TAK-788 as First-Line Treatment Versus Platinum-Based Chemotherapy for Non-Small Cell Lung Cancer (NSCLC) With EGFR Exon 20 Insertion Mutations

NCT ID: NCT04129502

Last Updated: 2025-04-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

354 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-10

Study Completion Date

2026-10-31

Brief Summary

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The purpose of this study is to compare effectiveness of TAK-788 as first-line treatment with that of platinum-based chemotherapy in participants with locally advanced or metastatic non-small cell lung cancer (NSCLC) whose tumors has epidermal growth factor receptor (EGFR) exon 20 insertion mutations.

Participants will be randomly assigned to one of the two treatment groups- TAK-788 group or Platinum-based chemotherapy group.

Participants will receive TAK-788 orally and pemetrexed/cisplatin or pemetrexed/carboplatin via vein until the participants experience worsening disease (PD) as assessed by blinded independent review committee (IRC), intolerable harmful effects or another discontinuation criteria.

Detailed Description

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The drug being tested in this study is called TAK-788. TAK-788 is being tested to evaluate the efficacy as a first line treatment compare with platinum-based chemotherapy in the participants with locally advanced or NSCLC whose tumors harbor EGFR exon 20 insertion mutations.

The study will enroll approximately 318 patients. Participants will be randomly assigned to one of the two treatment groups-

* TAK-788 Group (Arm A)
* Platinum-based Chemotherapy Group (Arm B)

The participants will be administered with TAK-788 orally in arm A and pemetrexed/cisplatin or pemetrexed/carboplatin intravenously (IV) in arm B until the participants experience progressive disease (PD) as assessed by blinded independent review committee (IRC), intolerable toxicity or another discontinuation criteria. Participants in the chemotherapy group may cross over to treatment with TAK-788 after IRC-assessed PD is documented. Randomized treatment with TAK-788 or platinum-based chemotherapy may be continued after PD, at the discretion of the investigator and with the sponsor's approval, if there is still evidence of clinical benefit.

This multi-center trial will be conducted in United States (US), Europe, and Asia. The overall time to participate in this study is until 3 years after the last participant is randomized. Participants will make multiple visits to the clinic and will be followed for survival, subsequent anticancer therapy, subsequent disease assessment outcome until disease progression on a subsequent anticancer therapy, and participant-reported health status (EuroQoL-5 Dimensions-5 Levels \[EQ-5D-5L\]) for 3 years after the last participant is randomized in the study and 30 days after the last dose of study drug for safety follow-up.

Conditions

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Advanced/Metastatic Non-Small Cell Lung Cancer (NSCLC)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TAK-788 Group (Arm A)

TAK-788 160 milligram (mg) with or without food, capsules, orally, once daily until the participants experience PD as assessed by blinded IRC, intolerable toxicity, or another discontinuation criteria.

Group Type EXPERIMENTAL

TAK-788

Intervention Type DRUG

TAK-788 capsule

Platinum-based Chemotherapy Group (Arm B)

Pemetrexed 500 milligram per meter square (mg/m\^2) plus cisplatin 75 mg/m\^2, infusion, IV, once on Day 1 of 21-day cycle pemetrexed 500 mg/m\^2 plus carboplatin, infusion, IV, once at a dose calculated to produce area under curve (AUC) of 5 milligram\*minute per milliliter (mg\*min/mL) on Day 1 of 21-day cycle until the participants experience PD as assessed by blinded IRC, intolerable toxicity, or another discontinuation criteria. Pemetrexed/cisplatin or pemetrexed/carboplatin will be repeated every 3 weeks for 4 cycles, followed by maintenance treatment with pemetrexed 500 mg/m\^2, on Day 1 of a 21-day cycle thereafter.

