A Phase 2 interventional study of QL1706, nab-paclitaxel, carboplatin in SMARCA4-Deficient Tumor and Locally Advanced or Metastatic Non-Small Cell Lung Cancer, sponsored by Zhijie Wang. Not yet recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-10-01.
Sponsored by Zhijie Wang · Phase 2, Interventional, and Treatment
This single-arm, open-label, Phase II study assesses first-line QL1706 (iparomlimab and tuvonralimab, an anti-PD-1/CTLA-4 bispecific antibody) combined with platinum-based chemotherapy to treat patients with treatment-naïve, locally advanced or metastatic, SMARCA4-deficient non-small cell lung cancer (NSCLC).
The main questions it aims to answer are:Evaluate the efficacy and safety of this combination regimen in this specific patient population. Explore correlations between tumor molecular characteristics, the immune microenvironment, and treatment efficacy or toxicity.
Participants must:
Have histologically or cytologically confirmed, treatment-naïve, locally advanced or metastatic non-small cell lung cancer (NSCLC) with SMARCA4 deficiency. Be willing to provide archived or fresh tumor tissue samples. If unavailable, enrollment may proceed per investigator assessment. Have at least one measurable lesion per RECIST v1.1.
SMARCA4-deficient non-small cell lung cancer (NSCLC) represents a highly aggressive molecular subtype, accounting for approximately 5-10% of all NSCLC cases. The majority of patients (over 80%) present with distant metastases at diagnosis, and prognosis is exceptionally poor, with median overall survival (mOS) historically ranging from 4 to 7 months. Currently, no standardized treatment exists for this subset, and therapeutic efficacy remains limited.
Immune checkpoint inhibitors (ICIs) combined with platinum-based chemotherapy have become a cornerstone of treatment for advanced NSCLC without driver mutations. However, the benefit of this approach in SMARCA4-deficient NSCLC is uncertain and appears heterogeneous. A large retrospective analysis (n=707) indicated that SMARCA4-mutant tumors derived significantly less benefit from first-line chemoimmunotherapy compared to wild-type tumors, showing inferior objective response rate (ORR) and progression-free survival (PFS). Conversely, other retrospective data suggest a potential survival advantage with ICI-chemotherapy over chemotherapy alone. This discrepancy may be influenced by BRG1 protein expression loss, a key molecular feature with prognostic implications, highlighting the complexity of this disease and the need for prospective validation.
QL1706 (iparomlimab and tuvonralimab) is a novel bifunctional MabPair antibody that concurrently targets PD-1 and CTLA-4 at a fixed 2:1 ratio. This design aims to enhance synergistic immune activation while potentially mitigating toxicity associated with conventional CTLA-4 inhibition. Approved in 2024, QL1706 has demonstrated promising efficacy and a manageable safety profile in multiple solid tumors, including NSCLC. In the DUBHE-L-201 trial, QL1706 combined with chemotherapy demonstrated encouraging activity.
To date, there are no prospective clinical data on the use of QL1706 combined with chemotherapy in SMARCA4-deficient NSCLC. This phase II, single-arm, open-label trial is proposed to evaluate the efficacy and safety of QL1706 plus platinum-based chemotherapy as a first-line treatment for patients with locally advanced or metastatic SMARCA4-deficient NSCLC. The study aims to address a significant unmet need and explore a potentially effective therapeutic strategy for this challenging patient population.
6,488 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,632 are open to participants now.
This study's planned enrollment of 28 is below the median of 62 across 5,213 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.
Browse Carcinoma, Non-Small-Cell Lung studies →Zhijie Wang is the lead sponsor of 3 studies on the registry; 3 are open to participants now.
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Participants must meet all of the following criteria to be eligible for the study:
10.1 Absolute neutrophil count (ANC) ≥ 1.5 × 10\^9/L 10.2 Platelet count ≥ 100 × 10\^9/L 10.3 Hemoglobin ≥ 90 g/L (without transfusion within 14 days) 10.4 Serum creatinine ≤ 1 × ULN OR Creatinine clearance > 50 mL/min (calculated by Cockcroft-Gault formula) 10.5 AST and ALT ≤ 2.5 × ULN (≤ 5 × ULN for patients with liver metastases) 10.6 Total bilirubin ≤ 1.5 × ULN (except for participants with Gilbert's syndrome) 10.7 TSH, FT3, and FT4 within normal limits (±10%)
Exclusion Criteria:
Participants meeting any of the following criteria will be excluded from the study:
This study evaluates a first-line treatment for locally advanced or metastatic SMARCA4-deficient non-small cell lung cancer (NSCLC), combining QL1706-a bifunctional antibody targeting both PD-1 and CTLA-4-with platinum-based chemotherapy (nab-paclitaxel + carboplatin). QL1706 is designed to provide dual immune checkpoint blockade with a optimized safety profile. This synergistic approach integrates immunotherapy and chemotherapy to address the high unmet need in this aggressive disease subset. Patients receive QL1706 monotherapy as maintenance treatment after 4-6 cycles of induction. No prior prospective studies have evaluated this regimen in SMARCA4-deficient NSCLC.
Drug: QL1706, nab-paclitaxel, carboplatin
Participants will receive QL1706 (5 mg/kg, IV, day 1) in combination with nab-paclitaxel (260 mg/m², IV, day 1) and carboplatin (AUC=4-5, IV, day 1) every 21 days for 4-6 cycles. Dose adjustments may be made based on clinical judgment. Patients who do not experience disease progression or intolerable toxicity will proceed to maintenance therapy with QL1706 (5 mg/kg, IV, day 1) every 21 days. Treatment will continue until disease progression, unacceptable toxicity, consent withdrawal, investigator decision, loss to follow-up, death, or meeting other protocol-defined criteria for discontinuation. The maximum duration of QL1706 treatment is 24 months, after which continuation will be at the investigator's discretion based on individual benefit-risk assessment.
Progression-Free Survival (PFS)
PFS is defined as the time from the first dose of study treatment to the first documentation of disease progression according to RECIST v1.1 (as assessed by investigators) or death from any cause, whichever occurs first. Subjects who are alive without progression at the time of analysis will be censored at the date of the last tumor assessment.
Time frame: From enrollment to the end of monitoring at 2 years.
Overall Survival (OS)
OS is defined as the time from the first dose of study treatment to death from any cause. Subjects who are alive at the time of analysis will be censored at the date of last follow-up.
Time frame: From enrollment to the end of monitoring at 2 years.
Objective Response Rate (ORR)
ORR is defined as the proportion of subjects who achieve a complete response (CR) or partial response (PR) as per RECIST v1.1.
Time frame: From enrollment to the end of monitoring at 2 years.
Duration of Response (DoR)
DoR is defined as the time from the first documentation of CR or PR to the first documentation of disease progression or death.
Time frame: From enrollment to the end of monitoring at 2 years.
Disease Control Rate (DCR)
DCR is defined as the proportion of subjects who achieve CR, PR, or stable disease (SD) as their best overall response.
Time frame: From enrollment to the end of monitoring at 2 years.
The incidence of adverse events
Incidence, nature, and severity of adverse events (AEs), graded according to NCI-CTCAE v5.0, including immune-related AEs and serious AEs.
Time frame: From enrollment to the end of monitoring at 2 years
Immune-Related Adverse Events (irAEs)
Occurrence and grade of immune-related adverse events as defined by pre-specified criteria, including rash, colitis, hepatitis, endocrinopathies, and pneumonitis.
Time frame: From enrollment to the end of monitoring at 2 years
Plan to share: No
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Carcinoma, Non-Small-Cell Lung→
Zhijie Wang