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CTRI Number  CTRI/2024/10/075224 [Registered on: 14/10/2024] Trial Registered Prospectively
Last Modified On: 11/10/2024
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   A study of Repotrectinib versus Crizotinib in Participants with Locally Advanced or Metastatic Tyrosine Kinase Inhibitor ROS1 positive Non-Small Cell Lung Cancer  
Scientific Title of Study   Randomized, Open-label, Multicenter,Phase 3 Trial of Repotrectinib VersusCrizotinib in Participants with Locally Advanced or Metastatic Tyrosine Kinase Inhibitor (TKI)-naïve ROS1-positive Non-Small Cell Lung Cancer (NSCLC) (TRIDENT-3) 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
2023-505604-32-00  EudraCT 
CA127-1030, Version No V01,Protocol Date 12 May 2023  Protocol Number 
U1111-1292-0487  UTN 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Shilpi Sinha 
Designation  Associate Director, Country Head RCO India 
Affiliation  Bristol Myers Squibb India Pvt. Ltd. 
Address  Bristol Myers Squibb India Pvt. Ltd. One International Centre, 6th Floor, Tower 1, Senapati Bapat Marg, Elphinstone (W), Mumbai - 400013 (Suburban), MAHARASHTRA, India

Mumbai (Suburban)
MAHARASHTRA
400013
India 
Phone  02266288600  
Fax    
Email  Shilpi.Sinha@bms.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Kartik Doshi 
Designation  Associate Director, Head Medical India 
Affiliation  Bristol Myers Squibb India Pvt. Ltd. 
Address  Bristol Myers Squibb India Pvt. Ltd. One International Centre, 6th Floor, Tower 1, Senapati Bapat Marg, Elphinstone (W), Mumbai - 400013 (Suburban), MAHARASHTRA, India

Mumbai (Suburban)
MAHARASHTRA
400013
India 
Phone  02266288600  
Fax    
Email  Kartik.Doshi@bms.com  
 
Details of Contact Person
Public Query
 
Name  Dr Kartik Doshi 
Designation  Associate Director, Head Medical India 
Affiliation  Bristol Myers Squibb India Pvt. Ltd. 
Address  Bristol Myers Squibb India Pvt. Ltd. One International Centre, 6th Floor, Tower 1, Senapati Bapat Marg, Elphinstone (W), Mumbai - 400013 (Suburban), MAHARASHTRA, India


MAHARASHTRA
400013
India 
Phone  02266288600  
Fax    
Email  Kartik.Doshi@bms.com  
 
Source of Monetary or Material Support  
Bristol Myers Squibb India Pvt. Ltd. One International Centre, 6th Floor, Tower 1, Senapati Bapat Marg, Elphinstone (W), Mumbai- 400013 India  
 
Primary Sponsor  
Name  Bristol Myers Squibb India Pvt Ltd  
Address  One International Centre, 6th Floor, Tower 1, Senapati Bapat Marg, Elphinstone (W), Mumbai - 400013 (Suburban), MAHARASHTRA, India 
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     Argentina
Austria
Brazil
Canada
Chile
China
Democratic People's Republic of Korea
France
Germany
Greece
Hungary
India
Italy
Japan
Poland
Romania
Spain
Switzerland
Turkey
United States of America  
Sites of Study  
No of Sites = 13  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Prabhat Malik  All India Institutes of Medical Sciences  Room No. 245, Dept of Medical Oncology, 2nd floor, Dr B R Ambedkar Institute of Rotary Cancer hospital, AIIMS, Ansari nagar, New Delhi - 110029
New Delhi
DELHI 
91-9968325318

drprabhatsm@gmail.com 
Dr Priya Tiwari  Artemis Hospital  Artemis Hospital, Department of Medical oncology, Lower Ground floor, Main building, Artemis hospital, Sector-51, Gurugram, Haryana - 122001, India
Gurgaon
HARYANA 
91-8377828241

priya.tiwari@artemishospitals.com 
Dr Ankur Bahl  Fortis Memorial Research Institute  Department of Medical Oncology, Lower Ground floor, Fortis Memorial Research Institute, Sec 44, Gurugram, Haryana - 122002, India
Gurgaon
HARYANA 
91-9811380301

drankurbahl@gmail.com 
Dr Kshitij Domadia  HCG Cancer Centre  HCG Cancer Centre, Sola-Science City Road, Nr. Sola Bridge, S.G. Highway, Ahmedabad - 380060, Gujarat, India
Ahmadabad
GUJARAT 
91-9427740225

krdomadia@gmail.com 
Dr Chirag Desai  Hemato Oncology Clinic Ahmedabad Pvt Ltd  HOC Vedanta (Hemato Oncology Clinic Ahmedabad Pvt Ltd) Niramaya Complex Ground floor to third floor, Beside Pandit Dindayal Upadhyay Auditorium, Rajpath Club Road, Off S G Highway, Ahmedabad, Gujarat – 380054, India
Ahmadabad
GUJARAT 
91-9824047561

