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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02369874
Other study ID # D4193C00002
Secondary ID
Status Completed
Phase Phase 3
First received
Last updated
Start date September 9, 2015
Est. completion date November 13, 2020

Study information

Verified date January 2021
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 determine the efficacy and safety of MEDI4736 + tremelimumab combination therapy and MEDI4736 monotherapy versus SoC therapy in the target patient population.


Description:

This is a randomized, open-label, multi-center, global, Phase III study to determine the efficacy and safety of MEDI4736 + tremelimumab combination therapy and MEDI4736 monotherapy versus SoC therapy in the target patient population. The main objectives of the study are to: - assess the efficacy of MEDI4736 + tremelimumab combination therapy versus SoC in patients with squamous cell carcinoma of the head and neck (SCCHN), in terms of overall survival (OS), regardless of PDL-1 status - assess the efficacy of MEDI4736 monotherapy versus SOC in patients with SCCHN, in terms of OS, regardless of PDL-1 status Patients will undergo a screening assessment on their tumor tissue sample to determine PD-L1 expression per a pre-specified cut-off level. Patients with ≥25% of tumor cells with membrane staining will be considered PD-L1 positive while those with 0% to 24% of tumor cells with membrane staining will be considered PD-L1 negative. Based on the underlying PD-L1 status, patients will be randomized in a 1:1:1 ratio to receive treatment with MEDI4736 monotherapy, MEDI4736 + tremelimumab combination therapy, or SoC therapy. Patients who discontinue treatment in 1 treatment group may not switch to treatment in a different group. Stratification factors include PD-L1 status, human papillomavirus status, (in patients with oropharyngeal cancer only), and smoking status. Tumor assessments will be performed every 8 weeks until objective tumor response by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1).


Recruitment information / eligibility

Status Completed
Enrollment 736
Est. completion date November 13, 2020
Est. primary completion date September 10, 2018
Accepts healthy volunteers No
Gender All
Age group 18 Years to 96 Years
Eligibility Inclusion Criteria: - Age =18 years; - Written informed consent obtained from the patient/legal representative; - Histologically or cytologically confirmed recurrent or metastatic SCCHN; - Tumor progression or recurrence during or after only one palliative systemic treatment regimen for recurrent or metastatic disease that must have contained a platinum agent OR progression within 6 months of the last dose of platinum given as part of multimodality therapy with curative intent; - Confirmed PD-L1-positive or -negative SCCHN by the Ventana PD-L1 SP263 IHC assay; - WHO/Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; At least 1 measurable lesion, - Not previously irradiated; - No prior exposure to immune-mediated therapy; - Adequate organ and marrow function; Evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal patients. Exclusion Criteria: - Histologically or cytologically confirmed squamous cell carcinoma of any other primary anatomic location in the head and neck; - Received more than 1 palliative systemic regimen for recurrent or metastatic disease; -Any concurrent chemotherapy, Investigational Product, biologic, or hormonal therapy for cancer treatment; - Receipt of any investigational anticancer therapy within 28 days or 5 half-lives; - Receipt of last dose of an approved (marketed) anticancer therapy (chemotherapy, targeted therapy, biologic therapy, mAbs, etc) within 21 days prior to the first dose of study treatment; - Major surgical procedure within 28 days prior to the first dose of Investigational Product; - Any unresolved toxicity NCI CTCAE Grade =2 from previous anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values defined in the inclusion criterion; - Current or prior use of immunosuppressive medication within 14 days before the first dose of their assigned Investigational Product; - History of allogeneic organ transplantation; - Active or prior documented autoimmune or inflammatory disorders; - Uncontrolled intercurrent illness; - Patients with a history of brain metastases, spinal cord compression, or leptomeningeal carcinomatosis; - Mean QT interval corrected for heart rate (QTc) =470 ms calculated from 3 electrocardiograms (ECGs) using Fridericia's Correction; - History of active primary immunodeficiency; - Active tuberculosis; - Active infection including hepatitis B, hepatitis C or human immunodeficiency virus (HIV); - Receipt of live, attenuated vaccine within 30 days prior to the first dose of Investigational Product; - Pregnant or breast-feeding female patients; - Known allergy or hypersensitivity to Investigational Product

Study Design


Related Conditions & MeSH terms

  • Carcinoma
  • Carcinoma, Squamous Cell
  • Recurrent or Metastatic PD-L1-positive or -Negative Squamous Cell Carcinoma of the Head and Neck SCCHN
  • Squamous Cell Carcinoma of Head and Neck

Intervention

Drug:
MEDI4736
MEDI4736 Monotherapy
MEDI4736 + Tremelimumab
MEDI4736 + Tremelimumab combination therapy
Standard of Care
Standard of Care

Locations

Country Name City State
Argentina Research Site Caba
Argentina Research Site San Miguel de Tucuman
Australia Research Site Adelaide
Australia Research Site Heidelberg
Australia Research Site Melbourne
Australia Research Site St Leonards
Australia Research Site Woolloongabba
Belgium Research Site Brussels
Belgium Research Site Bruxelles
Belgium Research Site Charleroi
Belgium Research Site Kortrijk
Belgium Research Site Leuven
Belgium Research Site Namur
Brazil Research Site Barretos
Brazil Research Site Curitiba
Brazil Research Site Porto Alegre
Brazil Research Site Porto Alegre
Brazil Research Site Rio de Janeiro
Brazil Research Site Santo Andre
Brazil Research Site São José do Rio Preto
Brazil Research Site São Paulo
Bulgaria Research Site Shumen
Bulgaria Research Site Sofia
Bulgaria Research Site Varna
Chile Research Site Temuco
Croatia Research Site Osijek
Croatia Research Site Zagreb
Czechia Research Site Olomouc
Czechia Research Site Zlin
France Research Site Angers
France Research Site Bordeaux
France Research Site Dijon
France Research Site Le Mans
France Research Site Lyon Cedex 08
France Research Site Montpellier Cedex 5
France Research Site Paris Cedex 5
France Research Site Plerin SUR MER
France Research Site Rouen
France Research Site St Grégoire
France Research Site Strasbourg Cedex
France Research Site Villejuif Cedex
Georgia Research Site Lorient Cedex
Germany Research Site Berlin
Germany Research Site Essen
Germany Research Site Halle
Germany Research Site Hannover
Germany Research Site Heidelberg
Germany Research Site Leipzig
Germany Research Site München
Germany Research Site Potsdam
Hungary Research Site Budapest
Hungary Research Site Budapest
Hungary Research Site Budapest
Hungary Research Site Gyor
Hungary Research Site Kecskemét
Israel Research Site Haifa
Israel Research Site Jerusalem
Israel Research Site Petach-Tikva
Israel Research Site Tel Aviv
Israel Research Site Tel Hashomer
Italy Research Site Aosta
Italy Research Site Bologna
Italy Research Site Gallarate
Italy Research Site Legnago
Italy Research Site Milano
Italy Research Site Napoli
Italy Research Site Pavia
Italy Research Site Roma
Italy Research Site Siena
Japan Research Site Chuo-ku
Japan Research Site Fukuoka-shi
Japan Research Site Hirakata-shi
Japan Research Site Isehara-shi
Japan Research Site Kashiwa
Japan Research Site Kitaadachi-gun
Japan Research Site Kobe-shi
Japan Research Site Koto-ku
Japan Research Site Matsuyama-shi
Japan Research Site Nagoya
Japan Research Site Natori-shi
Japan Research Site Okayama
Japan Research Site Osaka
Japan Research Site Osakasayama
Japan Research Site Sapporo
Japan Research Site Sapporo
