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RecruitingNCT06956001Updated Aug 13, 2026

Firmonertinib Versus Platinum Based Chemotherapy as First-line Treatment for NSCLC With EGFR PACC or EGFR l861q Mutation

A Phase 3 interventional study of Firmonertinib Mesilate Tablets and Pemetrexed Disodium for Injection in EGFR and NSCLC (Advanced Non-small Cell Lung Cancer), sponsored by Allist Pharmaceuticals, Inc.. Recruiting at 2 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-13.

Sponsored by Allist Pharmaceuticals, Inc. · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Registered 4 months after the study started (first participant enrolled Nov 2024, registered Apr 2025).
  • Started Nov 2024; still recruiting 1 year 11 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
300
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is a randomized, open, multicenter phase III clinical study, which aims to evaluate the efficacy and safety of firmonertinib mesylate compared with platinum based chemotherapy for patients with locally advanced or metastatic NSCLC who have not been treated with systemic antitumor therapy and carry EGFR PaCC mutation or EGFR l861q mutation.

Eligible patients were stratified by EGFR mutation type and CNS metastasis at the time of enrollment. Approximately 300 patients would be randomly assigned 1:1 to receive either firmonertinib mesylate (240mg, orally on an empty stomach daily) or platinum containing dual agent chemotherapy.

02

Conditions studied

  • EGFR
  • NSCLC (Advanced Non-small Cell Lung Cancer)

Keywords

  • firmonertinib
03

In context

Carcinoma, Non-Small-Cell Lung

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's planned enrollment of 300 is above the median of 62 across 6,019 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Allist Pharmaceuticals, Inc. is the lead sponsor of 25 studies on the registry; 9 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Voluntarily sign the form (ICF).
  2. Age ≥18 years at the time of ICF signing.
  3. At least one per v1.1, meeting the following:

    • No prior local therapy (e.g., radiotherapy)
    • Not used for during screening
  4. Histologically/ confirmed non-squamous NSCLC, classified as:

    • Locally advanced (Stage IIIB/IIIC, unsuitable for curative surgery and/or definitive chemoradiotherapy)
    • (Stage IV) (Based on UICC/AJCC 8th edition TNM staging)
  5. Agreement to provide:

    • Recent tumor tissue (from untreated lesions)
    • Blood samples
    • Central lab-confirmed EGFR PACC or L861Q mutation (If tumor tissue is unavailable due to inaccessible lesions, sponsor consultation is required.)
  6. No prior systemic therapy for advanced/metastatic NSCLC.

    • Allowed if: Prior (neo)adjuvant/definitive chemoradiotherapy completed ≥12 months before recurrence/progression
  7. performance status 0-1.
  8. ≥12 weeks.
  9. Adequate bone marrow/organ function within 14 days before treatment (no transfusion/G-CSF within 2 weeks prior).
  10. Women of (WOCBP):

    • Abstinence or use
    • No egg donation
  11. Non-sterilized males:

    • Abstinence or contraception use
    • No sperm donation
  12. allowed if protocol-specified criteria are met.

Exclusion criteria

Exclusion Criteria:

  1. Histologically/ confirmed tumor with >10% neuroendocrine carcinoma, sarcomatoid carcinoma, or squamous cell components.
  2. Known ALK-positive, ROS1-positive, RET fusion-positive, NTRK fusion-positive, BRAF V600E mutation, MET exon 14 skipping mutation, or other targetable alterations with approved therapies.
  3. Prior treatments including:

    1. Systemic anti-tumor therapy for advanced/ NSCLC (e.g., chemotherapy/targeted/immunotherapy). /adjuvant therapy exceptions per Inclusion Criterion #6.
    2. >30 Gy thoracic radiotherapy within 6 months or non-thoracic radiotherapy within 4 weeks prior to first dose (brain radiotherapy exceptions per Inclusion Criterion #12).
    3. Any prior EGFR-targeted therapy (including EGFR-TKIs, mAbs, bispecific antibodies, etc.).
    4. Strong inhibitors within 7 days or inducers within 21 days prior to first dose.
    5. Anticancer traditional Chinese medicines within 2 weeks prior to first dose.
    6. Non-specific immunomodulators (e.g., interferon, IL-2, thymosin) within 2 weeks prior to first dose.
    7. Major trauma/surgery within 4 weeks prior to treatment initiation.
  4. gastrointestinal abnormalities, including:

    • Moderate/severe atrophic gastritis
    • GI obstruction/perforation
    • Chronic diarrhea/short bowel syndrome
    • Major upper GI surgery (e.g., gastrectomy)
    • Inflammatory bowel disease (Crohn's/ulcerative colitis) or active intestinal inflammation
    • Inability to swallow tablets
  5. Uncontrolled systemic diseases.
  6. Severe acute/chronic infections.
  7. Interstitial lung disease (ILD)/non-infectious pneumonia:

