ClinicalTrials.gg
RecruitingNCT07348965Updated Apr 2, 2026

Pulsatile High-dose Furmonertinib in EGFR-mutant NSCLC With Leptomeningeal Metastasis

An interventional study of Furmonertinib 320mg qod po and Furmonertinib 160mg qd po in NSCLC (Advanced Non-small Cell Lung Cancer), Leptomeningeal Metastasis and Furmonertinib, sponsored by Guangzhou University of Traditional Chinese Medicine. Recruiting at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-04-02.

Sponsored by Guangzhou University of Traditional Chinese Medicine · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2026; still recruiting 8 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
42
Allocation
Non-randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The goal of this clinical trial is to clarify the efficacy and safety of the high-dose alternate-day furmonertinib in NSCLC with leptomeningeal metastasis. It will also explore the mechanism by which the high-dose alternate-day administration regimen enhances efficacy from a pharmacokinetic perspective, and investigate the impact of co-occurring mutations on the efficacy and prognosis of furmonertinib in the treatment of EGFR-mutant NSCLC with leptomeningeal metastasis. The main questions it aims to answer are:

Does the high-dose alternate-day administration regimen have definite efficacy? Does the high-dose alternate-day administration regimen have favorable safety? Does the high-dose alternate-day administration regimen improve efficacy by increasing the cerebrospinal fluid (CSF) concentration and CSF penetration rate of the drug? Which co-occurring mutations may affect the efficacy and prognosis of patients with EGFR-mutant NSCLC and leptomeningeal metastasis? Participants will enter Cohort A (320mg qod po) or Cohort B (160mg qd po) to receive furmonertinib based on their own willingness and the clinician's decision, until disease, progression or uncontrollable adverse reactions occur. All patients in Cohort A will undergo efficacy and safety evaluation, with some also participating in pharmacokinetic study; patients in Cohort B will only undergo pharmacokinetic study.

Efficacy and safety evaluation will be conducted through imaging examinations, neurological function assessment scales, quality of life self-assessment scales, and adverse event records. Pharmacokinetic study will be carried out by detecting the plasma concentrations and CSF concentrations of furmonertinib and its active metabolites, and calculating the CSF penetration rate for evaluation.

02

Conditions studied

  • NSCLC (Advanced Non-small Cell Lung Cancer)
  • Leptomeningeal Metastasis
  • Furmonertinib
  • EGFR Activating Mutation

Keywords

  • NSCLC
  • furmonertinib
  • leptomeningeal metastasis
  • cerebrospinal fluid
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 42 is below 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

Guangzhou University of Traditional Chinese Medicine is the lead sponsor of 58 studies on the registry; 19 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 Years
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. Patients with non-small cell lung cancer (NSCLC) confirmed by histopathological or cytopathological examination
  2. Patients with EGFR exon 19 deletion or exon 21 L858R mutation
  3. Patients with (LMD) confirmed by positive cerebrospinal fluid (CSF) cytology (within 28 days prior to the first dose administration) and with at least 1 LMD lesion that can be repeatedly evaluated by magnetic resonance imaging (MRI)
  4. Patients with disease progression after tyrosine kinase inhibitor (TKI) treatment
  5. Aged ≥18 years and ≤85 years, with no gender restrictions.
  6. Sufficient organ function, defined as: ≥ 1.5×10⁹/L, count ≥ 75×10⁹/L, ≥ 90g/L total ≤ 1.5× (ULN) (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN (for patients with liver , total bilirubin can be relaxed to ≤ 3×ULN, and ALT/AST can be relaxed to ≤ 5×ULN) serum creatinine ≤ 1.5×ULN or ≥ 50 mL/min (calculated by the Cockcroft-Gault formula)
  7. For patients enrolled in the pharmacokinetic study: no prior treatment with furmonertinib (either in combination or as monotherapy)
  8. Patients who have signed the form, are willing to receive treatment under this protocol, can adhere to medication administration, and have good compliance.

Exclusion criteria

Exclusion Criteria:

  1. Unable to complete the baseline assessment form
  2. Complicated with severe or uncontrolled systemic diseases, including active infection, electrolyte disturbance, bleeding tendency, etc.
  3. Pregnant or lactating women, or those with planned pregnancy during the study or within 6 months after the study ends
  4. Presence of central nervous system complications requiring emergency neurosurgical intervention
  5. Suffering from other malignant tumors or having a history of other malignant tumors
  6. Complicated with severe brain diseases or mental illnesses that affect the patient's ability to report symptoms by themselves
  7. Individuals without legal capacity, or those for whom medical or ethical reasons affect the continuation of the study
  8. Other circumstances deemed unsuitable for participation in this study by the researcher.
  9. Patients with a severe allergic diathesis, especially those who have experienced severe drug allergies or other serious adverse reactions during previous treatment with tyrosine kinase inhibitors (TKIs).
Terms in these criteria, in plain language(11)

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.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Metastases

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

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

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.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
42 participants (estimated)

Study arms

  • Experimental
    Cohort A

    furmonertinib 320mg qod po

    Drug: Furmonertinib 320mg qod po

  • Other
    Cohort B

    furmonertinib 160mg qd po

    Drug: Furmonertinib 160mg qd po

Interventions

06

What researchers measure

Primary outcomes

  1. LM-DCR

    Leptomeningeal metastasis-disease control rate, calculated as the proportion of patients with leptomeningeal metastasis who achieve remission or stable disease, which will be determined based on the modified imaging assessment method formulated by the RANO-LM working group with imaging assessments.

    Time frame: From date of first administration of the study drug until the date of first documented leptomeningeal disease progression or date of death from any cause, whichever came first, assessed up to 3 years.

Secondary outcomes

  1. LM-ORR

    Leptomeningeal metastasis objective response rate, calculated as the proportion of patients with leptomeningeal metastasis who achieve remission, which will be determined based on the modified imaging assessment method formulated by the RANO-LM working group with imaging assessments.

    Time frame: From date of first administration of the study drug until the date of first documented leptomeningeal disease progression or date of death from any cause, whichever came first, assessed up to 3 years.

  2. neurological function

    measured by NANO-LM standardized neurological examination

    Time frame: From date of first administration of the study drug until the date of first documented leptomeningeal disease progression or date of death from any cause, whichever came first, assessed up to 3 years.

  3. iDoR

    Intracranial duration of response means the time from the first achievement of intracranial disease remission to the first disease progression or death from any cause. Investigators will assess lesions other than leptomeningeal metastases according to the modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), while investigators and neuroradiological Independent Central Review (ICR) will evaluate the response of leptomeningeal metastases based on the modified neuroradiological criteria formulated by the RANO-LM working group.

    Time frame: From date of first administration of the study drug until the date of first documented leptomeningeal disease progression or date of death from any cause, whichever came first, assessed up to 3 years.

  4. iPFS

    Intracranial progression-free survival means the time from the date of enrollment to the first occurrence of intracranial disease progression or death from any cause. Investigators will assess lesions other than leptomeningeal metastases according to the modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), while investigators and neuroradiological Independent Central Review (ICR) will evaluate the response of leptomeningeal metastases based on the modified neuroradiological criteria formulated by the RANO-LM working group.

    Time frame: From date of enrollment until the date of first documented leptomeningeal disease progression or date of death from any cause, whichever came first, assessed up to 3 years.

  5. PFS

    Progression-free survival means the time from the date of enrollment to the first occurrence of disease progression or death from any cause. Investigators will assess lesions other than leptomeningeal metastases according to the modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), while investigators and neuroradiological Independent Central Review (ICR) will evaluate the response of leptomeningeal metastases based on the modified neuroradiological criteria formulated by the RANO-LM working group.

    Time frame: From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years.

  6. OS

    Overall survival refers to the time from the date of enrollment to the date of death from any cause.

    Time frame: From date of enrollment until the date of death from any cause, assessed up to 5 years.

  7. Quality of life evaluation

    Patient self-assessments of quality of life will be conducted using the Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). The EORTC QLQ-C30 is a 30-item questionnaire comprising 5 functional scales, 3 symptom scales, 1 global health/QoL scale and 6 single items. The score of this questionnaire ranges between 1 and 4 in functional scales, symptom scales, and single items. The score ranges between 1 and 7 in global health/QoL scale. The higher score indicates the worse quality of life.

    Time frame: From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years.

  8. Quality of life evaluation

    Patient self-assessments of quality of life will be also conducted using the Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Brain Cancer Module (EORTC QLQ-BN20). The QLQ-BN20 is a 20-item questionnaire that assesses future uncertainty, visual disorder, motor dysfunction, and communication deficit, as well as seven single items (headaches, seizures, drowsiness, hair loss, itchy skin, weakness of legs, bladder control). The score of this questionnaire ranges between 1 and 4. The higher score indicates the worse quality of life.

    Time frame: From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years.

  9. AEs

    Adverse events will be recorded according to Common Terminology Criteria for Adverse Events version 6.0 (CTCAE v6.0)

    Time frame: From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years.

  10. CSF Penetration Rate

    Cerebrospinal fluid penetration rate refers to the ratio of the drug's concentration in cerebrospinal fluid to its concentration in plasma.

    Time frame: Patients will undergo twice of specimen collection: the first before treatment (-14 to 0 days) and the second 4 weeks after treatment (4weeks ±7 days).

  11. Gene Mutation

    Testing the gene mutation of plasma, CSF and the tumor tissue by NGS

    Time frame: at baseline and date of progression (assessed up to 3 years)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes

Supporting information: Study protocol

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Mar 2026 (actual). Primary completion is estimated for Sep 2028, 30 months after the start.

Of 343 non-industry interventional studies with no phase under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 52 months of starting (the median), counting those still running; a quarter within 28 and three quarters within 98. This study's planned 30 months is below that.

Counting every sponsor, half of 359 studies reached it within 51 months; a quarter within 26 and three quarters within 97.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 14, 2025
First posted
Jan 16, 2026
StartActual
Mar 1, 2026
Primary completionEst.
Sep 30, 2028
CompletionEst.
Dec 31, 2028
Last update
Apr 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07348965
Lead sponsor
Guangzhou University of Traditional Chinese Medicine
Responsible party
Sponsor
First posted
Jan 16, 2026
Start date
Mar 1, 2026
Primary completion
Sep 30, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Apr 2, 2026

Study contacts

Yanjuan Zhu, M.D.
Contact
zyjsophy@gzucm.edu.cn
86-20-81887233 ext. 34830
Haibo Zhang, M.D.
principal investigator · Guangdong Provincial Hospital of Traditional Chinese Medicine

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Aflutinib

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