Japan Research Site Shimotsuke-shi
Japan Research Site Sunto-gun
Japan Research Site Takatsuki-shi
Japan Research Site Yokohama
Japan Research Site Yokohama-shi
Korea, Republic of Research Site Daegu
Korea, Republic of Research Site Goyang-si
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Suwon
Poland Research Site Kraków
Poland Research Site Lódz
Poland Research Site Poznan
Romania Research Site Baia Mare
Romania Research Site Brasov
Romania Research Site Cluj
Romania Research Site Cluj-Napoca
Romania Research Site Craiova
Russian Federation Research Site Arkhangelsk
Russian Federation Research Site Chelyabinsk
Russian Federation Research Site Kursk
Russian Federation Research Site Moscow
Russian Federation Research Site Moscow
Russian Federation Research Site Moscow
Russian Federation Research Site Moscow
Russian Federation Research Site Moscow
Russian Federation Research Site Nizhniy Novgorod
Russian Federation Research Site Omsk
Russian Federation Research Site Pyatigorsk
Russian Federation Research Site Saint Petersburg
Russian Federation Research Site Saint-Petersburg
Russian Federation Research Site Sankt-Peterburg
Russian Federation Research Site Sochi
Russian Federation Research Site Ufa
Russian Federation Research Site Vladimir
Serbia Research Site Belgrad
Serbia Research Site Belgrade
Serbia Research Site Kragujevac
Serbia Research Site Nis
Serbia Research Site Sremska Kamenica
Spain Research Site Barcelona
Spain Research Site Barcelona
Spain Research Site L'Hospitalet de Llobregat
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Madrid
Spain Research Site Malaga
Spain Research Site Marbella
Spain Research Site Pamplona
Spain Research Site Valencia
Spain Research Site Valencia
Spain Research Site Zaragoza
Taiwan Research Site Kaohsiung
Taiwan Research Site Taipei
Taiwan Research Site Taipei
Taiwan Research Site Taoynan
Ukraine Research Site Dnipro
Ukraine Research Site Kyiv
Ukraine Research Site Sumy
Ukraine Research Site Uzhhorod
Ukraine Research Site Zaporizhzhia
United States Research Site Atlanta Georgia
United States Research Site Boston Massachusetts
United States Research Site Dallas Texas
United States Research Site Dallas Texas
United States Research Site Denver Colorado
United States Research Site Evanston Illinois
United States Research Site Fullerton California
United States Research Site Germantown Tennessee
United States Research Site Lexington Kentucky
United States Research Site Los Angeles California
United States Research Site McAllen Texas
United States Research Site Miami Beach Florida
United States Research Site Nashville Tennessee
United States Research Site Newark Delaware
United States Research Site Norfolk Virginia
United States Research Site Orlando Florida
United States Research Site Pittsburgh Pennsylvania
United States Research Site Redondo Beach California
United States Research Site Rochester New York
United States Research Site Rochester New York
United States Research Site Stanford California
United States Research Site Tucson Arizona
United States Research Site Winston-Salem North Carolina

