Clinical Trials List
Protocol NumberTHIO-104
Active
2025-04-01 - 2027-12-31
Phase III
Recruiting10
ICD-10C33
Malignant neoplasm of trachea
ICD-10Z51.12
Encounter for antineoplastic immunotherapy
ICD-9162.0
Malignant neoplasm of trachea
A multicenter, open-label, randomized phase 3 trial evaluating sequential treatment with THIO followed by cemiplimab (LIBTAYO®) versus investigator’s choice of single-agent chemotherapy as third-line therapy in participants with advanced or metastatic non–small cell lung cancer (NSCLC).
-
Trial Applicant
STATPLUS, INC.
-
Sponsor
StatPlus, Inc.
-
Trial scale
Multi-Regional Multi-Center
-
Update
2026/02/01
Investigators and Locations
Co-Principal Investigator
The Actual Total Number of Participants Enrolled
0 Recruiting
The Actual Total Number of Participants Enrolled
0 Recruiting
Co-Principal Investigator
- Shang-Fu Hsu Division of Thoracic Medicine
- Chao-Hua Chiu Division of Thoracic Medicine
- Jia-Ruey Tsai Division of Hematology & Oncology
- Chun-Liang Chou Division of Thoracic Medicine
- Mei-Chuan Chen Division of Thoracic Medicine
- Chi-Li Chung Division of Thoracic Medicine
- Kai-Ling Lee Division of Thoracic Medicine
- Han-Pin Kuo 無
- Cheng-I Hsieh Division of Hematology & Oncology
The Actual Total Number of Participants Enrolled
0 Recruiting
The Actual Total Number of Participants Enrolled
0 Recruiting
Co-Principal Investigator
- 吳教恩 無
- Ping-Chih Hsu 無
- Cheng-Ta Yang 無
- 柯皓文 無
- 黃振洋 無
- 枋岳甫 無
- Chih-Hsi Kuo 無
The Actual Total Number of Participants Enrolled
0 Recruiting
The Actual Total Number of Participants Enrolled
0 Recruiting
Co-Principal Investigator
- 林理涵 無
- 李易濰 無
- 黃國棟 無
- CHIN-CHOU WANG 無
- Chia-Cheng Tseng 無
- 王逸熙 無
- 張晃智 無
- 鍾聿修 無
The Actual Total Number of Participants Enrolled
0 Recruiting
Co-Principal Investigator
- Yuh-Min Chen Division of Hematology & Oncology
- 趙恒勝 無
- Chi-Lu Chiang 無
- 廖映庭 無
- Hsu-ching Huang 無
- YEN-HAN TSENG 無
- 蕭慈慧 無
The Actual Total Number of Participants Enrolled
0 Recruiting
The Actual Total Number of Participants Enrolled
0 Recruiting
Principal Investigator
Jen-Yu Hung
Co-Principal Investigator
The Actual Total Number of Participants Enrolled
0 Recruiting
Condition/Disease
Advanced non–small cell lung cancer (NSCLC)
Objectives
Primary Objective:
• To evaluate the survival benefit of THIO followed by cemiplimab in participants with advanced non–small cell lung cancer (NSCLC).
Secondary Objectives:
• To further assess the efficacy of THIO followed by cemiplimab in participants with advanced NSCLC.
• To determine the safety and tolerability of THIO followed by cemiplimab in participants with advanced NSCLC.
Test Drug
LIBTAYO
THIO
THIO
Active Ingredient
THIO
cemiplimab
cemiplimab
Dosage Form
242
242
242
Dosage
20MG/8ML
350MG/7ML
350MG/7ML
Endpoints
Overall survival (OS) is defined as the time from randomization to death from any cause.
Inclution Criteria
Age
1. At least 18 years of age at the time of signing the Informed Consent Form (ICF) prior to initiation of any study-specific activities/procedures.
Disease characteristics
2. Stage 3b or 4 histologically or cytologically confirmed NSCLC.
Note: Stage is determined at the time of diagnosis.
3. Two (2) prior lines of systemic treatment for advanced/metastatic disease, including an ICI (anti-PD-1/PD-L1) and a platinum-based chemotherapy (given in combination or in separate lines) for advanced/metastatic disease.
Note: The combination of primary therapy followed by maintenance is considered as one line of therapy. Prior treatment with docetaxel is preferred (but not mandated), and is a pre-specified stratification factor.
4. Documented progression or intolerance following the most recent line of therapy.
○ Stage 4 subjects – must have progressed or relapsed after first-line treatment.
