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DS-1205c With Osimertinib for Metastatic or Unresectable Epidermal Growth Factor Receptor (EGFR)-Mutant Non-Small Cell Lung Cancer

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. Identifier: NCT03255083
Recruitment Status : Completed
First Posted : August 21, 2017
Last Update Posted : July 6, 2021
Information provided by (Responsible Party):
Daiichi Sankyo, Inc.

Brief Summary:

This study has two parts: dose escalation and dose expansion.

The primary objectives are:

  • For Dose Escalation, to assess the safety and tolerability of DS-1205c when combined with osimertinib in the study population and to determine the recommended dose for expansion of DS-1205c when combined with osimertinib in the study population
  • For Dose Expansion, to assess the safety and tolerability of DS-1205c when combined with osimertinib in the study population

In Dose Escalation, after a 7-day run in period (Cycle 0), there will be 21-day cycles (Cycle 1 onward). In Dose Expansion, there will be 21-day cycles.

The number of treatment cycles is not fixed in this study. Participants will continue study treatment until they decide not to (withdraw consent), their disease gets worse [progressive disease (PD)], or side effects become unacceptable (unacceptable toxicity).

Condition or disease Intervention/treatment Phase
Non-small Cell Lung Cancer (NSCLC) Drug: DS-1205c Drug: Osimertinib Phase 1

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 13 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter, Open-Label Phase 1 Study of DS-1205c in Combination With Osimertinib in Subjects With Metastatic or Unresectable EGFR-Mutant Non-Small Cell Lung Cancer
Actual Study Start Date : April 10, 2019
Actual Primary Completion Date : September 4, 2020
Actual Study Completion Date : September 4, 2020

Resource links provided by the National Library of Medicine

Drug Information available for: Osimertinib

Arm Intervention/treatment
Experimental: DS-1205c with osimertinib
Participants receive DS-1205c (at planned doses given orally twice daily: 200 mg, 400 mg, 600 mg, 800 mg) in combination with daily 80 mg oral dose of osimertinib
Drug: DS-1205c
DS-1205c 200 mg capsule

Drug: Osimertinib
Osimertinib 80 mg tablet

Primary Outcome Measures :
  1. Number of participants with dose-limiting toxicities (DLTs) when taking DS-1205c in combination with osimertinib during dose escalation [ Time Frame: within 28 days ]
  2. Number of participants with clinically significant safety measures when taking DS-1205c in combination with osimertinib [ Time Frame: within 36 months ]
    Categories: during dose escalation, during dose expansion

Secondary Outcome Measures :
  1. Area under the plasma concentration time curve (AUC) for DS-1205a [ Time Frame: during Cycle 0 of the dose escalation period (within 28 days) ]
    DS-1205a is the free form of DS-1205c when DS-1205c is administered alone

  2. Maximum observed analyte concentration (Cmax) of DS-1205a [ Time Frame: during Cycle 0 of the dose escalation period (7 days) ]
  3. Actual sampling time to reach Cmax (Tmax) of DS-1205a [ Time Frame: during Cycle 0 of the dose escalation period (7 days) ]
  4. Area under the analyte concentration versus time curve during a dosing interval (AUCtau) of DS-1205a [ Time Frame: during Cycle 0 of the dose escalation period (7 days) ]
  5. Minimum observed analyte concentration prior to the beginning, or at the end, of a dosing interval (Ctrough) of DS-1205a [ Time Frame: during Cycle 0 of the dose escalation period (7 days) ]
  6. Cmax during a dosing interval (Tau) at steady state (Cmax,ss) [ Time Frame: during the dose expansion period, within 36 months ]
    Categories: DS-1205a, osimertinib, and osimertinib active metabolites (AZ5104 and AZ7550)

  7. Plasma concentration of DS-1205a versus time [ Time Frame: during the dose expansion period, within 36 months ]
    Categories: DS-1205a, osimertinib, and osimertinib active metabolites (AZ5104 and AZ7550)

