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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03298451
Other study ID # D419CC00002
Secondary ID 2016-005126-11
Status Active, not recruiting
Phase Phase 3
First received
Last updated
Start date October 11, 2017
Est. completion date August 27, 2024

Study information

Verified date April 2024
Source AstraZeneca
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a randomized, open-label, multi-center, global, Phase III study to assess the efficacy and safety of durvalumab plus tremelimumab combination therapy and durvalumab monotherapy versus sorafenib in the treatment of patients with no prior systemic therapy for unresectable HCC. The patients cannot be eligible for locoregional therapy


Description:

The study population includes patients 18 years of age or older with advanced HCC, Barcelona Clinic Liver Cancer stage B not eligible for locoregional therapy or stage C, and Child-Pugh A classification liver disease. Patients must not have received any prior systemic therapy for unresectable HCC. Patients in all treatment arms may continue receiving their originally assigned treatment, at the Investigator's discretion, until progression Patients in all arms with confirmed PD who, in the Investigator's opinion, continue to receive benefit from their assigned treatment and meet the criteria for treatment in the setting of PD may continue to receive their assigned treatment. If a patient discontinues study drug(s) due to disease progression, the patient will enter survival follow-up. Patients who have discontinued treatment due to toxicity or symptomatic deterioration or who have commenced subsequent anticancer therapy, will have tumor assessments until confirmed PD and will be followed for survival


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 1324
Est. completion date August 27, 2024
Est. primary completion date August 27, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years to 100 Years
Eligibility Inclusion criteria - HCC based on histopathological confirmation - No prior systemic therapy for HCC - Barcelona Clinic Liver Cancer (BCLC) stage B (that is not eligible for locoregional therapy) or stage C - Child-Pugh Score class A - ECOG performance status of 0 or 1 at enrollment Exclusion criteria - Hepatic encephalopathy within past 12 months or requirement for medication to prevent or control encephalopathy - Clinically meaningful ascites - Main portal vein tumor thrombosis - Active or prior documented GI bleeding (eg, esophageal varices or ulcer bleeding) within 12 months - HBV and HVC co-infection, or HBV and Hep D co-infection

Study Design


Intervention

Drug:
Durvalumab
Durvalumab IV (intravenous infusion).
Tremelimumab (Regimen 1)
Tremelimumab IV (intravenous infusion).
Tremelimumab (Regimen 2)
Tremelimumab IV (intravenous infusion).
Sorafenib
Sorafenib, as per standard of care
Durvalumab (Regimen 1)
Durvalumab IV (intravenous infusion).
Durvalumab (Regimen 2)
Durvalumab IV (intravenous infusion).

