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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT02151981
Other study ID # D5160C00003
Secondary ID 2014-000594-39
Status Active, not recruiting
Phase Phase 3
First received
Last updated
Start date August 4, 2014
Est. completion date December 29, 2023

Study information

Verified date September 2023
Source AstraZeneca
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A Phase III, Open Label, Randomized Study of Osimertinib versus Platinum-Based Doublet Chemotherapy for Patients with Locally Advanced or Metastatic Non-Small Cell Lung Cancer whose Disease has Progressed with Previous Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy and whose Tumours harbour a T790M mutation within the Epidermal Growth Factor Receptor Gene


Description:

This is a phase III, open label, randomized study assessing Osimertinib (80 mg, orally, once daily) versus platinum-based doublet chemotherapy (standard of care) in subjects with confirmed diagnosis of Epidermal Growth Factor Receptor (EGFR) mutation positive NSCLC, who have progressed following prior therapy with an approved Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI) agent and whose tumours harbour a T790M mutation within the EGFR Gene. Subjects must be chemotherapy naive and must agree to provide a biopsy for central confirmation of T790 mutation status following confirmed disease progression on their first line EGFR-TKI treatment (e.g. erlotinib, gefitinib or afatinib). Suitable subjects will then be randomized to receive either Osimertinib (80mg orally, once daily) or platinum-based doublet chemotherapy (pemetrexed 500 mg/m2 + carboplatin area under the plasma concentration-time curve AUC 5 or pemetrexed 500 mg/m2 + cisplatin 75 mg/m2) on Day 1 of every 21-day cycle in a 2:1 (Osimertinib: platinum-based doublet chemotherapy) ratio. Once subjects on the platinum-based doublet chemotherapy arm are determined to have objective radiological progression according to RECIST 1.1 by the investigator and confirmed by independent central imaging review, they will be given the opportunity to begin treatment with Osimertinib 80mg, once daily. These subjects may continue treatment with Osimertinib even after disease progression, as long as they are continuing to show clinical benefit, as judged by the investigator. The primary objective of the study is to assess the efficacy of Osimertinib compared with platinum-based doublet chemotherapy by assessment of Progression Free Survival (PFS), using investigator assessments according to Response Evaluation Criteria in Solid Tumours (RECIST 1.1), as well as asensitivity analysis of Progression Free Survival using Blinded Independent Central Review (BICR).


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 419
Est. completion date December 29, 2023
Est. primary completion date April 15, 2016
Accepts healthy volunteers No
Gender All
Age group 18 Years to 130 Years
Eligibility Inclusion Criteria: - Subjects with histologically or cytologically documented NSCLC. - Locally advanced or metastatic NSCLC - Radiological documentation of disease progression following 1st line EGFR TKI Treatment without any further treatment - Eligible to receive treatment with the selected doublet-chemotherapy - Central confirmation of T790M+ mutation status - World Health Organization (WHO) performance status 0-1 - At least one lesion, not previously irradiated. Exclusion Criteria: - • Prior neo-adjuvant or adjuvant chemotherapy treatment within 6 months prior of starting 1st EGFR TKI treatment - Treatment with more than one prior line of treatment for advanced NSCLC - Treatment with an approved EGFR-TKI (e.g.,erlotinib, gefitinib, afatinib) within 8 days or approximately 5x half-life of the first dose of study treatment - Any investigational agents or other anticancer drugs from a previous treatment regimen or clinical study within 14 days of the first dose of study treatment - Previous treatment with Osimertinib, or a 3rd generation EGFR TKI For subjects who cross-over to Osimertinib: - Once subjects on the platinum-based doublet chemotherapy arm are determined to have objective radiological progression according to RECIST 1.1 by the investigator and confirmed by independent central imaging review. - At least 14 days since last dose of platinum-based doublet chemotherapy

Study Design


Intervention

Drug:
Chemotherapy
Randomization to either Osimertinib or platinum-based doublet-chemotherapy on Day 1 of every 21d cycle in a 2:1 (Osimertinib:platinum-based doublet-chemotherapy) ratio
Cross-over to Osimertinib
Once subjects on the platinum-based doublet chemotherapy arm are determined to have objective radiological progression according to RECIST 1.1 by the investigator and confirmed by independent central imaging review, they will be given the opportunity to begin treatment with Osimertinib 80mg, once daily. These subjects may continue treatment with Osimertinib even after disease progression, as long as they are continuing to show clinical benefit, as judged by the investigator. Subjects who stop platinum-based doublet chemotherapy for reasons other than objective disease progression according to RECIST 1.1 will not be eligible to cross-over to Osimertinib.

