Clinical Trials /

A Clinical Trial of Durvalumab (MEDI4736) as 1st Line Therapy in Advanced Non-small Cell Lung Cancer Patients

NCT02879617

Description:

This is a single-arm phase II clinical trial evaluating the safety and efficacy of the PD-L1 inhibitor durvalumab as first-line therapy in 50 patients with advanced NSCLC and ECOG Performance Status 2 (PS2).

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Clinical Trial of Durvalumab (MEDI4736) as 1st Line Therapy in Advanced Non-small Cell Lung Cancer Patients
  • Official Title: A Phase II Clinical Trial Evaluating the Safety and Efficacy of Durvalumab (MEDI4736) as 1st Line Therapy in Advanced Non-small Cell Lung Cancer (NSCLC) Patients With Eastern Cooperative Oncology Group (ECOG) Performance Status of 2

Clinical Trial IDs

  • ORG STUDY ID: 16-054
  • NCT ID: NCT02879617

Conditions

  • Non-Small Cell Lung Cancer NSCLC

Interventions

DrugSynonymsArms
durvalumabMEDI4736durvalumab

Purpose

This is a single-arm phase II clinical trial evaluating the safety and efficacy of the PD-L1 inhibitor durvalumab as first-line therapy in 50 patients with advanced NSCLC and ECOG Performance Status 2 (PS2).

Detailed Description

      Durvalumab will be supplied in glass vials containing 500 mg of liquid solution at a
      concentration of 50 mg/mL for intravenous (IV) administration. Durvalumab will be
      administered at 1500 mg (fixed dose) every 4 weeks until disease progression, death,
      unacceptable toxicity or withdrawal of consent for a maximum of 12 months of therapy.
    

Trial Arms

NameTypeDescriptionInterventions
durvalumabExperimental1500 mg of durvalumab will be administered intravenously (IV) on day 1 of every 28 day cycle.
  • durvalumab

Eligibility Criteria

        Inclusion Criteria:

          -  Written informed consent

          -  Patients must have histologically or cytologically confirmed Stage IIIB or IV
             (American Joint Committee on Cancer, 7th edition; AJCC 7) non-small cell lung cancer.

          -  Patients must have measurable disease.

          -  Patients must have not have received any prior therapy (chemotherapy, immunotherapy,
             endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal
             antibodies, other investigational agent) for the treatment of stage IV NSCLC.

          -  Age ≥ 18 years at time of study entry.

          -  ECOG performance status of 2.

          -  Life expectancy of greater than 12 weeks.

          -  Tissue available (archived or fresh tumor biopsy) for the PD-L1 assay.

          -  Patients must have normal organ and marrow function as defined below:

               -  Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L (> 1500 per mm^3)

               -  Hemoglobin ≥ 9.0 g/dL

               -  Platelet count ≥ 100 x 10^9/L (>100,000 per mm^3)

               -  Serum bilirubin ≤ 1.5 x institutional upper limit of normal (ULN).

               -  AST (SGOT)/ALT (SGPT) ≤ 2.5 x ULN unless liver metastases are present, in which
                  case it must be ≤ 5x ULN Serum creatinine CL>40 mL/min by the Cockcroft-Gault
                  formula

          -  Female subjects must either be of non-reproductive potential OR must have a negative
             serum pregnancy test upon study entry.

          -  The effects of durvalumab on the developing human fetus are unknown. For this reason
             and because immunomodulatory agents are potentially teratogenic, sexually active women
             of child-bearing potential and men must agree to use adequate contraception (2 methods
             of effective contraception from screening) from screening, for the duration of study
             participation, and for at least 90 days following the last infusion of durvalumab.

          -  Subject is willing and able to comply with the protocol for the duration of the study
             including undergoing treatment and scheduled visits and examinations including follow
             up.

        Exclusion Criteria:

          -  Involvement in the planning and/or conduct of the study; previous enrollment in the
             present study.

          -  Participation in another clinical study with an investigational product for cancer
             during the last 12 months.

          -  Any previous treatment with a PD1 or PD-L1 inhibitor, including durvalumab.

          -  Symptomatic or uncontrolled brain metastases requiring concurrent treatment, inclusive
             of but not limited to surgery, radiation and/or corticosteroids in excess of
             prednisone 10 mg/d or equivalent.

          -  Sensitizing mutations in EGFR or rearrangements in ALK or ROS1.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to durvalumab.

          -  Mean QT interval corrected for heart rate (QTc) ≥ 470 ms.

          -  Current or prior use of immunosuppressive medication within 28 days before the first
             dose of durvalumab, with the exceptions of intranasal and inhaled corticosteroids .
             Patients may be on systemic corticosteroids provided the dose does not exceed
             prednisone 10 mg/d or equivalent for 1 week prior to study drug administration.

          -  Active or prior documented autoimmune disease within the past 2 years NOTE: Subjects
             with vitiligo, Grave's disease, or psoriasis not requiring systemic treatment (within
             the past 2 years) are not excluded.

          -  Active or prior documented inflammatory bowel disease (e.g., Crohn's disease,
             ulcerative colitis).

          -  History of primary immunodeficiency.

          -  History of allogeneic organ transplant.

          -  Uncontrolled intercurrent illness.

          -  Known history of previous clinical diagnosis of tuberculosis.

          -  History of leptomeningeal carcinomatosis.

          -  Receipt of live attenuated vaccination within 30 days prior to study entry or within
             30 days of receiving durvalumab.

          -  Any condition that, in the opinion of the investigator, would interfere with
             evaluation of study treatment or interpretation of patient safety or study results.

          -  Subjects with uncontrolled seizures.

          -  Pregnant women; breastfeeding should be discontinued.

          -  Prior history of radiation pneumonitis.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Survival
Time Frame:Up to 42 months
Safety Issue:
Description:Median length of time from the start of treatment that patients are still alive.

Secondary Outcome Measures

Measure:Progression-Free Survival (PFS)
Time Frame:Up to 42 months
Safety Issue:
Description:The duration of time from start of treatment to time of progression or death, whichever occurs first. Per RECIST v1.0 Progressive Disease (PD) for target lesions: At least a 20% increase in the sum of the 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. (Note: the appearance of one or more new lesions is also considered progressions). For non-target lesions:Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase.
Measure:Overall Response Rate (ORR)
Time Frame:Up to 42 months
Safety Issue:
Description:Proportion of patients who achieve either a Complete Response or Partial Response to study treatment. Per RECIST v1.0, for target lesions: Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. For non-target lesions: Complete Response (CR): Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). If tumor markers are initially above the upper normal limit, they must normalize for a patient to be considered in complete clinical response. Non-CR/Non-PD: Persistence of one or more non-target lesion(s) and/or maintenance of tumor marker level above the normal limits.
Measure:Health Related Quality of Life (HRQL) - FACT-L questionnaire
Time Frame:At baseline, the end of each treatment cycle, and at the end of therapy; Up to 30 months
Safety Issue:
Description:Patient self-administered questionnaire that measures the respondents' health state over the last 7 days.Scoring: Five-point scale: 0 (not at all) to 4 (very much) Note: Questions are phrased so that higher numbers indicate a better health state, leading to some items being reverse-scored.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Academic Thoracic Oncology Medical Investigators Consortium

Trial Keywords

  • PD-L1 (programmed cell death ligand 1)

Last Updated

August 5, 2021