion Cohorts: Overall response rate (ORR)
Time frame: 24 months
Module A: Pharmacokinetic (PK) parameter
Time frame: 24 months
Maximum Plasma Concentration [Cmax]
Module A: Pharmacokinetic (PK) parameter
Time frame: 24 months
Area Under Curve [AUC]
Module B and C: Confirmed overall response rate (ORR) and duration of response (DOR) by independent review committee (IRC)
Time frame: 24 months
9 secondary outcomes
Phase 1 Dose Escalation and Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: ORR by Investigator assessment
Time frame: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: DOR (duration of response).
Time frame: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: DCR (disease control rate)
Time frame: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: PFS (progression free survival)
Time frame: 24 months
Phase 1 Dose Escalation and Dose Expansion, Phase 2a Dose Expansion, and Module B and C Cohorts: OS (overall survival)
Time frame: 24 months
All Cohorts: Assessment of maximum concentration (Cmax)
Time frame: 24 months
All Cohorts: Assessment of area under curve (AUC)
Time frame: 24 months
All Cohorts: Assessment of time to maximum concentration (tmax)
Time frame: 24 months
All Cohorts: Assessment of terminal half-life (t1/2)
Time frame: 24 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Jun 2026.
- Derived from this study: PubMed 40450572Piotrowska Z, Passaro A, Nguyen D, Ruiter G, Soo RA, Ho-Fun Lee V, Velcheti V, Tan DS, Lee SH, Kim SH, Wrangle J, Yang JC, Daga H, Juan Vidal OJ, Spira AI, Fernandez-Hinojal G, Kim SW, Umemura S, Provencio Pulla M, Keeton EK, Yang ZS, Li S, Xu ZC, Jones JA, Yu HA; REZILIENT1 Investigators. Zipalertinib in Patients With Epidermal Growth Factor Receptor Exon 20 Insertion-Positive Non-Small Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy With or Without Amivantamab. J Clin Oncol. 2025 Jul 20;43(21):2387-2397. doi: 10.1200/JCO-25-00763. Epub 2025 Jun 1.
- Derived from this study: PubMed 37384848Piotrowska Z, Tan DS, Smit EF, Spira AI, Soo RA, Nguyen D, Lee VH, Yang JC, Velcheti V, Wrangle JM, Socinski MA, Koczywas M, Janik JE, Jones J, Yu HA. Safety, Tolerability, and Antitumor Activity of Zipalertinib Among Patients With Non-Small-Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Exon 20 Insertions. J Clin Oncol. 2023 Sep 10;41(26):4218-4225. doi: 10.1200/JCO.23.00152. Epub 2023 Jun 29.
- Derived from this study: PubMed 33122578Ye L, Chen X, Zhou F. EGFR-mutant NSCLC: emerging novel drugs. Curr Opin Oncol. 2021 Jan;33(1):87-94. doi: 10.1097/CCO.0000000000000701.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Zosia Piotrowska, MD study chair
Massachusetts General Hospital
64 sites in 9 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing CLN-081 in people with Non Small Cell Lung Cancer and EGFR Exon 20 Mutation, run by Cullinan Therapeutics Inc. at 64 sites in 9 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 21 inclusion and 36 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: under way, not looking for participants, as of the sponsor's last update on 17 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 64 sites in United States, Spain, South Korea, Italy, Japan and 4 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
This study is still under way. Results are not available in the source record yet.
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?
All Cohorts: The rate and severity of treatment emergent AEs. (time frame: 24 months). The study lists 6 primary outcomes in all. 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 NCT04036682, which also lists 3 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 17 Jun 2026.