    • History requiring clinical intervention
    • Current presence
    • Suspicious imaging findings unresolved at screening
  8. Clinically significant cardiovascular dysfunction (active or history).
  9. Tumor invasion of critical adjacent structures (heart/esophagus/SVC etc.) with high bleeding/fistula risk. Exceptions may be considered if investigator assesses minimal risk.
  10. Pulmonary comorbidities causing severe impairment, including:

    1. Baseline lung diseases (e.g., pulmonary embolism [≤3 months], severe asthma//restrictive disease)
    2. /connective tissue disorders with pulmonary involvement (e.g., rheumatoid arthritis, sarcoidosis)
  11. Residual toxicity >Grade 1 (per v5.0) from prior anticancer therapy (except alopecia/neuropathy).
  12. Concurrent except:

    • Cured localized skin cancers (BCC/SCC), superficial bladder cancer, cervical/breast DCIS, or papillary thyroid cancer
    • Other malignancies cured by radical therapy ≥3 years prior
  13. Pregnancy/lactation or planned pregnancy within 6 months post-treatment.
  14. Inability to comply with study procedures/follow-up.
  15. Known to furmonertinib or .
  16. History of allergic reactions to pemetrexed/cisplatin/carboplatin.
  17. Other exclusionary per investigator judgment, including:

    • Alcohol/drug abuse
    • Severe comorbidities (including psychiatric) requiring treatment
    • Critical laboratory abnormalities
    • Social/familial factors compromising safety/data collection
Terms in these criteria, in plain language(21)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
300 participants (estimated)

Study arms

  • Experimental
    Firmonertinib

    Oral administration, 240mg, QD。

    Drug: Firmonertinib Mesilate Tablets

  • Active comparator
    chemotherapy

    Pemetrexed Disodium for Injection: 500mg/m2, intravenous infusion. Cisplatin for injection:75 mg/m2, intravenous infusion. Carboplatin Injection:administered according to the AUC of 5 mg/ml, intravenous infusion.

    Drug: Pemetrexed Disodium for Injection · Drug: Cisplatin for injection · Drug: Carboplatin Injection

Interventions

  • DrugFirmonertinib Mesilate Tablets

    Usage and dosage: oral, 240mg, QD。 Medication duration: 21 days as a cycle, until intolerable toxicity, loss of clinical benefit, disease progression (confirmed by BICR), death or other anti-tumor treatment (whichever occurs first).

  • Usage and dosage: 500mg/m2, intravenous infusion. Medication duration: 21 days as a cycle, D1 administration, until the occurrence of intolerable toxicity, loss of clinical benefit, disease progression (confirmed by BICR), death or other anti-tumor treatment (whichever occurs first).

  • Usage and dosage: 75 mg/m2, i.v. Medication duration: 21 days as a cycle, D1 administration, up to 4 cycles.

  • Usage and dosage: give the drug according to AUC 5 mg/ml, intravenous drip. Medication duration: 21 days as a cycle, D1 administration, up to 4 cycles.

06

What researchers measure

Primary outcomes

  1. Progression-free survival (PFS) assessed by the Independent Review Committee (BICR) according to RECIST v1.1.

    The time from the date of randomization to the date of first documentation of disease progression (assessed according to RECIST v1.1 criteria) or death from any cause, whichever occurred first.

    Time frame: Up to 3 years

Secondary outcomes

  1. Overall survival (OS)

    Time frame: Up to 3 years

  2. The incidence and severity of adverse events (AES) were determined according to NCI CTCAE V5.0

    Time frame: Up to 3 years

  3. Patient Reported Outcomes by EORTC QLQ LC13 questionnaire

    To assess the impact of firmonertinib on patients' disease-related symptoms and health related quality of life (HRQoL).

    Time frame: Up to 3 years

  4. Patient Reported Outcomes by EORTC QLQ-C30 questionnaire

    To assess the impact of firmonertinib on patients' disease-related symptoms and health related quality of life (HRQoL).

    Time frame: Up to 3 years

  5. Plasma concentrations of firmonertinib and its major metabolite (ast5902) in patients treated with firmonertinib at the indicated sampling time points

    Time frame: Up to 3 years

07

Study locations

2 of 2 sites recruiting
  • Ethics Committee of cancer hospital, Chinese Academy of Medical Sciences
    Beijing, Beijing Municipality 100021, China
    Recruiting
  • Shandong Tumor Hospital
    Shandong, Jinan, China
    Recruiting
    • Shandong Tumor Hospital Shandong Tumor Hospital · Contactsdzlllh803@126.com · 0531-67626929
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06956001
Responsible party
Sponsor
First posted
May 2, 2025
Start date
Nov 19, 2024
Primary completion
Dec 2027 (estimated)
Completion
Jul 2028 (estimated)
Last update
Aug 13, 2026

Study contacts

Shanghai Allist Pharmaceuticals Co., Ltd Shanghai Allist Pharmaceuticals Co., Ltd
Contact
zhenhua.gong@allist.com.cn
021-80423288

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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