Study name: CA240-0029: A Randomized Phase 2/3 Study of BMS-986504 in Combination with Pembrolizumab and Chemotherapy Versus Placebo Plus Pembrolizumab and Chemotherapy in First-line Metastatic Non-small Cell Lung Cancer Participants with Homozygous MTAP Deletion
Histology
NSCLC, all subtypes
Tumor stage
Stage III - IV
Host / recruiting site 1
UMC Groningen
Enrollment
Planned
Therapy line
First line (1L)
PD-L1 expression
Negative: <1%
,
Low: 1 - 49%
,
High: ≥50%
Design
A global, multicenter, randomized, two-part, phase 2/3 study. Phase 2 Dose Selection will be randomized, blinded to the investigators and participants, and will evaluate the efficacy and safety of two different doses of BMS-986504 in combination with pembrolizumab and chemotherapy versus placebo with pembrolizumab and chemotherapy. Phase 3 will be randomized, blinded to investigators, participants, and the Sponsor, and will evaluate the efficacy of the selected dose of BMS-986504 in combination with pembrolizumab and chemotherapy versus placebo with pembrolizumab and chemotherapy. The study will enroll previously untreated participants with MTAP-deleted mNSCLC. All participants in Phase 2 and Phase 3 will complete up to 4 study periods: pre-screening, screening, treatment, and follow-up.
Intervention
In the Phase 2 Dose Selection portion of the study, approximately 90 eligible participants will be randomized 2:2:1:1 to the following arms:
Arm A (n = approximately 30): BMS-986504 400 mg QD in 21-day cycles + pembrolizumab + chemotherapy
Arm B (n = approximately 30): BMS-986504 600 mg QD in 21-day cycles + pembrolizumab + chemotherapy
Arm C (n = approximately 15): BMS-986504 400 mg matching placebo QD in 21-day cycles + pembrolizumab + chemotherapy
Arm D (n = approximately 15): BMS-986504 600 mg matching placebo QD in 21-day cycles + pembrolizumab + chemotherapy
In the Phase 3 portion of the study, approximately 500 eligible participants will be randomized 1:1 to the following arms:
Arm E (n = approximately 250): selected dose of BMS-986504 QD in 21-day cycles + pembrolizumab + chemotherapy
Arm F (n = approximately 250): selected dose of BMS-986504 matching placebo QD in 21- day cycles + pembrolizumab + chemotherapy
Key outcome parameters
To compare PFS of BMS-986504 + pembrolizumab + chemotherapy vs placebo + pembrolizumab + chemotherapy in previously untreated participants with mNSCLC with homozygous MTAP deletion
Key inclusion criteria
Key Inclusion Criteria:
Metastatic (Stage IV or recurrent) NSCLC (as defined by the American Joint Committee on Cancer, Ninth Edition) with no prior systemic anti-cancer therapy for metastatic disease. • Histologically confirmed diagnosis of NSCLC and homozygous MTAP deletion or MTAP loss detected in tumor tissue using a Sponsor-provided central test or a Sponsor pre-approved local test.
Any PD-L1 expression (0 to 100%) as determined by the Sponsor pre-approved local PD-L1 IHC assays (VENTANA PD-L1 [SP263] assay, Agilent PD-L1 IHC 22C3 pharmDx, or Agilent PD-L1 IHC 28-8 pharmDx), from tissue collected within 6 months prior to signing the pre-screening informed consent, performed in accordance with the intended use of the assays. If, despite best efforts, a quantifiable result is not possible, non-evaluable or non-quantifiable results may be acceptable upon Medical Monitor (or designee) approval for a maximum of 10% of total participants. Testing must comply with local diagnostic regulations, and documentation of which PD-L1 test used must be provided.
At least 1 measurable lesion as per RECIST v1.1.
Key exclusion criteria
Key Exclusion Criteria:
Participants with nonsquamous histology with documented targetable oncogenic mutations or AGAs (eg, EGFR, ALK, ROS1) eligible for an approved targeted therapy in 1L, as deemed appropriate by the investigator
Symptomatic brain metastases or spinal cord compression.
Prior systemic therapy (chemotherapy, immunotherapy, targeted therapy, or biological therapy) for mNSCLC. Note: One cycle of SoC treatment prior to randomization will be allowed for participants who require immediate treatment if clinically indicated.
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