Overview
The is a randomized, controlled, open-label Phase III clinical study to evaluate the efficacy and safety of glumetinib combined with osimertinib mesylate versus platinum-based doublet chemotherapy in non-small cell lung cancer( NSCLC) patients with MET amplification and/or overexpression after resistance to EGFR-TKIs..
Approximately 350 NSCLC patients with MET amplification and/or overexpression after previous treatment with EGFR-TKIs are planned to be enrolled. After patients sign the informed consent form (ICF), those who are eligible for enrollment after screening examinations will be randomized to the investigational group or the control group in a 1:1 ratio by the central randomization system (IWRS).
Eligibility
Inclusion Criteria:
- 1. Patients who are able to understand and voluntarily sign the written ICF; 2. Male
or female patients aged ≥ 18 years (inclusive); 3. Patients with histologically or
cytologically confirmed NSCLC, which is unresectable locally advanced or metastatic
(Stage ⅢB, ⅢC, or Ⅳ) NSCLC according to the 8th edition of the TNM Staging System by
the International Association for the Study of Lung Cancer (IASLC). Note: If the
pathological type is mixed, it should be classified by primary cell type. However,
if there are small cell components or neuroendocrine carcinoma components,
enrollment will be not allowed; 4. Patients with EGFR-sensitive mutations confirmed
by tumor histology or cytology or hematology before the first-line treatment with
EGFR-TKIs; 5. Patients who have experienced documented imaging PD after treatment
with first-, second- or third-generation EGFR-TKIs (gefitinib, erlotinib, icotinib,
afatinib, dacomitinib, osimertinib, etc.); patients who have received prior adjuvant
EGFR-TKI treatment after radical surgery may be enrolled if they have had PD within
6 months after the last dose of EGFR-TKIs. 6. Patients with PD following EGFR-TKI treatment who meet any of the following
requirements: a. EGFR T790M negative with MET amplification and/or overexpression
after PD following treatment with first- or second-generation EGFR-TKIs; b. MET
amplification or overexpression after PD following treatment with third-generation
EGFR inhibitors; MET amplification or overexpression in tumor tissue samples as
confirmed by the sponsor-designated central laboratory (meeting one of the following
conditions):
- IHC: 3 +, ≥ 90%
- FISH: GCN ≥ 5 or MET/CEP7 ratio ≥ 2 7. Patients who have at least one
measurable lesion meeting the RECIST v1.1 criteria. Lesions that have
previously undergone local treatments such as radiotherapy can be considered as
target lesions upon confirmed progression. Brain metastases will not be
considered as target lesions.
Exclusion Criteria:
- 1. Patients with prior treatment with targeted MET drugs; 2. Patients with
T790M-positive mutation after PD following treatment with first- or second-generation EGFR-TKIs; 3. Patients who are positive for other driver genes, such as ALK/ROS1 positive after PD following EGFR-TKI treatment; 4. Patients with prior systemic anti-tumor therapy (including chemotherapy and immunotherapy) for advanced NSCLC other than EGFR-TKIs;