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克唑替尼治疗 MET 基因改变的晚期非小细胞肺癌日本患者的 II 期、开放标签、多中心研究:Co-MET 研究。

Phase II, open-label, multicenter trial of crizotinib in Japanese patients with advanced non-small cell lung cancer harboring a MET gene alteration: Co-MET study.

机构信息

Cancer Biostatistics Laboratory, Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.

Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.

出版信息

Trials. 2020 Mar 30;21(1):298. doi: 10.1186/s13063-020-4221-7.

Abstract

BACKGROUND

MET-deregulated non-small cell lung cancer represents an urgent clinical need because of the lack of specific therapies. Although recent studies have suggested a potential role for crizotinib in patients harboring MET gene alterations, no conclusive data are currently available. Therefore, we designed the Co-MET study, a single-arm phase II study to assess the efficacy and safety of crizotinib in patients with advanced non-small cell lung cancers harboring MET gene alterations.

METHODS

Co-MET is an open-label, multi-center, single-arm, phase II trial to assess the safety and efficacy of oral crizotinib in patients with advanced non-small cell lung cancer harboring MET exon 14 skipping mutation (cohort 1) or a high MET gene copy number of ≥ 7 (cohort 2). We will identify MET gene alterations using RT-PCR and/or next-generation sequencing. Oral crizotinib 250 mg BID will be administered until disease progression or unacceptable toxicity. A radiology committee will review tumor scans according to the RECIST criteria. The primary endpoint is the objective response rate. Assuming a null hypothesis of 20% objective response rate and an alternative hypothesis of 50% objective response rate for cohort 1, and a one-sided alpha error of 0.05 and 80% power based on the exact binomial distribution, the required number of evaluable patients is 19. We set the exploratory sample size for cohort 2 at 10 patients.

DISCUSSION

The results of this study are expected to provide evidence regarding the usefulness of oral crizotinib for advanced MET exon 14 skipping mutation-positive or MET high gene copy number-positive non-small cell lung cancer.

TRIAL REGISTRATION

This study was registered with the University Hospital Medical Information Network Clinical Trials Registry as UMIN000031623 on 3 March 2018.

摘要

背景

由于缺乏特异性治疗方法,MET 失调的非小细胞肺癌是一种迫切的临床需求。虽然最近的研究表明克唑替尼可能对携带 MET 基因改变的患者有一定作用,但目前尚无明确的数据。因此,我们设计了 Co-MET 研究,这是一项单臂 II 期研究,旨在评估克唑替尼治疗携带 MET 基因改变的晚期非小细胞肺癌患者的疗效和安全性。

方法

Co-MET 是一项开放标签、多中心、单臂、II 期试验,旨在评估口服克唑替尼治疗携带 MET 外显子 14 跳跃突变(队列 1)或高 MET 基因拷贝数≥7(队列 2)的晚期非小细胞肺癌患者的安全性和疗效。我们将使用 RT-PCR 和/或下一代测序来确定 MET 基因改变。口服克唑替尼 250mg BID 将持续给药,直到疾病进展或出现不可耐受的毒性。放射学委员会将根据 RECIST 标准审查肿瘤扫描。主要终点是客观缓解率。假设队列 1 的零假设客观缓解率为 20%,替代假设客观缓解率为 50%,单侧α误差为 0.05,基于精确二项式分布的 80%功效,需要评估的患者人数为 19 例。我们为队列 2 设定了 10 例患者的探索性样本量。

讨论

该研究的结果有望为口服克唑替尼治疗 MET 外显子 14 跳跃突变阳性或 MET 高基因拷贝数阳性的晚期非小细胞肺癌的有效性提供证据。

试验注册

该研究于 2018 年 3 月 3 日在大学医院医学信息网络临床试验注册中心注册,注册号为 UMIN000031623。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/7104510/a6820752c8d5/13063_2020_4221_Fig1_HTML.jpg

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