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RecruitingNCT07709585BE-MASTERUpdated Nov 4, 2026

Befotertinib Plus Chemotherapy With an MRD-guided Adaptive Strategy for Treatment Escalation and Response Optimization in EGFR-mutated NSCLC Patients

A Phase 2 interventional study of Befotinib and Pemetrexed + Cisplatin /Carboplatin in Advanced Non-small Cell Lung Cancer (NSCLC), EGFR Exon 19 Deletion Mutation and EGFR Exon 21 Mutation, sponsored by Guangzhou University of Traditional Chinese Medicine. Recruiting at 2 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by Guangzhou University of Traditional Chinese Medicine · Phase 2, Interventional, and Treatment

Updated Nov 4, 2026Now RecruitingSite recruiting status changed+2 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
124
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This is a multicenter, phase II exploratory clinical trial in untreated patients with EGFR-mutant non-small cell lung cancer (stages IIIB-IV) .All participants will receive oral befotertinib monotherapy for 3 weeks first, then serial minimal residual disease (MRD/MRD) testing is performed to adjust subsequent treatment. Patients with positive MRD will receive 4 cycles of pemetrexed plus platinum chemotherapy; patients with negative MRD will continue single-agent befotertinib. After induction, maintenance therapy will be given according to follow-up MRD results. The primary goal is to evaluate progression-free survival guided by dynamic MRD monitoring, and secondary endpoints include objective response rate, disease control rate, safety and MRD clearance rate.

02

Conditions studied

  • Advanced Non-small Cell Lung Cancer (NSCLC)
  • EGFR Exon 19 Deletion Mutation
  • EGFR Exon 21 Mutation
  • EGFR Exon 21 L858R Mutation

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Keywords

  • EGFR sensitive mutation
  • Minimal Residual Disease
  • MRD dynamic monitoring
  • Befotinib
  • Advanced Non-small Cell Lung Cancer
  • Targeted therapy plus chemotherapy
03

In context

Neoplasm, Residual

293 studies on the registry are indexed under Neoplasm, Residual; 137 are open to participants now.

This study's planned enrollment of 124 is above the median of 50 across 198 interventional studies indexed under Neoplasm, Residual.

Browse Neoplasm, Residual 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 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. or cytologically confirmed stage IIIB-IV non-small cell lung cancer (NSCLC).
  2. Age ≥18 years, any gender.
  3. Confirmed EGFR exon 19 deletion or exon 21 (L858R) substitution mutation by central laboratory or site-validated testing assay.
  4. No prior systemic anti-tumor therapy.
  5. performance status 0-2.
  6. Expected survival ≥12 weeks.
  7. Able to swallow oral study medication.
  8. At least one per 1.1 criteria.
  9. Adequate organ function as defined below:

    1. ≥1.5 × 10\^9/L;
    2. count ≥100 × 10\^9/L;
    3. ≥9 g/dL (transfusion allowed);
    4. Total ≤1.5 × ;
    5. /AST ≤2.5 × ULN (≤5 × ULN if liver );
    6. Serum creatinine ≤1.5 × ULN, or ≥45 mL/min by Cockcroft-Gault formula if creatinine >1.5 × ULN.
  10. Fertile men and women agree to effective during study treatment and for specified time after last dose.

Exclusion criteria

Exclusion Criteria:

  1. Receiving other systemic anti-tumor therapy, or plan to combine other systemic anti-cancer agents during study.
  2. Participated in another drug trial within 4 weeks prior to first study drug; major surgery within 4 weeks; unhealed wound, active ulcer or fracture; radiotherapy within 2 weeks without recovery.
  3. Severe cardiovascular disease: ≥450 ms or abnormality; uncontrolled hypertension (SBP>160 mmHg or DBP>100 mmHg); congestive heart failure, cardiomyopathy, arrhythmia requiring intervention, unstable angina, myocardial infarction, stroke or within 6 months prior to treatment.
  4. Uncontrolled active infection including active , , , active syphilis infection judged by investigator. Stable infection without safety risk is permitted.
  5. History of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis requiring , or active interstitial lung disease.
  6. Active hemorrhage, clinically significant hemoptysis, high thromboembolic risk or prior severe thromboembolic events unsuitable for study treatment.
  7. Renal dysfunction with \<45 mL/min; prior intolerable toxicity to pemetrexed; severe to pemetrexed or its .
  8. Positive serum pregnancy test within 7 days before treatment, pregnant or breastfeeding women; fertile subjects refusing during study and 3 months after last dose.
  9. Known severe hypersensitivity to befotertinib, cisplatin, carboplatin or their excipients.
  10. Any other medical, metabolic, physical or lab abnormality that may compromise subject safety or interfere with study results per investigator judgment.
Terms in these criteria, in plain language(24)

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.

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.

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.

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.

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.

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.

