E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Locally Advanced, Unresectable Non-Small Cell Lung Cancer (Stage III) |
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E.1.1.1 | Medical condition in easily understood language |
Non-Small Cell Lung Cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066490 |
E.1.2 | Term | Progression of non-small cell lung cancer |
E.1.2 | System Organ Class | 100000004864 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029514 |
E.1.2 | Term | Non-small cell lung cancer NOS |
E.1.2 | System Organ Class | 100000004864 |
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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 assess the efficacy of MEDI4736 treatment compared with placebo in terms of OS and PFS |
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E.2.2 | Secondary objectives of the trial |
- To further assess the efficacy of MEDI4736 compared with placebo in terms of: OS24, ORR, DoR, APF12, APF18, PFS2, TTR and TTDM.
- To assess the safety and tolerability profile of MEDI4736 compared with placebo
- To assess symptoms and health-related quality of life in patients treated with MEDI4736 compared with placebo |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Pharmacogenetics Research |
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E.3 | Principal inclusion criteria |
1. Provision of signed, written and dated informed consent prior to any study specific procedures
2. Male or female aged 18 years or older
3. Patients must have histologically- or cytologically-documented NSCLC who present with locally advanced, unresectable (Stage III) disease
4. Patients must have received at least 2 cycles of platinum-based chemotherapy concurrent with radiation therapy.
5. Patients must have not progressed following definitive, platinumbased, concurrent chemoradiation therapy.
6. Provision of an archived tumour tissue block where such samples exist in a quantity sufficient to allow for analysis.
7. Life expectancy ≥12 weeks
8. World Health Organization (WHO) Performance Status of 0 or 1
9. Evidence of post-menopausal status, or negative urinary or serum pregnancy test for female pre-menopausal patients.
10. Adequate organ and marrow function |
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E.4 | Principal exclusion criteria |
1. Participation in another clinical study with an investigational product during the last 4 weeks
2. Concurrent enrolment in another clinical study, unless it is an observational (non-interventional) clinical study or the follow-up period of an interventional study
3. Mixed small cell and non-small cell lung cancer histology
4. Receipt of sequential chemoradiation therapy for locally advanced NSCLC
5. Patients with locally advanced NSCLC who have progressed whilst receiving definitive platinum based, concurrent chemoradiation therapy
6. Receipt of any immunotherapy, or investigational drug within 4 weeks prior to the first dose of study drug
7. Current or prior use of immunosuppressive medication within 28 days before the first dose of study drug, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid. Systemic steroid administration required as prophylaxis against or to manage toxicities arising from chemotherapy and/or radiation therapy delivered as part of the chemoradiation therapy for locally advanced NSCLC is allowed.
8. Prior exposure to any anti-PD-1 or anti-PD-L1 antibody
9. Any unresolved toxicity CTCAE >Grade 2 from the prior chemoradiation therapy.
10. Patients with irreversible toxicity that is not reasonably expected to be exacerbated by study drug may be included (eg, hearing loss) after consultation with the AstraZeneca/MedImmune medical monitor.
11. Patients with > or equal grade 2 pneumonitis from prior chemoradiation therapy
12. Any concurrent chemotherapy, immunotherapy, biologic or hormonal therapy for cancer treatment.
13. Recent major surgery within 4 weeks
14. Active or prior documented autoimmune disease within the past 2 years, except for: Vitiligo, Grave's disease, or psoriasis not requiring systemic treatment
15. Active or prior documented inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis)
16. History of primary immunodeficiency
17. History of allogeneic organ transplant
18. History of hypersensitivity to MEDI4736 or any excipient
19. Uncontrolled intercurrent illness
20. Receipt of live attenuated vaccination within 30 days prior to study entry or within 30 days of receiving study drug.
21. History of another primary malignancy within 5 years prior to starting study drug, except for adequately treated in situ malignancies such as basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study
22. Female patients who are pregnant, breast-feeding or male or female patients of reproductive potential who are not employing an effective method of birth control
23. Any condition that, in the opinion of the investigator, would interfere with evaluation of the study drug or interpretation of patient safety or study results.
24. Either Previous drug assignment in the present study or Prior randomisation or treatment in a previous durvalumab (MEDI4736) and/or tremelimumab clinical study regardless or treatment arm assignment. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Both Progression free survival (PFS) and Overall survival (OS) are co-primary endpoints.
OS - Overall Survival is defined as the time from the date of randomization until death due to any cause.
PFS - Progression-Free Survival is defined as the time from randomization until the date of objective disease progression or death. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The interim PFS analysis will be done at approx. 27 months, the primary PFS analysis and interim OS analysis will be done at approx. 36 months, the primary OS analysis will be done at approx. 62 months.
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E.5.2 | Secondary end point(s) |
- Proportion of patients alive at 24 months from randomization (OS24)
- Objective response rate (ORR). Defined as the number (%) of patients with at least 1 visit response of CR (Complete response) or PR (Partial response) and will be based on all randomised patients who have measurable disease. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Analysis of OS24 and ORR will be done at approx. 36 and 62 months. |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
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.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 83 |
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 | No |
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 |
Argentina |
Australia |
Brazil |
Canada |
Chile |
European Union |
Japan |
Korea, Republic of |
Mexico |
Peru |
Philippines |
Singapore |
South Africa |
Taiwan |
Thailand |
Turkey |
United States |
Vietnam |
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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
|
The study will continue until all analyses for long term PFS/OS benefit are complete and those patients who have been in OS and PFS follow-up for approximately 5 years will be considered to have completed the study. |
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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 | 7 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |