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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600126630 |
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最近更新日期: Date of Last Refreshed on: |
2026-06-12 15:02:30 |
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注册时间: Date of Registration: |
2026-06-12 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
比较表皮生长因子受体阳性、实性、IA2-IA3期非小细胞肺癌经皮消融治疗术后联合和不联合伏美替尼有效性和安全性的随机、对照、多中心研究 |
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Public title: |
A Randomized, Controlled, Multicenter Study Comparing the Efficacy and Safety of Percutaneous Ablation With or Without Furmonertinib in EGFR-Positive, Solid, Stage IA2–IA3 Non-Small Cell Lung Cancer |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
比较表皮生长因子受体阳性、实性、IA2-IA3期非小细胞肺癌经皮消融治疗术后联合和不联合伏美替尼有效性和安全性的随机、对照、多中心研究 |
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Scientific title: |
A Randomized, Controlled, Multicenter Study Comparing the Efficacy and Safety of Percutaneous Ablation With or Without Furmonertinib in EGFR-Positive, Solid, Stage IA2–IA3 Non-Small Cell Lung Cancer |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
敖敏 |
研究负责人: |
杨丽 |
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Applicant: |
Min Ao |
Study leader: |
Li Ly |
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申请注册联系人电话: Applicant telephone: |
+86 23 8901 2626 |
研究负责人电话:
Study leader's |
+86 23 8901 2680 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
lishula2021@163.com |
研究负责人电子邮件: Study leader's E-mail: |
315764964@qq.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
重庆市渝中区袁家岗友谊路1号 |
研究负责人通讯地址: |
重庆市袁家岗友谊路1号 |
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Applicant address: |
No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China |
Study leader's address: |
1st You Yi Road, Yu Zhong District, Chongqing 400016, China |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
重庆医科大学附属第一医院 |
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Applicant's institution: |
The First Affiliated Hospital of Chongqing Medical University |
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研究负责人所在单位: |
重庆医科大学附属第一医院 |
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Affiliation of the Leader: |
The First Affiliated Hospital of Chongqing Medical University |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2026年科研伦审(ZZ2026-0267-01) |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
重庆医科大学附属第一医院医学研究伦理审查委员会 |
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Name of the ethic committee: |
Medical Research Ethics Review Committee of the First Affiliated Hospital of Chongqing Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-05-14 00:00:00 | ||
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伦理委员会联系人: |
严青 |
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Contact Name of the ethic committee: |
Yan Qing |
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伦理委员会联系地址: |
重庆市袁家岗友谊路1号 |
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Contact Address of the ethic committee: |
1st You Yi Road, Yu Zhong District, Chongqing 400016, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 23 8901 1876 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
444158752@qq.com |
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研究实施负责(组长)单位: |
重庆医科大学附属第一医院 |
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Primary sponsor: |
The First Affiliated Hospital of Chongqing Medical University |
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研究实施负责(组长)单位地址: |
重庆市袁家岗友谊路1号 |
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Primary sponsor's address: |
1st You Yi Road, Yu Zhong District, Chongqing 400016, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
自选课题(自筹) |
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Source(s) of funding: |
Self-Selected Research Project |
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研究疾病: |
非小细胞肺癌 |
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Target disease: |
Non-small cell lung cancer (NSCLC) |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
1.主要目的: 比较EGFR阳性实性IA2-IA3期NSCLC经皮消融治疗术后,联合或不联合伏美替尼的2年无病生存率(DFS)。 2.次要目的: (1)比较EGFR阳性实性IA2-IA3期NSCLC经皮消融治疗术后,联合或不联合伏美替尼治疗的DFS,总生存期(Overall Survival, OS);3和5年DFS率;1、2、3、4和5年局部控制率(Local Control Rate, LCR);2、3和5年OS率;OS 定义为从随机化日期到因任何原因死亡日期的时间; (2)比较EGFR阳性实性IA2-IA3期NSCLC经皮消融治疗术后,联合或不联合伏美替尼治疗的安全性。 |
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Objectives of Study: |
1. Primary Objective:To compare the 2-year disease-free survival (DFS) rate after percutaneous ablation with or without furmonertinib in patients with EGFR-positive, solid, stage IA2–IA3 non-small cell lung cancer (NSCLC).2. Secondary Objectives:(1) To compare disease-free survival (DFS), overall survival (OS), 3- and 5-year DFS rates, 1-, 2-, 3-, 4-, and 5-year local control rates (LCR), and 2-, 3-, and 5-year OS rates in patients with EGFR-positive, solid, stage IA2–IA3 NSCLC after percutaneous ablation with or without furmonertinib. OS is defined as the time from the date of randomization to the date of death from any cause.(2) To compare the safety of percutaneous ablation with or without furmonertinib in patients with EGFR-positive, solid, stage IA2–IA3 NSCLC. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.年龄≥18岁; 2.性别不限; 3.消融前的肺原发灶肺窗最长径10-30mm; 4.消融前的肺原发灶为CTR=1的实性肿瘤; 5.消融的肺原发灶经细胞学或病理学确诊为NSCLC; 6.消融前,须通过以下影像学检查明确肿瘤分期为原发或多原发IA2?~?IA3期肺癌:PETCT、或者分步筛查头颅MRI(平扫或增强)或头颅CT(平扫或增强)、胸部CT(平扫或增强)、腹部超声或腹部CT(平扫或增强)、全身骨显像。疾病分期按照国际抗癌联盟(UICC) 与美国癌症联合委员会(AJCC )第9版肺癌TNM分期执行;如果PET/CT或胸部增强CT提示淋巴结是否转移状态模棱两可,满足以下条件之一可入组:(1)通过纵隔镜检查或经支气管或食管超声等活检确认病理阴性;(2)经多学科讨论后评估为阴性,并且可疑淋巴结在入组前复查胸部CT(平扫或增强)对比消融治疗前胸部CT大小无变化; 7.耐受或拒绝外科手术、拒绝立体定向放疗或根治性放疗的经CT引导下经皮消融(射频、微波或冷冻)治疗术后1月±1周以内的患者,且回顾消融治疗术中胸部CT图像,消融边界超过瘤体5-10mm; 8.消融病灶的肿瘤细胞学、组织样本或血液样本经研究者认同的实验室检测确认为EGFR敏感突变(外显子19缺失或/和L858R突变,两者单独存在或共存); 9.若是多原发IA2-IA3期肺癌,在满足Martini-Melamed 多原发肺癌诊断标准、非消融肺癌病灶疾病稳定无复发基础上,需满足以下条件:(1)其他确诊肺癌病灶符合磨玻璃密度(CTR<1)可入组;(2)其他确诊病灶若为实性(CTR=1)肺癌时,两次确诊肺癌病史需≥5年,且半年内未进行任何抗肿瘤治疗可入组; 10.既往合并肺外系统肿瘤时,该肿瘤病情稳定,且半年内未进行系统性的抗肿瘤治疗; 11.消融术后入组前复查胸部CT(平扫或增强),研究者判断消融范围完全覆盖消融术前病灶; 12.术后拒绝行化疗、抗血管生成治疗、免疫治疗以及放疗; 13.美国东部肿瘤协作组(ECOG)体能状态(PS)评分 ≤2分(见附录C); 14.预计生存期大于6个月; 15.育龄女性从筛选到停止研究治疗后3个月需采取合适的避孕措施且不应该哺乳。开始给药前,妊娠试验为阴性,或者满足下列标准之一证明没有妊娠风险: 1)绝经后定义为年龄大于50岁和停止所有外源性激素替代治疗后闭经至少12个月; 2)年龄小于50岁女性,如果停止所有外源性激素治疗后闭经12个月或以上,且促黄体激素和卵泡刺激激素水平在实验室绝经后参考值范围内,也可认为是绝经后; 3)曾经接受不可逆的绝育手术,包括子宫切除,双侧卵巢切除或双侧输卵管切除,但双侧输卵管结扎除外; 16.未进行手术绝育的男性从筛选到停止研究治疗后3个月内应使用屏障避孕(即避孕套),不得捐献精子; 17.受试者本人自愿参加并书面签署知情同意书; |
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Inclusion criteria |
1. Age >=18 years; 2. No restriction on sex; 3. Before ablation, the primary lung tumor measures 10–30 mm in longest diameter on the lung window; 4. Before ablation, the primary lung tumor is a solid tumor with a consolidation tumor ratio (CTR) = 1; 5. The ablated primary lung tumor is confirmed as NSCLC by cytology or pathology; 6. Before ablation, tumor staging must be determined as primary or multiple primary stage IA2–IA3 lung cancer by the following imaging examinations: PET-CT, or a stepwise screening comprising brain MRI (plain or enhanced) or brain CT (plain or enhanced), chest CT (plain or enhanced), abdominal ultrasound or abdominal CT (plain or enhanced), and whole-body bone scan. Disease staging is performed according to the 9th edition of the UICC/AJCC TNM staging system for lung cancer. If PET/CT or contrast-enhanced chest CT suggests equivocal lymph node metastasis, the patient may be enrolled if one of the following is met: (1) negative pathology confirmed by biopsy via mediastinoscopy, transbronchial or esophageal ultrasound, etc.; (2) assessed as negative after multidisciplinary discussion, and a follow-up chest CT (plain or enhanced) before enrollment shows no change in the size of the suspicious lymph node compared with the chest CT before ablation; 7. Patients who are intolerant of or refuse surgery, refuse stereotactic body radiotherapy or radical radiotherapy, and have undergone CT-guided percutaneous ablation (radiofrequency, microwave, or cryoablation) within 1 month +/- 1 week, with retrospective review of intraoperative chest CT images showing an ablation margin extending 5–10 mm beyond the tumor; 8. Tumor cytology, tissue, or blood samples from the ablated lesion are confirmed by a laboratory acceptable to the investigator as harboring an EGFR sensitizing mutation (exon 19 deletion and/or L858R mutation, either alone or in combination); 9. For multiple primary stage IA2–IA3 lung cancer, in addition to meeting the Martini-Melamed criteria for multiple primary lung cancers (see Appendix B) and having non-ablated lung cancer lesions that are stable without recurrence, the following conditions must be met: (1) other confirmed lung cancer lesions are ground-glass density (CTR <1) for enrollment; (2) if another confirmed lesion is a solid (CTR = 1) lung cancer, the interval between the two lung cancer diagnoses must be >=5 years, and no antitumor therapy has been administered within the past 6 months; 10. If there is a prior history of extrapulmonary systemic tumor, that tumor must be stable and no systemic antitumor therapy has been given within the past 6 months; 11. A post-ablation chest CT (plain or enhanced) obtained before enrollment shows that, in the investigator's judgment, the ablation zone completely covers the pre-ablation lesion; 12. Refusal of chemotherapy, anti-angiogenic therapy, immunotherapy, and radiotherapy after ablation; 13. Eastern Cooperative Oncology Group (ECOG) performance status (PS) score <=2 (see Appendix C); 14. Expected survival >6 months; 15. Women of childbearing potential must use appropriate contraception from screening until 3 months after discontinuation of study treatment and must not breastfeed. A negative pregnancy test is required before the first dose, or one of the following criteria demonstrating no risk of pregnancy must be met: (1) Postmenopausal defined as age >50 years and amenorrhea for at least 12 months after cessation of all exogenous hormonal treatments; (2) Women aged <50 years are considered postmenopausal if they have been amenorrheic for 12 months or more after cessation of exogenous hormonal treatments and luteinizing hormone and follicle-stimulating hormone levels are within the laboratory's postmenopausal reference range; (3) Prior irreversible surgical sterilization, including hysterectomy, bilateral oophorectomy, or bilateral salpingectomy, but not bilateral tubal ligation. 16. Non-surgically sterilized males must use barrier contraception (i.e., condoms) from screening until 3 months after discontinuation of study treatment and must not donate sperm; 17. The subject voluntarily participates and signs a written informed consent form. |