  8. Tmax [ Time Frame: during the dose expansion period, within 36 months ]
    Categories: DS-1205a, osimertinib, and osimertinib active metabolites (AZ5104 and AZ7550)

  9. Ctrough [ Time Frame: during the dose expansion period, within 36 months ]
    Categories: DS-1205a, osimertinib, and osimertinib active metabolites (AZ5104 and AZ7550)

  10. AUCtau [ Time Frame: during the dose expansion period, within 36 months ]
    Categories: DS-1205a, osimertinib, and osimertinib active metabolites

  11. Objective response rate (ORR), graded according to RECIST version 1.1 [ Time Frame: within 36 months ]
    Objective response rate is calculated as the number of participants with best objective response [complete response (CR) or partial response (PR) determined by Investigator assessment based on Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1], divided by the number of participants in the analysis population.

  12. Change from baseline in size of target lesion(s) [ Time Frame: within 36 months ]
  13. Duration of response (DOR) [ Time Frame: within 36 months ]
    DOR is defined as the time from documentation of tumor response [either CR or PR] to disease progression

  14. Disease control rate (DCR) [ Time Frame: first dose to 36 months ]
    DCR is defined as the sum of CR rate, PR rate, and stable disease (SD) rate

  15. Progression-free survival (PFS) [ Time Frame: baseline to objective disease progression or death from any cause (within 36 months) ]
    PFS is defined as the time from the date of the first dose to the earlier of the dates of the first objective documentation of radiographic PD, or death due to any cause

  16. Overall survival (OS) [ Time Frame: baseline to death from any cause (within 36 months) ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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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:

  1. Has histologically or cytologically documented adenocarcinoma NSCLC.
  2. Has locally advanced or metastatic NSCLC, not amenable to curative surgery or radiation.
  3. Has acquired resistance to EGFR TKI according to the Jackman criteria (PMID: 19949011):

    1. Historical confirmation that the tumor harbors an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q) or
    2. Has experienced clinical benefit from an EGFR TKI, followed by systemic progression (Response Evaluation Criteria in Solid Tumors [RECIST version 1.1] or World Health Organization [WHO]) while on continuous treatment with an EGFR TKI.
  4. Is currently receiving, and is able to discontinue erlotinib, gefinitib, or afatinib; or is currently receiving osimertinib at the prescribed 80 mg dose and is able to interrupt osimertinib.
  5. Has been receiving erlotinib, gefitinib, or afatinib for at least 6 weeks with well-controlled related toxicities less than Grade 3 in severity at the time of screening period.
  6. Has radiological documentation of disease progression while receiving continuous treatment with erlotinib, gefitinib, afatinib, or osimertinib.
  7. Has at least one measurable lesion per RECIST version 1.1.
  8. Is willing to provide archival tumor tissue from a biopsy performed after progression during treatment with erlotinib, gefitinib, afatinib , or osimertinib OR has at least one lesion not previously irradiated, amenable to core biopsy, and is willing to undergo screening tumor biopsy.
  9. Demonstrates absence of EGFR T790M. No EGFR mutation testing is required if treated with osimertinib.
  10. Has Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1, with no deterioration over the previous 2 weeks.

Exclusion Criteria:

  1. Has any evidence of small cell histology, or combined small cell and non-small cell histology, in original tumor biopsy or in screening biopsy performed since progression.
  2. Has previously documented evidence of anaplastic lymphoma kinase (ALK) fusion, ROS proto-oncogene 1 (ROS1) fusion, BRAF V600E mutation, rearranged during transfection (RET) rearrangement, human epidermal growth factor receptor 2 (HER2) mutation, or MET exon 14 skipping mutation. No new testing for these genomic alterations is required for Screening.
  3. Has received treatment with any of the following:

    1. Any cytotoxic chemotherapy, immune checkpoint inhibitor therapy, investigational agent or other anticancer drug(s) from a previous cancer treatment regimen or clinical study (other than EGFR TKI), within 14 days of the first dose of study treatment.
    2. Immune checkpoint inhibitor therapy within 30 days of first dose of study treatment.
    3. Major surgery (excluding placement of vascular access) within 4 weeks of the first dose of study treatment.
    4. Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of radiation within 4 weeks, or palliative radiation therapy within 2 weeks of the first dose of study drug treatment.
  4. Has history of other active malignancy within 3 years prior to enrollment, except:

    1. Adequately treated non-melanoma skin cancer OR
    2. Superficial bladder tumors (tumor stage "a" [Ta], tumor stage "is" [Tis], tumor stage "1" [T1]) OR
    3. Curatively treated in situ disease OR
    4. Low risk non-metastatic prostate cancer (with Gleason score < 7, and following local treatment or undergoing active surveillance)
  5. Has spinal cord compression or clinically active brain metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. Subjects with clinically inactive brain metastases may be included in the study. Subjects with treated brain metastases that are no longer symptomatic and who require no treatment with corticosteroids or anticonvulsants may be included in the study if they have recovered from the acute toxic effect of radiotherapy. A minimum of 2 weeks must have elapsed between the end of whole brain radiotherapy and study enrollment (1 week for stereotactic radiotherapy).
  6. Presence of retinal disease in the eye that is not due to neovascular age-related macular degeneration (nAMD; eg, significant diabetic retinopathy, glaucomatous retinal atrophy, retinal detachment).
  7. Has history of myocardial infarction within the past 6 months.
  8. Has symptomatic congestive heart failure (New York Heart Association [NYHA] Classes II-IV), unstable angina, or cardiac arrhythmia requiring antiarrhythmic treatment.
  9. Has left ventricular ejection fraction (LVEF) <45% by either echocardiogram (ECHO) or multigated acquisition (MUGA) scan.
  10. Has any clinically important abnormalities in rhythm, conduction or morphology of resting ECG, eg, complete left bundle branch block, third-degree heart block, second-degree heart block, or PR interval >250 milliseconds (ms).
  11. Has a mean QT interval corrected using Fridericia's correction (QTcF) prolongation >470 ms for females and >450 ms for males in three successive Screening measurements.
  12. Unable or unwilling to discontinue concomitant use of drugs that are known to prolong the QT interval.
  13. Has any factors that increase the risk of QTc prolongation or risk of arrhythmic events, such as congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age in first degree relatives.
  14. Has any history of interstitial lung disease (pulmonary fibrosis or severe radiation pneumonitis) or is suspected to have such disease by imaging during screening.
  15. Has history of pancreatitis within the past 6 months.

Information from the National Library of Medicine

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 identifier (NCT number): NCT03255083

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Taipei Medical University, Shuang Ho Hospital
New Taipei City, Taiwan, 23561
China Medical University Hospital
Taichung, Taiwan, 40447
Taichung Veterans General Hospital
Taichung, Taiwan, 40705
National Cheng-Kung University Hospital
Tainan, Taiwan, 70457
National Taiwan University Hospital
Taipei, Taiwan, 10048
Taipei Medical University Hospital
Taipei, Taiwan, 11031
Taipei Veterans General Hospital
Taipei, Taiwan, 11217
Sponsors and Collaborators
Daiichi Sankyo, Inc.
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Study Director: Global Clinical Leader Daiichi Sankyo, Inc.
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Responsible Party: Daiichi Sankyo, Inc. Identifier: NCT03255083    
Other Study ID Numbers: DS1205-A-U101
First Posted: August 21, 2017    Key Record Dates
Last Update Posted: July 6, 2021
Last Verified: July 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address:
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Clinical Study Report (CSR)
Time Frame: Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
Access Criteria: Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Daiichi Sankyo, Inc.:
Advanced Non-small Cell Lung Cancer
Inoperable Non-small Cell Lung Cancer
Epidermal growth factor receptor
Additional relevant MeSH terms:
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Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action