Trilaciclib in Patients Receiving Sacituzumab Tirumotecan for EGFR-mutated, Advanced Non-Small Cell Lung Cancer (NSCLC)

NCT06992739 | Recruiting Phase 2

• 1 other identifier: PROTECT-2
• Study Type: interventional
• Target: 49
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a prospective, single arm phase II clinical trial aimed at patients with advanced non-small cell lung cancer resistant to EGFR-TKI. The aim is to evaluate the efficacy and safety of trilaciclib in bone marrow protection before monotherapy with sacituzumab tirumotecan. Patients with advanced non-small cell lung cancer resistant to EGFR-TKI, after signing informed consent, will be screened for eligible subjects who meet the inclusion criteria. Prior to receiving treatment with sacituzumab tirumotecan, they will be treated with trilaciclib until disease progression or intolerable toxicity occurs. Record the dynamic changes of whole blood cell count; Hematological toxicity, including febrile neutropenia and associated infections; Transfusion of blood products and supplementation of hematopoietic raw materials. Perform tumor imaging evaluation according to RECIST 1.1. Baseline imaging examination should be conducted within 21 days prior to the first administration, and tumor imaging evaluation shall be conducted every 6 weeks (± 7 days) from the first study drug administration, or the frequency of imaging evaluation may be increased when there are clinical indications. Subjects who terminate the study drug treatment due to intolerable toxicity or other non disease progression reasons continue to receive tumor evaluation follow-up until disease progression, withdrawal from the study, or death (whichever occurs earliest). After the screening period and one cycle of treatment, subjects may choose to undergo whole-body PET/CT imaging for exploratory analysis.

Conditions

NSCLC (Advanced Non-small Cell Lung Cancer); EGFR; Myelosuppression

Outcome Measures

Primary Outcomes (1)

• Incidence of grade ≥ 3 neutropenia during sacituzumab tirumotecan treatment

  Time from date of first dose of trilaciclib and sacituzumab tirumotecan through 30 days following the last dose of trilaciclib and sacituzumab tirumotecan

Secondary Outcomes (11)

• Incidence rate of grade 3 or 4 thrombocytopenia

  Time from date of first dose of trilaciclib and sacituzumab tirumotecan 30 days following the last dose of trilaciclib and sacituzumab tirumotecan

• Incidence rate of grade 3 or 4 anemia during sacituzumab tirumotecan treatment

  Time from date of first dose of trilaciclib and sacituzumab tirumotecan through 30 days following the last dose of trilaciclib and sacituzumab tirumotecan

• Incidence rate of febrile neutropenia

  Time from date of first dose of trilaciclib and sacituzumab tirumotecan through 30 days following the last dose of trilaciclib and sacituzumab tirumotecan

• Usage rate of symptomatic treatments for myelosuppression

  Time from date of first dose of trilaciclib and sacituzumab tirumotecan through 30 days following the last dose of trilaciclib and sacituzumab tirumotecan

• Objective response rate (ORR)

  18 months after the last subject participating in

Study Arms (1)

Trilaciclib and Sacituzumab Tirumotecan

EXPERIMENTAL

Trilaciclib and Sacituzumab Tirumotecan

Drug: Trilaciclib and Sacituzumab Tirumotecan

Interventions

Trilaciclib and Sacituzumab Tirumotecan DRUG

Trilaciclib: 240 mg/m2 as a 30-min iv. infusion, completed ≤4h prior to sacituzumab tirumotecan. Sacituzumab Tirumotecan: 5 mg/kg on days 1 \& 15 of a 28 day cycle via intravenous (IV) infusion until progressive disease or discontinuation.

Trilaciclib and Sacituzumab Tirumotecan

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age range: 18-75 years old; No gender restrictions;
• ECOG PS score 0-1;
• Expected survival time ≥ 3 months;
• Patients with locally advanced or metastatic EGFR mutant non-small cell lung cancer diagnosed by histological or cytological examination, who have failed third-generation EGFR-TKI treatment and have experienced up to second-line EGFR-TKI treatment failure;
• Patients who have only progressed with 1-2 generations of EGFR-TKI treatment need to undergo third-generation EGFR-TKI treatment;
• If patients receive third-generation EGFR-TKI during neoadjuvant and/or postoperative adjuvant therapy and progress to metastatic or locally advanced disease more than 6 months after the last dose, they need to receive third-generation EGFR-TKI treatment again before they can participate in this study;
• If patients receive third-generation EGFR-TKI during neoadjuvant and/or postoperative adjuvant therapy and progress to metastatic or locally advanced disease within 6 months after the last dose, they can directly participate in this study;
• Imaging disease progression was recorded during or after the recent first-line treatment process.
• There must be at least one measurable lesion that meets the RECIST 1.1 criteria;
• The main organ functions well and meets the following standards:
• Blood routine examination (without blood transfusion or correction with hematopoietic stimulating factor drugs within 14 days): hemoglobin (Hb) ≥ 90g/L; Absolute neutrophil count (ANC) ≥ 1.5 × 109/L; Platelet count (PLT) ≥ 80 × 109/L; Biochemical examination: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN (≤ 5 × ULN for patients with liver metastasis); Serum total bilirubin (TBIL) ≤ 1.5 × ULN (Gilbert syndrome subjects, ≤ 3×ULN）； Serum creatinine (Cr) ≤ 1.5 × ULN, or creatinine clearance rate ≥ 60mL/min; Coagulation function: activated partial thromboplastin time (APTT), international normalized ratio (INR), prothrombin time (PT) ≤ 1.5 × ULN;
• The subject must recover from all toxic reactions (except hair loss) of previous treatment to ≤ level 1 (evaluated based on CTCAE 5.0 criteria);
• Women: All women with potential fertility must have a negative serum pregnancy test result during the screening period, and must take reliable contraceptive measures from signing the informed consent form until 3 months after the last dose;
• Participants voluntarily participate in this study, understand and sign the informed consent form.

You may not qualify if:

• History of myeloid leukemia, myelodysplastic syndrome, or accompanying sickle cell disease;
• Symptomatic CNS metastases and/or leptomeningeal diseases that require immediate radiotherapy or steroid treatment;
• Have undergone surgery or radiation therapy within 4 weeks prior to the administration of the first dose of the study drug;
• Clinical symptoms or diseases of the heart that have not been well controlled, such as: (1) NYHA grade 2 or above heart failure; (2) Unstable angina pectoris; (3) Have experienced myocardial infarction within 6 months; (4) Patients with clinically significant supraventricular or ventricular arrhythmias that require treatment or intervention;
• History of interstitial lung disease, slow progressive dyspnea and dry cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary allergic pneumonia, or multiple allergic or peripheral arterial diseases (such as claudication, Leo Buerger's disease).
• Patients who have received hematopoietic stem cell or bone marrow transplantation in the past;
• Patients who need to receive radiation therapy at the same time;
• Those who are known to have a history of allergies to the components of this drug regimen;
• Pregnant or lactating women;
• The researcher believes that the patient is not suitable to participate in any other circumstances of this study.

Sponsors & Collaborators

• The First Affiliated Hospital of Xiamen University: lead

Study Sites (1)

The First Affiliated Hospital of Xiamen University

Xiamen, Fujian, China

RECRUITING

MeSH Terms

Conditions

Carcinoma, Non-Small-Cell Lung

Interventions

trilaciclib

Condition Hierarchy (Ancestors)

Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 6, 2025
• First Posted: May 28, 2025
• Study Start: December 8, 2025
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: April 14, 2026

Record last verified: 2026-03

Locations

CN (1)