RecruitingPhase 1

A Study of Gilteritinib in Adults With Advanced ALK-positive Non-small Cell Lung Cancer (NSCLC)

A Phase 1b Study of Gilteritinib in Participants With Locally Advanced or Metastatic NSCLC With ALK Rearrangement After Prior Treatment With an ALK Inhibitor

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years and older
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 4 years
  • Procedures mentioned: Pills

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "People in the study will take tablets of gilteritinib once a day in a 28-day cycle."
  • "People will be in the study for up to 4 years, depending on how they respond to gilteritinib."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests the safety of gilteritinib and how well adults can handle it. It is for adults with advanced non-small cell lung cancer that has a change in the ALK gene and has worsened after ALK-blocking treatment. Participants take gilteritinib tablets once a day.

Genes give your body instructions on how to make proteins. Proteins are needed to keep the body working properly. Many types of cancer are caused by changes in certain genes, making them faulty. Some people with non small cell lung cancer (NSCLC) have a faulty ALK gene. ALK stands for anaplastic lymphoma kinase. People with NSCLC who have the faulty ALK gene are called ALK-positive. ALK inhibitors are an approved treatment for people with ALK positive NSCLC. Some people stop responding to treatment with ALK inhibitors over time due to more changes happening in their faulty ALK gene, so there is an unmet medical need. Gilteritinib is an approved treatment for people with acute myeloid leukemia (AML) with the faulty FLT3 gene who haven't responded to previous treatment, or their cancer came back after previous treatment. Gilteritinib also blocks changes in the ALK gene which could help people with ALK-positive NSCLC. A study needs to be done with gilteritinib in people with ALK-positive NSCLC. The main aim of the study is to check the safety of gilteritinib in people with ALK-positive NSCLC and if they tolerate gilteritinib. People in this study will be adults with locally advanced or metastatic ALK-positive non-small cell lung cancer (NSCLC). Locally advanced means the cancer has spread to nearby tissue. Metastatic means the cancer has spread to other parts of the body. They have stopped responding to treatment with ALK inhibitors, including alectinib or lorlatinib, over time. The key reasons people cannot take part are if they have symptomatic cancers in the brain or nervous system, their cancer has spread to the thin tissue that covers the brain and spinal cord (leptomengingeal metastasis), have recently had or planning to have major surgery, have certain heart conditions, or have recently had an infection, a stroke or mini-stroke. People in the study will take tablets of gilteritinib once a day in a 28-day cycle. They may be given up to 2 different doses of gilteritinib. People in the study will start on the lower dose but can eventually switch to the higher dose if they tolerate the lower dose and meet the safety checks. Whilst taking gilteritinib, people will have regular scans of their tumors. People will continue taking gilteritinib until their cancer gets worse, they have medical problems from gilteritinib that they can't tolerate, they ask to stop taking gilteritinib, they start other cancer treatment or, sadly pass away. People will visit the clinic about 7 days and then 30 days after they stop taking gilteritinib. They will be asked about any medical problems and will have a safety check. After this, people who stopped taking gilteritinib, but their cancer hadn't become worse, will continue to have regular scans of their tumors. If their cancer does get worse, they will no longer have scans of their tumors. After finishing gilteritinib, people will be phoned every 12 weeks to check on their health. People will be in the study for up to 4 years, depending on how they respond to gilteritinib.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Have ALK-positive lung cancer that has spread nearby or to other parts of the body and cannot be treated with the goal of a cure.
  • Have cancer that grew or came back during or after the most recent treatment and can be measured on scans.
  • Have had lorlatinib, or have had alectinib as the only ALK-blocking drug and meet extra treatment rules.
  • Provide a new tumor sample after the last cancer treatment. If this is not medically possible, an older sample may be allowed with study approval.
  • Be able to care for yourself and be out of bed or a chair for at least half the day. Blood and other lab tests must meet study rules.
  • Not be pregnant. If you can become pregnant, have a negative pregnancy test and follow birth control rules through 180 days after treatment.
  • Follow rules for breastfeeding, birth control, and egg or sperm donation during and after treatment.
  • Agree not to join another study that gives a treatment while taking part.

