Carcinoma, Non-Small-Cell Lung Clinical Trial
Official title:
Global PANORAMA Real World Molecular Testing, Treatment Patterns, and Clinical Outcomes in Patients With Locally Advanced or Metastatic NSCLC.
This is an observational cohort study of patients with locally advanced or metastatic NSCLC
(non-small cell lung cancer).
Patients will be recruited from participating sites in Europe, Asia, and Canada. The study
will include 2 patient cohorts.
Study Design This will be an observational cohort study of patients with locally advanced or
metastatic NSCLC (non-small cell lung cancer).
Patients will be recruited from participating sites in Europe, Asia, and Canada. Patients
meeting the study inclusion/exclusion criteria will be selected during a 24-month enrolment
period per country and will be followed from enrolment in the study until death, loss to
follow-up, withdrawal of consent or study end date (whichever occurs earlier). Data Sources
Data will be collected following enrolment in the study and entered in the electronic case
report form (eCRF). All data will be collected using patient medical records. The
investigator will be responsible for ensuring that all the required data is collected and
entered into the eCRF. The site will collect the patient questionnaires and the data will be
uploaded according to the data entry procedures.
Study Population
- Adult male or female patients (according to age of majority/adulthood as defined by
local regulations) who have given written informed consent as per local regulations.
- The primary cohort will include patients with EGFR (epidermal growth factor receptor)
mutation-positive locally advanced or metastatic NSCLC who have progressed while on or
after receiving front-line EGFR-TKI (tyrosine kinase inhibitors) therapy (e.g.,
gefitinib, erlotinib, afatinib, or icotinib).
- Additionally, a secondary cohort of patients will include patients newly diagnosed with
locally advanced or metastatic NSCLC who are treatment naive or patients who were
diagnosed at an earlier stage but have progressed to metastatic NSCLC during the
selection period.
Exposures There are no specific drug exposures or interventions being evaluated, as cohort
eligibility (for both cohorts) is not exposure-based, but rather disease-based. All molecular
testing and treatments will be at the discretion of the treating physician. Study Measures
and Outcomes
- Patient demographic and clinical characteristics
- Molecular testing patterns and outcomes
- Treatment patterns
- Physician-reported clinical outcomes
- Cancer-related health care utilization
- Treatment- and biopsy-related complications
- CNS metastases (brain metastases and leptomeningeal metastases) and treatments
associated with CNS (central nervous system) metastases
- HRQoL (Health Related Quality of Life) and symptoms Precision and Sample Size
Estimations For the primary cohort the minimum sample size recommended for conducting a
country-level analysis is 200 patients per country. This is based on the precision
estimation calculation for the categorical study measure (% of patients tested) and will
allow a maximum of
- 8.3% precision (i.e., assuming 50% undergoing molecular testing) around the point
estimate for the categorical measure. For the secondary cohort the minimum sample
size recommended for conducting a country-level analysis is 300 patients which was
determined using precision estimates calculated for a categorical (% of patients
tested) and a time-to-event (overall survival) measure. The overall study will
include approximately 2800-3300 patients across all participating countries across
both primary (1200-1300 patients) and secondary (1600-2000 patients) cohorts.
Statistical Analysis No formal hypothesis testing is specified. Study measures
including patient demographics and clinical characteristics, molecular testing
patterns, treatment sequence patterns, physician-reported outcomes (overall
survival) and patient-reported outcomes (HRQoL) will be reported by primary and
secondary cohorts, unless indicated otherwise. Continuous study measures (e.g.,
age, duration of therapy) will be reported descriptively with mean, standard
deviation, median, minimum and maximum. Frequencies and percentages will be used to
document categorical measures of interest (e.g., number and proportion of patients
with a post progression molecular test, number and proportion of patients with a
T790M mutation) and will include 95% CIs for key outcome variables. Kaplan-Meier
curves and median survival will be estimated, overall and on an exploratory basis
by clinical and treatment characteristics of interest (provided there are
sufficient events available; e.g., chemotherapy vs. targeted therapy) as
pre-specified in the statistical analysis plan.
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