Disitamab Vedotin in Combination with Tislelizumab and Bevacizumab in a Phase II Clinical Study of Locally Advanced or Metastatic Non-small Cell Lung Cancer with HER2 Mutation/amplification/expression
The goal of this clinical trial is to learn ifDisitamab Vedotin in combination with tislelizumab and bevacizumab can treat in locally advanced or metastatic non-small cell lung cancer patients with HER2 mutation/amplification/expression. The main questions it aims to answer are: 1. objective response rate; 2. Progression-Free Survival; 3. Overall Survival; 4. Disease Control Rate; 5. Duration of Response.
• Prior to the implementation of any trial-related procedures, written informed consent must be obtained;
• Aged \>= 18 years;
• Patients with locally advanced (Stage III B/III C), metastatic, or recurrent (Stage IV) non-small cell lung cancer (NSCLC) confirmed histologically or cytologically, who are ineligible for surgical intervention and cannot undergo curative radiochemotherapy, as per the 8th edition TNM staging classification of the International Association for the Study of Lung Cancer and the American Joint Committee on Cancer;
• Provision of archived tumor tissue or tissue obtained during screening biopsy for biomarker testing, including PD-L1 expression, HER2 mutation status, etc.;
• HER2 mutation, amplification, or HER2 expression (IHC 1+, 2+, or 3+);
• Investigator confirmation of at least one measurable lesion according to RECIST 1.1 criteria;
• Cohort I: Patients who have received prior ≥1 line of systemic therapy or HER2 tyrosine kinase inhibitors such as afatinib, pyrotinib, or pozitinib. Cohort II: No prior receipt of any systemic anti-tumor therapy for advanced/metastatic disease; For patients who have previously received platinum-containing adjuvant/radiotherapy, neoadjuvant/radiotherapy, or radical chemoradiotherapy for advanced disease, disease progression occurs \>6 months after the end of the last treatment, may participate in this study;
• Expected life expectancy \>= 3 months;
• ECOG PS 0-1;
⁃ Adequate hematologic function, defined as an absolute neutrophil count \>= 1.5×10\^9/L, platelet count \>= 100×10\^9/L, hemoglobin \>= 90g/L (without a history of blood transfusion in the past 7 days);
⁃ Adequate liver function, defined as total bilirubin level \<= 1.5 times the upper limit of normal (ULN) and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels \<= 2.5 times ULN for all patients, or for patients with liver metastasis, AST and ALT levels \<= 5 times ULN;
⁃ Adequate renal function, defined as serum creatinine \<= 1.5 times ULN;
⁃ Adequate coagulation function, defined as international normalized ratio (INR) or prothrombin time (PT) \<= 1.5 times ULN; if a subject is on anticoagulant therapy, INR/PT should be within the therapeutic range set by the anticoagulant;
⁃ Women of childbearing potential must undergo a pregnancy test within 7 days prior to the start of treatment, with negative results; and reliable contraception methods (such as intrauterine devices, oral contraceptives, and condoms) should be used during the trial and for 30 days after the end of the trial. Men of childbearing potential should use condoms for contraception during the trial and for 30 days after the end of the trial;
⁃ Willingness to comply with regular follow-up visits and adhere to trial requirements.