chiragdesai.oncology@gmail.com 
Dr Amit Rauthan  Manipal Hospitals  Oncology Department, Manipal hospital, # 98, OLD Airport Road, Bangalore - 560017, Karnataka, India
Bangalore
KARNATAKA 
91-9880463958

amitrauthan@yahoo.com 
Dr Meher Lakshmi Konatam  Nizams Institute of Medical Sciences  Department of Medical Oncology, Room No 26, Out patient block, Nizams Institute of Medical Sciences, Punja Gutta - 500082, Hyderabad, India
Hyderabad
TELANGANA 
91-9440592569

drmeherlak@gmail.com 
Dr Ullas Batra  Rajiv Gandhi Cancer Institute & Research Centre  Room 3153, 1st floor, D block, Rajiv Gandhi Cancer Institute and Research Centre, D-18, Sir Chotu Ram Marg, Rohini Institutional Area, Sector - 5, Rohini, Delhi - 110085, India
East
DELHI 
91-9711080001

ullasbatra@gmail.com 
Dr Anoop Manoharan  Regional Cancer Centre hospital   Medical Oncology Department, Regional Cancer Centre, Medical college Campus, Thiruvananthapuram - 695011, Kerala, India
Thiruvananthapuram
KERALA 
91-9447134973

dranooptm@gmail.com 
Dr Minish Jain  Ruby Hall Clinic  Ruby Hall Clinic, 40, Sassoon Road, Pune - 411001, Maharashtra, India
Pune
MAHARASHTRA 
91-9823133390

minishjain009@gmail.com 
Dr Tushar Patil  Sahyadri Super Speciality Hospital  Sahyadri Super Specialty Hospital, 30 - C Erandwane, Karve Road, Pune - 411004, Maharashtra, India
Pune
MAHARASHTRA 
91-9552522556

tussipats@hotmail.com 
Dr Sewanti Limaye  Sir H. N. Reliance Foundation Hospital and Research Centre  3rd floor, Kapol Niwas, Tower building, Raja Rammohan Roy Road, Prarthana Samaj, Charni Road - 400004, Mumbai, India
Mumbai (Suburban)
MAHARASHTRA 
91-9619607339

Sewanti.Limaye@rfhospital.org 
Dr Vanita Noronha  Tata Memorial Centre  303, OPD, 3rd floor, Homi Bhabha block, Dr Ernest Borges Road, Parel - 400012, Mumbai, India
Mumbai (Suburban)
MAHARASHTRA 
91-9769328047

vanita.noronha@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 13  
Name of Committee  Approval Status 
Artemis Health Sciences Institutional Ethics Committee  Approved 
Ethics Committee of CIMS (Care Institute of Medical Sciences)  Approved 
Ethics Committee Of Manipal Hospitals  Approved 
HCG MULTI SPECIALTY ETHICS COMMITTEE  Approved 
Human Ethics Committee  Submittted/Under Review 
IEC, Fortis Memorial Research Institute  Approved 
Institute Ethics Committee All India Institute of Medical Sciences  Submittted/Under Review 
Institutional Ethics Committee of Sir H. N Reliance Foundation Hospital & Research Centre  Submittted/Under Review 
Institutional Ethics Committee Poona Medical Foundation  Approved 
Institutional Review Board Rajiv Gandhi Cancer Institute and Research Centre  Approved 
NIMS Institutional Ethics Committee  Submittted/Under Review 
Sahyadri Hospitals Pvt Ltd Ethics committee   Approved 
TMH, Institutional Ethics Committee-I TMH, Institutional Ethics Committee-II  Submittted/Under Review 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C349||Malignant neoplasm of unspecifiedpart of bronchus or lung,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Crizotinib 250mg capsules  Crizotinib will be administered at a dose of 250 mg BID orally (with or without food). The dose and treatment duration for crizotinib is in alignment with the approved product label and has been shown to be safe and provide clinical benefit in patients with ROS1-positive NSCLC. 
Intervention  Repotrectinib 40mg,160-mg capsules   Repotrectinib will be administered at a dose of 160 mg QD orally (with or without food) for the first 14 days, after which the dosing frequency will increase to 160 mg BID if all safety criteria are met: · Otherwise, participants will continue to receive repotrectinib 160 mg QD. Dose escalation to 160 mg BID beyond the first 14 days of QD treatment, if tolerated, will be allowed and not considered a protocol deviation. After 30 days of 160 mg QD treatment, the Medical Monitor should be notified upon dose escalation.  
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  99.00 Year(s)
Gender  Both 
Details  1. Participant has histologically or cytologically confirmed diagnosis of locally advanced or metastatic NSCLC (Stage IIIB, IIIC, IVA, or IVB per 8th edition American Joint Committee on Cancer classification).
2. Participant has a ROS1 gene rearrangement or fusion as detected by a local test. (Central testing is required if local test is not acceptable by Sponsor-required criteria.)
3. At least 1 measurable lesion according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1), as assessed by the investigator.
4. Participants must not be exposed previously with TKIs that demonstrated activities in ROS1-positive NSCLC (eg, crizotinib, ceritinib, lorlatinib, brigatinib, entrectinib, ensartinib, DS605 1 b, NVL-520, taletrectinib, foretinib, and cabozantinib).
5. Up to 1 prior line of systemic treatment for NSCLC is permitted (chemotherapy-based, immunotherapy-based, chemotherapy + immunotherapy combination regimens, non-ROS1 TKI regimens, or concurrent chemoradiation regimens [when administered in the context of definitive thoracic radiotherapy]). Prior (neo)-adjuvant treatment for resectable NSCLC does not count as a prior line of therapy if no disease recurrence within 6 months of the completion of the (neo)-adjuvant therapy.
6. Eastern Cooperative Oncology Group Performance Status less than equal to 2 
 
