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Ref Type | Journal Article | ||||||||||||
PMID | (38295954) | ||||||||||||
Authors | Shi Y, Hu X, Li X, Gong C, Wang K, Li Y, Zhang S, Luo Y, Wang P, Jiang L, Meng X, Dong X, Wang H, Yang R, Mei Q, Liu B, Yang L, Sun Y | ||||||||||||
Title | Ficonalkib (SY-3505) in Advanced ALK-Positive Non-Small-Cell Lung Cancer: A Multicenter, Open-Label, Single-Arm, Phase I/Ⅱ Study. | ||||||||||||
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Abstract Text | Treatment options for second-generation (2nd-gen) anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) resistant patients are limited. We evaluated the safety, pharmacokinetics, and efficacy of ficonalkib (SY-3505), a third-generation (3rd-gen) ALK TKI.This first-in-human, phase I/Ⅱ study (Chinese Clinical Trial Registry identifier: ChiCTR1900025619; ClinicalTrials.gov identifier: NCT05257512) had two parts. Phase I included a dose-escalation phase (25-800 mg quaque die [QD]) and a dose-expansion phase (500 mg QD or 600 mg QD). Phase Ⅱ enrolled patients treated at recommended phase Ⅱ dose (RP2D). Primary endpoints were safety in phase I and objective response rate (ORR) in phase Ⅱ.Between Apr 21, 2020, and Aug 31, 2023, a total of 127 patients were enrolled, with 62 in phase I. Ficonalkib was well absorbed and tolerated, with one dose limited toxicity event occurring at 800 mg QD. Treatment-related adverse events (TRAEs) occurred in 85.5% of patients, with 19.4% experienced ≥ grade 3 events. The ORR was 38.3% (23/60, 95% confidence interval [CI] 26.1-51.8%) in phase I, and 600 mg QD was established as RP2D. In phase Ⅱ, a total of 65 patients received ficonalkib at 600 mg QD. Totally 88 patients received ficonalkib at 600 mg QD in phase I/Ⅱ, and all had received prior 2nd-gen ALK TKI treatment. 90.9% of patients experienced TRAEs and 14.8% experienced ≥ grade 3 events. The ORR in efficacy-evaluable patients received ficonalkib at 600 mg QD was 47.5% (38/80, 95% CI 36.2-59.0%), with an intracranial ORR of 37.5% (12/32, 95% CI 21.1-56.3%) in these patients with measurable brain lesions at baseline.Ficonalkib (SY-3505) was well tolerated, with favorable safety profiles and promising efficacy in patients resistant to prior 2nd-gen ALK TKI. |