A Study of Napabucasin (BBI-608) Plus Weekly Paclitaxel Versus Weekly Paclitaxel Alone in Patients With Advanced, Previously Treated, Non-Squamous Non-Small Cell Lung Cancer (CanStem43L)

Sumitomo Pharma

Status and phase: Terminated; Phase 3

Conditions: Carcinoma, Non-Small-Cell Lung

Treatments: Drug: Paclitaxel; Drug: Napabucasin

Study type: Interventional

Funder types: Industry

Identifiers

NCT02826161

CanStem43L

Details and patient eligibility

About

This is an international, multi-center, prospective, randomized, open-label Phase 3 clinical trial of the cancer stemness inhibitor napabucasin administered with weekly paclitaxel versus weekly paclitaxel alone in patients with advanced non-squamous non-small cell lung cancer who have disease progression following systemic treatment with a platinum-based combination regimen in the metastatic setting, who have received treatment with an immune checkpoint inhibitor if a candidate, additional approved therapies, and for whom weekly paclitaxel is an acceptable treatment option.

Enrollment: 4 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria:

• Must have histologically or cytologically confirmed non-squamous NSCLC.
• Must have progressed following treatment with platinum-based combination chemotherapy for metastatic disease, and patients with an EGFR or ALK/ROS1 genetic aberration must have received appropriately targeted treatment.
• Must have received either nivolumab or pembrolizumab or a different IND-approved anti-PD1 or anti-PD-L1 therapy, unless medically contraindicated
• Weekly paclitaxel must be an acceptable treatment option
• Must submit tumor tissue for correlative analyses
• Women of child-bearing potential and partners of women of child-bearing potential must take measures to avoid pregnancy while receiving and for a period of time following protocol therapy
• Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, adequate organ function, and a life expectancy of ≥ 3 months

Key Exclusion Criteria:

• Has squamous NSCLC
• Has received prior systemic treatment with a taxane for advanced/metastatic disease
• Has received systemic anti-cancer therapy within the 14 days prior to randomization
• Has received radiotherapy within the 28 days prior to randomization, with the exception of palliative radiotherapy to focal lesions for pain or other symptom control
• Has brain metastases with evolving neurologic symptoms or a steroid requirement.
• Has had major surgery requiring general anesthesia and/or mechanical ventilation within the 28 days prior to randomization
• Has a corrected QT interval (QTc) > 470 ms or has an electrocardiogram (ECG) with a new abnormal finding that is clinically significant
• Has peripheral neuropathy ≥ Grade 2 (NCI-CTCAE)
• Refuses to complete quality of life questionnaires either alone or with assistance from study staff despite adequate fluency
• Has an intercurrent (non-malignant) chronic medical or psychiatric illness or condition(s) not optimally controlled and carrying a moderate to high risk of interfering with protocol therapy administration or compliance with required procedures, in the judgment of the investigator

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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4 participants in 2 patient groups

Napabucasin plus Weekly Paclitaxel

Experimental group

Description:

Patients randomized to this arm will receive napabucasin administered orally, twice daily in combination with paclitaxel administered intravenously, once weekly, on 3 of every 4 weeks.

Treatment:

Drug: Paclitaxel

Drug: Napabucasin

Weekly Paclitaxel

Active Comparator group

Description:

Patients randomized to this arm will receive weekly paclitaxel alone administered intravenously, once weekly, on 3 of every 4 weeks.

Treatment:

Drug: Paclitaxel