E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Locally Advanced or Metastatic (Stage IIIb/IV) Non Small Cell Lung Cancer. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10025052 |
E.1.2 | Term | Lung cancer non-small cell stage III |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029522 |
E.1.2 | Term | Non-small cell lung cancer stage IV |
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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 determine the efficacy of cediranib (30 mg) when added to gemcitabine and cisplatin compared to the efficacy of placebo when added to gemcitabine and cisplatin by assessment of progression free survival (PFS). |
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E.2.2 | Secondary objectives of the trial |
1. To determine the efficacy of cediranib (30 mg) when added to gemcitabine and cisplatin compared to the efficacy of placebo when added to gemcitabine and cisplatin by assessment of overall survival (OS), overall response rate (ORR) and duration of response. 2. To determine the safety and tolerability of cediranib (30 mg) when added to gemcitabine and cisplatin compared to placebo when added to gemcitabine and cisplatin. 3. To determine the effects on disease-related symptoms (dyspnoea, pain and cough from EORTC QLQ-C30 and EORTC QLQ-LC13) of cediranib when added to gemcitabine and cisplatin, compared to placebo when added to gemcitabine and cisplatin.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of informed consent 2. Male or female aged 18 years and older 3. Histological or cytological confirmation of locally advanced or metastatic non-small cell lung cancer (NSCLC) on entry into the study. 4. Patients with stage IIIb/IV NSCLC who are not candidates for combined modality treatment with chemotherapy and radiotherapy. 5. No prior systemic therapy for metastatic or recurrent NSCLC except prior adjuvant therapy for completely resected disease, providing completed at least 12 months prior to randomisation 6. World Health Organisation (WHO) performance status 0-1 7. Life expectancy > 12 weeks 8. One or more measurable lesions at least 10 mm in the longest diameter by spiral computed tomography (CT) scan or 20 mm with conventional techniques (RECIST criteria) 9. Patients considered by the Investigator to be suitable for orally administered treatment
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E.4 | Principal exclusion criteria |
1. Mixed small cell and non small cell lung cancer histology 2. Prior treatment with chemotherapy or other systemic anti-cancer therapy including adjuvant therapy within 12 months prior to study entry 3. CTC grade 2 or greater pre-existing motor or sensory neuropathy 4. Known hypersensitivity to cediranib and any of its excipients 5. Known hypersensitivity to gemcitabine or cisplatin and any of their excipients 6. Prior therapy with monoclonal antibodies or small molecule inhibitors against VEGF and VEGF receptors including bevacizumab and cediranib 7. Prior radiation therapy ≤28 days prior to randomisation on the study, except palliative radiotherapy 8. Serum creatinine ≥ institutional normal upper limit, or a creatinine clearance of ≤ 60 ml/min calculated by Cockcroft-Gault 9. Untreated unstable brain or meningeal metastases. Patients with radiological evidence of stable brain metastases are eligible providing that they are asymptomatic and either do not require corticosteroids or have been treated with corticosteroids, with clinical and radiological evidence of stabilisation at least 10 days after discontinuation of steroids 10. Inadequate bone marrow reserve as demonstrated by an absolute neutrophil count ≤1.5 x 10(to power 9)/L or platelet count ≤100 x 10(to power 9)/L or requiring regular blood transfusions to maintain haemoglobin >9g/dL 11. Serum bilirubin ≥ 1.5 x ULRR (except for patients with known documented cases of Gilbert’s syndrome) 12. Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) ≥ 2.5 x ULRR. If liver metastases are present, ALT or AST > 5 x ULRR 13. Greater than +1 proteinuria on two consecutive dipsticks taken no less than 1 week apart unless urinary protein < 1.5g in a 24 hour period 14. History of significant gastrointestinal impairment, as judged by the Investigator, that would significantly affect the absorption of cediranib, including the ability to swallow the tablet whole 15. Patients with a history of poorly controlled hypertension with resting blood pressure >150/100 mmHg in the presence or absence of a stable regimen of anti-hypertensive therapy, or patients who are requiring maximal doses of calcium channel blockers to stabilise blood pressure 16. Any evidence of severe or uncontrolled diseases e.g. unstable or uncompensated respiratory, cardiac, hepatic or renal disease 17. Unresolved toxicity > CTC grade 1 from previous anti-cancer therapy (including radiotherapy) except haematological toxicity (see criteria 10) and alopecia (if applicable) 18. Mean QTc with Bazetts correction >470msec in screening ECG or history of familial long QT syndrome 19. Significant haemorrhage (>30mL bleeding/episode in previous 3 months) or haemoptysis (>5mL fresh blood in previous 4 weeks) 20. Recent (<14 days) major thoracic or abdominal surgery prior to entry into the study, or a surgical incision that is not fully healed 21. Pregnant or breast-feeding women or women of childbearing potential with a positive pregnancy test prior to receiving study medication 22. History of other malignancies (except for adequately treated basal or squamous cell carcinoma or carcinoma in situ) within 5 years, unless the patient has been disease free for 2 years and there is a tissue diagnosis of the primary cancer of interest from a target lesion 23. Known risk of the patient transmitting Human Immunodeficiency Virus (HIV), hepatitis B or C via infected blood 24. Involvement in the planning and conduct of the study (applies to both AstraZeneca staff or staff at the study site) 25. Previous enrolment or randomisation of treatment in the present study. 26. Treatment with an investigational (non-registered) drug within 30 days prior to the first dose of cediranib 27. Other concomitant anti-cancer therapy (including lutenising hormone-releasing hormone [LHRH] agonists) except steroids
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E.5 End points |
E.5.1 | Primary end point(s) |
The end of the study is defined as the latest of the date out of when all the patients have permanently discontinued study treatment or when 442 deaths have been observed. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Information not present in EudraCT |
E.6.2 | Prophylaxis | Information not present in EudraCT |
E.6.3 | Therapy | Information not present in EudraCT |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Information not present in EudraCT |
E.6.7 | Pharmacodynamic | Information not present in EudraCT |
E.6.8 | Bioequivalence | Information not present in EudraCT |
E.6.9 | Dose response | Information not present in EudraCT |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Information not present in EudraCT |
E.6.12 | Pharmacoeconomic | Information not present in EudraCT |
E.6.13 | Others | Information not present in EudraCT |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | Information not present in EudraCT |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
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 | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
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.8.5.1 | Number of sites anticipated in the EEA | 110 |
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 | Yes |
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 the study is defined as the latest of the date out of when all the patients have permanently discontinued study treatment or when 442 deaths have been observed. |
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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 | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |