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Non-small Cell Lung Cancer (NSCLC)Phase 2NCT04139317

Safety and Efficacy of Capmatinib (INC280) Plus Pembrolizumab vs Pembrolizumab Alone in NSCLC With PD-L1≥ 50%

A Phase 2 study testing Capmatinib and Pembrolizumab in people with Non-small Cell Lung Cancer (NSCLC), run by Novartis Pharmaceuticals at 36 sites in 16 countries.

Terminated

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

Official record
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Trial summary

The purpose was to evaluate the efficacy and safety of the combination of capmatinib with pembrolizumab compared to pembrolizumab alone as first-line treatment for subjects with locally advanced or metastatic NSCLC who have PD-L1 expression ≥ 50% and have no EGFR mutation or ALK rearrangement. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-small Cell Lung Cancer (NSCLC)
What is being tested?
Capmatinib and Pembrolizumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
36 sitesin 16 countries
Study dates
22 Jan 2020to 7 Feb 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

  • Histologically confirmed and documented locally advanced stage III (not candidates for surgical resection or definitive chemo-radiation) or stage IV (metastatic) NSCLC (per AJCC/IASLC v.8) for treatment in the first-line setting
  • Histologically or cytologically confirmed diagnosis of NSCLC that is both EGFR wild type status and ALK- negative rearrangement statu
  • Have an archival tumor sample or newly obtained tumor biopsy with high PD-L1 expression (TPS ≥ 50%)
  • ECOG performance status score ≤ 1
  • Have at least 1 measurable lesion by RECIST 1.1
  • Have adequate organ function

Who cannot join

  • Prior treatment with a MET inhibitor or HGF-targeting therapy
  • Prior immunotherapy (e.g. anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways)
  • Have untreated symptomatic central nervous system (CNS) metastases
  • Clinically significant, uncontrolled heart diseases
  • Prior palliative radiotherapy for bone lesions ≤ 2 weeks prior to starting study treatment

Trial locations and contacts

36 sites in 16 countries.

