Tests zipalertinib versus placebo after surgery for early lung cancer
Tests zipalertinib or placebo in adults with early lung cancer with uncommon EGFR mutations.
Plain-language title generated from the registry record
Registry title: A Study to Assess Zipalertinib Versus Placebo in Participants With Early Stage NSCLC With Uncommon EGFR Mutations, Following Complete Tumor Resection
Key facts
- Where
- Cologne, Frankfurt am Main, Giessen, and Loewenstein, GermanySee the 4 sites
- Phase
- Phase 3
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with early stage non-small cell lung cancer (NSCLC) who have had the whole tumor removed by surgery and whose tumor has an uncommon EGFR gene change.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- Primary NSCLC, mostly non-squamous type, after surgery at stage IB, IIA, IIB or IIIA. Stage IIIB can join if lymph node involvement is N2. ECOG performance status 0 or 1.
- Earlier treatment
- The tumor must have been completely removed with clear margins and full recovery from surgery. Up to 4 cycles of platinum-based chemotherapy after surgery are allowed. No other earlier cancer drug treatment, no radiation for this lung cancer, and no earlier EGFR inhibitor.
- Biomarker or test result
- An uncommon EGFR gene change confirmed by local testing: exon 20 insertion, or other changes such as G719X, L861Q or S768I. Stored tumor tissue must be available.
Main reasons for not taking part
- Brain metastasis on the brain scan
- History of interstitial lung disease or pneumonitis
- Only a wedge resection of the tumor
- Cannot swallow tablets or has a bowel problem that affects drug absorption
- Another cancer in the past, with some exceptions
Read by machine on 9 November 2026.
Where in Germany
- Kliniken der Stadt Koeln gGmbHCologne, GermanyNo longer taking part
- Krankenhaus Nordwest GmbHFrankfurt am Main, GermanyNo longer taking part
- Justus-Liebig-Universitaet GiessenGiessen, GermanyNo longer taking part
- SLK-Kliniken Heilbronn GmbHLoewenstein, GermanyNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Taiho Oncology, Inc.
- Trial code
- NCT07128199EU 2025-521775-31-00
- Record updated
- 13 October 2026
- Original description
The purpose of this study is to compare the efficacy of zipalertinib versus placebo in participants with early stage resected non-small cell lung cancer (NSCLC) harboring uncommon epidermal growth factor receptor mutation (EGFRmt).Read full original descriptionShow less
A Randomized, Placebo-Controlled, Double-Blind, Multi-Center Phase 3 Study of Zipalertinib Versus Placebo in Early Stage NSCLC Patients With Uncommon EGFR Mutations Following Complete Tumor Resection (REZILIENT4)
The purpose of this study is to compare the efficacy of zipalertinib versus placebo in participants with early stage resected non-small cell lung cancer (NSCLC) harboring uncommon epidermal growth factor receptor mutation (EGFRmt).
Inclusion: Histologically confirmed diagnosis of primary NSCLC on predominantly non-squamous histology; Documented EGFRmt status as determined by local testing performed at a clinical laboratory improvement amendment (CLIA) certified (United States [US]) or accredited (outside of the US) local laboratory, defined as either one of the following EGFRmt:; exon20 insertion mutations (ex20ins) or; other uncommon, non-ex20ins EGFRmt (eg, G719X, L861Q, or S768I) exons 18-21 of the EGFR tyrosine kinase domain; Baseline imaging assessment of the brain (MRI [preferred modality] or CT scan) performed within 8 weeks prior to randomization must show no evidence of brain metastasis; Complete surgical resection of the primary NSCLC is mandatory with negative surgical margins and systematic lymph node sampling or dissection; Complete recovery from surgery, including post-operative wound healing, and prior adjuvant chemotherapy (if applicable) at the time of randomization. Randomization timing is defined as follows:; For participants without prior adjuvant chemotherapy: 4 weeks and 12 weeks following surgery; For participants with prior adjuvant chemotherapy: 4 weeks and 8 weeks after the last dose of adjuvant chemotherapy; Eastern cooperative oncology group performance status (ECOG PS) of 0 or 1; Pathologic (post-operative) Stage IB, IIA, IIB, or IIIA according to the AJCC 9th tumor nodes metastasis (TNM) staging system for lung cancer. In addition, participants with stage IIIB are eligible when regional lymph node involvement is N2; Archival tumor tissue available for submission, with minimum quantity sufficient to evaluate EGFRmt status and, where possible, other biomarkers.
Exclusion: Is currently receiving an investigational drug in a clinical trial or participating in any other type of medical research; Has received only wedge resections (complete anatomic segmentectomy is acceptable); Unable to swallow tablets or has any disease or condition that may significantly affect gastrointestinal (GI) absorption of zipalertinib (such as inflammatory bowel disease, malabsorption syndrome, or prior significant bowel resection); Has a history of any other cancer except for any of the following:; Non-melanoma skin cancer treated with curative intent; Carcinoma in situ treated with curative intent; Other curatively treated cancer, with no evidence of disease for >3 years following the end of treatment and, in the opinion of the treating physician, has no substantial risk of recurrence; Concurrent malignancy of which natural history does not have the potential to interfere with the safety or efficacy assessment (eg, Gleason 6 prostate cancer); Past medical history of interstitial lung disease (ILD)/pneumonitis, drug-induced ILD/pneumonitis or any evidence of clinically active ILD/pneumonitis; Known history of hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) that is unstable or not controlled with treatment; Active bleeding disorders; Known hypersensitivity to the ingredients in zipalertinib/placebo or any drugs similar in structure or class; Treatment with any of the following within the time frame specified:; Zipalertinib (TAS6417/CLN-081) or any other EGFR inhibitor at any time; Pre-operative or post-operative or planned radiation therapy for the current lung cancer; Any prior systemic anticancer therapy for NSCLC, including preoperative (neoadjuvant) chemotherapy, immunotherapy, or investigational therapy. (Exception: Participants who have received postoperative adjuvant platinum-based chemotherapy up to 4 cycles are permitted); Major surgery (including primary tumor surgery, excluding placement of vascular access) within 4 weeks prior to the first dose of study treatment; Treatment with an investigational drug within five half-lives of the compound or any of its related material, if known.