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A Study to Evaluate Chemotherapy Plus Osimertinib Against Chemotherapy Plus Placebo in Patients With Non-small Cell Lung Cancer (NSCLC)

NCT04765059

Description:

The study will evaluate the efficacy and safety of treatment with chemotherapy in combination with osimertinib compared to chemotherapy in combination with placebo in patients who have progressed extracranially following first-line osimertinib treatment.

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

Not yet recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: A Study to Evaluate Chemotherapy Plus Osimertinib Against Chemotherapy Plus Placebo in Patients With Non-small Cell Lung Cancer (NSCLC)
  • Official Title: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Platinum Plus Pemetrexed Chemotherapy Plus Osimertinib Versus Platinum Plus Pemetrexed Chemotherapy Plus Placebo in Patients With EGFRm, Locally Advanced or Metastatic NSCLC Who Have Progressed Extracranially Following First-Line Osimertinib Therapy (COMPEL)

Clinical Trial IDs

  • ORG STUDY ID: D5162C00042
  • NCT ID: NCT04765059

Conditions

  • Non-small Cell Lung Cancer

Interventions

DrugSynonymsArms
Osimertinib (AZD9291) pemetrexed cisplatin or carboplatinTreatment Arm A
Placebo for osimertinib (AZD9291) pemetrexed cisplatin or carboplatinTreatment Arm B

Purpose

The study will evaluate the efficacy and safety of treatment with chemotherapy in combination with osimertinib compared to chemotherapy in combination with placebo in patients who have progressed extracranially following first-line osimertinib treatment.

Detailed Description

      This is a Phase III, randomized, double-blind, placebo-controlled study of platinum plus
      pemetrexed chemotherapy plus osimertinib versus platinum plus pemetrexed chemotherapy plus
      placebo in patients with epidermal growth factor receptor mutation-positive (EGFRm),
      metastatic NSCLC who responded to first-line osimertinib therapy and subsequently experienced
      radiological, extracranial disease progression. Approximately 204 patients will be randomized
      in a 1:1 ratio to treatment with platinum plus pemetrexed chemotherapy plus osimertinib
      (Treatment Arm A) or platinum plus pemetrexed chemotherapy plus placebo (Treatment Arm B).
      Patients will be stratified based on the presence of brain metastases (stable brain
      metastases based on central nervous system (CNS) Response Evaluation Criteria in Solid
      Tumors, Version 1.1 [RECIST 1.1] assessments versus no brain metastases).

      The 2 randomized treatment regimens are as follows:

        -  Treatment Arm A: Osimertinib 80 mg once daily (QD) with pemetrexed (500 mg/m^2) (with
           pre-treatment) plus either cisplatin (75 mg/m^2) or carboplatin (area under the
           concentration-time curve [AUC] 5), both administered on Day 1 of 21-day cycles for 4
           cycles, followed by osimertinib 80 mg QD plus pemetrexed maintenance (500 mg/m^2) on Day
           1 of 21-day cycles

        -  Treatment Arm B: Placebo QD with pemetrexed (500 mg/m^2) (with pre-treatment) plus
           either cisplatin (75 mg/m^2) or carboplatin (AUC5), both administered on Day 1 of 21-day
           cycles for 4 cycles, followed by placebo QD plus pemetrexed maintenance (500 mg/m^2) on
           Day 1 of 21-day cycles.
    

Trial Arms

NameTypeDescriptionInterventions
Treatment Arm AExperimentalAll randomized patients will receive osimertinib 80 mg QD with pemetrexed (500 mg/m^2) (with pre-treatment) plus either cisplatin (75 mg/m^2) or carboplatin ([AUC] 5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by osimertinib 80 mg QD plus pemetrexed maintenance (500 mg/m^2) on Day 1 of 21-day cycles
  • Osimertinib (AZD9291) pemetrexed cisplatin or carboplatin
Treatment Arm BPlacebo ComparatorAll randomized patients will receive placebo QD with pemetrexed (500 mg/m^2) (with pre-treatment) plus either cisplatin (75 mg/m^2) or carboplatin (AUC5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by placebo QD plus pemetrexed maintenance (500 mg/m^2) on Day 1 of 21-day cycles
  • Placebo for osimertinib (AZD9291) pemetrexed cisplatin or carboplatin

Eligibility Criteria

        Inclusion Criteria:

          1. Capable of giving signed informed consent, which includes compliance with the
             requirements and restrictions listed in the informed consent form and in this
             protocol.

          2. Pathologically confirmed non-squamous NSCLC.

          3. Locally advanced (clinical stage IIIB or IIIC) or metastatic NSCLC (clinical stage IVA
             or IVB) or recurrent NSCLC), not amenable to curative surgery or radiotherapy.

          4. Evidence of radiological extracranial disease progression following response with
             first-line osimertinib treatment but who have not received further, subsequent
             treatment.