ExclusionCriteria 
Details  1. Symptomatic brain metastases or symptomatic leptomeningeal involvement.
2. History of previous cancer requiring therapy within the previous 2 years, except for NSCLC under study, squamous cell or basal-cell carcinoma of the skin, or any in situ carcinoma that has been completely resected.
3. Known tumor targetable co-mutations or rearrangements (ie, epidermal growth factor receptor [EGFR] or anaplastic lymphoma kinase [ALK]).
4. Clinically significant cardiovascular disease (either active or within 6 months prior to enrollment): myocardial infarction, unstable angina, coronary or peripheral artery bypass graft, symptomatic congestive heart failure (New York Heart Association Classification Class more than II), cerebrovascular accident or transient ischemic attack, symptomatic bradycardia, requirement for anti-arrhythmic medication. Ongoing cardiac dysrhythmias of Common Terminology Criteria of Adverse Events version 5.0 Grade more than equal to 2. 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Centralized 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
To compare the PFS per BICR of repotrectinib and crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Until disease progression,death, or end of study (up to 5 years or time of final OS analysis[approximately 130events]), whichever occurs earlier. 
 
Secondary Outcome  
Outcome  TimePoints 
To compare the OS of repotrectinib & crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Up to 5 years from last participants randomized, or until the time of final OS analysis(approximately 130events), whichever occurs later. 
To assess the tumor response of repotrectinib & crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Until disease progression, death, or end of study (up to 5 years or time of final OS analysis[approximately 130events]), whichever occurs earlier. 
To assess the PFS per investigator of repotrectinib & crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Until disease progression, death, or end of study (up to 5 years or time of final OS analysis[approximately 130events]), whichever occurs earlier. 
To assess time to intracranial progression of repotrectinib & crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Until disease progression, death, or end of study (up to 5 years or time of final OS analysis[approximately 130events]), whichever occurs earlier. 
To assess the safety of repotrectinib and crizotinib in all treated participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Incidence of AEs, SAEs, AEs leading to study intervention discontinuation, drug-related AEs, and deaths 
To assess disease-related symptoms for repotrectinib and crizotinib in all randomized participants with locally advanced or metastatic TKI-naïve ROS1-positive NSCLC  Proportion of participants without meaningful symptom deterioration (at least 3-point change) as measured by the NSCLC-SAQ total score 
 
Target Sample Size   Total Sample Size="230"
Sample Size from India="12" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   01/11/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  21/12/2023 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="5"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Open to Recruitment 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   The data collected during this study are confidential and proprietary to the Sponsor or designee. Any publications or abstractsarising from this study must adhere to the publication requirements set forth in the Clinical Trial Agreement (CTAg) governing [study site or investigator] participation in the study. These requirements include, but are not limited to, submitting proposedpublications to the Sponsor or designee at the earliest practicable time prior to submission or presentation and otherwise within the period set forth in the CTAg.Scientific publications (such as abstracts, congress podium presentations and posters, and manuscripts) of the study results will be a collaborative effort between the study Sponsor and the external authors. No public presentation or publication of any interim results may be made by any Principal Investigator, sub-investigator,or any other member of the study staff without the prior written consent of the Sponsor.Authorship of publications at the Sponsor is aligned with the criteria of the International Committee of Medical Journal Editors (ICMJE;www.icmje.org). Authorship selection is based on significant contributions to the study (ie, ICMJE criterion #1). Authors must meet all 4 ICMJE criteria for authorship:
1)Substantial intellectual contribution to the conception or design of the work; or the acquisition of data (ie, evaluable participants with quality data), analysis, or interpretation of data for the work(eg, problem solving, advice, evaluation, insights,and conclusion)2)Drafting the work or revising it critically for important intellectual content3)Final approval of the version to be published4)Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolvedThose who make the most significant contributions, as defined above, will be considered by the Sponsor for authorship of the primary publication. Sub-investigators will generally not be considered for authorship in the primary publication. Geographic representation will also be considered.Authors will be listed by order of significant contributions (highest to lowest), with the exception of the last author. Authors in first and last position have provided the most significant contributions to the work. For secondary analyses and related publications, author list and author order may vary from primary to reflect additional contributions.
 
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