36 sites in 16 countries

Spain5 sites
  • Novartis Investigative Site

    Badalona, Catalonia, 08916

  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    Barcelona, 08041

  • Novartis Investigative Site

    Madrid, 28040

  • Novartis Investigative Site

    Valencia, Valencia, 46010

Other trials in Spain

Australia3 sites
  • Novartis Investigative Site

    North Adelaide, South Australia, 5006

  • Novartis Investigative Site

    Shepparton, Victoria, 3630

  • Novartis Investigative Site

    Wollongong, New South Wales, 2500

Other trials in Australia

France3 sites
  • Novartis Investigative Site

    Lille, 59000

  • Novartis Investigative Site

    Strasbourg, 67091

  • Novartis Investigative Site

    Toulouse, 31400

Other trials in France

India3 sites
  • Novartis Investigative Site

    Delhi, 110 085

  • Novartis Investigative Site

    Kolkata, West Bengal, 700160

  • Novartis Investigative Site

    Mumbai, Maharashtra, 401107

Other trials in India

Netherlands3 sites
  • Novartis Investigative Site

    Amersfoort, 3813 TZ

  • Novartis Investigative Site

    Breda, 4819 EV

  • Novartis Investigative Site

    Zwolle, 8025 AB

Other trials in Netherlands

Thailand3 sites
  • Novartis Investigative Site

    Bangkok, 10330

  • Novartis Investigative Site

    Bangkok, 10400

  • Novartis Investigative Site

    Bangkok, 10700

Other trials in Thailand

Germany2 sites
  • Novartis Investigative Site

    Berlin, 14165

  • Novartis Investigative Site

    Cologne, 50937

Other trials in Germany

Greece2 sites
  • Novartis Investigative Site

    Athens, 11526

  • Novartis Investigative Site

    Thessaloniki, 57001

Other trials in Greece

Italy2 sites
  • Novartis Investigative Site

    Ancona, AN, 60126

  • Novartis Investigative Site

    Aviano, PN, 33081

Other trials in Italy

Japan2 sites
  • Novartis Investigative Site

    Nagoya, Aichi-ken, 466 8560

  • Novartis Investigative Site

    Yokohama, Kanagawa, 236 0051

Other trials in Japan

Malaysia2 sites
  • Novartis Investigative Site

    Kuala Lumpur, 59100

  • Novartis Investigative Site

    Kuching, Sarawak, 93586

Other trials in Malaysia

Taiwan2 sites
  • Novartis Investigative Site

    Changhua, 50006

  • Novartis Investigative Site

    Taichung, 40705

Other trials in Taiwan

Belgium1 site
  • Novartis Investigative Site

    Yvoir, 5530

Other trials in Belgium

Canada1 site
  • Novartis Investigative Site

    Québec, Quebec, GIV 4G5

Other trials in Canada

Czechia1 site
  • Novartis Investigative Site

    Ostrava Vitkovice, 703 84

Other trials in Czechia

Hong Kong1 site
  • Novartis Investigative Site

    Shatin New Territories, Hong Kong

Other trials in Hong Kong

About this study

Official title: A Randomized, Open Label, Multicenter Phase II Study Evaluating the Efficacy and Safety of Capmatinib (INC280) Plus Pembrolizumab Versus Pembrolizumab Alone as First Line Treatment for Locally Advanced or Metastatic Non-small Cell Lung Cancer With PD-L1≥ 50%

The purpose was to evaluate the efficacy and safety of the combination of capmatinib with pembrolizumab compared to pembrolizumab alone as first-line treatment for subjects with locally advanced or metastatic NSCLC who have PD-L1 expression ≥ 50% and have no EGFR mutation or ALK rearrangement. Capmatinib has demonstrated immunomodulatory activities when combined with an anti-PD1 antibody in preclinical tumor models irrespective of MET dysregulation. The combination of capmatinib with checkpoint inhibitors has been established to be tolerable and could provide additional clinical benefit to the subjects.

Read the detailed description

This was a randomized, open-label, multicenter, phase II study evaluating the efficacy and safety of capmatinib plus pembrolizumab in comparison to pembrolizumab alone as first line treatment for locally advanced or metastatic non-small cell lung cancer (NSCLC) with programmed cell death ligand-1 (PD-L1) expression ≥ 50%, mesenchymal epithelial transition (MET) unselected, epidermal growth factor receptor (EGFR) wild type and anaplastic lymphoma kinase (ALK) negative.

All eligible subjects were randomized to one of the treatment arms in a 2:1 (capmatinib plus pembrolizumab: pembrolizumab alone) ratio. Participants in both treatment arms were to receive up to 35 cycles (approximately 24 months) of study treatment. The study enrollment was halted on 21-Jan-2021 per sponsor's decision. The enrollment halt decision was based on lack of tolerability observed in the capmatinib plus pembrolizumab arm.

Immediately following the enrollment halt, the below procedural changes were performed:

  • Capmatinib treatment was discontinued in subjects on the combination arm. All ongoing subjects were allowed to continue receiving pembrolizumab single agent treatment as per investigator's discretion until unacceptable toxicity, or disease progression, or up to 35 cycles of treatment, whichever occurred first.
  • Termination of capmatinib pharmacokinetics (PK) sample collection.
  • Termination of pembrolizumab PK/immunogenicity (IG) sample collection. After the enrollment halt, the study protocol was amended (amendment 03) and the collection of efficacy data was stopped. As pembrolizumab is a registered and commercialized treatment for the study indication, the efficacy and safety assessments were to be performed as per each institution's standard of care and no longer captured in the electronic Case Report Form (eCRF) (except reporting of adverse events). Additionally, as single-agent pembrolizumab is a well-established standard treatment for the study indication, the requirement for post-treatment disease progression follow-up and survival follow-up were removed.
Being tested
Capmatinib, Pembrolizumab
Keywords
capmatinib, pembrolizumab, NSCLC, PD-L1, EGFR, ALK, MET,, squamous, non-squamous
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.

