E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Non-small cell lung cancer |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to demonstrate an improvement in PFS in the combination of ZACTIMA with docetaxel compared with docetaxel plus placebo in patients with locally advanced or metastatic NSCLC after failure of 1st line anti-cancer therapy |
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E.2.2 | Secondary objectives of the trial |
To demonstrate, for ZACTIMA in combination with docetaxel compared with docetaxel plus placebo:
- An improvement in overall survival - An improvement in the overall objective response rate (ORR) (complete response [CR] + PR), disease control rate (DCR) (CR + PR + Stable Disease [SD] ≥6 weeks) and duration of response (DOR) using modified RECIST - A beneficial effect on disease-related symptoms based on the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) lung cancer subscale (LCS) - A quality of life (QoL) by assessment of the FACT-L and the Trial Outcome Index (TOI) - An improvement in time to deterioration of disease-related symptoms (TDS) based on the FACT-L LCS
To study, in this patient population: - the tolerability and safety, - the population pharmacokinetics - the PK-QTc relationship, - PK-safety relationship - PK-efficacy relationship - Plasma levels of the N-desmethyl and N-oxide metabolites
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
1. Provision of informed consent
2. Female or male aged 18 years and over
3. Histologic or cytologic confirmation of locally advanced or metastatic NSCLC (IIIb-IV) on entry into study
4. Failure of 1 st line anti-cancer therapy (either radiological documentation of disease progression or due to toxicity) or subsequent relapse of disease following first line therapy
5. WHO PS 0 – 1
6. One or more measurable lesions at least 10 mm in the longest diameter (LD) by spiral CT scan or 20 mm with conventional techniques according to RECIST criteria
7. Negative pregnancy test for women of childbearing potential
8. Life expectancy of 12 weeks or longer |
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E.4 | Principal exclusion criteria |
1. Mixed small cell and non-small cell lung cancer histology
2. Patients who have received second-line anti-cancer therapy
3. Prior treatment with docetaxel (prior treatment with paclitaxel is acceptable)
4. Prior treatment with VEGFR TKIs (previous treatment with bevacizumab [Avastin] is permitted)
5. The last dose of prior chemotherapy or other anti-cancer therapy is discontinued less than 4 weeks before the start of study therapy (6 weeks for nitrosoureas, mitomycin, and suramin)
6. The last radiation therapy within 4 weeks before the start of study therapy, not including local palliative radiation
7. Major surgery within 4 weeks, or incompletely healed surgical incision
8. Any unresolved toxicity > CTCAE grade 2 from previous anti-cancer therapy
9. Neutrophils <1.5 x 10e9 /L or platelets <100 x 10 e9 /L
10. Serum bilirubin greater than upper limit of reference range (ULRR)
11. Creatinine clearance < 30ml/min ((calculated by Cockcroft-Gault formula)
12. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >1.5 x ULRR or alkaline phosphatase >2.5 x ULRR
13. Significant cardiovascular event (eg. myocardial infarction, superior vena cava [SVC] syndrome, New York Heart Association [NYHA] classification of heart disease 2 [See Appendix L]) within 3 months before entry, or presence of cardiac disease that in the opinion of the Investigator increases the risk of ventricular arrhythmia
14. History of arrhythmia (multifocal premature ventricular contractions [PVCs], bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial fibrillation) which is symptomatic or requires treatment (CTCAE grade 3) or asymptomatic sustained ventricular tachycardia. Atrial fibrillation, controlled on medication is not excluded.
15. Congenital long QT syndrome or 1st degree relative with unexplained sudden death under 40 years of age
16. QT prolongation with other medications that required discontinuation of that medication
17. Presence of left bundle branch block (LBBB)
18. QTc with Bazett’s correction unmeasurable or ≥480 msec on screening ECG (Note: If a patient has QTc interval > or = 480 msec on screening ECG, the screen ECG may be repeated twice [at least 24 hours apart]. The average QTc from the three screening ECGs must be <480 msec in order for the patient to be eligible for the study. Subjects who are receiving a drug that has a risk of QTc prolongation (see Appendix D, Table 2) are excluded if the screening QTc is ≥460 msec.
19. Potassium <4.0 mmol despite supplementation; serum calcium (ionized or adjusted for albumin), or magnesium out of normal range despite supplementation
20. Women who are pregnant or breast feeding
21. Any concomitant medications that may cause QTc prolongation or induce Torsades de Pointes (see Appendix D for the lists of medications in Table 1 & Table 2) or induce CYP3A4 function (see Section 3.7.2) within 2 weeks of start of study treatment. Drugs listed in Appendix D, Table 2, that in the Investigator’s opinion cannot be discontinued, are allowed (additional criteria must also be met - see Exclusion Criteria #18).
22. Brain metastases or spinal cord compression, unless treated at least 4 weeks before entry, and stable without steroid treatment for 10 days
23. Hypertension not controlled by medical therapy (systolic blood pressure greater than 160 millimeter of mercury [mmHg] or diastolic blood pressure greater than 100 mmHg)
24. Previous or current malignancies of other histologies within the last 5 years, with the exception of in situ carcinoma of the cervix and adequately treated basal cell or squamous cell carcinoma of the skin
25. Evidence of severe or uncontrolled systemic disease or any concurrent condition which in the Investigator’s opinion makes it undesirable for the patient to participate in the trial or which would jeopardize compliance with the protocol
26. Previous randomization in the present study
27. Involvement in the planning and conduct of the study (applies to both AstraZeneca staff or staff at the investigational site)
28. Treatment with a non-approved or investigational drug within 30 days before Day 1 of study treatment
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of study will be declared once a program has been established that allows all remaining patients still receiving ZACTIMA study treatment to receive open-label supplies after the final analysis of the trial has occurred. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 6 |