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排除标准: |
1. 病理为小细胞肺癌(SCLC)与 NSCLC 混合的肺癌; 2. 伴有 EGFR20 外显子插入和/或 ALK 突变; 3. 多原发 IA2-IA3 期肺癌的非消融肺癌靶病灶为实性病灶时,间隔确诊时间<5 年;或虽间隔时间>=5 年,但原肺癌疾病不稳定; 4. 存在严重或不能控制的全身性疾病(如严重的精神、神经疾病、癫痫或痴呆,不稳定或不能代偿的呼吸、心血管、肝或肾脏疾病,左心室射血分数(LVEF)<40%,未得到控制的高血压[即指经过药物治疗后仍为大于或等于 CTCAE 3 级高血压])的证据;患有吞咽功能障碍、活动性胃肠道出血性疾病、既往做过胃大部分切除术者、或其他显著影响口服药物的吸收、分布、代谢以及排泄的疾病; 5. 有重度间质性肺病(ILD)病史(也包括药物诱导 ILD)、正在接受>10 mg/d 泼尼松等效的长期全身类固醇治疗的间质性肺炎病史,或有临床活动性 ILD 的任何证据; 6. 不稳定心绞痛,充血性心力衰竭,纽约心脏病协会(NYHA)分级>2 级的慢性心衰; 7. 3 个月内发生过心肌梗塞、冠状动脉/外周动脉搭桥或脑血管意外; 8. 在患者使用研究药物之前 21 天内接受过除肺部以外其他部位的开放性外科手术(以活检为目的的手术除外); 9. 近 2 年内确诊合并其他恶性疾病,病情不稳定(不包括完全切除的基底细胞癌、原位膀胱癌、宫颈原位癌); 10. 经连续 3 次心电图(ECG)测量的平均 QTc 间期>470 ms(经 Fridericia 公式校正的 QT 间期[QTcF])或可能增加 QT 间期延长风险的其他心律失常或临床状态(例如,完全性左束支传导阻滞、III 级房室传导阻滞、PR 间期>250 ms、先天性长 QT 综合征、长 QT 间期综合征家族史、或 40 岁以下直系亲属不明原因猝死、严重低钾血症等); 11. 骨髓储备或器官功能不足,筛选期内达到下列任何一项实验室限值(实验室检查抽血前 1 周内无纠正治疗): (1) 绝对嗜中性粒细胞计数<1.5×10^9/L; (2) 血小板计数<80×10^9/L; (3) 血红蛋白<80 g/L(<8 g/dL); (4) 丙氨酸氨基转移酶>3 倍的正常上限(ULN); (5) 天冬氨酸氨基转氨酶>3×ULN; (6) 总胆红素>1.5×ULN; (7) 肌酐>1.5×ULN 或肌酐清除率<45 mL/min; (8) 血清白蛋白(ALB)<25 g/L; 12. 既往半年内因全身各系统肿瘤,接受过下列任一治疗: (1) 既往使用过任何 EGFR 酪氨酸激酶抑制剂或其他明确肺癌靶点相关的靶向药物; (2) 既往接受任何针对肺癌的系统性化疗、抗血管生成治疗、免疫治疗、放疗; 13. 既往 4 周内使用过抗肿瘤作用的中成药,停药 4 周及以上可以入组; 14. 首次给药前 2 周内正在使用任何已知延长 QT 间期的药物; 15. 妊娠期、哺乳期或计划在研究期间妊娠的女性受试者; 16. 对伏美替尼的任何活性或非活性成分或对与伏美替尼化学结构类似或伏美替尼同类别的药物有超敏反应史; 17. 2 周内使用/食用已知具有强效 CYP3A4 抑制和/或诱导作用,或作为 CYP3A4 底物(具有狭窄治疗指数)的药物(附录 D); 18. 2 周内使用过 P-gp 强抑制剂(包括但不限于维拉帕米、环孢素 A、右维拉帕米); 19. 研究者判断存在任何危及受试者安全或干扰研究评估的状况的受试者。 |
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Exclusion criteria: |
1. Pathology showing mixed small cell lung cancer (SCLC) and NSCLC; 2. Presence of EGFR exon 20 insertion and/or ALK mutation; 3. For multiple primary stage IA2–IA3 lung cancer, if the non-ablated target lesion is a solid lesion and the interval between diagnoses is <5 years; or if the interval is >=5 years but the original lung cancer is not stable; 4. Evidence of severe or uncontrolled systemic disease (e.g., severe psychiatric, neurological disease, epilepsy or dementia, unstable or uncompensated respiratory, cardiovascular, hepatic, or renal disease, left ventricular ejection fraction [LVEF] <40%, uncontrolled hypertension [i.e., hypertension >= CTCAE grade 3 despite medication]); presence of swallowing dysfunction, active gastrointestinal bleeding disease, prior major gastrectomy, or other conditions significantly affecting the absorption, distribution, metabolism, or excretion of oral drugs; 5. History of severe interstitial lung disease (ILD) (including drug-induced ILD), history of interstitial pneumonitis requiring long-term systemic steroid therapy at a dose equivalent to >10 mg/day prednisone, or any evidence of clinically active ILD; 6. Unstable angina, congestive heart failure, New York Heart Association (NYHA) class >2 chronic heart failure; 7. Myocardial infarction, coronary/peripheral artery bypass surgery, or cerebrovascular accident within 3 months; 8. Open surgical