  • CapmatinibDrug

    Also called INC280

    INC280 tablets were administered orally at 400 mg on a continuous twice daily (BID) dosing schedule, from Day 1 until Day 21 of each 21-day cycle.

  • PembrolizumabBiological

    Also called Keytruda®, MK-3475

    Pembrolizumab was administered by intravenous infusion at 200 mg once every 3 weeks (Q3W).

Study groups in NCT04139317
Study groupRoleWhat they receive
Capmatinib 400mg BID + pembrolizumab 200mg Q3WExperimentalCapmatinib (INC280) 400 mg orally twice daily (BID) in combination with pembrolizumab 200 mg intravenously every 3 weeks (Q3W)
Receives: Drug: Capmatinib; Biological: Pembrolizumab
Pembrolizumab 200mg Q3WActive comparatorPembrolizumab 200 mg intravenously every 3 weeks (Q3W)
Receives: Biological: Pembrolizumab

What is being measured

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

  1. Progression-Free Survival (PFS) by Investigator Assessment as Per RECIST 1.1

    PFS is defined as the time from the date of randomization to the date of the first documented progression or death due to any cause. Tumor response was based on investigator assessment per Response Evaluation Criteria In Solid Tumors (RECIST) v1.1.

    If a patient did not have an event, PFS was censored at the date of the last adequate tumor assessment, the start of a subsequent anti-neoplastic therapy (if any) or the date of sponsor's decision to discontinue capmatinib (applicable only to subjects on the combination arm).

    Due to the discontinuation of one of the investigational drugs (capmatinib) in all subjects in the combination arm, PFS was censored on the 21-Jan-2021 or the last adequate tumor assessment prior to that date for the capmatinib plus pembrolizumab arm.

    PFS was analyzed using Kaplan-Meier estimates.

    Measured: Up to 1.3 years

Secondary outcomes (11)
  1. Overall Response Rate (ORR) by Investigator Assessment as Per RECIST 1.1

    Tumor response was based on local investigator assessment as RECIST v1.1. ORR per RECIST v1.1 is defined as the percentage of participants with a best overall response (BOR) of Complete Response (CR) or Partial Response (PR). For the capmatinib plus pembrolizumab arm, 21-Jan-2021 or any last adequate tumor assessment prior to that date was considered as the end of evaluation period for BOR.

    For RECIST v1.1, CR=Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR= At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters.

    Measured: Up to 1.3 years

  2. Disease Control Rate (DCR) by Investigator Assessment as Per RECIST 1.1

    Tumor response was based on local investigator assessment per RECIST v1.1. DCR is defined as the percentage of participants with a BOR of Complete Response (CR), Partial Response (PR), Stable Disease (SD), and non-CR/non-progressive disease (for subjects without target lesions). For the capmatinib plus pembrolizumab arm, 21-Jan-2021 or any last adequate tumor assessment prior to that date was considered as the end of evaluation period for BOR.

    For RECIST v1.1, CR=Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR= At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters; SD= Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for progression).

    Measured: Up to 1.3 years

  3. Time to Response (TTR) by Investigator Assessment as Per RECIST 1.1

    TTR is defined as the time from the date of randomization to the first documented response of either complete response or partial response, which must be subsequently confirmed (although initial date of response is used, not date of confirmation).

    TTR was analyzed using the Kaplan-Meier method as defined in the statistical analysis plan.

    Measured: Up to 1.3 years

  4. Duration of Response (DOR) by Investigator Assessment as Per RECIST 1.1

    DOR only applies to patients for whom best overall response is complete response (CR) or partial response (PR) based on local investigator assessment of overall lesion response according to RECIST v1.1. DOR is defined as the time from the date of first documented response (confirmed CR or confirmed PR) to the date of first documented disease progression or death due to any cause. If a patient not had an event, duration was censored at the date of last adequate tumor assessment before the start of a new anticancer therapy, if any.

    DOR was analyzed using the Kaplan-Meier method as defined in the statistical analysis plan.

    Measured: Up to 1.3 years

  5. Overall Survival (OS)

    OS is defined as the time from the date of randomization to the date of death due to any cause.