○ Stage 3b subjects – must have already failed, or be ineligible for, local, curative-intent therapy including surgery, and/or chemoradiation.
Note: Local, curative-intent therapy including surgery, and/or chemoradiation is not considered a treatment line in the advanced setting.
5. Documented secondary resistance to the prior ICI treatment, as defined by the Society for Immunotherapy of Cancer (SITC) immunotherapy resistance task force (IRTF) (Kluger, 2020).
6. No prior targeted therapy for driver mutations.
7. At least one measurable target lesion that that meets the definition of RECIST v1.1., with documented progression following the most recent line of therapy.
8. An archival tissue sample (formalin-fixed, paraffin-embedded [FFPE] tissue block or unstained slides) is required if tissue is available at baseline.
Note: The sample does not need to be received by the central laboratory prior to Cycle 1, Day 1 (C1D1). Subjects without archival tissue available at baseline may be eligible with Medical Monitor approval.
9. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
10. Demonstrate adequate organ function as defined below. All screening laboratories should be performed up to 14 days prior to start of study treatment:
Bone marrow function:
○ Neutrophil count ≥ 1500/mm3, hemoglobin ≥ 9.0 g/dL, platelet count ≥ 100,000/mm3
Liver function:
○ Total bilirubin ≤ 1.5 x the upper limit of normal (ULN), up to ≤ 3 × ULN due to Gilbert’s syndrome
○ Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 1.5 × ULN.
Note: For subjects with liver metastases present at baseline, ALT and/or AST ≤ 3 × ULN is permitted.
Renal function:
○ Creatinine clearance ≥ 60 mL/min calculated by the Cockcroft-Gault formula using actual body weight (see Table 4) or 24-hour urine collection.
Gender and reproductive considerations
11. Women of childbearing potential (WOCBP) must have negative serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [hCG]) within 72 hours prior to start of study treatment.
12. Contraception
In the THIO / cemiplimab arm:
WOCBP must agree to use a highly effective birth control and refrain from oocyte donation during the study (prior to the first dose with THIO, for the duration of the treatment with THIO, and for six months after the last dose of study treatment, if conception is possible during this interval).
Unless permanently sterile by bilateral orchidectomy, male subjects and WOCBP partners of male subjects should use a combination of the methods specified for female subjects in the full protocol, along with a male condom, from start of study treatment, for the duration of the treatment, and for six months after the last dose of study treatment. Male subjects should also refrain from sperm donation during this time.
In the single-agent chemotherapy arm: For WOCBP, male subjects and WOCBP partners of male subjects, contraception requirements should follow the relevant product’s package labelling and standard of care.
Note: Contraception use by men or women in both treatment arms should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
Informed consent
13. Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in the study protocol.
1. At least 18 years of age at the time of signing the Informed Consent Form (ICF) prior to initiation of any study-specific activities/procedures.
Disease characteristics
2. Stage 3b or 4 histologically or cytologically confirmed NSCLC.
Note: Stage is determined at the time of diagnosis.
3. Two (2) prior lines of systemic treatment for advanced/metastatic disease, including an ICI (anti-PD-1/PD-L1) and a platinum-based chemotherapy (given in combination or in separate lines) for advanced/metastatic disease.
Note: The combination of primary therapy followed by maintenance is considered as one line of therapy. Prior treatment with docetaxel is preferred (but not mandated), and is a pre-specified stratification factor.
4. Documented progression or intolerance following the most recent line of therapy.
○ Stage 4 subjects – must have progressed or relapsed after first-line treatment.
○ Stage 3b subjects – must have already failed, or be ineligible for, local, curative-intent therapy including surgery, and/or chemoradiation.
Note: Local, curative-intent therapy including surgery, and/or chemoradiation is not considered a treatment line in the advanced setting.
5. Documented secondary resistance to the prior ICI treatment, as defined by the Society for Immunotherapy of Cancer (SITC) immunotherapy resistance task force (IRTF) (Kluger, 2020).
6. No prior targeted therapy for driver mutations.
7. At least one measurable target lesion that that meets the definition of RECIST v1.1., with documented progression following the most recent line of therapy.
8. An archival tissue sample (formalin-fixed, paraffin-embedded [FFPE] tissue block or unstained slides) is required if tissue is available at baseline.
Note: The sample does not need to be received by the central laboratory prior to Cycle 1, Day 1 (C1D1). Subjects without archival tissue available at baseline may be eligible with Medical Monitor approval.
9. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
10. Demonstrate adequate organ function as defined below. All screening laboratories should be performed up to 14 days prior to start of study treatment:
Bone marrow function:
○ Neutrophil count ≥ 1500/mm3, hemoglobin ≥ 9.0 g/dL, platelet count ≥ 100,000/mm3
Liver function:
○ Total bilirubin ≤ 1.5 x the upper limit of normal (ULN), up to ≤ 3 × ULN due to Gilbert’s syndrome
○ Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 1.5 × ULN.
Note: For subjects with liver metastases present at baseline, ALT and/or AST ≤ 3 × ULN is permitted.
Renal function:
○ Creatinine clearance ≥ 60 mL/min calculated by the Cockcroft-Gault formula using actual body weight (see Table 4) or 24-hour urine collection.
Gender and reproductive considerations
11. Women of childbearing potential (WOCBP) must have negative serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [hCG]) within 72 hours prior to start of study treatment.
12. Contraception
In the THIO / cemiplimab arm:
WOCBP must agree to use a highly effective birth control and refrain from oocyte donation during the study (prior to the first dose with THIO, for the duration of the treatment with THIO, and for six months after the last dose of study treatment, if conception is possible during this interval).
Unless permanently sterile by bilateral orchidectomy, male subjects and WOCBP partners of male subjects should use a combination of the methods specified for female subjects in the full protocol, along with a male condom, from start of study treatment, for the duration of the treatment, and for six months after the last dose of study treatment. Male subjects should also refrain from sperm donation during this time.
In the single-agent chemotherapy arm: For WOCBP, male subjects and WOCBP partners of male subjects, contraception requirements should follow the relevant product’s package labelling and standard of care.
Note: Contraception use by men or women in both treatment arms should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
Informed consent
13. Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in the study protocol.
Exclusion Criteria
Prior therapy and disease characteristics
1. For subjects who have received prior treatment with a checkpoint inhibitor: primary resistance to prior checkpoint inhibitor, as defined by the SITC IRTF (Kluger, 2020)
2. Untreated or symptomatic central nervous system (CNS) metastases. Note: Subjects with treated asymptomatic brain metastasis are eligible.
3. Prior chemotherapy and/or non-biologic targeted therapy within 28 days, or biologic targeted therapy, immunotherapy, and/or radiation therapy within 42 days prior to start of study treatment.
Note: Subjects who receive targeted radiation therapy for localized palliative care may be eligible to start study treatment earlier than 42 days with Medical Monitor agreement.
4. Prior treatment with cemiplimab.
5. Prior treatment with a targeted therapy for an epidermal growth factor receptor (EGFR) mutation.
6. Received blood, red blood cell or platelet transfusion within 14 days prior to start of study treatment.
7. Any live, attenuated, inactivated or research vaccines within 30 days prior to start of study treatment.
Note: Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed.
8. Prior allogeneic hematopoietic stem cell transplant or solid organ transplant.
9. Undergone major surgery within 28 days prior to start of study treatment.
Medical conditions
10. Have not recovered to Grade ≤ 1 from adverse events due to prior anti-cancer treatment.
11. Ongoing immune-related / stimulated adverse events (irAEs) from other agents or required permanent discontinuation of prior ICIs due to irAEs.
Note: Subjects with resolved irAE may be allowed to enroll following consultation with the Medical Monitor.
12. Active gastrointestinal bleeding as evidenced by either hematemesis or melena.
13. History of another concurrent malignancy other than the present condition (except nonmelanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for that disease for a minimum of three years.
14. A condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days prior to start of study treatment.
Note: Inhaled or topical steroids, adrenal replacement doses 10 mg daily prednisone equivalents, and systemic corticosteroids to manage adverse events are permitted in the absence of active autoimmune disease.
15. Active, uncontrolled bacterial, viral or fungal infections, requiring systemic therapy within 14 days of screening.
16. Positive for Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), active hepatitis B or hepatitis C.
17. Significant cardiovascular impairment (history of New York Heart Association Functional Classification System Class III or IV) or a history of myocardial infarction or unstable angina within the past six months prior to start of study treatment.
18. QT interval corrected for heart rate (using Fridericia’s correction formula; QTcF) > 480 msec at screening (based on average of triplicate electrocardiograms [ECGs] at baseline).
Note: If the QTc is prolonged in a subject with a pacemaker or bundle branch block, the subject may be enrolled in the study if confirmed by the Medical Monitor.