Locations

Country Name City State
Brazil Research Site Barretos
Brazil Research Site Curitiba
Brazil Research Site Florianopolis
Brazil Research Site Porto Alegre
Brazil Research Site Rio de Janeiro
Brazil Research Site Sao Paulo
Canada Research Site Calgary Alberta
Canada Research Site Edmonton Alberta
Canada Research Site Hamilton Ontario
Canada Research Site Kingston Ontario
Canada Research Site London Ontario
Canada Research Site Montreal Quebec
Canada Research Site Quebec City Quebec
Canada Research Site Sherbrooke Quebec
Canada Research Site Toronto Ontario
China Research Site Beijing
China Research Site Changchun
China Research Site Changsha
China Research Site Chengdu
China Research Site Dalian
China Research Site Fuzhou
China Research Site Guangzhou
China Research Site Hangzhou
China Research Site Harbin
China Research Site Hefei
China Research Site Nanchang
China Research Site Nanjing
China Research Site Nanning
China Research Site Shanghai
China Research Site Suzhou
China Research Site Wuhan
China Research Site Xian
China Research Site Zhengzhou
France Research Site Clichy
France Research Site Lile
France Research Site Marseille
France Research Site Montpellier
France Research Site Nancy
France Research Site Nantes
France Research Site Nice
France Research Site Pessac
France Research Site Poitiers
France Research Site Reims
France Research Site Rouen
France Research Site Saint-Etienne
France Research Site Toulouse
France Research Site Villejuif
Germany Research Site Aachen
Germany Research Site Essen
Germany Research Site Hannover
Germany Research Site Heidelberg
Germany Research Site Koeln
Germany Research Site Leipzig
Germany Research Site Mainz
Germany Research Site Muenchen
Germany Research Site Tuebingen
Germany Research Site Ulm
Hong Kong Research Site Hong Kong
India Research Site Bangalore
India Research Site Bhubneshwar
India Research Site Chennai
India Research Site Hubli
India Research Site Hyderabad
India Research Site Karmsad
India Research Site Mumbai
India Research Site Nashik
India Research Site New Delhi
Italy Research Site Benevento
Italy Research Site Meldola
Italy Research Site Milano
Italy Research Site Napoli
Italy Research Site Perugia
Italy Research Site Pisa
Italy Research Site Roma
Italy Research Site Rozzano
Japan Research Site Bunkyoku
Japan Research Site Chiba
Japan Research Site Fukuoka
Japan Research Site Hiroshima
Japan Research Site Iizuka
Japan Research Site Kanazawa
Japan Research Site Kotoku
Japan Research Site Kumamoto
Japan Research Site Kurume
Japan Research Site Matsuyama
Japan Research Site Mitakashi
Japan Research Site Musashino
Japan Research Site Nagoya
Japan Research Site Ogaki
Japan Research Site Okayama
Japan Research Site Osaka
Japan Research Site Osaka Sayama
Japan Research Site Saga
Japan Research Site Sapporo
Japan Research Site Shiwa
Japan Research Site Suntogun
Japan Research Site Tsu
Japan Research Site Yokohama
Korea, Republic of Research Site Busan
Korea, Republic of Research Site Daegu
Korea, Republic of Research Site Ilsan Gyeonggi-do
Korea, Republic of Research Site Seongnam-si Gyeonggi-do
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Russian Federation Research Site Moscow
Russian Federation Research Site Murmansk
Russian Federation Research Site Nizhniy Novgorod
Russian Federation Research Site Novosibirsk
Russian Federation Research Site Obninsk
Russian Federation Research Site Omsk
Russian Federation Research Site Saint Petersburg
Russian Federation Research Site Ufa
Spain Research Site Barcelona
Spain Research Site Madrid
Spain Research Site Oviedo
Spain Research Site Pamplona Madrid
Spain Research Site Santander
Taiwan Research Site Chiayi
Taiwan Research Site Kaohsiung
Taiwan Research Site Taichung
Taiwan Research Site Tainan
Taiwan Research Site Taipei
Taiwan Research Site Taoyuan
Thailand Research Site Bangkok
Thailand Research Site Chang Mai
Thailand Research Site Khon Kaen
Thailand Research Site Phitsanulok
Thailand Research Site Songkhla
Ukraine Research Site Dnipro
Ukraine Research Site IvanoFrankivsk
Ukraine Research Site Kharkiv
Ukraine Research Site Kropyvnitskyi
Ukraine Research Site Kyiv
Ukraine Research Site Lviv
Ukraine Research Site Odesa
Ukraine Research Site Uzhgorod
United States Research Site Ann Arbor Michigan
United States Research Site Baltimore Maryland
United States Research Site Charlotte North Carolina
United States Research Site Dallas Texas
United States Research Site Dallas Texas
United States Research Site Dallas Texas
United States Research Site Fort Myers Florida
United States Research Site Houston Texas
United States Research Site Houston Texas
United States Research Site Jacksonville Florida
United States Research Site Los Angeles California
United States Research Site Murray Utah
United States Research Site New York New York
United States Research Site Orange California
United States Research Site Pittsburgh Pennsylvania
United States Research Site Portland Oregon
United States Research Site Rochester Minnesota
United States Research Site San Francisco California
United States Research Site Washington District of Columbia
United States Research Site Westwood Kansas
Vietnam Research Site Hanoi
Vietnam Research Site Hochiminh

Sponsors (1)

Lead Sponsor Collaborator
AstraZeneca

Countries where clinical trial is conducted

United States,  Vietnam,  Brazil,  Canada,  China,  France,  Germany,  Hong Kong,  India,  Italy,  Japan,  Korea, Republic of,  Russian Federation,  Spain,  Taiwan,  Thailand,  Ukraine, 

