RecruitingPhase 3NCT07185997

Study to Evaluate Efficacy and Safety of Firmonertinib Compared With Investigator's Choice of EGFR Inhibitor as First-Line Treatment in Participants Who Have Locally Advanced or Metastatic NSCLC With EGFR P-Loop and Alpha C-Helix Compressing (PACC) Uncommon Mutations

A Global, Phase 3, Randomized, Multicenter, Open-Label Study to Evaluate the Efficacy and Safety of Firmonertinib Compared With Investigator's Choice of Osimertinib or Afatinib as First-Line Treatment in Participants Who Have Locally Advanced or Metastatic Non-Small-Cell Lung Cancer With Epidermal Growth Factor Receptor P-Loop and Alpha C-Helix Compressing (PACC) Uncommon Mutations (ALPACCA)


Sponsor

ArriVent BioPharma, Inc.

Enrollment

480 participants

Start Date

Dec 17, 2025

Study Type

INTERVENTIONAL

Summary

Global, Phase 3, randomized, multicenter, open-label study evaluating the efficacy and safety of firmonertinib at a dose level of 240 mg QD compared to investigator's choice of osimertinib (80 mg QD) or afatinib (40 mg QD) in participants who have locally advanced or metastatic NSCLC with EGFR PACC mutations, and who have not received any prior therapy for advanced disease. Participants will be randomized in a 1:1 ratio to treatment with firmonertinib or osimertinib or afatinib and will take the assigned dose daily.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is comparing a new targeted lung cancer drug called firmonertinib against the doctor's choice of another EGFR-targeted drug as the first treatment for people with advanced or spreading non-small cell lung cancer (NSCLC) that has a specific rare genetic mutation (called a PACC mutation in the EGFR gene). **You may be eligible if...** - You have confirmed advanced or metastatic non-small cell lung cancer - Your tumor or blood test shows a specific EGFR PACC mutation - You have not had prior systemic treatment for advanced/metastatic disease - You may have asymptomatic brain metastases (cancer that has spread to the brain without causing symptoms) **You may NOT be eligible if...** - You have previously received any EGFR-targeting therapy for metastatic disease - You have had prior chemotherapy or immunotherapy within the last 12 months (if it was for early-stage disease) Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGFirmonertinib

240 mg oral, daily firmonertinib tablet

DRUGEGFR-TKI inhibitor based on investigator's choice

osimertinib 80 mg oral, daily tablet OR afatinib 40 mg oral, daily tablet


Locations(56)

USC/Norris Comprehensive Cancer Center

Los Angeles, California, United States

University of California Davis Comprehensive Cancer Center

Sacramento, California, United States

UCSF Medical Center-Mission Bay

San Francisco, California, United States

Kaiser Permanente Medical Center

Vallejo, California, United States

Illinois Cancer Specialists

Arlington Heights, Illinois, United States

University of Illinois Hospital and Health Sciences Systems

Chicago, Illinois, United States

Laura & Isaac Perlmutter Cancer Center at NYU Langone Health

New York, New York, United States

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Texas Oncology

Dallas, Texas, United States

The University of Texas MD Anderson Cancer Center

Houston, Texas, United States

University of Virginia

Charlottesville, Virginia, United States

Virginia Cancer Specialists

Fairfax, Virginia, United States

Shenandoah Oncology, P.C.

Winchester, Virginia, United States

Blacktown Cancer and Haematology Centre

Blacktown, New South Wales, Australia

Chris O'Brien Lifehouse

Camperdown, New South Wales, Australia

GenesisCare North Shore Health Hub

St Leonards, New South Wales, Australia

Austin Health

Heidelberg, Victoria, Australia

The Ottawa Hospital Cancer Centre

Ottawa, Ontario, Canada

Sunnybrook Research Institute

Toronto, Ontario, Canada

Henry Dunant Hospital Center

Athens, Greece

Athens Medical Center S.A., European Interbalkan Medical Center

Thessaloniki, Greece

Thoracic General Hospital of Athens I Sotiria

Thessaloniki, Greece

Humanity and Health Clinical Trial Centre

Central, Hong Kong

Queen Mary Hospital

Hong Kong, Hong Kong

SOC Oncologia Medica e dei Tumori Immuno-correlati

Aviano, Italy

Istituto Europeo di Oncologia (IEO)

Milan, Italy

Aichi Cancer Center

Nagoya, Aichi-ken, Japan

Kurume University Hospital

Kurume-Shi, Fukuoka, Japan

National Hospital Organization Hokkaido Cancer Center

Sapporo, Hokkaido, Japan

Hyogo Cancer Center

Akashi-shi, Hyōgo, Japan

Miyagi Cancer Center

Natori-shi, Miyagi, Japan

Niigata Cancer Center Hospital

Niigata, Niigata, Japan

Kansai Medical University Hospital

Hirakata-shi, Osaka, Japan

Nippon Medical School Hospital

Bunkyo-ku, Tokyo, Japan

Tokyo Metropolitan Komagome Hospital

Bunkyō-Ku, Tokyo, Japan

National Cancer Center Hospital

Chuo-ku, Tokyo, Japan

Hospital Kuala Lumpur

Kuala Lumpur, WP Kuala Lumpur, Malaysia

National Cancer Centre Singapore

Singapore, Singapore

Curie Oncology (Farrer)

Singapore, Singapore

Tan Tok Seng Hospital

Singapore, Singapore

The Catholic University of Korea, St. Vincent's Hospital

Suwon, Gyeonggi-do, South Korea

Chonnam National University Hwasun Hospital

Hwasun, Jeollanam-do, South Korea

Gachon University Gil Medical Center

Incheon, South Korea

Kangbuk Samsung Hospital

Seoul, South Korea

Asan Medical Center

Seoul, South Korea

Samsung Medical Center

Seoul, South Korea

Hospital Universitari Son Espases

Palma, Balearic Islands, Spain

Hospital Clinic de Barcelona

Barcelona, Spain

Hospital QuironSalud Malaga

Málaga, Spain

Hospital Universitario Central de Asturias

Oviedo, Spain

Hospital Universitario y Politecnico La Fe

Valencia, Spain

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, Taiwan

Taichung Veterans General Hospital

Taichung, Taiwan

University College London Hospitals NHS Foundation Trust

London, England, United Kingdom

The Christie NHS Foundation Trust

Manchester, England, United Kingdom

The Royal Marsden NHS Foundation Trust

London, United Kingdom

View Full Details on ClinicalTrials.gov

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NCT07185997