A Study of Selpercatinib (LY3527723) in Participants With Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer (LIBRETTO-431)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT04194944 |
Recruitment Status :
Active, not recruiting
First Posted : December 11, 2019
Last Update Posted : May 23, 2023
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Condition or disease | Intervention/treatment | Phase |
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Non-Small Cell Lung Cancer | Drug: Selpercatinib Drug: Carboplatin Drug: Cisplatin Drug: Pemetrexed Drug: Pembrolizumab | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 250 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | LIBRETTO-431: A Multicenter, Randomized, Open-Label, Phase 3 Trial Comparing Selpercatinib to Platinum-Based and Pemetrexed Therapy With or Without Pembrolizumab as Initial Treatment of Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer |
Actual Study Start Date : | February 17, 2020 |
Estimated Primary Completion Date : | December 2024 |
Estimated Study Completion Date : | July 2027 |

Arm | Intervention/treatment |
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Experimental: Selpercatinib
Selpercatinib administered orally.
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Drug: Selpercatinib
Administered orally
Other Names:
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Active Comparator: Pemetrexed with or without Pembrolizumab
Pemetrexed administered intravenously (IV) plus the investigator's discretion of carboplatin IV or cisplatin IV with or without pembrolizumab IV.
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Drug: Carboplatin
Administered IV Drug: Cisplatin Administered IV Drug: Pemetrexed Administered IV Drug: Pembrolizumab Administered IV |
Active Comparator: Pemetrexed with Pembrolizumab
Pemetrexed administered IV plus the investigator's discretion of carboplatin IV or cisplatin IV with pembrolizumab IV.
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Drug: Carboplatin
Administered IV Drug: Cisplatin Administered IV Drug: Pemetrexed Administered IV Drug: Pembrolizumab Administered IV |
- Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) (with Pembrolizumab) [ Time Frame: Baseline to Progressive Disease or Death from Any Cause (Estimated at up to 24 Months) ]PFS by BICR (with Pembrolizumab)
- PFS by BICR (with or without Pembrolizumab) [ Time Frame: Baseline to Progressive Disease or Death from Any Cause (Estimated at up to 24 Months) ]PFS by BICR (with or without Pembrolizumab)
- Disease Control Rate (DCR) by BICR (with Pembrolizumab) [ Time Frame: Baseline to Progressive Disease or Death from Any Cause (Estimated at up to 24 Months) ]DCR by BICR (with Pembrolizumab)
- DCR by BICR (with or without Pembrolizumab) [ Time Frame: Baseline to Progressive Disease or Death from Any Cause (Estimated at up to 24 Months) ]DCR by BICR (with or without Pembrolizumab)
- PFS2 (with Pembrolizumab) [ Time Frame: Baseline to Second Disease Progression or Death from Any Cause (Estimated at up to 36 Months) ]PFS2 (with Pembrolizumab)
- PFS2 (with or without Pembrolizumab) [ Time Frame: Baseline to Second Disease Progression or Death from Any Cause (Estimated at up to 36 Months) ]PFS2 (with or without Pembrolizumab)
- Overall Response Rate (ORR): Percentage of Participants with Complete Response (CR) or Partial Response (PR) by BICR (with Pembrolizumab) [ Time Frame: Baseline through Disease Progression or Death (Estimated at up to 24 Months) ]ORR: Percentage of Participants with CR or PR by BICR (with Pembrolizumab)
- ORR: Percentage of Participants with CR or PR by BICR (with or without Pembrolizumab) [ Time Frame: Baseline through Disease Progression or Death (Estimated at up to 24 Months) ]ORR: Percentage of Participants with CR or PR by BICR (with or without Pembrolizumab)
- Duration of Response (DoR) by BICR (with Pembrolizumab) [ Time Frame: Date of CR or PR to Date of Disease Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]DOR by BICR (with Pembrolizumab)
- DOR by BICR (with or without Pembrolizumab) [ Time Frame: Date of CR or PR to Date of Disease Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]DOR by BICR (with or without Pembrolizumab)
- Overall Survival (OS) (with Pembrolizumab) [ Time Frame: Baseline to Date of Death from Any Cause (Estimated at up to 48 Months) ]OS (with Pembrolizumab)
- OS (with or without Pembrolizumab) [ Time Frame: Baseline to Date of Death from Any Cause (Estimated at up to 48 Months) ]OS (with or without Pembrolizumab)
- Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 by BICR (with Pembrolizumab) [ Time Frame: Baseline through Central Nervous System (CNS) Progression or Death (Estimated at up to 24 Months) ]Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with Pembrolizumab)
- Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with or without Pembrolizumab) [ Time Frame: Baseline through CNS Progression or Death (Estimated at up to 24 Months) ]Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with or without Pembrolizumab)
- Intracranial DOR per RECIST 1.1 by BICR (with Pembrolizumab) [ Time Frame: Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]Intracranial DOR per RECIST 1.1 by BICR (with Pembrolizumab)
- Intracranial DOR per RECIST 1.1 by BICR (with or without Pembrolizumab) [ Time Frame: Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]Intracranial DOR per RECIST 1.1 by BICR (with or without Pembrolizumab)
- Time to Deterioration of Pulmonary Symptoms (with Pembrolizumab) [ Time Frame: Baseline to Deterioration of Pulmonary Symptoms (Estimated at up to 24 Months) ]Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-Symptom Assessment Questionnaire (SAQ) (with Pembrolizumab)
- Time to Deterioration of Pulmonary Symptoms (with or without Pembrolizumab) [ Time Frame: Baseline to Deterioration of Pulmonary Symptoms (Estimated at up to 24 Months) ]Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-SAQ (with or without Pembrolizumab)
- The Concordance of the Local Lab and the Central Lab RET Results: Percentage of Participants with RET-Positive Specimens as Called by the Central Lab, which is also RET-Positive as Called by a Local Lab (Positive Percent Agreement) [ Time Frame: Baseline ]The Concordance of the Local Lab and the Central Lab RET Results: Percentage of Participants with RET-Positive Specimens as Called by the Central Lab, which is also RET-Positive as Called by a Local Lab (Positive Percent Agreement)
- Time to CNS Progression per RECIST 1.1 by BICR (with Pembrolizumab) [ Time Frame: Baseline through CNS Progression or Death (Estimated at up to 24 Months) ]Time to CNS Progression per RECIST 1.1 by BICR (with Pembrolizumab)
- Time to CNS Progression per RECIST 1.1 by BICR (with or without Pembrolizumab) [ Time Frame: Baseline through CNS Progression or Death (Estimated at up to 24 Months) ]Time to CNS Progression per RECIST 1.1 by BICR (with or without Pembrolizumab)
- Intracranial ORR: Percentage of Participants with Intracranial CR or PR per Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) by BICR (with Pembrolizumab) [ Time Frame: Baseline through CNS Progression or Death (Estimated at up to 24 Months) ]Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RANO-BM by BICR (with Pembrolizumab)
- Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RANO-BM by BICR (with or without Pembrolizumab) [ Time Frame: Baseline through CNS Progression or Death (Estimated at up to 24 Months) ]Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RANO-BM by BICR (with or without Pembrolizumab)
- Intracranial DOR per RANO-BM by BICR (with Pembrolizumab) [ Time Frame: Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]Intracranial DOR per RANO-BM by BICR (with Pembrolizumab)
- Intracranial DOR per RANO-BM by BICR (with or without Pembrolizumab) [ Time Frame: Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause (Estimated at up to 24 Months) ]Intracranial DOR per RANO-BM by BICR (with or without Pembrolizumab)

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically or cytologically confirmed, Stage IIIB-IIIC or Stage IV non-squamous NSCLC that is not suitable for radical surgery or radiation therapy.
- A RET gene fusion in tumor and/or blood from a qualified laboratory.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
- Adequate hematologic, hepatic and renal function.
- Willingness of men and women of reproductive potential to observe conventional and highly effective birth control for the duration of treatment and for 6 months after.
- Ability to swallow capsules.
Exclusion Criteria:
- Additional validated oncogenic drivers in NSCLC if known.
- Prior systemic therapy for metastatic disease. Treatment (chemotherapy, immunotherapy, or biological therapy) in the adjuvant/neoadjuvant setting is permitted if it was completed at least 6 months prior to randomization.
- Major surgery within 3 weeks prior to planned start of selpercatinib.
- Radiotherapy for palliation within 1 week of the first dose of study treatment or any radiotherapy within 6 months prior to the first dose of study treatment if more than 30 Gy to the lung.
- Symptomatic central nervous system (CNS) metastases, carcinomatous meningitis, or untreated spinal cord compression.
- Clinically significant active cardiovascular disease or history of myocardial infarction within 6 months prior to planned start of selpercatinib or prolongation of the QT interval corrected for heart rate using Fridericia's formula (QTcF) > 470 milliseconds.
- Active uncontrolled systemic bacterial, viral, or fungal infection or serious ongoing intercurrent illness, such as hypertension or diabetes, despite optimal treatment.
- Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal absorption of the study drug.
- Pregnancy or lactation.
- Other malignancy unless nonmelanoma skin cancer, carcinoma in situ of the cervix or other in situ cancers or a malignancy diagnosed ≥2 years previously and not currently active.
- Uncontrolled, disease related pericardial effusion or pleural effusion.
- Requiring chronic treatment with steroids.
Exclusion Criteria for Participants Receiving Pembrolizumab:
- History of interstitial lung disease or interstitial pneumonitis.
- Active autoimmune disease or any illness or treatment that could compromise the immune system.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04194944

Study Director: | Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST) | Eli Lilly and Company |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Loxo Oncology, Inc. |
ClinicalTrials.gov Identifier: | NCT04194944 |
Other Study ID Numbers: |
17479 J2G-MC-JZJC ( Other Identifier: Eli Lilly and Company ) 2019-001979-36 ( EudraCT Number ) |
First Posted: | December 11, 2019 Key Record Dates |
Last Update Posted: | May 23, 2023 |
Last Verified: | May 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement. |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Clinical Study Report (CSR) |
Time Frame: | Data are available 6 months after the primary publication and approval of the indication studied in the US and EU, whichever is later. Data will be indefinitely available for requesting. |
Access Criteria: | A research proposal must be approved by an independent review panel and researchers must sign a data sharing agreement. |
URL: | http://vivli.org/ |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
targeted therapy |
Lung Neoplasms Carcinoma, Non-Small-Cell Lung Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Neoplasms Lung Diseases Respiratory Tract Diseases Carcinoma, Bronchogenic Bronchial Neoplasms |
Carboplatin Pembrolizumab Pemetrexed Antineoplastic Agents Antineoplastic Agents, Immunological Immune Checkpoint Inhibitors Molecular Mechanisms of Pharmacological Action Enzyme Inhibitors Folic Acid Antagonists Nucleic Acid Synthesis Inhibitors |