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A Study Evaluating the Efficacy and Safety of Divarasib Versus Sotorasib or Adagrasib in Participants With Previously Treated KRAS G12C-positive Advanced or Metastatic Non-Small Cell Lung Cancer (Krascendo 1) Fase 3 338

Actief, niet rekruterend
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De klinische studie NCT06497556 (Krascendo 1) onderzoekt behandeling bij Niet-kleincellige longkanker, KRAS G12C Lung Cancer. Deze Fase 3 interventioneel-studie heeft de status actief, niet rekruterend. Het doel is om 338 deelnemers te includeren vanaf 23 september 2024. De studie wordt geleid door Roche en de voltooiing is gepland op 30 november 2029. Laatste update op ClinicalTrials.gov: 20 januari 2026.
Beknopte samenvatting
The purpose of this study is to assess the safety and efficacy of divarasib compared to locally approved KRAS G12C inhibitors (sotorasib or adagrasib) in participants with KRAS G12C-positive (KRAS G12C +) advanced or metastatic non-small cell lung cancer (NSCLC).
Officiële titel

A Phase III, Randomized, Open-Label, Multicenter Study Evaluating the Efficacy and Safety of Divarasib Versus Sotorasib or Adagrasib in Patients With Previously Treated KRAS G12C-Positive Advanced or Metastatic Non-Small Cell Lung Cancer

Aandoeningen
Niet-kleincellige longkankerKRAS G12C Lung Cancer
Andere studie-ID's
  • Krascendo 1
  • BO45217
  • 2024-510908-37-00 (Overige identificatiecode) (EU CT Number)
NCT-ID
Startdatum (Werkelijk)
2024-09-23
Laatste update geplaatst
2026-01-20
Verwachte einddatum
2029-11-30
Inschrijving (Geschat)
338
Studietype
Interventioneel
FASE
Fase 3
Status
Actief, niet rekruterend
Trefwoorden
Advanced Non-Small Cell Lung Cancer
KRAS G12 Lung Cancer
Advanced Lung Cancer
Metastatic lung cancer
Divarasib
KRAS G12C Inhibitor
KRAS G12C Positive
KRAS Mutation
KRAS G12C Mutation
Lung Cancer Mutation
Primaire doel
Behandeling
Toewijzing
Gerandomiseerd
Interventiemodel
Parallel
Blindering
Geen (Open-label)
Armen / Interventies
Deelnemersgroep/StudiearmInterventie/Behandeling
ExperimenteelDivarasib
Participants will receive divarasib orally, once daily (QD).
Divarasib
Divarasib will be administered orally QD
Actieve comparatorKRAS G12C inhibitor
Participants will receive sotorasib orally QD or adagrasib orally twice a day (BID)
Sotorasib
Sotorasib will be administered orally QD
Adagrasib
Adagrasib will be administred orally BID
Primaire uitkomst
UitkomstmaatBeschrijving van de uitkomstmaatTijdsbestek
Progression-Free Survival (PFS)
PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by blinded independent central review (BICR) according to RECIST v1.1, or death from any cause (whichever occurs first)
Up to approximately 4 years
Secundaire uitkomst
UitkomstmaatBeschrijving van de uitkomstmaatTijdsbestek
Overall Survival (OS)
OS is defined as the time from randomization to death from any cause
Up to approximately 4 years
Confirmed Objective Response
Confirmed objective response is defined as complete response (CR) or partial response (PR) on two occasions ≥ 4 weeks apart, as determined by BICR according to RECIST v1.1
Up to approximately 4 years
Time to Confirmed Deterioration (TTCD) on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Dyspnea Item and Physical Functioning Scale
Baseline up to approximately 4 years
TTCD on the EORTC Quality-of-Life Questionnaire-Supplemental Lung Cancer Module (QLQ-LC13) Cough Scale
Baseline up to approximately 4 years
Duration of Response (DOR)
DOR is defined as the time from the first occurrence of a documented confirmed objective response to disease progression, as determined by BICR according to RECIST v1.1, or death from any cause (whichever occurs first)
Up to approximately 4 years
Percentage of Participants with Adverse Events (AEs)
Up to approximately 4 years
Number of Participants Reporting Presence, Frequency, Severity, and/or Degree of Interference with Daily Function of Symptomatic Treatment Toxicities Assessed by NCI Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Up to approximately 4 years
Change from Baseline in Diarrhea, Nausea, Vomiting, Anorexia, Alopecia, Dyspnea, Cough, Constipation, Myalgia, Headache, and Rash/Acne as Assessed Through use of the NCI PRO-CTCAE
Baseline up to approximately 4 years
Frequency of Participants' Response of the Degree they are Troubled with Treatment Symptoms, as Assessed Through use of the single-item EORTC Item List (IL46)
Up to approximately 4 years
Change from Baseline in Cough, Chest Pain, Dyspnea, Physical and Role Functioning, and Global Health Status score/Quality of Life Score (GHS/QoL) at Each Timepoint as Assessed Through use of the EORTC QLQ-LC13 and QLQ-C30
Baseline up to approximately 4 years
TTCD on the EORTC QLQ-C30 Role Functioning and GHS/QoL scales
Up to approximately 4 years
TTCD on the Chest Pain Scale of the QLQ-LC13 Scales
Up to approximately 4 years
Deelname-assistent
Geschiktheidscriteria