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.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

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.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
124 participants (estimated)

Study arms

  • Experimental
    Befotertinib with chemotherapy guided by dynamic MRD monitoring

    All participants receive oral befotertinib 75 mg once daily for 3 weeks as induction therapy, followed by MRD detection. Treatment is adjusted dynamically based on serial MRD results: MRD-positive patients get 4 cycles of befotertinib plus pemetrexed-platinum chemotherapy; MRD-negative patients continue single-agent befotertinib. Subsequent MRD tests every 12 weeks guide treatment adjustment: patients who have not previously received pemetrexed -platinum chemotherapy and convert to MRD-positive will receive 4 cycles of befotertinib plus pemetrexed-platinum chemotherapy; patients who have previously received pemetrexed-platinum chemotherapy will receive single agent befotertinib if MRD-negative or befotertinib plus pemetrexed maintenance if MRD-positive.Treatment cycles are 21 days, continued until disease progression, intolerable toxicity, withdrawal of consent or death.

    Drug: Befotinib · Drug: Pemetrexed + Cisplatin /Carboplatin

Interventions

  • DrugBefotinib

    Oral administration, initial dose 75 mg once daily; dose adjusted to 100 mg once daily based on safety and clinical benefit. Used as induction, single-agent maintenance, or combined with chemotherapy.

  • DrugPemetrexed + Cisplatin /Carboplatin

    Drug pages: Pemetrexed · Cisplatin · Carboplatin

    This is induction combination chemotherapy for MRD-positive patients after initial befotinib monotherapy. Pemetrexed at 500 mg/m² is given intravenously on Day 1 of each 21-day cycle, combined with either Cisplatin (75 mg/m² IV Day 1) or Carboplatin (AUC 5 IV Day 1) at investigator's discretion based on patient renal function and tolerability, for up to 4 cycles. Standard premedication with folic acid, vitamin B12 and dexamethasone is administered per pemetrexed prescribing guidelines.

06

What researchers measure

Primary outcomes

  1. Progression-Free Survival (PFS)

    Time from first dose of study treatment to first radiographically confirmed isease progression according to RECIST version 1.1 or death from any cause, whichever occurs first.

    Time frame: Up to 48 months after the last participant enrollment,including at least 24 months of follow-up after the last participant is enrolled.

Secondary outcomes

  1. Median Overall Survival (OS)

    Defined as the time from first dose of study treatment to death from any cause.

    Time frame: Including at least 24 months of follow-up after the last participant is enrolled.Participants lost to follow-up will be censored at the last date they were known to be alive.

  2. Objective response rate (ORR)

    Defined as the proportion of participants achieving confirmed complete response (CR) or partial response (PR) per RECIST version 1.1.

    Time frame: including at least 24 months of follow-up after the last participant is enrolled.

  3. Disease control rate (DCR)

    defined as the proportion of participants achieving confirmed complete response (CR), partial response (PR) or stable disease (SD) per RECIST version 1.1.

    Time frame: including at least 24 months of follow-up after the last participant is enrolled.

  4. Time to intolerable toxicity

    Defined as the time from the first dose of study treatment to the first occurrence of treatment-related intolerable adverse event leading to permanent discontinuation of study therapy.

    Time frame: Including at least 24 months of follow-up after the last participant is enrolled.

07

Study locations

1 of 2 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Nov 4, 2026
Sites
1 site added. Guangdong Provincial Hospital of Chinese Medicine is now Not yet recruiting
Show site
  • Guangdong Provincial Hospital of Traditional Chinese Medicine · Guangzhou, China
Nov 4, 2026
Start date
Jul 5, 2026→Nov 30, 2026
Nov 4, 2026
Show all 1 update
  1. Nov 4, 2026
    Not yet recruiting→Recruiting
    1 site added. Guangdong Provincial Hospital of Chinese Medicine is now Not yet recruiting
    Show site
    • Guangdong Provincial Hospital of Traditional Chinese Medicine · Guangzhou, China
    Start date Jul 5, 2026→Nov 30, 2026
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07709585
Lead sponsor
Guangzhou University of Traditional Chinese Medicine
Collaborators
Guangdong Provincial Hospital of Traditional Chinese Medicine, Beijing Chest Hospital, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Sichuan Cancer Hospital and Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, First Affiliated Hospital of Xinjiang Medical University
Responsible party
Zhu Yanjuan (Associate Chief Physician, Guangdong Provincial Hospital of Traditional Chinese Medicine) — Principal investigator
First posted
Jul 16, 2026
Start date
Nov 30, 2026 (estimated)
Primary completion
Jul 31, 2030 (estimated)
Completion
Jul 31, 2030 (estimated)
Last update
Nov 4, 2026

Study contacts

Xiaoshu Chai, MD
Contact
chaixiaoshu@126.com
+8613570301605
Yanjuan Zhu, MD
Contact
zyjsophy@gzucm.edu.cn
+8613902260217
Xiaoshu Chai, MD
principal investigator · Guangdong Provincial Hospital of Traditional Chinese Medicine

Oversight

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

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Studies of the drugs tested here: Pemetrexed · Cisplatin · Carboplatin

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