Group Type ACTIVE_COMPARATOR

Pemetrexed

Intervention Type DRUG

Pemetrexed IV infusion

Cisplatin

Intervention Type DRUG

Cisplatin IV infusion

Carboplatin

Intervention Type DRUG

Carboplatin IV infusion

Interventions

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TAK-788

TAK-788 capsule

Intervention Type DRUG

Pemetrexed

Pemetrexed IV infusion

Intervention Type DRUG

Cisplatin

Cisplatin IV infusion

Intervention Type DRUG

Carboplatin

Carboplatin IV infusion

Intervention Type DRUG

Other Intervention Names

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AP32788 Mobocertinib Alimta

Eligibility Criteria

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Inclusion Criteria

* Male or female adult patients (aged 18 years or older)
* Histologically or cytologically confirmed nonsquamous cell locally advanced not suitable for definitive therapy, recurrent, or metastatic (Stage IV) NSCLC
* Documented epidermal growth factor receptor (EGFR) in-frame exon 20 insertion mutation assessed by a clinical laboratory improvements amendment (CLIA)-certified (US sites) or an accredited (outside of the US) local laboratory The EGFR exon 20 insertion mutation can be either alone or in combination with other EGFR or human epidermal growth factor receptor 2 (HER2) mutations except EGFR mutations for which there are approved anti-EGFR tyrosine kinase inhibitors \[TKIs\] (ie, exon 19 del, L858R, T790M, L861Q, G719X, or S768I, where X is any other amino acid)
* Adequate tumor tissue available, either from primary or metastatic sites, for central laboratory confirmation of EGFR exon 20 insertion mutation
* At least 1 measurable lesion per RECIST Version 1.1
* Life expectancy ≥3 months
* Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
* Adequate organ and hematologic function as defined by blood transfusions with a recommended \>/ 14 day washout period.

Exclusion Criteria

* Received prior systemic treatment for locally advanced or metastatic disease, including local administration, such as intra-pleural injection of anticancer medication with the exception noted below:

* Neoadjuvant or adjuvant chemotherapy/immune therapy for Stage I to III or combined modality chemotherapy/radiation for locally advanced disease is allowed if completed \>6 months before the development of metastatic disease.
* Received radiotherapy ≤14 days before randomization or has not recovered from radiotherapy-related toxicities
* Received a moderate or strong cytochrome P450 (CYP)3A inhibitor or moderate or strong CYP3A inducer within 10 days before first dose of TAK-788
* Have been diagnosed with another primary malignancy other than NSCLC
* Have current spinal cord compression or leptomeningeal disease
* Have uncontrolled hypertension. Participants with hypertension should be under treatment on study entry to control blood pressure
* Received a live vaccine within 4 weeks before randomization per Summary of product characteristics (SmPCs) for pemetrexed, cisplatin, and carboplatin
* Taking medication(s) known to be associated with the development of torsades de pointes.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Takeda

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Study Director

Role: STUDY_DIRECTOR

Takeda

Locations

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City of Hope National Medical Center

Long Beach, California, United States

Site Status

University of California Irvine

Orange, California, United States

Site Status

Stanford University

Palo Alto, California, United States

Site Status

AdventHealth

Orlando, Florida, United States

Site Status

Northwestern University

Chicago, Illinois, United States

Site Status

University of Maryland Greenebaum Cancer Center

Baltimore, Maryland, United States

Site Status

Beth Israel Deaconess Medical Center - 330 Brookline Ave

Boston, Massachusetts, United States

Site Status

Dana Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Sarah Cannon Cancer Center

Nashville, Tennessee, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

GenesisCare North Shore

St Leonards, New South Wales, Australia

Site Status

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Klinik Floridsdorf

Vienna, , Austria

Site Status

Cliniques Universitaires Saint-Luc

Brussels, Brussels Capital, Belgium

Site Status

Grand Hopital de Charleroi asbl

Charleroi, Hainaut, Belgium

Site Status

AZ Sint-Lucas

Aalst, Oost-Vlaanderen, Belgium

Site Status

British Columbia Cancer Agency

Vancouver, British Columbia, Canada

Site Status

William Osler Health System

Brampton, Ontario, Canada

Site Status

Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

Hopital Du Sacre Coeur de Montreal

Montreal, Quebec, Canada

Site Status

Beijing Cancer Hospital - PPDS

Beijing, Beijing Municipality, China

Site Status

Henan Cancer Hospital

Zhengzhou, Henan, China

Site Status

Jilin Cancer Hospital

Changchun, Jilin, China

Site Status

Beijing Cancer Hospital - PPDS

Beijing, , China

Site Status

Beijing Chest Hospital, Capital Medical Univerity

Beijing, , China

Site Status

Icahn School of Medicine at Mount Sinai

Beijing, , China

Site Status

Sichuan Cancer Hospital & Institute

Chengdu, , China

Site Status

Guangdong Provincial People's Hospital

Guangzhou, , China

Site Status

The First Affiliated Hospital, Zhejiang University School of Medicine

Hangzhou, , China

Site Status

Harbin Medical University Tumor Hospital

Harbin, , China

Site Status

Shanghai East Hospital

Shanghai, , China

Site Status

Hubei Cancer Hospital

Wuhan, , China

Site Status

Centre Francois Baclesse

Caen, Calvados, France

Site Status

CHU de Nantes - Hoptal Nord Laennec

Nantes, Loire-Atlantique, France

Site Status

Hopital Calmette

Lille, Nord, France

Site Status

Centre Leon Berard

Lyon, Rhone, France

Site Status

Institut Gustave Roussy

Villejuif, Val-de-Marne, France

Site Status

CHU de Grenoble

Grenoble, , France

Site Status

Hopital Nord AP-HM

Marseille, , France

Site Status

CRLC Val d'Aurelle - Paul Lamarque

Montpellier, , France

Site Status

Hopital Tenon

Paris, , France

Site Status

Nouvel Hopital Civil

Strasbourg, , France

Site Status

Hopital Larrey

Toulouse, , France

Site Status

Thoraxklinik-Heidelberg gGmbH

Heidelberg, Baden-Wurttemberg, Germany

Site Status

LMU Klinikum der Universitat Munchen

München, Bavaria, Germany

Site Status

University Clinic Regensburg

Regensburg, Bavaria, Germany

Site Status

Universitatsklinikum Frankfurt

Frankfurt am Main, Hesse, Germany

Site Status

Pius Hospital Oldenburg

Oldenburg, Lower Saxony, Germany

Site Status

Helios Klinikum Emil Von Behring

Berlin, , Germany

Site Status

Sotiria Chest Hospital of Athens

Athens, Attica, Greece

Site Status

Bioclinic Thessaloniki (Galinos clinic)

Thessaloniki, , Greece

Site Status

Princess Margaret Hospital

Kowloon City, Kowloon City, Hong Kong

Site Status

Pamela Youde Nethersole Eastern Hospital

Hong Kong, , Hong Kong

Site Status

Queen Elizabeth Hospital (QEH)

Hong Kong, , Hong Kong

Site Status

Queen Mary Hospital - PPDS

Hong Kong, , Hong Kong

Site Status

Tuen Mun Hospital

Hong Kong, , Hong Kong

Site Status

Prince of Wales Hospital

Shatin, , Hong Kong

Site Status

Soroka University Medical Centre

Beersheba, , Israel

Site Status

Sheba Medical Center - PPDS

Ramat Gan, , Israel

Site Status

AORN Dei Colli- Ospedale Monaldi Napoli

Napoli, Campania, Italy

Site Status

Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - IRST S.r.l - PPDS

Meldola, Forli-Cesena, Italy

Site Status

Istituto Nazionale Dei Tumori

Milan, Lombardy, Italy

Site Status

Instituto Europeo Di Oncologia

Milan, Lombardy, Italy

Site Status

Azienda Sanitaria Ospedaliera S Luigi Gonzaga

Orbassano, Piedmont, Italy

Site Status

Centro Di Riferimento Oncologico

Aviano, Pordenone, Italy

Site Status

Azienda Ospedaliero Universitaria Pisana

Pisa, Tuscany, Italy

Site Status

Azienda Ospedaliero Universitaria di Parma

Parma, , Italy

Site Status

Ospedale Santa Maria Delle Croci

Ravenna, , Italy

Site Status

Fujita Health University Hospital

Toyoake-Shi, Aiti, Japan

Site Status

National Cancer Center Hospital East

Kashiwa-Shi, Chiba, Japan

Site Status

Ehime University Hospital

Matsuyama, Ehime, Japan

Site Status

National Hospital Organization Hokkaido Cancer Center

Sapporo, Hokkaido, Japan

Site Status

Kurume University Hospital

Kurume-Shi, Hukuoka, Japan

Site Status

Kanagawa Cancer Center

Yokohama, Kanagawa, Japan

Site Status

Saiseikai Kumamoto Hospital

Kumamoto, Kumamoto, Japan

Site Status

Miyagi Cancer Center

Natori-shi, Miyagi, Japan

Site Status

Okayama University Hospital

Okayama, Okayama-ken, Japan

Site Status

Osaka International Cancer Institute

Chuo Ku, Osaka, Japan

Site Status

Saitama Cancer Center

Komoro, Saitama, Japan

Site Status

The Cancer Institute Hospital of Japanese Foundation For Cancer Research

Koto-Ku, Tokyo, Japan

Site Status

VU Medisch Centrum

Amsterdam, North Holland, Netherlands

Site Status

Centro Hospitalar do Porto Hospital de Santo Antonio

Santa Maria da Feira, Aveiro District, Portugal

Site Status

Hospital Cuf Porto

Vila Nova de Gaia, Porto District, Portugal

Site Status

Centro Hospitalar de Lisboa Norte E.P.E Hospital Pulido Valente

Lisbon, , Portugal

Site Status

Instituto Portugues de Oncologia Do Porto Francisco Gentil Epe - PPDS

Porto, , Portugal

Site Status

Centro Hospitalar de Sao Joao, E.P.E.

