Description:
The aim of this study is to assess the efficacy and safety of single agent AZD9291 in a real
world setting in adult patients with advanced or metastatic, epidermal growth factor receptor
(EGFR) T790M mutation-positive Non-Small Cell Lung Cancer (NSCLC), who have received prior
EGFR-tyrosine kinase inhibitor (TKI) therapy.
Title
- Brief Title: Real World Treatment Study of AZD9291 for Advanced/Metastatic EGFR T790M Mutation NSCLC
- Official Title: Open Label, Multinational, Multicenter, Real World Treatment Study of Single Agent AZD9291 for Patients With Advanced/Metastatic Epidermal Growth Factor Receptor (EGFR) T790M Mutation-Positive Non-Small Cell Lung Cancer (NSCLC) Who Have Received Prior Therapy With an EGFR Tyrosine Kinase Inhibitor (EGFR-TKI)
Clinical Trial IDs
- ORG STUDY ID:
D5160C00022
- NCT ID:
NCT02474355
Conditions
Interventions
Drug | Synonyms | Arms |
---|
AZD9291 Dosing | | AZD9291 |
Purpose
The aim of this study is to assess the efficacy and safety of single agent AZD9291 in a real
world setting in adult patients with advanced or metastatic, epidermal growth factor receptor
(EGFR) T790M mutation-positive Non-Small Cell Lung Cancer (NSCLC), who have received prior
EGFR-tyrosine kinase inhibitor (TKI) therapy.
Detailed Description
Objective: The primary objective of this study is to assess the efficacy and safety of single
agent AZD9291 in a real world setting in adult patients with advanced or metastatic,
epidermal growth factor receptor (EGFR) T790M mutation-positive Non-Small Cell Lung Cancer
(NSCLC), who have received prior EGFR-tyrosine kinase inhibitor (TKI) therapy.
Study site(s) and number of patients planned: Approximately 1500 patients will be recruited
in Europe. The recruitment will be increased beyond that as the study will expand in other
regions of the world (America, Asia).
Study Design This will be an open-label, single-arm, multinational, multicenter, real world
treatment study.
Target patient population: Adult patients (fulfilling the definition of "age of majority" per
local regulations) with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC with
confirmed T790M mutation, who have received prior EGFR-TKI therapy.
Investigational product (IP), dosage, and mode of administration: AZD9291 is an oral, potent,
selective, irreversible inhibitor of both EGFR-TKI sensitising and resistance mutations in
NSCLC with a significant selectivity margin over wild-type EGFR. AZD9291 will be administered
orally as one 80 mg tablet once a day.
Duration of IP administration: Patients may continue to receive AZD9291 as long as they
continue to show clinical benefit, as judged by the investigator, and in the absence of
discontinuation criteria). The study will be closed in each participating country as soon as
possible following national reimbursement of AZD9291 in that country (up to a max of 90 days
post reimbursement). Enrolment will be closed within 6 months after market license approval
in that country or at national reimbursement, whichever is sooner. Patients withdrawing from
the treatment prior to national reimbursement will be followed up as part of this study.
Patients on treatment will receive commercial supply until documented disease progression as
per investigator assessment.
In the event that national reimbursement should not be granted following a reasonable time
after market license approval in the country, the study will be closed in a maximum period of
18 months after the last patient is enrolled in that country. If applicable, timelines for
conversion to commercial drug will be agreed with local bodies which may include regulatory
agencies, ethics committees, and institutions. Patient will be followed until death or lost
to follow-up.
Study measures: Data collected will include patient demographics, information needed to
determine patient eligibility (including medical history, past and current disease
characteristics, and tumor EGFR mutational status), AZD9291 exposure, investigator-reported
efficacy (including tumor response and disease progression), overall survival (OS), and
safety (including serious adverse events [SAEs], adverse events leading to dose modification,
and adverse events of special interest [interstitial lung disease/pneumonitis-like events,
and QTc prolongation events]).
Statistical methods: All data will be presented for the overall full analysis/evaluable set,
and also by cohorts defined by number and type of previous treatment lines for the advanced
disease. Descriptive statistics will be used for all variables, as appropriate. Continuous
variables will be summarised by the number of observations, mean, standard deviation, median,
minimum, and maximum. Categorical variables will be summarised by frequency counts and
percentages for each category. OS and PFS will be summarized using Kaplan-Meier estimates of
the median time to death or censoring and quartiles together with their 95% confidence
intervals.
Trial Arms
Name | Type | Description | Interventions |
---|
AZD9291 | Experimental | Single arm of AZD9291, starting dose of 80mg | |
Eligibility Criteria
Inclusion Criteria:
1. Provision of signed and dated written informed consent by the patient or legally
acceptable representative prior to any study-specific procedures
2. Adults (according to each country regulations for age of majority)
3. Locally advanced (stage IIIB) or metastatic (stage IV) EGFRm NSCLC, not amenable to
curative surgery or radiotherapy, with confirmation of the presence of the T790M
mutation
4. Prior therapy with an EGFR-TKI. Patients may have also received additional lines of
treatment
5. World Health Organization (WHO) performance status 0-2
6. Adequate bone marrow reserve and organ function as demonstrated by complete blood
count, biochemistry in blood and urine at baseline (please refer to IB for guidance)
7. ECG recording at baseline showing absence of any cardiac abnormality as per exclusion
criterion #6
8. Female patients of childbearing potential must be using adequate contraceptive
measures, must not be breast feeding, and must have a negative pregnancy test prior to
start of dosing. Otherwise, they must have evidence of nonchildbearing potential
9. Male patients must be willing to use barrier contraception, i.e., condoms
Exclusion Criteria:
1. Previous (within 6 months) or current treatment with AZD9291
2. Patients currently receiving (or unable to stop use at least 1 week prior to receiving
the first dose of AZD9291) any treatment known to be potent inhibitors or inducers of
cytochrome P450 (CYP) 3A4
3. Any evidence of severe or uncontrolled systemic diseases, including uncontrolled
hypertension, active bleeding diatheses, active infection including hepatitis B,
hepatitis C, and human immunodeficiency virus, or significantly impaired bone marrow
reserve or organ function, including hepatic and renal impairment, which in the
investigator's opinion would significantly alter the risk/benefit balance.
4. Patient with symptomatic central nervous system (CNS) metastases who is neurologically
unstable or has required increasing doses of steroids to manage CNS symptoms within
the 2 weeks prior to start AZD9291 administration;
5. Past medical history of ILD, drug-induced ILD, radiation pneumonitis requiring steroid
treatment, or any evidence of clinically active ILD
6. Any of the following cardiac criteria:
1. Mean resting corrected QT interval (QTcF) > 470 ms using Fredericia's formula :
2. Any clinically important abnormalities in rhythm, conduction or morphology of
resting ECG (e.g., complete left bundle branch block, third degree heart block,
second degree heart block)
3. Any factors that increase the risk of QTc prolongation or risk of arrhythmic
events
7. Any unresolved toxicity from prior therapy CTCAE > grade 3 at the time of starting
treatment
8. History of hypersensitivity to excipients of AZD9291 or to drugs with a similar
chemical structure or class to AZD9291
Maximum Eligible Age: | 130 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Efficacy of AZD9291 by the analysis of overall survival. |
Time Frame: | From first dose intake to end of study (Last subject last visit (LSLV)) (up to approximately 24 months) |
Safety Issue: | |
Description: | Efficacy will be measured by the analysis of Overall Survival defined as the date of 1st dose until date of death. |
Secondary Outcome Measures
Measure: | Efficacy of AZD9291 by the analysis of Progression Free Survival (PFS) |
Time Frame: | from first dose intake to progression or death. |
Safety Issue: | |
Description: | PFS will be summarized using Kaplan-Meier estimates of the median time to progression or death and quartiles with their 95% confidence intervals. |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | AstraZeneca |
Trial Keywords
Last Updated
March 17, 2020