Leeftijd van deelnemers
Volwassene, Oudere volwassene
Minimumleeftijd
18 Years
Geslachten die in aanmerking komen voor de studie
Allen
  • Unequivocal histologically or cytologically confirmed diagnosis of metastatic or locally advanced NSCLC not amenable to treatment with surgical resection or combined chemoradiation
  • Disease progression during or after treatment with at least one prior systemic therapy but no more than three lines of prior systemic therapy in the advanced or metastatic setting
  • Measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
  • Documentation of the presence of a KRAS G12C mutation
  • Availability of a representative formalin-fixed, paraffin-embedded (FFPE) tumor specimen in a paraffin block (preferred) or 10-15 (15 preferred) unstained, freshly cut, serial slides with an associated pathology report
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Life expectancy of >= 12 weeks

  • Known hypersensitivity to any of the components of divarasib, or sotorasib or adagrasib
  • Malabsorption syndrome or other condition that would interfere with enteral absorption
  • Known concomitant second oncogenic driver
  • Mixed small-cell lung cancer or large cell neuroendocrine histology
  • Known and untreated, or active central nervous system (CNS) metastases
  • Leptomeningeal disease or carcinomatous meningitis
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures biweekly or more frequently
  • Any infection that, in the opinion of the investigator, could impact patient safety, or treatment with therapeutic oral or IV antibiotics within 14 days prior to Day 1 of Cycle 1
  • Prior treatment with any KRAS G12C inhibitor or pan-KRAS/RAS inhibitor
  • More than 30 Gy of radiotherapy to the lung within 6 months of randomization
  • Uncontrolled tumor-related pain
  • Unresolved toxicities from prior anticancer therapy
  • History of malignancy within 5 years prior to screening, with the exception of the cancer under investigation in this study and malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate >90%), such as adequately treated carcinoma in situ of the cervix, nonmelanoma skin carcinoma, localized prostate cancer, ductal carcinoma in situ, or Stage I uterine cancer
Geen contactgegevens beschikbaar
151 Studielocaties in 26 landen
Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, 5223 GZ, Netherlands
Ziekenhuis Rijnstate, Arnhem, 6815 AD, Netherlands
Amphia Ziekenhuis, Breda, 4818CK, Netherlands
Ziekenhuis St. Jansdal, Harderwijk, 3844 DG, Netherlands
Medisch Centrum Haaglanden, locatie Antoniushove, Leidschendam, 2262 BA, Netherlands
Isala, Zwolle, 8025 AB, Netherlands
AZORG Campus Aalst-Moorselbaan, Aalst, 9300, Belgium
UZ Brussel, Brussels, 1090, Belgium
Cliniques Universitaires St-Luc, Brussels, 1200, Belgium
UZ Antwerpen, Edegem, 2650, Belgium
Jessa Zkh (Campus Virga Jesse), Hasselt, 3500, Belgium
CHU de Liège (Sart Tilman), Liège, 4000, Belgium
CHU UCL Mont-Godinne, Mont-godinne, 5530, Belgium
AZ Delta (Campus Rumbeke), Roeselare, 8800, Belgium
Vitaz, Sint-Niklaas, 9100, Belgium
ZAS Sint Augustinus Wilrijk, Wilrijk, 2610, Belgium

Arizona

Banner Health MD Anderson AZ, Gilbert, Arizona, 85234, United States

California

Los Angeles Cancer Network, Los Angeles, California, 90017-4803, United States
UCLA Hematology / Oncology Clinic, Los Angeles, California, 90095, United States
University of California, San Francisco, San Francisco, California, 94158, United States

Connecticut

Yale Cancer Center, New Haven, Connecticut, 06519, United States

Florida

University of Miami, Miami, Florida, 33136, United States
Florida Cancer Specialists - North;725 6th Ave South (St. Petersburg), St. Petersburg, Florida, 33701-4553, United States

Illinois

University of Chicago Medical Center, Chicago, Illinois, 60637, United States

Maine

New England Cancer Specialists, Westbrook, Maine, 04092, United States

Massachusetts

Dana Farber Cancer Institute, Boston, Massachusetts, 02215, United States

Michigan

University of Michigan, Ann Arbor, Michigan, 48109-0934, United States
Cancer and Hematology Centers of Western Michigan, Grand Rapids, Michigan, 49503, United States

Minnesota

Minnesota Oncology Edina, Edina, Minnesota, 55435, United States

New York

Columbia University Medical Center, New York, New York, 10032, United States

Ohio

Taylor Cancer Research Center, Maumee, Ohio, 43537, United States

Oregon

Oncology Associates of Oregon, P.C, Eugene, Oregon, 97401, United States
Oregon Health & Science University, Portland, Oregon, 97239, United States

Pennsylvania

Fox Chase Cancer Center, Philadelphia, Pennsylvania, 19111, United States
Allegheny Cancer Center, Pittsburgh, Pennsylvania, 15212, United States

Tennessee

Tennessee Oncology, PLLC - Chattanooga, Chattanooga, Tennessee, 37404, United States
Baptist Clinical Research Institute, Memphis, Tennessee, 38120, United States
Tennessee Oncology, Nashville, Tennessee, 37203, United States

Texas

JPS Health Network, Fort Worth, Texas, 76104, United States
MD Anderson Cancer Center, Houston, Texas, 77030, United States
Texas Oncology - Northeast Texas, Longview, Texas, 75601, United States
Hospital Britanico, Buenos Aires, C1280AEB, Argentina
Centro Oncologico Korben, Ciudad Autonoma Buenos Aires, C1426AGE, Argentina

New South Wales

Liverpool Hospital, Liverpool, New South Wales, 2170, Australia
GenesisCare North Shore, St Leonards, New South Wales, 2065, Australia

Queensland

Sunshine Coast University Hospital, Birtinya, Queensland, 4575, Australia

South Australia

Lyell McEwin Hospital, Elizabeth Vale, South Australia, 5112, Australia

Victoria

Peter Maccallum Cancer Centre, Melbourne, Victoria, 3000, Australia
Krankenhaus Nord - Klinik Floridsdorf, Vienna, 1210, Austria

Estado de Bahia

Hospital Sao Rafael - HSR, Salvador, Estado de Bahia, 41253-190, Brazil

São Paulo

Hospital de Cancer de Barretos, Barretos, São Paulo, 14784-400, Brazil
Hospital de Base de Sao Jose do Rio Preto, São José do Rio Preto, São Paulo, 15090-000, Brazil
Hospital Sírio-Libanês, São Paulo, São Paulo, 01308-050, Brazil
Hospital Alemao Oswaldo Cruz, São Paulo, São Paulo, 01323-903, Brazil

Ontario

William Osler Health Centre - Brampton Civic Hospital, Brampton, Ontario, L6R 3J7, Canada

Quebec

Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada
Aarhus Universitetshospital, Aarhus N, 8200, Denmark
Herlev Hospital, Herlev, 2730, Denmark
Regionshospitalet Gødstrup, Herning, 7400, Denmark
Helsinki University Central Hospital, Helsinki, 00029, Finland
Kuopio Uni Hospital, Kuopio, 70211, Finland
CHRU Brest, Brest, 29200, France
Chu Toulouse, Bron, 69500, France
Hopital Louis Pradel, Bron, 69677, France
CHRU Lille, Lille, 59037, France
Centre Leon Berard, Lyon, 69373, France
CHU Montpellier, Montpellier, 34295, France
Centre Antoine Lacassagne Centre Régional de Lutte Contre Le Cancer, Nice, 06100, France
Hopital Tenon, Paris, 75970, France
CHU Bordeaux, Pessac, 33604, France
CH de Saint Quentin, Saint-Quentin, 2100, France
Chru de Strasbourg, Strasbourg, 67091, France
Hia Sainte Anne, Toulon, 83041, France
Evangelische Lungenklinik Berlin, Berlin, 13125, Germany
Helios Klinikum Emil von Behring GmbH, Berlin, 14165, Germany
Klinikum Koeln-Merheim, Cologne, 51109, Germany
KEM/Evang. Kliniken Essen Mitte gGmbH, Essen, 45136, Germany
Universitätsklinikum Essen, Essen, 45147, Germany
Klinikum Esslingen, Esslingen am Neckar, 73730, Germany
Asklepios Fachkliniken GmbH, Gauting, 82131, Germany
LungenClinic Großhansdorf GmbH, Großhansdorf, 22927, Germany
Thoraxklinik Heidelberg gGmbH, Heidelberg, 69126, Germany
Lungenklinik Hemer, Hemer, 58675, Germany
Universität Des Saarlandes, Homburg, 66421, Germany
SLK Kliniken Heilbronn GmbH, Standort Fachklinik Löwenstein, Löwenstein, 74245, Germany
Universitätsklinikum Schleswig-Holstein, Lübeck, 23538, Germany
Klinikum Bogenhausen, München, 81925, Germany
Universitätsklinikum Münster, Medizinische Klinik A, Translationale Onkologie, Münster, 48149, Germany
Universitätsklinikum Regensburg, Regensburg, 93053, Germany
Klinikum Würzburg Mitte gGmbH, Würzburg, 97074, Germany
Uoa Sotiria Hospital, Athens, 115 27, Greece
Errikos Dynan Hospital, Athens, 11526, Greece
University Hospital of Larissa, Larissa, 411 10, Greece
Theageneio Hospital, Thessaloniki, 546 39, Greece
Ag. Loukas Hospital, Thessaloniki, 55236, Greece
Tuen Mun Hospital, Hong Kong, Hong Kong
Prince of Wales Hosp, Shatin, Hong Kong

Apulia

Irccs Ist. Tumori Giovanni Paolo Ii, Bari, Apulia, 70124, Italy

Emilia-Romagna

A.O. Universitaria Di Parma, Parma, Emilia-Romagna, 43100, Italy

Lazio

IRCCS Istituto Regina Elena (IFO), Rome, Lazio, 00144, Italy

Liguria

Ospedale Policlinico San Martino, Genoa, Liguria, 16132, Italy

Sardinia

Ospedale Civile SS Annunziata, Sassari, Sardinia, 07100, Italy

Tuscany

Azienda Ospedaliero-Universitaria Careggi, Florence, Tuscany, 50139, Italy
Azienda Ospedaliero Universitaria Pisana, Pisa, Tuscany, 56126, Italy

Veneto

IRCCS Istituto Oncologico Veneto (IOV), Padova, Veneto, 35128, Italy
Kyushu University Hospital, Fukuoka, 812-8582, Japan
Sendai Kousei Hospital, Miyagi, 981-0914, Japan
Kindai University Hospital, Osaka, 589-8511, Japan
National Cancer Center Hospital, Tokyo, 104-0045, Japan
The Cancer Institute Hospital of JFCR, Tokyo, 135-8550, Japan
Wakayama Medical University Hospital, Wakayama, 641-8510, Japan
ARKE Estudios Clínicos S.A. de C.V., Mexico City, 06700, Mexico
Uniwersyteckie Centrum Kliniczne, Klinika Onkologii i Radioterapii, Gdansk, 80-214, Poland
Instytut Gruzlicy I Chorob Pluc, Warsaw, 01-138, Poland
Dolno?L?Skie Centrum Onkologii, Pulmonologii I Hematologii, Wroc?aw, 53-439, Poland
Hospital de Braga, Braga, 4710-243, Portugal
CHUC - Unidade de Pneumologia Oncológica, Coimbra, 3000-075, Portugal
Centro Clinico Champalimaud, Lisbon, 1400-038, Portugal
Centro Hospitalar do Porto ? Hospital de Santo António, Porto, 4099-001, Portugal
IPO do Porto, Porto, 4200-072, Portugal
National Cancer Centre, Singapore, 168583, Singapore
St. Vincent's Hospital, Gyeonggi-do, 16247, South Korea
Gachon University Gil Medical Center, Incheon, 21565, South Korea
Chonnam National University Hwasun Hospital, Jeollanam-do, 58128, South Korea
Seoul National University Bundang Hospital, Seongnam-si, 463-707, South Korea
Seoul National University Hospital, Seoul, 03080, South Korea
Samsung Medical Center, Seoul, 06351, South Korea

Barcelona

Institut Catala d Oncologia Hospitalet, L'Hospitalet de Llobregat, Barcelona, 08908, Spain

Sevilla

Hospital Nuestra Senora de Valme, Seville, Sevilla, 41014, Spain
Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
Hospital Vall Hebron, Barcelona, Spain
Hospital General Universitario Gregorio Marañon, Madrid, 28007, Spain
Hospital Regional Universitario de Malaga, Málaga, 29010, Spain
Hospital Universitario la Fe, Valencia, 46026, Spain
Hospital Universitario Miguel Servet, Zaragoza, 50009, Spain
Gävle Sjukhus, Gävle, 80187, Sweden
National Taiwan University Hospital, Taipei, 00100, Taiwan
Taipei Veterans General Hospital, Taipei, 112, Taiwan
Chang Gung Medical Foundation - Linkou, Taoyuan District, 333, Taiwan
Vajira Hospital, Bangkok, 10300, Thailand
Siriraj Hospital - Chulabhorn Bone Marrow Transplant Centre, Bangkok, 10700, Thailand
Songklanagarind Hospital, Songkhla, 90110, Thailand
Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
Castle Hill Hospital, Cottingham, HU16 5JQ, United Kingdom
Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, United Kingdom
St James University Hospital, Leeds, LS9 7TF, United Kingdom
Guy's Hospital - Cancer Centre, London, SE1 9RT, United Kingdom
Royal Marsden Hospital - London, London, SW3 6JJ, United Kingdom
Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom
Royal Marsden Hospital (Sutton), Sutton, SM2 5PT, United Kingdom
Torbay Hospital, Torquay, TQ27AA, United Kingdom