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RecruitingLast updated: 18 August 2026

Beamion 44: Testing whether a targeted therapy can be safely combined with chemotherapy, with or without immunotherapy, for people with advanced HER2-mutant non-small cell lung cancer.A Randomized, Open-label, Multi-center Phase IIa Platform Trial to Evaluate the Safety and Tolerability of Zongertinib Plus Platinum-based Doublet Chemotherapy With or Without Pembrolizumab (and Potential Other Combinations) in Treatment-naïve Patients With Locally Advanced/Metastatic Non-squamous NSCLC With Activating HER2 Mutations

Trial purpose

Medical clipboardCancer treatment

Tumor type

Lung Cancers Lung cancer

Age

People18+

Trial acronym

Beamion 44

Clinical summary

Summary

Researchers are investigating zongertinib in combination with chemotherapy, with or without immunotherapy, for people with advanced non-small cell lung cancer that has a HER2 gene mutation.
 
The main aim is to find out how safe and tolerable zongertinib is when used together with chemotherapy, with or without the immunotherapy drug pembrolizumab.

Zongertinib works by targeting and blocking HER2, a protein involved in cancer cell growth.

Who can take part?
You may be eligible for this study if you:

  • are aged 18 years or older
  • have non-squamous non-small cell lung cancer (NSCLC)
  • have a HER2 mutation in your tumour
  • have locally advanced or metastatic disease
  • have not received previous treatment for your lung cancer

Study details
Participants are randomly assigned (by chance) to one of two treatment groups:

  • Zongertinib tablets plus platinum-based chemotherapy
  • Zongertinib tablets plus platinum-based chemotherapy and pembrolizumab (an immunotherapy)

Zongertinib is taken by mouth once a day.

Chemotherapy and pembrolizumab are given through a drip into a vein (IV infusion). Chemotherapy is given every 3 weeks for up to 3 months, followed by maintenance treatment for up to 2 years. Participants in the immunotherapy group receive pembrolizumab every 3 weeks for up to 2 years.

How long does the study go for?
The study does not have a set end date.

Participants may receive some study treatments for up to 2 years. People who are benefiting from zongertinib and tolerating it well may continue taking it for longer.

During the study, participants will attend regular clinic visits. The study team will monitor tumour size and whether the cancer has spread, check participants' overall health, and record any side effects or unwanted effects from treatment.

Conditions

This trial is treating people with advanced or metastatic non-squamous non-small cell lung cancer

Eligibility

Inclusion

  1. Patients ≥18 years of age or over the legal age of consent in countries where that is greater than 18 years at the time of signature of the informed consent form (ICF)
  2. Histologically or cytologically confirmed diagnosis of an advanced and/or metastatic non-squamous non-small cell lung cancer (NSCLC)
  3. Documented activating human epidermal growth factor receptor 2 (HER2) mutation as per existing local lab result
  4. An archival tumor tissue sample must be submitted to the central laboratory after randomization to retrospectively confirm the HER2 status
  5. Patients who have not received any systemic treatment for unresectable, locally advanced or metastatic disease
  6. Presence of at least one measurable non-Central Nervous System (CNS) lesion according to response evaluation criteria in solid tumors (RECIST) 1.1
  7. Eligible to receive treatment with the selected platinum based doublet chemotherapy and pembrolizumab in accordance with the summary of product characteristics (SmPC)/Product Information
  8. Eastern Cooperative On

Exclusion

  1. Tumors with targetable alterations with approved available therapy
  2. Presence or history of leptomeningeal disease
  3. Radiotherapy within 4 weeks prior to treatment start with exception of palliative radiotherapy to regions other than the chest if completed at least 2 weeks prior to treatment start
  4. Major surgery (major according to the investigator's assessment) performed within 4 weeks prior to randomization or planned within 6 months after screening
  5. Any history of or concomitant condition that, in the opinion of the investigator, would compromise the patient's ability to comply with the trial or interfere with the evaluation of the safety and efficacy of the test drug
  6. Previous therapy with a HER2-directed agent
  7. History or presence of cardiovascular abnormalities which are considered as clinically relevant by the investigator. Myocardial infarction, stroke, or pulmonary embolism within 6 months prior to randomization Further exclusion criteria apply.

Inclusion

  • Your cancer has spread to other parts of the body (metastatic) or has grown into nearby parts of the body (locally advanced).

Exclusion

  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov, EU Clinical Trials Register *. View further details about this trial on the registry via the links below:

  • NCT07486817 *
  • 2025-523567-38-00 *
  • 1479-0044; U1111-1327-3020

Trial sponsor

Boehringer Ingelheim

Scientific Title

A Randomized, Open-label, Multi-center Phase IIa Platform Trial to Evaluate the Safety and Tolerability of Zongertinib Plus Platinum-based Doublet Chemotherapy With or Without Pembrolizumab (and Potential Other Combinations) in Treatment-naïve Patients With Locally Advanced/Metastatic Non-squamous NSCLC With Activating HER2 Mutations

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