E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
advanced NSCLC of Stage IIIb or IV undergoing first line chemotherapy |
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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 |
To assess the progression free survival (PFS) in patients with advanced NSCLC of Stage IIIb or IV undergoing first line chemotherapy with pemetrexed in combination with cisplatin or carboplatin. Patients will be randomized to one of the above regimens in a 1:1 ratio. |
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E.2.2 | Secondary objectives of the trial |
to assess the following parameters of either treatment arm: • Overall survival including 1-year survival rate • Objective response rate (according to RECIST criteria) • Time to treatment failure • To characterize the quantitative and qualitative potential toxicities, and the necessity of dose reductions and cycle delays due to toxicities of both treatment regimens. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
[1] Cytologically and/or histologically confirmed NSCLC Stage IIIb or IV according to Protocol Attachment S109.3, American Joint Committee on Cancer Staging Criteria for Lung Cancer (Fleming et al. 1997). [2] No previous systemic chemotherapy for this cancer. Previous adjuvant therapy is allowed if it has been more than one year since the end of adjuvant therapy. [3] At least one unidimensionally measurable lesion meeting Response Evaluation Criteria in Solid Tumors (RECIST; Therasse et al. 2000), at least 10 mm in longest diameter with spiral computed tomography (CT) scan, or at least 20 mm with conventional techniques. Positron emission tomography (PET) scans and ultrasounds may not be used. [4] ECOG Performance status of 0 or 1 (Protocol Attachment S109.4). [5] Adequate organ function including the following: Adequate bone marrow reserve: absolute neutrophil (segmented and bands) count (ANC) 1.5 109/L, platelets 100 109/L, and hemoglobin 9 g/dL. Hepatic: bilirubin 1.5 times the upper limit of normal ( ULN), alkaline phosphatase (AP), aspartate transaminase (AST) and alanine transaminase (ALT) 3.0 ULN. Exception: AP, AST, ALT .0 ULN is acceptable only in case of tumor involvement of the liver. Renal: calculated creatinine clearance (CrCl) 45 mL/min based on the standard Cockroft and Gault formula (Protocol Attachment S109.5). [6] Prior radiation therapy allowed but limited to < 25% of the patient’s bone marrow (Cristy and Eckerman 1987). Previous radiation must not have included whole pelvis radiation, and must be completed 30 days before study entry. [7] For women: Must be surgically sterile, post-menopausal, or compliant with a medically approved contraceptive regimen during and for 6 months after the treatment period; must have a negative serum or urine pregnancy test within 7 days before study enrollment and must not be lactating. For men: Must be surgically sterile, or compliant with a contraceptive regimen during and for 6 months after the treatment period. [8] Estimated life expectancy of at least 12 weeks. [9] Patient’s compliance and geographic proximity that allow adequate follow-up. [10] Signed informed consent document. [11] At least 18 years of age. |
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E.4 | Principal exclusion criteria |
[12] Have received treatment within the last 30 days with a drug that has not received regulatory approval for any indication at the time of study entry. [13] Have previously completed or withdrawn from this study or any other study investigating pemetrexed. [14] Have a serious concomitant systemic disorder (eg, active infection including HIV, or cardiac disease) that, in the opinion of the investigator, would compromise the patient’s ability to complete the study. [15] Have an active infection (≥38.5ºC fever and/or receiving intravenous antibiotic therapy). [16] A significant cardiovascular disease in terms of an abnormal electrocardiogram (ECG) coupled with clinical signs of recent or recurrent cardiac disease (including myocardial infarction within the last 6 months, angina or uncontrolled hypertension), or heart disease as defined by the New York Heart Association Class III or IV. [17] Patient with mild to moderate renal insufficiency who are unable to interrupt salicylates (like aspirin) or other nonsteroidal anti-inflammatory drugs (NSAIDs) for a 5-day period starting 2 days before administration of pemetrexed (8-day period for long-acting agents such as piroxicam). Exception: Low dose aspirin (acetyl salicylic acid) intake up to 150 mg per day is permitted without interruption. For details regarding concomitant therapy with NSAIDs and aspirin refer to Section 5.7.2 . [18] A second primary malignancy that is clinically detectable at the time of consideration for study enrollment. [19] Any symptomatic central nervous system (CNS) metastases requiring concurrent corticosteroid therapy. Treated stable CNS metastases are allowed; the patient must be stable after radiotherapy for ≥2 weeks and off corticosteroids for ≥1 week. [20] Presence of clinically significant third-space fluid collections, for example, ascites or pleural effusions that cannot be controlled by drainage or other procedures. [21] Significant weight loss (that is, ≥10%) over the 6 week period prior to study entry. [22] Concurrent administration of any other antitumor therapy. [23] Have had recent (within 30 days of study treatment) or concurrent yellow fever vaccination. [24] Inability or unwillingness to take folic acid, vitamin B12 supplementation or dexamethasone (or equivalent corticosteroid); or any other inability to comply with protocol or study related procedures. [25] Pregnant or breast feading
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E.5 End points |
E.5.1 | Primary end point(s) |
progression free survival (PFS) |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
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 | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Yes |
E.8.2.2 | Placebo | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 15 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
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
|
End of study (trial) is the date of the last patient visit shown in the Study Schedule of the last subject active in the study. This Phase 2 study will be considered complete following final validation and authorization to “lock” the database. Lilly physician will notify investigators in the event of study closure and the decision to stop collecting data. |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |