E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Locally advanced or metastatic Non small cell lung cancer (NSCLC) without predominantly squamous cell histology |
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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 | 10066490 |
E.1.2 | Term | Progression of non small cell lung cancer |
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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 demonstrate an improvement in survival for the combination of ZD4054 plus pemetrexed compared to pemetrexed alone in patients with locally advanced or metastatic NSCLC without predominantly squamous histology after failure of first line anti-cancer therapy. |
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E.2.2 | Secondary objectives of the trial |
(i) The efficacy of ZD4054 in combination with pemetrexed versus pemetrexed alone for the treatment of patients with NSCLC who have failed first line cancer therapy by the assessment of disease progression. Progression is defined as any of the following:
- Objective disease progression measured using Response Evaluation Criteria In Solid Tumours (RECIST) and/or clinical progression on or before the Mandatory Tumour Assessment Visit (MTAV)
- Death from any cause.
(ii) The safety and tolerability of ZD4054 in combination with pemetrexed for the treatment of NSCLC by review of adverse events and laboratory parameters
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of written informed consent. 2. Female or male aged 18 years or older. 3. Histologically or cytologically confirmed locally advanced or metastatic NSCLC on entry into study, where the histology is not predominantly of squamous type. 4. Patients requiring treatment that meet one of the following criteria: - Have progressed following one prior platinum-based chemotherapy regimen for locally advanced or metastatic disease; - Have progressed within 6 months of adjuvant platinum-based chemotherapy. 5. World Health Organisation (WHO) performance status 0-2. 6. Life expectancy of > 12 weeks. 7. Patient suitable for treatment with pemetrexed.
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E.4 | Principal exclusion criteria |
1. Prior treatment with pemetrexed in the last 12 months. 2. Prior therapy with an ET receptor antagonist. 3. Any recent surgery, unhealed surgical incision, severe concomitant medical condition (eg, unstable cardiac, hepatic or renal disease) or significant laboratory finding which, in the Investigator’s opinion, makes it undesirable for the patient to participate in the study or which would jeopardize compliance with the study protocol. 4. New York Heart Association Stage II, III or IV cardiac failure or myocardial infarction in the 6 months prior to randomisation. 5. Current or prior malignancy within previous 3 years (other than NSCLC or adequately treated basal cell or squamous cell carcinoma of the skin or in-situ carcinoma of the cervix). 6. Brain metastases or spinal cord compression unless treated and stable off steroids for 1 month. 7. History of past or current epilepsy, epilepsy syndrome or other seizure disorder. 8. Uncontrolled superior vena cava syndrome. 9. Any unresolved toxicity ≥ Common toxicology criteria (CTC) grade 2 from previous anticancer therapy (unless specified elsewhere within these criteria). 10. Less than 4 weeks since completion of prior radiotherapy to the primary tumour or persistence of any acute radiotherapy toxicity. 11. Corrected QT interval (QTc) > 470 msec using Bazett’s formula. 12. Patients with factors that increase risk of QTc prolongation or arrhythmic events such as heart failure, hypokalaemia, family history of long QT syndrome or any concomitant medication known to prolong QTc. 13. Any of the following laboratory values: - Total bilirubin > 1.5 x upper limit of normal (ULN) unless patient has confirmed Gilbert’s syndrome. - Either alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 x ULN or alkaline phosphatase (ALP) > 3 x ULN if no demonstrable liver metastases or ALT or AST or ALP > 5 x ULN in the presence of liver metastases. - Platelets < 100 x 10 to the power of 9 /L; - Haemoglobin < 9 g/dL despite transfusion; - Absolute neutrophil count (ANC) < 1.5 x 10 to the power of 9 /L; - Creatinine clearance ≤ 50 mL/min determined using either the Cockcroft and Gault equation or with a 24-hour urine collection. - Presence of clinically significant blood or protein in urine sample. 14. Use of drugs that are potent inducers of CYP450 (eg, phenytoin, rifampicin, carbamazepine, phenobarbitone, St John’s Wort) within 2 weeks of randomisation. Dexamethasone, a known inducer of CYP2D6 and CYP3A4, may be used as premedication for pemetrexed. 15. Use of systemic retinoids within 2 weeks of randomisation. 16. History of hypersensitivity to active or inactive excipients of any study medication (ZD4054/placebo, polysorbate 80, pemetrexed) or family history of hypersensitivity to ET receptor antagonists. 17. Pregnancy, breastfeeding or women of child-bearing potential not using an effective method of birth control 18. Involvement in the planning and conduct of the study (applies to both AstraZeneca staff, staff at the study site or representatives of AstraZeneca). 19. Previous enrolment or randomisation of treatment in the present study. 20. Known risk of transmitting human immunodeficiency virus or Hepatitis B or C via infected blood.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary outcome variable is time to death (TTD). |
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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 | Information not present in EudraCT |
E.6.7 | Pharmacodynamic | Yes |
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 | 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) | 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 | 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.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 12 |
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 | 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
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The end of the study will be data cut-off for survival estimated to be 12 months after the last patient is randomised, following which no further data are expected on the clinical database. |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 10 |