Description:
This is a Phase III, randomised, controlled, 3-arm, multi-centre study of neoadjuvant
osimertinib as monotherapy or in combination with chemotherapy, versus SoC chemotherapy
alone, for the treatment of patients with resectable EGFRm Non-Small Cell Lung Cancer
Title
- Brief Title: A Study of Osimertinib With or Without Chemotherapy Versus Chemotherapy Alone as Neoadjuvant Therapy for Patients With EGFRm Positive Resectable Non-Small Cell Lung Cancer
- Official Title: A Phase III, Randomised, Controlled, Multi-center, 3-Arm Study of Neoadjuvant Osimertinib as Monotherapy or in Combination With Chemotherapy Versus Standard of Care Chemotherapy Alone for the Treatment of Patients With Epidermal Growth Factor Receptor Mutation Positive, Resectable Non-small Cell Lung Cancer
Clinical Trial IDs
- ORG STUDY ID:
D516AC00001
- NCT ID:
NCT04351555
Conditions
- Non-Small Cell Lung Cancer
Interventions
Drug | Synonyms | Arms |
---|
Osimertinib | AZD9291; TAGRISSO | Arm 2: Osimertinib with platinum-based chemotherapy |
Cisplatin | | Arm 1: Placebo with platinum-based chemotherapy |
Carboplatin | | Arm 1: Placebo with platinum-based chemotherapy |
Placebo | | Arm 1: Placebo with platinum-based chemotherapy |
Pemetrexed | | Arm 1: Placebo with platinum-based chemotherapy |
Purpose
This is a Phase III, randomised, controlled, 3-arm, multi-centre study of neoadjuvant
osimertinib as monotherapy or in combination with chemotherapy, versus SoC chemotherapy
alone, for the treatment of patients with resectable EGFRm Non-Small Cell Lung Cancer
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1: Placebo with platinum-based chemotherapy | Placebo Comparator | Placebo plus investigator's choice of platinum-based standard of care chemotherapy (pemetrexed/carboplatin or pemetrexed/cisplatin) | - Cisplatin
- Carboplatin
- Placebo
- Pemetrexed
|
Arm 2: Osimertinib with platinum-based chemotherapy | Experimental | Osimertinib 80 mg QD (Dose may be reduced to 40 mg QD at the discretion of the investigator) plus investigator's choice of platinum-based standard of care chemotherapy (pemetrexed/carboplatin or pemetrexed/cisplatin) | - Osimertinib
- Cisplatin
- Carboplatin
- Pemetrexed
|
Arm 3: Osimertinib monotherapy | Experimental | Osimertinib 80 mg QD (Dose may be reduced to 40 mg QD at the discretion of the investigator) | |
Eligibility Criteria
Inclusion Criteria:
- Male or female, at least 18 years of age. For patients aged <20 years and enrolled in
Japan, a written informed consent should be obtained from the patient and his or her
legally acceptable representative
- Histologically or cytologically documented non-squamous NSCLC with completely
resectable (Stage II - IIIB N2) disease (according to Version 8 of the IASLC Cancer
Staging Manual [IASLC Staging Manual in Thoracic Oncology 2016]).
- Complete surgical resection of the primary NSCLC must be deemed achievable, as
assessed by a MDT evaluation (which should include a thoracic surgeon, specialised in
oncologic procedures).
- Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1 at enrolment, with no
deterioration over the previous 2 weeks prior to baseline or day of first dosing
- A tumour which harbours one of the 2 common EGFR mutations known to be associated with
EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR
mutations (ie, T790M, G719X, Exon20 insertions, S7681 and L861Q).
Exclusion Criteria:
- Past medical history of ILD, drug-induced ILD, radiation pneumonitis which required
steroid treatment, or any evidence of clinically active ILD.