Outcome

Type Measure Description Time frame Safety issue
Primary Overall Survival (OS) - Treme 300 mg x1 Dose + Durva 1500 mg vs Sora 400 mg OS was defined as the time from the date of randomization until death due to any cause, regardless of whether the participant withdrew from randomized therapy or received another anticancer therapy. Any participant not known to have died at the DCO date was censored based on the last recorded date on which the participant was known to be alive. If the last known date alive or if the date of death was after the DCO date, participants were censored at the DCO date. This primary outcome measure presents OS analysis of Treme 300mg x1 dose + Durva 1500 mg vs Sora 400 mg at the time of the final analysis DCO (27Aug2021). From the date of randomization until death due to any cause, assessed up to the data cut-off date (27Aug2021, to a maximum of approximately 46 months).
Secondary Overall Survival (OS) - Durva 1500 mg vs Sora 400 mg OS was defined as the time from the date of randomization until death due to any cause, regardless of whether the participant withdrew from randomized therapy or received another anticancer therapy. Any participant not known to have died at the DCO date was censored based on the last recorded date on which the participant was known to be alive. If the last known date alive or if the date of death was after the DCO date, participants were censored at the DCO date. This secondary outcome measure presents OS analysis of Durva 1500 mg vs Sora 400 mg at the time of the final analysis DCO (27Aug2021). From the date of randomization until death due to any cause, assessed up to the data cut-off date (27Aug2021, to a maximum of approximately 46 months).
Secondary Overall Survival (OS) at 18, 24, and 36 Months After Randomization Percentage of participants who were alive at fixed time points (18, 24, and 36 months) after randomization. The estimated percentage of survival along with the 95% confidence interval were calculated using Kaplan-Meier technique on the full analysis set. At 18, 24, and 36 months post-randomization. Assessed at the final analysis DCO (27Aug2021).
Secondary Progression Free Survival (PFS) PFS (per Response Evaluation Criteria in Solid Tumors, version 1.1 [RECIST 1.1] using Investigator assessments) was defined as the time from the date of randomization until the date of objective disease progression or death by any cause in the absence of progression, regardless of whether the patient withdrew from study treatment or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as a at least 20% increase in the sum of diameters of TLs, taking as reference the smallest previous sum of diameters (nadir) - this includes the baseline sum if that is the smallest on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm from nadir. Tumor scans performed at baseline, every 8 weeks for the first 48 weeks following randomization, and every 12 weeks thereafter until RECIST 1.1-defined progression. Assessed up to DCO (27Aug2021, to a maximum of approximately 46 months)
Secondary Time To Progression (TTP) TTP was defined as the time from randomization until objective tumor progression in the absence of death. If participants died without tumor progression, they were censored at the time of death. From the date of randomization until objective tumor progression, assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary Objective Response Rate (ORR) ORR (per RECIST 1.1 as assessed by the Investigator) was defined as the number (%) of participants with at least 1 confirmed visit response of CR or PR until progression, or the last evaluable assessment in the absence of progression. Participants who go off treatment without progression, receive a subsequent therapy, and then respond will not be included as responders in the ORR. Complete response (ie., CR) was defined as disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis diameter to <10 mm. Partial response (ie., PR) was defined as at least a 30% decrease in the sum of the diameter of TL, taking as reference the baseline sum of diameters. From the date of randomization until objective tumor progression, assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary Disease Control Rate (DCR) Number (%) of participants with a Best Objective Response (BoR) of CR, PR, or SD. Complete response (ie., CR) was defined as disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis diameter to <10 mm. Partial response (ie., PR) was defined as at least a 30% decrease in the sum of the diameter of TL, taking as reference the baseline sum of diameters. Stable disease (ie., SD) was defined as neither sufficient decrease in sum of diameters to qualify for PR nor sufficient increase to qualify for progression. From the date of randomization until objective tumor progression or date of death, assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary Duration of Objective Response (DoR) Time from the date of first documented confirmed response (complete or partial response) until the first date of documented progression or death in the absence of disease progression. Complete response (ie., CR) was defined as disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis diameter to <10 mm. Partial response (ie., PR) was defined as at least a 30% decrease in the sum of the diameter of TL, taking as reference the baseline sum of diameters. From the date of first documented response until the first date of documented progression or death, assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary Overall Survival (OS) by PD-L1 Overall survival by baseline PD-L1 expression levels (positive vs. negative). PD-L1 expression level is based on the Tumor and Immune Cell Positivity (TIP) score method as: PD-L1 Positive (TIP = 1%) or PD-L1 Negative (TIP < 1%). From the date of randomization until death due to any cause, assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary EORTC QLQ-C30 Time to Global Health Status/QoL Deterioration European Organisation for Research and Treatment of Cancer (EORTC) 30-item core quality of life questionnaire (QLQ-C30), which consists of 30 questions combined to produce a global health status/QoL scale. Higher scores indicate better health. A clinically meaningful deterioration is defined as a decrease in the score from baseline of =10. Time to deterioration is defined as the time from the date of randomization until the date of the first clinically meaningful deterioration that is confirmed at a subsequent visit or death by any cause in the absence of a clinically meaningful deterioration, regardless of whether the patient discontinues study drug(s) or receives another anticancer therapy. At baseline and every 8 weeks for the first 48 weeks and then every 12 weeks thereafter until death or the final analysis DCO (27Aug2021), assessed up to approximately 46 months.
Secondary EORTC QLQ-HCC18 Time to Symptom (Abdominal Pain) Deterioration EORTC 18-item hepatocellular cancer health-related quality of life questionnaire (QLQ-HCC18) is an 18-item questionnaire design used along with the 30-item EORTC QLQ-C30, which includes 8 symptom scales such as fatigue, jaundice, body image, nutrition, pain, fever, sex life and abdominal swelling. A high score for a symptom scale/item represents a high level of symptomatology/problem. A clinically meaningful deterioration is defined as an increase in the score from baseline of =10. Time to deterioration is defined as the time from the date of randomization until the date of the first clinically meaningful deterioration that is confirmed at a subsequent visit or death by any cause in the absence of a clinically meaningful deterioration, regardless of whether the patient discontinues study drug(s) or receives another anticancer therapy. At baseline and every 8 weeks for the first 48 weeks and then every 12 weeks thereafter until death or the final analysis DCO (27Aug2021), assessed up to approximately 46 months.
Secondary EORTC QLQ-HCC18 Time to Symptom (Shoulder Pain) Deterioration EORTC 18-item hepatocellular cancer health-related quality of life questionnaire (QLQ-HCC18) is an 18-item questionnaire design used along with the 30-item EORTC QLQ-C30, which includes 8 symptom scales such as fatigue, jaundice, body image, nutrition, pain, fever, sex life and abdominal swelling. A high score for a symptom scale/item represents a high level of symptomatology/problem. A clinically meaningful deterioration is defined as an increase in the score from baseline of =10. Time to deterioration is defined as the time from the date of randomization until the date of the first clinically meaningful deterioration that is confirmed at a subsequent visit or death by any cause in the absence of a clinically meaningful deterioration, regardless of whether the patient discontinues study drug(s) or receives another anticancer therapy. At baseline and every 8 weeks for the first 48 weeks and then every 12 weeks thereafter until death or the final analysis DCO (27Aug2021), assessed up to approximately 46 months.
Secondary EORTC QLQ-HCC18 Time to Symptom (Abdominal Swelling) Deterioration EORTC 18-item hepatocellular cancer health-related quality of life questionnaire (QLQ-HCC18) is an 18-item questionnaire design used along with the 30-item EORTC QLQ-C30, which includes 8 symptom scales such as fatigue, jaundice, body image, nutrition, pain, fever, sex life and abdominal swelling. A high score for a symptom scale/item represents a high level of symptomatology/problem. A clinically meaningful deterioration is defined as an increase in the score from baseline of =10. Time to deterioration is defined as the time from the date of randomization until the date of the first clinically meaningful deterioration that is confirmed at a subsequent visit or death by any cause in the absence of a clinically meaningful deterioration, regardless of whether the patient discontinues study drug(s) or receives another anticancer therapy. At baseline and every 8 weeks for the first 48 weeks and then every 12 weeks thereafter until death or the final analysis DCO (27Aug2021), assessed up to approximately 46 months.
Secondary Presence of ADA for Durvalumab Number of participants with Anti-Drug Antibody (ADA) response to Durvalumab. ADA positive post-baseline only was also referred to as treatment-induced ADA. Treatment-emergent ADA was defined as the sum of treatment-induced ADA and treatment-boosted ADA. Results are reported as number of participants with ADA responses to Durvalumab for each indicated category. Samples were collected on Day 1 (Week 0), Week 12 and at 3 months after the last dose of durvalumab. Assessed until the final analysis DCO (27Aug2021, to a maximum of approximately 46 months).
Secondary Presence of ADA for Tremelimumab Number of participants with Anti-Drug Antibody (ADA) response to Tremelimumab. ADA positive post-baseline only was also referred to as treatment-induced ADA. Treatment-emergent ADA was defined as the sum of treatment-induced ADA and treatment-boosted ADA. Results are reported as number of participants with ADA responses to Tremelimumab for each indicated category. Samples were collected on Day 1 (Week 0), Week 12 and at 3 months after the last dose of tremelimumab. Assessed up to approximately 46 months after the first randomization.
Secondary Summary of Durvalumab Concentration Over Time Blood sample were collected at pre-specified timepoints and Durvalumab concentrations in serum (ug/mL) were reported over time. To evaluate the PK of Durvalumab, samples were collected pre-dose at week 4 and week 12 and post-dose at week 12. Assessed at the final analysis DCO (27Aug2021).
Secondary Summary of Tremelimumab Concentration Over Time Blood sample were collected at pre-specified timepoints and Tremelimumab concentrations in serum (ug/mL) were reported over time. To evaluate the PK of Tremelimumab, samples were collected at week 0 (post-dose), week 4, and week 12. Assessed at the final analysis DCO (27Aug2021).
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