Locations

Country Name City State
Australia Research Site Darlinghurst
Australia Research Site Heidelberg
Australia Research Site Kogarah
Australia Research Site Nedlands
Australia Research Site Woolloongabba
Canada Research Site Edmonton Alberta
Canada Research Site Halifax Nova Scotia
Canada Research Site Montreal Quebec
Canada Research Site Ottawa Ontario
Canada Research Site Toronto Ontario
Canada Research Site Vancouver British Columbia
China Research Site Beijing
China Research Site Beijing
China Research Site Changchun
China Research Site Chongqing
China Research Site Chongqing
China Research Site Fuzhou
China Research Site Guangzhou
China Research Site Guangzhou
China Research Site Hangzhou
China Research Site Harbin
China Research Site Nanchang
China Research Site Shanghai
China Research Site Shanghai
China Research Site Tianjin
China Research Site Ürümqi
China Research Site Zhengzhou
France Research Site Clermont Ferrand
France Research Site Dijon
France Research Site Lille
France Research Site Marseille Cedex 20
France Research Site Paris
France Research Site Strasbourg Cedex
France Research Site Toulouse Cedex 09
France Research Site Villejuif
Germany Research Site Essen
Germany Research Site Frankfurt
Germany Research Site Gerlingen
Germany Research Site Oldenburg
Germany Research Site Regensburg
Germany Research Site Würzburg
Hong Kong Research Site Hong Kong
Hong Kong Research Site Shatin
Hungary Research Site Budapest
Italy Research Site Avellino
Italy Research Site Meldola
Italy Research Site Milano
Italy Research Site Orbassano
Italy Research Site Roma
Japan Research Site Akashi-shi
Japan Research Site Bunkyo-ku
Japan Research Site Fukuoka
Japan Research Site Hirakata-shi
Japan Research Site Kanazawa
Japan Research Site Kitaadachi-gun
Japan Research Site Kobe-shi
Japan Research Site Kurashiki-shi
Japan Research Site Kyoto-shi
Japan Research Site Matsuyama-shi
Japan Research Site Nagoya-shi
Japan Research Site Natori-shi
Japan Research Site Niigata-shi
Japan Research Site Okayama-shi
Japan Research Site Osaka-shi
Japan Research Site Osaka-shi
Japan Research Site Osakasayama
Japan Research Site Sakai-shi
Japan Research Site Shinjuku-ku
Japan Research Site Sunto-gun
Japan Research Site Takatsuki-shi
Japan Research Site Wakayama-shi
Japan Research Site Yokohama-shi
Japan Research Site Yokohama-shi
Japan Research Site Yokohama-shi
Korea, Republic of Research Site Busan
Korea, Republic of Research Site Cheongju-si
Korea, Republic of Research Site Goyang-si
Korea, Republic of Research Site Incheon
Korea, Republic of Research Site Jinju-si
Korea, Republic of Research Site Seongnam-si
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Suwon-si
Korea, Republic of Research Site Ulsan
Mexico Research Site Mexico
Mexico Research Site Oaxaca
Netherlands Research Site Amsterdam
Netherlands Research Site Amsterdam
Netherlands Research Site Groningen
Russian Federation Research Site Ekaterinburg
Russian Federation Research Site Moscow
Russian Federation Research Site Omsk
Russian Federation Research Site Saint Petersburg
Russian Federation Research Site Saint Petersburg,
Russian Federation Research Site Saint-Petersburg
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Málaga
Spain Research Site Sevilla
Spain Research Site Zaragoza
Sweden Research Site Göteborg
Sweden Research Site Lund
Sweden Research Site Stockholm
Taiwan Research Site Changhua
Taiwan Research Site Hsinchu
Taiwan Research Site Kaohsiung
Taiwan Research Site Kaohsiung
Taiwan Research Site Kaohsiung City
Taiwan Research Site Taichung
Taiwan Research Site Taichung
Taiwan Research Site Tainan
Taiwan Research Site Taipei
Taiwan Research Site Taipei
Taiwan Research Site Taoyuan
United Kingdom Research Site Aberdeen
United Kingdom Research Site Bristol
United Kingdom Research Site Glasgow
United Kingdom Research Site Huddersfield
United Kingdom Research Site London
United Kingdom Research Site London
United Kingdom Research Site Manchester
United Kingdom Research Site Newcastle-Upon-Tyne
United Kingdom Research Site Nottingham
United Kingdom Research Site Wolverhampton
United States Research Site Anaheim California
United States Research Site Atlanta Georgia
United States Research Site Brick New Jersey
United States Research Site Charleston South Carolina
United States Research Site Chevy Chase Maryland
United States Research Site Gainesville Florida
United States Research Site Hershey Pennsylvania
United States Research Site Houston Texas
United States Research Site Indianapolis Indiana
United States Research Site Lacey Washington
United States Research Site Lebanon New Hampshire
United States Research Site Marrero Louisiana
United States Research Site Milwaukee Wisconsin
United States Research Site New York New York
United States Research Site Norwalk Connecticut
United States Research Site Orange California
United States Research Site Orlando Florida
United States Research Site Park Ridge Illinois
United States Research Site Pembroke Pines Florida
United States Research Site Santa Rosa California
United States Research Site Tacoma Washington

Sponsors (1)

Lead Sponsor Collaborator
AstraZeneca

Countries where clinical trial is conducted

United States,  Australia,  Canada,  China,  France,  Germany,  Hong Kong,  Hungary,  Italy,  Japan,  Korea, Republic of,  Mexico,  Netherlands,  Russian Federation,  Spain,  Sweden,  Taiwan,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Other Time to First Subsequent Therapy (TFST) Time from randomisation to first subsequent anti-cancer therapy (FST) following randomised treatment discontinuation, or death if no FST administered. Any patient not known to have died nor received any subsequent anti-cancer therapy (ST) was censored at the last time known not to have received ST, ie, the last follow-up visit this was confirmed. From date of randomisation until time of final OS analysis, a median follow-up of 43 months
Other Time to Second Subsequent Therapy (TSST) Time from randomisation to second subsequent anti-cancer therapy (SST) following randomised treatment discontinuation, or death if no SST administered. Any patient not known to have died nor received any SST was censored at the last time known not to have received SST, ie, the last follow-up visit this was confirmed. From date of randomisation until time of final OS analysis, a median follow-up of 43 months
Primary Progression Free Survival (PFS) by Investigator Assessment Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Progressive Disease (PD): >= 20% increase in the sum of diameters of TLs and an absolute increase in sum of diameters of >=5mm (compared to the previous minimum sum) or progression of NTLs or a new lesion. PFS is the time from date of randomisation until the date of PD (by investigator assessment) or death (by any cause in the absence of progression) regardless of whether the patient withdrew from randomised therapy or received another anti-cancer therapy prior to progression. Patients who had not progressed or died at the time of analysis were censored at the time of the latest date of assessment from their last evaluable RECIST 1.1 assessment. RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
Secondary Objective Response Rate (ORR) by Investigator Assessment Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions. ORR is the percentage of patients with at least 1 visit response of CR or PR prior to progression or any further therapy. RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
Secondary Duration of Response (DoR) by Investigator Assessment Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions. DoR is the time from the date of first documented response until the date of documented progression or death in the absence of disease progression. RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
Secondary Disease Control Rate (DCR) by Investigator Assessment Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions; Stable disease (SD): Neither sufficient shrinkage to qualify as a response nor sufficient growth to qualify as progression; Progressive Disease (PD): >= 20% increase in the sum of diameters of TLs and an absolute increase in sum of diameters of >=5mm (compared to the previous minimum sum) or progression of NTLs or a new lesion. DCR is the percentage of patients with best response of CR, PR or SD at >=6 weeks, prior to any progressive disease (PD). RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
Secondary Tumour Shrinkage by Investigator Assessment Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Tumour size was calculated as the sum of the longest diameters (SLD) of the Target Lesions. Tumour shrinkage is percentage change in tumour size from baseline using RECIST v1.1 tumour response. RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
Secondary Secondary: Overall Survival (OS) From date of randomization until time of final OS analysis, a median follow-up of 43 months