Porto, , Portugal

Site Status

GBUZ Saint Petersburg Clinical Research Center of Specialized Types of Care (Oncology)

Saint Petersburg, Leningradskaya Oblast', Russia

Site Status

LLC "EuroCityClinic"

Saint Petersburg, Sankt-Peterburg, Russia

Site Status

National Cancer Centre

Singapore, , Singapore

Site Status

Chungbuk National University Hospital

Cheongju-si, North Chungcheong, South Korea

Site Status

Pusan National University Hospital

Busan, , South Korea

Site Status

National Cancer Center

Goyang, , South Korea

Site Status

Chonnam National University Hwasun Hospital

Jeongnam, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Asan Medical Center - PPDS

Seoul, , South Korea

Site Status

Samsung Medical Center PPDS

Seoul, , South Korea

Site Status

The Catholic University of Korea, Seoul St. Mary's Hospital

Seoul, , South Korea

Site Status

Severance Hospital Yonsei University Health System - PPDS

Seoul, , South Korea

Site Status

ICO lHospitalet Hospital Duran i Reynals

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status

Hospital Universitario A Coruna

A Coruña, , Spain

Site Status

Hospital General Universitario de Alicante

Alicante, , Spain

Site Status

Hospital Universitario Vall d'Hebron - PPDS

Barcelona, , Spain

Site Status

Hospital Clinic de Barcelona

Barcelona, , Spain

Site Status

C.H. Regional Reina Sofia - PPDS

Córdoba, , Spain

Site Status

Hospital Universitario Fundacion Jimenez Diaz

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Hospital Universitario La Paz - PPDS

Madrid, , Spain

Site Status

Hospital Universitari i Politecnic La Fe de Valencia

Valencia, , Spain

Site Status

Karolinska Universitetssjukhuset Solna

Stockholm, Södermanland County, Sweden

Site Status

Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

Dalin, , Taiwan

Site Status

National Taiwan University Hospital - YunLin Branch

Douliu, , Taiwan

Site Status

Kaohsiung Medical University - Chung-Ho Memorial Hospital

Kaohsiung City, , Taiwan

Site Status

E-DA hospital

Kaohsiung City, , Taiwan

Site Status

Taichung Veterans General Hospital

Taichung, , Taiwan

Site Status

National Cheng Kung University Hospital

Tainan City, , Taiwan

Site Status

Chi Mei Medical Center, Liouying

Tainan City, , Taiwan

Site Status

National Taiwan University Hospital

Taipei, , Taiwan

Site Status

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status

Baskent University Medical Faculty Adana Practice and Research Center

Yüreğir, Adana, Turkey (Türkiye)

Site Status

T.C. Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin City Hospital

Kadıköy, Istanbul, Turkey (Türkiye)

Site Status

Ege University Medical Faculty

Bornova, İzmir, Turkey (Türkiye)

Site Status

SAKARYA University Medical Faculty

Karaman, Sakarya, Turkey (Türkiye)

Site Status

Hacettepe University Medical Faculty

Ankara, , Turkey (Türkiye)

Site Status

Trakya University Medical Faculty

Edirne, , Turkey (Türkiye)

Site Status

Municipal Non-profit Enterprise "City Clinical Hospital # 4" of Dnipro City Council - PPDS

Dnipropetrovsk, Dnipropetrovsk Oblast, Ukraine

Site Status

Communal Non-profit Enterprise Regional Center of Oncology

Kharkiv, Kharkivs’ka Oblast’, Ukraine

Site Status

Private Enterprise Private Manufacturing Company Acinus

Kropyvnytskyi, , Ukraine

Site Status

University College London Hospitals (UCLH)

London, London, City of, United Kingdom

Site Status

Royal Marsden Hospital - Surrey

Sutton, Surrey, United Kingdom

Site Status

Clatterbridge Centre For Oncology

Bebington, Wirral, United Kingdom

Site Status

Leicester General Hospital

Leicester, , United Kingdom

Site Status

The Christie NHS Foundation Trust - PPDS

Manchester, , United Kingdom

Site Status

Countries

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United States Australia Austria Belgium Canada China France Germany Greece Hong Kong Israel Italy Japan Netherlands Portugal Russia Singapore South Korea Spain Sweden Taiwan Turkey (Türkiye) Ukraine United Kingdom

References

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Janne PA, Wang BC, Cho BC, Zhao J, Li J, Hochmair M, Peters S, Besse B, Pavlakis N, Neal JW, Kato T, Wu YL, Nguyen D, Lin J, Lin J, Vranceanu F, Szumski A, Lin HM, Fram RJ, Mok TSK. First-Line Mobocertinib Versus Platinum-Based Chemotherapy in Patients With EGFR Exon 20 Insertion-Positive Metastatic Non-Small Cell Lung Cancer in the Phase III EXCLAIM-2 Trial. J Clin Oncol. 2025 May;43(13):1553-1563. doi: 10.1200/JCO-24-01269. Epub 2025 Jan 29.

Reference Type DERIVED
PMID: 39879577 (View on PubMed)

Other Identifiers

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NL20191212

Identifier Type: REGISTRY

Identifier Source: secondary_id

2019-001845-42

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1232-6059

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

jRCT2071210098

Identifier Type: REGISTRY

Identifier Source: secondary_id

TAK-788-3001

Identifier Type: -

Identifier Source: org_study_id

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