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RecruitingNCT07010419FIRMOSTUpdated Aug 13, 2026

A Study to Assess the Efficacy and Safety of Firmonertinib Versus Placebo for Adjuvant Treatment in Participants With Stage IB - IIIB NSCLC With Uncommon Epidermal Growth Factor Receptor (EGFR) Mutations, Following Complete Surgical Resection With or Without Adjuvant Chemotherapy(FIRMOST)

A Phase 3 interventional study of Firmonertinib and Placebo in NSCLC and Adjuvant Treatment, 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

Phase
Phase 3
Study type
Interventional
Enrollment
338
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a Phase 3, global, double-blind, randomized, controlled multicenter clinical study to assess the efficacy and safety of adjuvant treatment with firmonertinib versus placebo in participants with Stage IB-IIIB NSCLC with uncommon EGFR mutations (exon 20 insertions, PACC and classical-like mutations) after complete surgical resection with or without adjuvant chemotherapy.

About 338 eligible participants will be enrolled and randomized in a 1:1 ratio to receive either firmonertinib 240 mg QD or placebo QD in 21-day treatment cycles. Before randomization, the participant must have undergone complete surgical resection (R0 resection), must have sufficiently recovered from surgery, and must have completed adjuvant chemotherapy (if applicable). The participants will receive firmonertinib or placebo as adjuvant treatment until unacceptable toxicity, withdrawal of informed consent, disease recurrence, initiation of new antitumor treatment, completion of treatment, or other end of treatment reason is met.

02

Conditions studied

  • NSCLC
  • Adjuvant Treatment

Keywords

  • EGFR
  • NSCLC
  • Firmonertinib
03

Who can participate

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

Inclusion criteria

  1. Sign the Informed Consent Form (ICF).
  2. Aged ≥ 18 years old. Participants from Japan/Taiwan aged ≥ 20 years old.
  3. Histologically confirmed diagnosis of primary non-small cell lung cancer (NSCLC) of predominantly non-squamous histology.
  4. Underwent complete surgical resection of primary lung cancer and systematic lymph node dissection (R0 resection).
  5. Classified post-operatively as Stage IB, II, IIIA, or IIIB (T3N2M0 only) on the basis of pathologic criteria, with the disease staging following the 9th Edition TNM Staging Classification: Lung Cancer issued by Union for International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC).
  6. Documented results of the presence of uncommon EGFR mutations (exon 20 insertion mutations, PACC mutations, and/or classical-like mutations, either as single mutations or as co-mutations), in tumor tissue or blood via a validated NGS or validated PCR assay.

Exclusion criteria

Exclusion Criteria:

A participant would be excluded from the study if he/she meets any of the following:

  1. NSCLC with EGFR Exon 19 deletion or L858R or C797S mutation.
  2. Incomplete resection (R1/R2) or segmentectomy or wedge resection only.
  3. Prior treatment with any of the following:

    1. Prior treatment with any antineoplastic therapy other than standard platinum-based doublet adjuvant chemotherapy.
    2. prior treatment with neoadjuvant therapy.
  4. Concurrent malignant tumors other than the primary tumor; participants with cancers that can be treated locally and cured may be eligible.
  5. Previous ILD (including drug-induced ILD) or active ILD/active radiation pneumonitis.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
338 participants (estimated)

Study arms

  • Experimental
    Firmonertinib

    Firmonertinib: 240 mg, QD, orally

    Drug: Firmonertinib

  • Placebo comparator
    Placebo

    Placebo: 240 mg, QD, orally

    Drug: Placebo

Interventions

  • DrugFirmonertinib

    Firmonertinib: 240 mg, QD, orally

  • DrugPlacebo

    Placebo: 240 mg, QD, orally

05

What researchers measure

Primary outcomes

  1. Disease free survival (DFS)

    DFS as assessed by the investigator in Stage II- IIIB. DFS defined as the time from the date of randomization to the first observation of disease recurrence (by pathological diagnosis or imaging) or death caused by any reason, whichever occurs first.

    Time frame: Up to 3 years

Secondary outcomes

  1. Disease free survival (DFS)

    DFS as assessed by the blinded independent central review (BICR) in Stage II-IIIB

    Time frame: Up to 3 years

  2. Disease free survival (DFS)

    DFS as assessed by the investigator in Stage IB-IIIB; DFS as assessed by the BICR in Stage IB-IIIB

    Time frame: Up to 3 years

  3. Disease free survival rates

    2-, 3-, and 5-year DFS rates as assessed by the investigator and BICR in Stage II-IIIB and in Stage IB-IIIB

    Time frame: Up to 5 years

  4. Overall survival (OS)

    OS defined as the time from the date of randomization to the date of death due to any cause, in Stage II-IIIB and in Stage IB-IIIB

    Time frame: Up to 5 years

  5. Overall survival rates

    2-, 3-, and 5-year OS rates in Stage II-IIIB and in Stage IB-IIIB

    Time frame: Up to 5 years

  6. Adverse event (AE)

    Incidence and severity of AEs, with severity as determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0 (NCI CTCAE v5.0)

    Time frame: Up to 5 years

06

Study locations

2 of 2 sites recruiting
  • Peking University People's Hospital
    Beijing, Beijing Municipality 100044, China
    Recruiting
  • Sun Yat-sen University Cancer Center
    Guangdong, Guangzhou 510060, China
    • Sun Yat-sen University Cancer Center Sun Yat-sen University Cancer Center · Contact · llwyh@sysucc.org.cn · 020-87343009
    Recruiting
07

Registry details

Key details

Study ID
NCT07010419
Lead sponsor
Allist Pharmaceuticals, Inc.
Collaborators
ArriVent BioPharma, Inc.
Responsible party
Sponsor
First posted
Jun 8, 2025
Start date
May 28, 2025
Primary completion
Oct 31, 2028 (estimated)
Completion
Apr 30, 2032 (estimated)
Last update
Aug 13, 2026

Study contacts

Li Zhang, Master
Contact
Zhangli6@mall.sysu.edu.cn
020-87342288
Li Zhang, Master
principal investigator · Sun Yat-Sen University Cancer Center
Fan Yang, Doctor
principal investigator · Peking University People's Hospital

Oversight

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

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