          5. World Health Organization performance status of 0 to 1 at screening with no clinically
             significant deterioration in the previous 2 weeks.

          6. Life expectancy >12 weeks at Day 1.

          7. At least 1 lesion, not previously irradiated.

          8. Females must be using highly effective contraceptive measures, and must have a
             negative pregnancy test prior to start of dosing if of child-bearing potential, or
             must have evidence of non-child-bearing potential by fulfilling criteria at screening.

          9. Male patients must be willing to use barrier contraception

        Exclusion Criteria:

          1. Clinical or radiological evidence of CNS progression on first-line osimertinib.

          2. Past medical history of ILD (interstitial lung disease)/pneumonitis, drug-induced
             ILD/pneumonitis, radiation pneumonitis that required steroid treatment, or any
             evidence of clinically active ILD/pneumonitis.

          3. Any evidence of severe or uncontrolled extracranial diseases.

          4. Any of the following cardiac criteria:

             i) Mean resting QTc >470 msec ii) Any clinically important abnormalities in rhythm,
             conduction, or morphology of resting electrocardiogram iii) Any factors that increase
             the risk of QTc prolongation or risk of arrhythmic events

          5. Any concurrent and/or other active malignancy that has required treatment within 2
             years of first dose of investigational product (IP).

          6. Any unresolved toxicities from prior extracranial therapy.

          7. Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to
             swallow the formulated product, or previous significant bowel resection that would
             preclude adequate absorption of osimertinib.

          8. More than 4 weeks elapsed since last dose of osimertinib by date of randomization.

          9. Unable to tolerate osimertinib 80 mg first-line therapy.

         10. Prior treatment with any systemic anti-cancer therapy.

         11. Major surgery within 4 weeks of the first dose of IP.

         12. Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of
             radiation within 4 weeks of the first dose of IP.

         13. Current use of medications or herbal supplements known to be strong inducers of
             cytochrome P450 (CYP) 3A4.

         14. Participation in another clinical study with an IP other than first-line osimertinib.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression free survival (PFS): time from randomization until progression (intracranial or extracranial, whichever occurs first) per RECIST 1.1 (for extracranial progression) and CNS RECIST 1.1 (for intracranial progression)
Time Frame:At Screening,every 6 weeks for the first 13 cycles (each cycle is 21 days),then every 12 weeks, relative to randomization,and upto intracranial or extracranial disease progression or end of survival follow-up,whichever comes first (approximately 3 years)
Safety Issue:
Description:To compare the efficacy of chemotherapy plus osimertinib treatment relative to chemotherapy plus placebo based on PFS

Secondary Outcome Measures

Measure:Intracranial PFS is defined as time from randomization until intracranial progression per CNS RECIST 1.1 as assessed by the Investigator at local site or death due to any cause
Time Frame:At Screening,every 6 weeks for the first 13 cycles (each cycle is 21 days),then every 12 weeks, relative to randomization,and upto intracranial or extracranial disease progression or end of survival follow-up,whichever comes first (approximately 3 years)
Safety Issue:
Description:To compare the efficacy of chemotherapy plus osimertinib treatment relative to chemotherapy plus placebo based on intracranial PFS in patients with baseline brain metastases and patients without baseline brain metastases
Measure:Extracranial PFS is defined as time from randomization until extracranial progression per RECIST 1.1 as assessed by the Investigator at local site or death due to any cause
Time Frame:At Screening,every 6 weeks for the first 13 cycles (each cycle is 21 days),then every 12 weeks, relative to randomization,and upto intracranial or extracranial disease progression or end of survival follow-up,whichever comes first (approximately 3 years)
Safety Issue:
Description:To compare the efficacy of chemotherapy plus osimertinib treatment relative to chemotherapy plus placebo based on extracranial PFS
Measure:OS: the length of time from randomization until the date of death due to any cause
Time Frame:At Screening,every 6 weeks for the first 13 cycles (each cycle is 21 days),then every 12 weeks, relative to randomization,and upto intracranial or extracranial disease progression or end of survival follow-up,whichever comes first (approximately 3 years)
Safety Issue:
Description:To compare the efficacy of chemotherapy plus osimertinib treatment relative to chemotherapy plus placebo based on OS
Measure:Number of patients with serious and non-serious adverse events
Time Frame:From screening through post progression survival follow-up (at least once every 12 weeks relative to randomization)
Safety Issue:
Description:To assess the safety and tolerability of chemotherapy plus osimertinib treatment relative to chemotherapy plus placebo in patients with metastatic EGFRm NSCLC who have progressed extracranially on first line osimertinib treatment

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:AstraZeneca

Trial Keywords

  • Osimertinib
  • Platinum
  • Pemetrexed
  • Epidermal growth factor receptor mutation positive (EGFRm)
  • Extracranial progression

Last Updated

July 21, 2021