    The requirement for survival follow-up period was removed following the discontinuation of one of the investigational drugs (capmatinib) in all subjects in the combination arm and the implementation of Protocol Amendment 03.

    OS was analyzed using the Kaplan-Meier method as defined in the statistical analysis plan.

    Measured: Up to 2.1 years

  6. Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Number of participants with AEs (any AE regardless of seriousness) and SAEs, including changes from baseline in vital signs, electrocardiograms and laboratory results qualifying and reported as AEs.

    Measured: From first dose of study treatment to 30 days after last dose, up to 2.1 years

  7. Maximum Observed Plasma Concentration (Cmax) of Capmatinib

    Pharmacokinetic (PK) parameters were calculated based on capmatinib plasma concentrations by using non-compartmental methods. Cmax is defined as the maximum (peak) observed plasma concentration following a dose.

    Measured: pre-dose and 1, 2, 4 and 8 hours after morning dose on Cycle 2 Day 1. The duration of one cycle was 21 days.

  8. Time to Reach Maximum Plasma Concentration (Tmax) of Capmatinib

    PK parameters were calculated based on capmatinib plasma concentrations by using non-compartmental methods. Tmax is defined as the time to reach maximum (peak) plasma concentration following a dose. Actual recorded sampling times were considered for the calculations.

    Measured: pre-dose and 1, 2, 4 and 8 hours after morning dose on Cycle 2 Day 1. The duration of one cycle was 21 days.

  9. Area Under the Plasma Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUClast) of Capmatinib

    PK parameters were calculated based on capmatinib plasma concentrations by using non-compartmental methods. The linear trapezoidal method was used for AUClast calculation.

    Measured: pre-dose and 1, 2, 4 and 8 hours after morning dose on Cycle 2 Day 1. The duration of one cycle was 21 days.

  10. Trough Serum Concentration (Ctrough) of Pembrolizumab

    PK parameters were calculated based on pembrolizumab serum concentrations by using non-compartmental methods. Ctrough is defined as the concentration reached immediately before the next dose is administered. All drug concentrations below the lower limit of quantification were treated as zero for the calculation of PK parameters.

    Measured: pre-dose on Cycle 2 Day 1, Cycle 3 Day 1, Cycle 6 Day 1 and Cycle 12 Day 1. The duration of one cycle was 21 days.

  11. Number of Participants With Anti-pembrolizumab Antibodies

    Immunogenicity (IG) was evaluated in serum samples. The assay to quantify and assess the IG was a validated homogeneous enzyme-linked immunosorbent assay (ELISA).

    • ADA-negative at baseline: ADA-negative sample at baseline
    • ADA-positive at baseline: ADA-positive sample at baseline
    • ADA-negative post-baseline: patient with ADA-negative sample at baseline and at least 1 post baseline determinant sample, all of which are ADA-negative samples
    • ADA-positive post-baseline: patient with at least 1 ADA-positive sample post baseline

    Measured: Baseline (pre-dose), up to 8 months

Timeline

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

  1. First posted25 Oct 2019
  2. Study start22 Jan 2020
  3. Primary completion14 Jan 2022
  4. Study completion7 Feb 2023

Why it stopped: Sponsor decision to terminate due to the lack of tolerability observed in patients treated with capmatinib and pembrolizumab in the combination arm as compared to patients treated with pembrolizumab alone in the pembrolizumab single agent arm

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
Masking
None (open label)
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04139317
Sponsor's protocol ID
CINC280I12201
Other IDs
2019-002660-27, 2019
Status last verified
Oct 2024
First submitted
14 Oct 2019
Last updated
9 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Capmatinib and Pembrolizumab in people with Non-small Cell Lung Cancer (NSCLC), run by Novartis Pharmaceuticals at 36 sites in 16 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 6 inclusion and 5 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 9 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in Spain, Australia, France, India, Netherlands and 11 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 8 Feb 2024). 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?

Progression-Free Survival (PFS) by Investigator Assessment as Per RECIST 1.1 (time frame: Up to 1.3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Oct 2024.

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