Sponsors (1)

Lead Sponsor Collaborator
AstraZeneca

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Belgium,  Brazil,  Bulgaria,  Chile,  Croatia,  Czechia,  France,  Georgia,  Germany,  Hungary,  Israel,  Italy,  Japan,  Korea, Republic of,  Poland,  Romania,  Russian Federation,  Serbia,  Spain,  Taiwan,  Ukraine, 

Outcome

Type Measure Description Time frame Safety issue
Primary Overall Survival (OS) OS is defined as the time from the date of randomization until death due to any cause. OS was analyzed for the full analysis set, regardless of programmed death-ligand 1 (PD-L1) status. September 2015 to September 2018 (36 months)
Secondary Overall Survival (OS) in PD-L1 Negative Participants OS is defined as the time from the date of randomization until death due to any cause. PD-L1 negative was defined as <25% of tumor cells with membrane staining for PD-L1 at any intensity. September 2015 to September 2018 (36 months)
Secondary Overall Survival (OS) in PD-L1 Positive Participants OS is defined as the time from the date of randomization until death due to any cause. PD-L1 positive was defined as =25% of tumor cells with membrane staining for PD-L1 at any intensity. September 2015 to September 2018 (36 months)
Secondary Progression Free Survival (PFS) PFS was defined as the time from the date of randomization until the date of objective disease progression or death based on investigator assessments, according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). Objective disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (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. September 2015 to September 2018 (36 months)
Secondary Objective Response Rate (ORR) The percentage of participants who experienced an objective response (complete response [CR] or partial response [PR]), based on investigator assessments according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). A CR was defined as the disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis to <10 mm. A PR was defined as at least a 30% decrease in the sum of the diameters of TLs, taking as reference the baseline sum of diameters. Assessed at randomization and every 8 weeks thereafter
Secondary Duration of Response (DoR) Median DoR, in months, based on investigator assessments, according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). A complete response was defined as the disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis to <10 mm. A partial response was defined as at least a 30% decrease in the sum of the diameters of TLs, taking as reference the baseline sum of diameters. September 2015 to September 2018 (36 months)
Secondary Disease Control Rate (DCR) 6 Months: The percentage of participants who had a best objective response of complete response (CR) or partial response (PR) in the first 6 months or had demonstrated stable disease (SD) for a minimum interval of 24 weeks following randomization.
12 Months: The percentage of participants who had a best objective response of CR or PR within 12 months or had demonstrated SD for a minimum interval of 48 weeks following randomization.
Objective response was based on investigator assessments, according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). A CR was defined as the disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis to <10 mm. A PR was defined as at least a 30% decrease in the sum of the diameters of TLs, taking as reference the baseline sum of diameters.
Baseline up to 6 months; baseline up to 12 months
Secondary Percentage of Participants Alive and Progression Free (APF) APF is defined as the percentage of participants who are alive and progression free at 6 months and 12 months after randomization. Estimates of progression free survival were based on investigator assessments according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). Objective disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (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. Baseline up to 6 months; baseline up to 12 months
Secondary Percentage of Participants Alive Percentage of participants alive at 12, 18 and 24 months using a Kaplan Meier estimate. 12, 18 and 24 months
Secondary Progression Free Survival (PFS) in PD-L1 Negative Participants Number of participants with confirmed objective disease progression (PD) at the time of the participant's last evaluable response evaluation criteria in solid tumors 1.1 (RECIST1.1) assessment. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (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. PD-L1 negative was defined as <25% of tumor cells with membrane staining for PD-L1 at any intensity. September 2015 to September 2018 (36 months)
Secondary Objective Response Rate (ORR) in PD-L1 Negative Participants The percentage of PD-L1 negative participants who experienced an objective response (complete response [CR] or partial response [PR]), based on investigator assessments according to response evaluation criteria in solid tumors 1.1 (RECIST1.1). A CR was defined as the disappearance of all target lesions (TLs) since baseline. Any pathological lymph nodes selected as TLs must have a reduction in short axis to <10 mm. A PR was defined as at least a 30% decrease in the sum of the diameters of TLs, taking as reference the baseline sum of diameters. PD-L1 negative was defined as <25% of tumor cells with membrane staining for PD-L1 at any intensity. September 2015 to September 2018 (36 months)
Secondary Time to Deterioration in European Organisation for Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire, Version 3 (EORTC QLQ-C30) The EORTC QLQ-C30 consists of 30 questions that can be combined to produce functional scales (e.g. physical), symptom scales (e.g. fatigue), and a global measure of health status. Each of the scales are measured from 0 to 100. Deterioration was defined as a 10-point decrease from baseline in a functioning or global health status/ quality of life score or a 10-point increase from baseline in a symptom score. September 2015 to September 2018 (36 months)
Secondary Time to Deterioration for European Organisation for Research and Treatment of Cancer 35-item Head and Neck Quality of Life Questionnaire (EORTC QLQ-H&N35) The EORTC QLQ-H&N35 comprises of 35 questions to assess head and neck cancer symptoms (e.g. pain, swallowing). Deterioration was defined as a 10-point increase from baseline in the symptom score. September 2015 to September 2018 (36 months)
Secondary Number of Participants Reporting One or More Adverse Events (AE) An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. Inclusive of AEs and serious AEs. First dose to last dose + 90 days or data cut off (up to 36 months)