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Not yet recruitingNCT07750704Updated Aug 6, 2026

Lorlatinib Plus Sacituzumab Tirumotecan With Peripheral ctDNA Guidance as First-Line Therapy for ALK Fusion-Positive NSCLC

A Phase 2 interventional study of Lorlatinib and sacituzumab tirumotecan plus lorlatinib in ALK Positive Non-small Cell Lung Cancer, sponsored by Guangdong Association of Clinical Trials. Not yet recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-06.

Sponsored by Guangdong Association of Clinical Trials · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
153
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This investigator-initiated, open-label, prospective Phase II clinical trial, planned to take place across multiple centers in China. We design this trial to evaluate the safety and efficacy of lorlatinib plus sacituzumab tirumotecan based on peripheral blood ctDNA as first-line treatment for ALK fusion NSCLC.

Read the detailed description

All enrolled subjects are patients with locally advanced or metastatic ALK fusion NSCLC who are not candidates for curative therapy. This study plans to enroll approximately 153 eligible subjects, who will be stratified into a ctDNA-positive group and a ctDNA-negative group based on baseline peripheral blood ctDNA status. Subjects in the ctDNA-negative group will receive lorlatinib monotherapy. Subjects in the ctDNA-positive group will be randomized in a 1:1 ratio to receive either lorlatinib combined with sacituzumab tirumotecan or lorlatinib monotherapy. Each treatment cycle consists of 4 weeks (28 days). Subjects receiving lorlatinib monotherapy will receive lorlatinib 100 mg orally once daily (QD). Subjects receiving the combination therapy will receive lorlatinib 100 mg orally once daily (QD) plus sacituzumab tirumotecan 4 mg/kg administered as an intravenous infusion on Day 1 and Day 15 of each 4-week cycle (Q4W) for 4 cycles.

02

Conditions studied

  • ALK Positive Non-small Cell Lung Cancer
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 153 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

Guangdong Association of Clinical Trials is the lead sponsor of 53 studies on the registry; 18 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. Patients aged ≥ 18 years at the time of signing the , regardless of gender;
  2. Histologically/ confirmed NSCLC, Stage III (locally advanced) or IV (), unsuitable for curative surgery and/or curative radiotherapy, with or without prior concurrent/sequential chemotherapy;
  3. No prior systemic therapy for locally advanced or metastatic NSCLC, patients previously treated with curative-intent /neoadjuvant chemo or concurrent/sequential chemoradiotherapy for non-metastatic disease are eligible if progression occurred ≥ 12 months after the last treatment;
  4. Confirmation of ALK fusion by tumor histology, cytology, or blood-based testing;
  5. Patients must have at least one according to v1.1. Lesions that have been previously irradiated should not be selected as target lesions. Subjects with only skin lesions or bone lesions are not eligible for inclusion;
  6. performance status score of 0 or 1 within 7 days prior to the first dose of study drug;
  7. Estimated survival of ≥ 12 weeks;
  8. Adequate organ and bone marrow function, without having received blood transfusion, recombinant human thrombopoietin, or colony-stimulating factors within 2 weeks prior to the first dose of study drug.

Exclusion criteria

Exclusion Criteria:

  1. Histological or cytological confirmation of mixed small cell lung cancer, neuroendocrine carcinoma, carcinosarcoma, or squamous cell carcinoma components;
  2. Prior receipt of any of the following therapies (including in the or neoadjuvant setting): a) TROP2-targeted therapy; b) Any therapy containing topoisomerase I, including antibody-drug conjugate (ADC) therapy; c) Lorlatinib targeted therapy;
  3. Presence of factors affecting oral drug administration;
  4. Documented severe dry eye syndrome, severe meibomian gland disease and/or blepharitis, or history of corneal disease that precludes or delays corneal healing;
  5. Presence of spinal cord compression. Subjects who have received adequate local treatment (surgery or radiotherapy) and have clinical evidence of symptom relief for ≥ 1 week prior to the first dose may be enrolled;
  6. Presence of active central nervous system (CNS) . Subjects with stable asymptomatic may be enrolled;
  7. Presence of other within 3 years prior to the first dose (except for tumors cured by local therapy or in situ carcinomas that do not require immediate treatment);
  8. Presence of severe cardiovascular or cerebrovascular disease or cardiovascular risk factors;
  9. History of (non-infectious) interstitial lung disease (ILD) or non-infectious pneumonitis requiring therapy, current ILD or non-infectious pneumonitis, or suspected ILD or non-infectious pneumonitis that cannot be ruled out by imaging at screening;
  10. Prior antitumor therapy-related toxicities have not recovered to ≤ grade 1 (based on v5.0) or to the levels specified in the eligibility criteria (excluding toxicities deemed by the investigator to be of low safety risk, such as alopecia, fatigue, or peripheral neuropathy);
  11. Active (hepatitis B surface antigen [HBsAg] positive, requiring HBV-DNA testing; HBV-DNA ≥ 2000 IU/mL or above the lower limit of detection, whichever is higher) or (positive for hepatitis C antibody with HCV-RNA above the lower limit of detection).
Terms in these criteria, in plain language(13)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
153 participants (estimated)

Study arms

  • Active comparator
    baseline ctDNA negative

    Drug: Lorlatinib

  • Experimental
    baseline ctDNA positive-lorlatinib

    Drug: Lorlatinib

  • Experimental
    baseline ctDNA positive-lorlatinib+sacituzumab tirumotecan

    Drug: sacituzumab tirumotecan plus lorlatinib

Interventions

  • lorlatinib 100 mg orally once daily (QD)

  • Drugsacituzumab tirumotecan plus lorlatinib

    Drug pages: Sacituzumab tirumotecan · Lorlatinib

    lorlatinib 100 mg orally once daily (QD) plus sacituzumab tirumotecan 4 mg/kg administered as an intravenous infusion on Day 1 and Day 15 of each 4-week cycle (Q4W) for 4 cycles

06

What researchers measure

Primary outcomes

  1. 1-year PFS rate

    PFS is defined as the time from the start of study treatment to the first documented radiographic disease progression or death from any cause, whichever occurs first (according to RECIST v1.1). The Kaplan-Meier method will be used to estimate the median PFS and its 95% confidence interval, to generate survival curves, and to calculate the 1-year PFS rate

    Time frame: From date of first dosing to first documented progression or death from any cause, whichever came first, assessed up to 1 year.

Secondary outcomes

  1. PFS

    PFS is defined as the time from the start of study treatment to the first documented radiographic disease progression or death from any cause, whichever occurs first (according to RECIST v1.1). The Kaplan-Meier method will be used to estimate the median PFS and its 95% confidence interval, to generate survival curves.

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

  2. ORR

    The objective response rate (ORR) is defined as the proportion of subjects in the analysis population who achieve a complete response (CR) or partial response (PR) as assessed by the investigator according to RECIST version 1.1 criteria.

    Time frame: Up to 2 years

  3. DCR

    The disease control rate (DCR) is defined as the proportion of subjects who achieve complete response (CR), partial response (PR), or stable disease (SD) as assessed by the investigator according to RECIST version 1.1 criteria.

    Time frame: Up to 2 years

  4. TTR

    Time to response (TTR) is defined as the interval from the first dose to the first documented complete response (CR) or partial response (PR), as assessed by the investigator according to RECIST version 1.1 criteria.

    Time frame: Up to 2 years

  5. DOR

    Duration of response (DOR) is defined as the time interval from the first documented response to disease progression or death (whichever occurs first), as assessed by the investigator according to RECIST version 1.1 criteria.

    Time frame: up to 3 years

  6. OS

    Overall survival (OS) is defined as the time from the start of study treatment to death from any cause.

    Time frame: up to 5 years

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: No

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

Start is estimated for Sep 2026; primary completion for Sep 2029, 36 months later.

Of 730 non-industry phase 2 interventional studies under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 56 months of starting (the median), counting those still running; a quarter within 36 and three quarters within 84. This study's planned 36 months is below that.

Counting every sponsor, half of 1,047 studies reached it within 48 months; a quarter within 30 and three quarters within 76.

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

Registered
Aug 2, 2026
First posted
Aug 6, 2026
StartEst.
Sep 2026
Primary completionEst.
Sep 2029
CompletionEst.
Mar 2030
Last update
Aug 6, 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 Aug 6, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07750704
Lead sponsor
Guangdong Association of Clinical Trials
Responsible party
Yi-Long Wu (Principal Investigator, Guangdong Association of Clinical Trials) — Principal investigator
First posted
Aug 6, 2026
Start date
Sep 2026 (estimated)
Primary completion
Sep 2029 (estimated)
Completion
Mar 2030 (estimated)
Last update
Aug 6, 2026

Study contacts

Bingfei Xu, MD
Contact
xubingfei@gdph.org.cn
13036100430
Yi-Long Wu, MD
principal investigator · Guangdong Provincial People's Hospital

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Lorlatinib · Sacituzumab tirumotecan

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