19. Active autoimmune diseases or history of autoimmune diseases that may relapse, with the following exceptions:
○ Controlled Type 1 diabetes
○ Hypothyroidism (provided it is managed with hormone replacement therapy only)
○ Controlled celiac disease
○ Skin diseases not requiring systemic treatment (e.g., vitiligo, psoriasis, or alopecia)
○ Any other disease that is not expected to recur in the absence of external triggering factors.
20. Pregnancy or lactating.
21. A serious nonmalignant disease (e.g., psychiatric, substance abuse, uncontrolled intercurrent illness, interstitial lung disease etc.) that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor.
22. Any other condition that, in the opinion of the Investigator, would prohibit the subject from participating in the study.
Prior / concurrent clinical study experience
23. Currently enrolled in a clinical study involving another investigational product or nonapproved use of a drug or device, or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study.
Other
24. History of allergy to excipients of THIO, cemiplimab or any of the chemotherapies under study.
1. For subjects who have received prior treatment with a checkpoint inhibitor: primary resistance to prior checkpoint inhibitor, as defined by the SITC IRTF (Kluger, 2020)
2. Untreated or symptomatic central nervous system (CNS) metastases. Note: Subjects with treated asymptomatic brain metastasis are eligible.
3. Prior chemotherapy and/or non-biologic targeted therapy within 28 days, or biologic targeted therapy, immunotherapy, and/or radiation therapy within 42 days prior to start of study treatment.
Note: Subjects who receive targeted radiation therapy for localized palliative care may be eligible to start study treatment earlier than 42 days with Medical Monitor agreement.
4. Prior treatment with cemiplimab.
5. Prior treatment with a targeted therapy for an epidermal growth factor receptor (EGFR) mutation.
6. Received blood, red blood cell or platelet transfusion within 14 days prior to start of study treatment.
7. Any live, attenuated, inactivated or research vaccines within 30 days prior to start of study treatment.
Note: Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed.
8. Prior allogeneic hematopoietic stem cell transplant or solid organ transplant.
9. Undergone major surgery within 28 days prior to start of study treatment.
Medical conditions
10. Have not recovered to Grade ≤ 1 from adverse events due to prior anti-cancer treatment.
11. Ongoing immune-related / stimulated adverse events (irAEs) from other agents or required permanent discontinuation of prior ICIs due to irAEs.
Note: Subjects with resolved irAE may be allowed to enroll following consultation with the Medical Monitor.
12. Active gastrointestinal bleeding as evidenced by either hematemesis or melena.
13. History of another concurrent malignancy other than the present condition (except nonmelanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for that disease for a minimum of three years.
14. A condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days prior to start of study treatment.
Note: Inhaled or topical steroids, adrenal replacement doses 10 mg daily prednisone equivalents, and systemic corticosteroids to manage adverse events are permitted in the absence of active autoimmune disease.
15. Active, uncontrolled bacterial, viral or fungal infections, requiring systemic therapy within 14 days of screening.
16. Positive for Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), active hepatitis B or hepatitis C.
17. Significant cardiovascular impairment (history of New York Heart Association Functional Classification System Class III or IV) or a history of myocardial infarction or unstable angina within the past six months prior to start of study treatment.
18. QT interval corrected for heart rate (using Fridericia’s correction formula; QTcF) > 480 msec at screening (based on average of triplicate electrocardiograms [ECGs] at baseline).
Note: If the QTc is prolonged in a subject with a pacemaker or bundle branch block, the subject may be enrolled in the study if confirmed by the Medical Monitor.
19. Active autoimmune diseases or history of autoimmune diseases that may relapse, with the following exceptions:
○ Controlled Type 1 diabetes
○ Hypothyroidism (provided it is managed with hormone replacement therapy only)
○ Controlled celiac disease
○ Skin diseases not requiring systemic treatment (e.g., vitiligo, psoriasis, or alopecia)
○ Any other disease that is not expected to recur in the absence of external triggering factors.
20. Pregnancy or lactating.
21. A serious nonmalignant disease (e.g., psychiatric, substance abuse, uncontrolled intercurrent illness, interstitial lung disease etc.) that could compromise protocol objectives in the opinion of the Investigator and/or the Sponsor.
22. Any other condition that, in the opinion of the Investigator, would prohibit the subject from participating in the study.
Prior / concurrent clinical study experience
23. Currently enrolled in a clinical study involving another investigational product or nonapproved use of a drug or device, or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study.
Other
24. History of allergy to excipients of THIO, cemiplimab or any of the chemotherapies under study.
The Estimated Number of Participants
-
Taiwan
72 participants
-
Global
300 participants