Who can't join

  • Have another known gene change that drives the cancer, or certain other cancers within the past 2 years. Some cured or low-risk cancers are allowed.
  • Have cancer in the brain or spinal cord that causes symptoms, or cancer in the thin covering around the brain and spinal cord.
  • Have had major surgery within 4 weeks, have not fully recovered from surgery, or plan surgery during treatment.
  • Have lasting side effects from earlier cancer treatment, other than hair loss; have had cancer treatment within 14 days; or have had an experimental treatment too recently.
  • Have had fever or certain infections within 28 days, active hepatitis B or C with some exceptions, or HIV with AIDS-related problems.
  • Have certain heart or heart rhythm problems, weak heart pumping, or a stroke, mini-stroke, heart attack, or certain serious heart symptoms within 6 months.
  • Have a history of a type of lung inflammation called interstitial pneumonia, or need certain medicines that are not allowed in the study.
  • Have a known or suspected allergy to gilteritinib or its ingredients, or another condition that makes the study unsafe for you.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: * Participant has histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer (NSCLC) with a documented anaplastic lymphoma kinase (ALK) rearrangement and is not amenable to curative intent treatment. * Participant is willing to submit, prior to enrollment, a fresh tumor tissue sample that was collected after completion of the most recent anti-cancer treatment and before the first dose of study intervention. If it is not medically feasible for a participant to provide a fresh tumor tissue sample, enrollment into the study should be confirmed with the Astellas medical monitor. In this case, an archival tumor tissue sample must be provided. * Participant must have at least one prior line of ALK inhibitor-based therapy and meet one of the following criteria: * Participant received alectinib as the only prior ALK inhibitor regimen. Participant is ineligible or unable to tolerate approved and available second-line therapy or is determined to potentially benefit from gilteritinib in this setting. Participant is eligible if chemotherapy was received in the neoadjuvant or adjuvant setting, and relapse or disease progressed after 12 months from completion of the treatment. * Participant received lorlatinib as one of the prior ALK inhibitor regimens. * Participant has measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. * Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2. * Participant must have had progression or recurrence of NSCLC during or following receipt of the most recent therapy. * Female participant is not pregnant and at least 1 of the following conditions apply: * Not a woman of childbearing potential (WOCBP). * WOCBP who has a negative urine or serum pregnancy test within 7 days prior to the first dose of study intervention and agrees to follow the contraceptive guidance from the time of informed consent through at least 180 days after final study intervention administration. * Female participant must not be breastfeeding or lactating starting at screening and throughout the investigational period and for 60 days after final study intervention administration. * Female participant must not donate ova starting at the first administration of study intervention and throughout the investigational period and for 180 days after final study intervention administration. * Male participant must agree to use contraception with female partner(s) of childbearing potential (including breastfeeding partner) throughout the treatment period and for 120 days after final study intervention administration. * Male participant must agree to remain abstinent or use a condom with pregnant partner(s) for the duration of the pregnancy throughout the investigational period and for 120 days after final study intervention administration. * Male participant must not donate sperm during the treatment period and for 120 days after final study intervention administration. * Participant must meet the criteria as indicated on the clinical laboratory tests. * Participant agrees not to participate in another interventional study while receiving study intervention in the present study/participating in the present study. Exclusion Criteria: * Participant has known oncogenic driver alterations other than ALK rearrangement. * Participant has symptomatic central nervous system (CNS) metastases or leptomeningeal metastasis. * Participant has a history of malignancy other than NSCLC within 2 years before screening (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix or malignancy considered cured with minimal risk of recurrence). * Participant had major surgery (e.g., requiring general anesthesia) within 4 weeks prior to first dose of study intervention, or will not have fully recovered from surgery, or has surgery planned during the study treatment. * Participant has ongoing clinically significant toxicity (Grade 2 or higher with the exception of alopecia) associated with prior anti-cancer treatment. * Participant has/had febrile illness or symptomatic, viral, bacterial (including upper respiratory infection) or fungal (noncutaneous) infection within 28 days prior to first dose of study intervention. * Participant has a history of unexplained syncope, cardiac arrest, unexplained cardiac arrhythmias or torsades de pointes, structural heart disease or a family history of long QT syndrome. * Participant has a history of a cerebral vascular event (stroke or transient ischemic attack), unstable angina, myocardial infarction or cardiac symptoms (including congestive heart failure) consistent with New York Heart Association Class III-IV within 6 months prior to the first dose of study intervention. * Participant has a history of interstitial pneumonia. * Participant had completed target therapy, radiotherapy, chemotherapy, biologics and/or immunotherapy within 14 days prior to first dose of study intervention. * Participant requires treatment with strong inducers of cytochrome P450 (CYP) 3A. * Participant requires treatment with concomitant drugs that target serotonin 5HT1 or 5HT2B receptors or sigma nonspecific receptor with the exception of drugs that are considered absolutely essential for the care of the participant. * Participant has received any investigational therapy within 14 days or 5 half-lives, whichever is longer, prior to screening. * Participant has a mean Fridericia-corrected QT interval (QTcF) of \> 450 msec at screening. * Participant has known active hepatitis B virus (HBV) infection (defined as hepatitis B surface antigen (HBsAg)-positive and/or anti-HBV core antibody-positive) or known active hepatitis C virus (HCV) infection (defined as HCV RNA \[qualitative\] detected). * Participant with HBsAg-positivity and/or anti-HBV core antibody-positivity but with a negative HBV DNA PCR assay is permitted with appropriate antiviral prophylaxis or routine monitoring according to local practice. * Participant who has been curatively treated for HCV infection is permitted if he/she has documented sustained virologic response of 12 weeks. * Participant has a known history of human immunodeficiency virus (HIV) infection with acquired immunodeficiency syndrome (AIDS)-related complications. * Participant has echocardiogram (ECHO) or multigated acquisition scan (MUGA) at screening revealing left ventricular ejection fraction \< 45%. * Participant has any condition that makes the participant unsuitable for study participation. * Participant has a known or suspected hypersensitivity to gilteritinib or any components of the formulation used.

Study sites (10)

CA

CO

GA

IL

MI

MO

NJ

TX

VA