- History of another primary malignancy, except for the following: Malignancy treated
with curative intent and with no known active disease ≥2 years before the first dose
of investigational product (IP) and of low potential risk for recurrence; Adequately
treated non-melanoma skin cancer or lentigo malignancy without evidence of disease;
Adequately treated carcinoma in situ without evidence of disease
- Patients who have pre-operative radiotherapy treatment as part of their care plan
- Mixed small cell and NSCLC histology
- Stages I, IIIB N3, IIIC, IVA, and IVB NSCLC
- T4 tumours infiltrating the aorta, the oesophagus and/or the heart; and/or any bulky
N2 disease
- Patients who are candidates to undergo only segmentectomies or wedge resections
- Prior treatment with any systemic anti-cancer therapy for NSCLC including
chemotherapy, biologic therapy, immunotherapy, or any investigational drug
- Prior treatment with EGFR-TKI therapy
- Current use of (or unable to stop use prior to receiving the first dose of study
treatment) medications or herbal supplements known to be strong inducers of cytochrome
P450 (CYP) 3A4 (at least 3 weeks prior)
Maximum Eligible Age: | 100 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Major Pathological Response (MPR) |
Time Frame: | From date of randomization to an average of 12 weeks after the first dose |
Safety Issue: | |
Description: | Defined as ≤10% residual cancer cells in the main tumour, as assessed per central pathology laboratory post-surgery |
Secondary Outcome Measures
Measure: | Pathological complete response (pCR) |
Time Frame: | From date of randomization to an average of 12 weeks after the first dose |
Safety Issue: | |
Description: | Defined as absence of any residual cancer cells in the dissected tumour samples, including the main tumour and lymph nodes, assessed post-surgery |
Measure: | Event-free survival (EFS) |
Time Frame: | Up to approximately 42 months after the last patient is randomized |
Safety Issue: | |
Description: | An event is defined as documented disease progression that precludes surgery or requires non-protocol therapy; recurrence or a new lesion, local or distant (a new primary malignancy confirmed by pathology is not considered to be an EFS event.); death due to any cause |
Measure: | Overall Survival (OS) |
Time Frame: | Up to approximately 5.5 years after the last patient is randomized |
Safety Issue: | |
Description: | Patients will be followed up to approximately 5.5 years after they are randomized. |
Measure: | Disease free survival (DFS) |
Time Frame: | From date of randomization up to approximately 42 months after date of resection |
Safety Issue: | |
Description: | DFS is defined as the time from the date of surgery until the first date of disease recurrence (local or distant) or date of death due to any cause, whichever occurs first. |
Measure: | Downstaging |
Time Frame: | From date of randomization to an average of 12 weeks after the first dose |
Safety Issue: | |
Description: | Measured using pathologic mediastinal lymph node evaluation |
Measure: | Difference between treatment arms in change from baseline in EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 items) |
Time Frame: | From randomization to 264 weeks post-surgery |
Safety Issue: | |
Description: | Assess disease-related symptoms, functioning, and global health status/quality-of-life in patients |
Measure: | Concordance of EGFRm status between tumour tissue DNA and patient-matched plasma-derived ctDNA |
Time Frame: | Baseline |
Safety Issue: | |
Description: | |
Measure: | Corcordance of EGFR mutation status between the local and central cobas EGFR mutation test results from baseline tumour samples |
Time Frame: | Baseline |
Safety Issue: | |
Description: | |
Measure: | PK plasma concentrations of osimertinib |
Time Frame: | From the pre-dose of Cycle 2 to post-dose of Cycle 3 (each cycle is 21 days) |
Safety Issue: | |
Description: | |
Measure: | Difference between treatment arms in change from baseline in EORTC QLQ-LC13 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Lung Cancer 13 items) |
Time Frame: | From randomization to 264 weeks post-surgery |
Safety Issue: | |
Description: | Assess lung cancer-associated symptoms and side effects from conventional chemotherapy and radiotherapy |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | AstraZeneca |
Trial Keywords
- Resectable; NSCLC; Osimertinib; EGFRm Positive; Neoadjuvant; Adjuvant
Last Updated
August 6, 2021