procedure (except biopsy) on any site other than the lung within 21 days before the patient receives study drug; 9. Diagnosis of another malignant disease within the past 2 years that is not stable (excluding completely resected basal cell carcinoma, bladder carcinoma in situ, cervical carcinoma in situ); 10. Mean QTc interval >470 ms from triplicate electrocardiograms (ECGs) (QT interval corrected using Fridericia's formula [QTcF]), or other arrhythmias or clinical conditions that may increase the risk of QT prolongation (e.g., complete left bundle branch block, third-degree atrioventricular block, PR interval >250 ms, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death in first-degree relatives under 40 years of age, severe hypokalemia, etc.); 11. Inadequate bone marrow reserve or organ function, meeting any of the following laboratory values during the screening period (without corrective treatment within 1 week before blood draw): (1) Absolute neutrophil count <1.5 × 10^9/L; (2) Platelet count <80 × 10^9/L; (3) Hemoglobin <80 g/L (<8 g/dL); (4) Alanine aminotransferase >3 × upper limit of normal (ULN); (5) Aspartate aminotransferase >3 × ULN; (6) Total bilirubin >1.5 × ULN; (7) Creatinine >1.5 × ULN or creatinine clearance <45 mL/min; (8) Serum albumin (ALB) <25 g/L; 12. Receipt of any of the following treatments for systemic tumors within the past 6 months: (1) Prior use of any EGFR tyrosine kinase inhibitor or other targeted drugs with a clear lung cancer target; (2) Prior systemic chemotherapy, anti-angiogenic therapy, immunotherapy, or radiotherapy for lung cancer; 13. Use of Chinese patent medicines with antitumor effects within the past 4 weeks; enrollment is allowed after discontinuation for >=4 weeks; 14. Currently using any drugs known to prolong the QT interval within 2 weeks before the first dose; 15. Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study; 16. History of hypersensitivity to any active or inactive ingredient of furmonertinib, or to drugs with a similar chemical structure or the same class as furmonertinib; 17. Use/consumption of drugs known to have strong CYP3A4 inhibition and/or induction, or drugs that are CYP3A4 substrates with a narrow therapeutic index, within 2 weeks (Appendix D); 18. Use of strong P-gp inhibitors (including but not limited to verapamil, cyclosporine A, dexverapamil) within 2 weeks; 19. Any condition that, in the investigator's judgment, jeopardizes the subject's safety or interferes with the study evaluation. |
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研究实施时间: Study execute time: |
从 From 2026-06-16 00:00:00至 To 2032-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-06-16 00:00:00 至 To 2026-12-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
总中心分区组按1:1比例进行随机 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Central stratified block randomization will be performed at a 1:1 ratio. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
开放标签 |
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Blinding: |
Open-label study |
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
2033-1-1 EDC 暂无网址 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
2033-1-1 EDC No URL available |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
数据收集:CRF 数据管理:EDC |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Data Collection: CRF Data Management: EDC |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |