A Trial of LBL-024 Combined With Platinum-based Chemotherapy for the Treatment of Advanced EP-NEC

A total of 280 patients with advanced EP-NEC without systemic treatment will be enrolled in this study. Eligible patients will be randomly assigned to the experimental group or control group at a ratio of 1:1.

• LBL-024 for Injection (Drug), also known as LBL-024: Intravenous infusion
• Etoposide injection (Drug), also known as Etoposide: Intravenous infusion
• Cisplatin injection (Drug), also known as Cisplatin: Intravenous infusion
• Carboplatin injection (Drug), also known as Carboplatin: Intravenous infusion
• LBL-024 placebo for injection (Drug), also known as LBL-024 placebo: Intravenous infusion

Primary outcomes

• Overall survival (OS) [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: Time from randomization to death for any reason in a clinical trial.

Secondary outcomes

• Objective Response Rate (ORR) [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: Objective Response Rate (complete response (CR) + partial response (PR)), as assessed by Response Evaluation Criteria in Solid Tumors (RECIST 1.1), refers to the percentage of study subjects who achieve a complete response or partial response.
• Disease Control Rate(DCR） [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: Percentage of participants achieving complete response (CR) or partial response (PR) and stable disease (SD) after treatment.
• Duration of Response(DOR） [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: DoR (per RECIST 1.1) is defined as the time from the date for first documented response of complete response (CR) or partial response (PR) to the date of first documented of disease progression or death, whichever occurs first.
• Progression-free Survival(PFS) [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: According to the evaluation criteria of RECIST V1.1 (solid tumour),Time from first dose to disease progression or death from any cause.It was used to evaluate Time of disease no-progression or Drug resistance .
• Occurrence of adverse event (AE) and serious adverse event (SAE) [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (90 days after drug withdrawal or before the start of new anti-tumor therapy)]: Adverse event (AE) will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) 5.0.The safety profile of combination therapy will be assessed by monitoring the adverse event (AE) and serious adverse event (SAE).
• Cmax [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: Maximum drug concentration in plasma after administration.
• Tmax [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: After administration,Time to reach maximum drug concentration in plasma.
• Immunogenicity [From all subjects signed the informed consent form up to the completion of the follow-up period of drug withdrawal (28 days after drug withdrawal or before the start of new anti-tumor therapy)]: The immunogenicity is evaluated by the incidence of anti-drug antibodies (ADA) and neutralizing antibodies (if applicable) in subjects.Immunogenicity refers to the performance that can elicit an immune response.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

1. Agrees to follow the investigational treatment protocol, visit schedule and laboratory test, comply with other requirements of the protocol, voluntarily enroll, and sign a written informed consent.
2. Age ≥ 18 years (inclusive) at the time of signing informed consent.
3. The Eastern Cooperative Oncology Group's physical status scoring standard (ECOG) is 0\~1.
4. expected survival time of at least 12 weeks.
5. According to RECIST 1.1, participants were required to have at least one measurable lesion.
6. Male of childbearing potential and Females of childbearing age are willing to take highly effective contraceptive measures From the signing of the informed consent form to within 6 months after the last administration of the trial drug.

Exclusion Criteria:

1. Diagnosed with Mixed neuroendocrine-non endocrine neoplasm (MiNENs).
2. Major surgery (other than aspiration biopsy) within 28 days prior to the first dose of study drug or significant trauma,or required to undergo scheduled surgery during the trial.
3. Use of immunomodulatory drugs within 14 days before the first use of study drug,Including but not limited to thymopeptide, interleukins, interferon, etc.
4. Patients with active infection requiring intravenous anti-infective therapy within 2 weeks prior to the first dose of study drug.
5. serious cardiac and cerebrovascular disorder.
6. History of immunodeficiency including HIV antibody test positive.
7. patients with active hepatitis B or C.
8. Women during pregnancy or lactation.
9. The investigator believes that the subject has other conditions that may affect compliance or are not suitable for participating in this study.

• Lin Shen, Principal investigator, Peking University Cancer Hospital & Institute