Gocatamig and I-DXd (short for ifinatamab deruxtecan) are study medicines. Researchers want to know if giving gocatamig and I-DXd together can treat ES-SCLC. Researchers will also look at giving the study medicines with standard treatment. Gocatamig is a T-cell engager therapy. I-DXd is an antibody drug conjugate. T-cell engager therapy is a certain type of immunotherapy that uses T-cells to find and destroy cancer cells. A T-cell is a type of white blood cell, which are cells that help the body fight infection. An antibody drug conjugate (ADC) is a treatment that attaches to a protein on cancer cells and delivers treatment to destroy those cells. The goals of this study are to learn: About the safety of combining gocatamig and I-DXd and if people tolerate them together If people who receive gocatamig and I-DXd have ES-SCLC respond, which means the cancer gets smaller or goes away
In Part A, participants will be allocated to Arm 1 or Arm 2 per investigator's discretion. In Part B, participants will be allocated to Arm 1 per investigator's discretion and randomized to Arms 2, 3, and 4.
Detailed eligibility criteria is available on clinicaltrials.gov. These requirements will be discussed with your doctor and/or study representative. Click the NCT number link below to learn more about this study on ClinicalTrials.gov The main inclusion criteria include but are not limited to the following: Has a histologically or cytologically confirmed diagnosis of extensive-stage small cell lung cancer (ES-SCLC) For participants receiving gocatamig + ifinatamab deruxtecan (I-DXd) in maintenance only: Completed 3 to 4 cycles of platinum + etoposide chemotherapy with concurrent approved anti-programmed cell death 1/Ligand 1 (anti PD-1/L1) as first line (1L) treatment of ES-SCLC within 6 weeks prior to enrollment No radiological disease progression per Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST 1.1) No other prior systemic ES-SCLC therapy allowed Rechallenge therapy counts as an additional line and leads to exclusion For participants receiving gocatamig + I-DXd in induction and maintenance, or gocatamig + I-DXd in induction followed by gocatamig + atezolizumab in maintenance, or carboplatin + etoposide + atezolizumab in induction followed by atezolizumab in maintenance: No prior systemic ES-SCLC treatment allowed Applicable to all participants: prior limited-stage small cell lung cancer (SCLC) is allowed if > 6 months have passed since the end of previous therapy and progression Must be able to provide a pretreatment archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion not previously irradiated Measurable disease by RECIST 1.1 as assessed by the local site investigator/radiology. Lesions situated in a previously irradiated area are considered measurable if growth has been shown in such lesions since the completion of radiation The main exclusion criteria include but are not limited to the following: Has pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures Has any history of interstitial lung disease (ILD)/pneumonitis irrespective of steroid use, current ILD, ILD that cannot be ruled out by imaging at screening, or suspected ILD Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses Has history of clinically significant intracranial bleeding or spinal cord bleeding Has active neurologic paraneoplastic syndrome Has history of coronary/peripheral artery bypass graft and/or any coronary/peripheral angioplasty or clinically significant cardiovascular disease such as myocardial infarction, symptomatic congestive heart failure (CHF), and/or uncontrolled cardiac arrhythmia within 6 months before the first dose of study intervention Has other uncontrolled or significant protocol specified cardiovascular disease Has history of arterial thrombosis within 6 months before the first dose of study intervention Has chronic liver disease Has history of allogeneic tissue/solid organ transplant Has history of leptomeningeal disease Is infected with human immunodeficiency virus (HIV) and has a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease Has received prior therapy with an anti-programmed cell death protein 1 (anti-PD-1), anti-programmed cell death ligand 1 (anti-PD-L1), or anti-programmed cell death ligand 2 (anti-PD-L2) agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor Has received prior radiotherapy within 2 weeks of start of study intervention, or has radiation-related toxicities, requiring corticosteroids Has known additional malignancy that is progressing or has required active treatment within the past 3 years Has active autoimmune disease that has required systemic treatment in the past 2 years except replacement therapy Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis Has major surgery within 4 weeks or minor surgery
Protocol Number: 26-0320
More information available at ClinicalTrials.gov: NCT07227597
Principal Investigator