E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with resectable Non-small Cell Lung Cancer (Stage IIA to IIIB; either squamous or non-squamous) |
Pacjenci z operacyjnym niedrobnokomórkowym rakiem płuc (faza IIA do IIIB płaskonabłonkowym lub niepłaskonabłonkowym) |
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E.1.1.1 | Medical condition in easily understood language |
Patients with "non-small cell lung cancer" (NSCLC) at a specific stage (Stage IIA to IIIB) |
Pacjenci z niedrobnokomórkowym rakiem płuc (NDRP) w określonej fazie (faza IIA do IIIB) |
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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 | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 compare the efficacy of durvalumab + chemotherapy administered prior to surgery followed by durvalumab post-surgery compared with placebo + chemotherapy administered prior to surgery followed by placebo post-surgery in terms of EFS To compare the activity of durvalumab + chemotherapy administered prior to surgery compared with placebo + chemotherapy administered prior to surgery in terms of pCR |
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E.2.2 | Secondary objectives of the trial |
- To compare the efficacy of perioperative durvalumab + neoadjuvant - chemotherapy compared with placebo + neoadjuvant chemotherapy in terms of DFS - To compare the efficacy of perioperative durvalumab + neoadjuvant chemotherapy compared with placebo + neoadjuvant chemotherapy in terms of MPR - To compare the efficacy of perioperative durvalumab + neoadjuvant chemotherapy compared with placebo + neoadjuvant chemotherapy in terms of OS - To compare the efficacy of perioperative durvalumab + neoadjuvant chemotherapy compared with placebo + neoadjuvant chemotherapy in patients with PD-L1 TC ≥1% tumors in terms of EFS, pCR, DFS, MPR and OS - To assess disease-related symptoms and HRQOL in patients treated with perioperative durvalumab + neoadjuvant chemotherapy compared with placebo + neoadjuvant chemotherapy - To assess the PK and immunogenicity of durvalumab |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age ≥18 years 2. Newly diagnosed and previously untreated patients with histologically or cytologically documented NSCLC with resectable (Stage IIA to select [ie, N2] Stage IIIB) disease 3. World Health Organization (WHO)/ECOG PS of 0 or 1 at enrollment 4. At least 1 lesion, not previously irradiated, that qualifies as a RECIST 1.1 Target Lesion (TL) at baseline 5. No prior exposure to immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies, excluding therapeutic anticancer vaccines. 6. Adequate organ and marrow function 7. Confirmation of a patients tumour PD-L1 status 8. Provision of sufficient tumour biopsy sample for evaluation and confirmation of EGFR and ALK status 9. Planned surgery to be performed need to include lobectomy, sleeve resection or bilobectomy. 10. A pre- or post-bronchodilator FEV of 1.0 L and >40% post-operative predicted value. |
1. Wiek ≥18 lat 2. Nowo zdiagnozowani lub wcześniej nieleczeni pacjenci z udokumentowanym histologicznie lub cytologicznie operacyjnym NDRP (stopień zaawansowania IIA do wybranych przypadków [tj. N2] IIIB) 3. Stan sprawności (PS) w skali Światowej Organizacji Zdrowia (WHO) /ECOG musi wynosić 0 lub 1 w chwili włączenia do badania 4. Co najmniej jedna zmiana, która nie była wcześniej naświetlana i która została sklasyfikowana jako zmiana docelowa wg kryteriów RECIST 1.1 podczas oceny wyjściowej. 5. Niestosowanie wcześniej leczenia immunologicznego, w tym w szczególności innych przeciwciał anty CTLA 4, anty PD-1, anty PD-L1 i anty PD-L2, z wyłączeniem leczniczych szczepionek przeciwnowotworowych 6. Wydolna czynność narządów i szpiku kostnego 7. Potwierdzony status ekspresji PD-L1 8. Dostarczenie wystarczającej próbki biopsji do oceny i potwierdzenia statusu receptora naskórkowego czynnika wzrostu (EGFR) i kinazy chłoniaka anaplastycznego (ALK) 9. Planowana operacja musi obejmować lobektomię, resekcję rękawową lub bilobektomię. 10. FEV przed lub po leku rozszerzającym oskrzela o wartości 1,0 L oraz > 40% przewidywanej wartości pooperacyjnej. |
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E.4 | Principal exclusion criteria |
1. History of allogeneic organ transplantation 2. Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease, diverticulitis, systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome). 3. History of another primary malignancy 4. History of active primary immunodeficiency 5. Active infection including tuberculosis hepatitis B and C, or human immunodeficiency virus 6. Deemed unresectable NSCLC by multidisciplinary evaluation 7. Patients who have pre-operative radiotherapy treatment as part of their care plan 8. Patients who have brain metastases or spinal cord compression 9. Stage IIIB N3 and Stages IIIC, IVA, and IVB NSCLC 10. Known allergy or hypersensitivity to any of the study drugs or excipients 11. Existence of more than one primary tumour such as mixed small cell and NSCLC histology 12. Patients who are candidates to undergo only pneumonectomy, segmentectomies or wedge resections. 13. Patients with a documented test result confirming the presence of EGFRm or ALK translocation. |
1. Stan po allogenicznym przeszczepieniu narządu 2. Udokumentowane aktywne lub wcześniej przebyte choroby autoimmunologiczne lub zapalne (w tym choroba zapalna jelit, zapalenie uchyłków, toczeń rumieniowaty układowy, sarkoidoza lub zespół Wegenera) 3. Inny pierwotny nowotwór złośliwy w wywiadzie 4. Aktywny pierwotny niedobór immunologiczny w wywiadzie 5. Aktywne zakażenie, w tym gruźlica, wirusowe zapalenie wątroby typu B lub C lub ludzkim wirusem niedoboru odporności 6. NDRP uznany za nieoperacyjny na podstawie oceny wielodyscyplinarnej 7. Pacjenci poddawani radioterapii przedoperacyjnej w ramach planu opieki 8. Pacjenci z przerzutami do mózgu lub uciskiem na rdzeń kręgowy 9. NDRP w stopniu zaawansowania IIIB N3 oraz IIIC, IVA i IVB 10. Znana alergia lub nadwrażliwość na którykolwiek z badanych leków lub substancję pomocniczą 11. Obecność więcej niż jednego guza pierwotnego, takiego jak mieszany drobnokomórkowy i niedrobnokomórkowy rak płuca 12. Pacjenci, którzy są kandydatami wyłącznie do przeprowadzenia pneumonektomii, segmentektomii lub resekcji klinowej 13. Pacjenci z udokumentowanym wynikiem badania potwierdzającym obecność mutacji EGFR lub translokacji genu ALK |
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E.5 End points |
E.5.1 | Primary end point(s) |
Event-free Survival (EFS) and pathological Complete Response (pCR) in modified intent-to-treat (mITT). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
approximately 7 months after last patient randomized and up to 5.5 years after FSR |
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E.5.2 | Secondary end point(s) |
1. DFS in the modified resected population 2. mPR (≤10% viable tumour cells in lung primary tumour after complete evaluation in the resected lung cancer specimen) 3. OS 4. EFS, pCR, DFS, mPR, OS in the population with PD-L1 TC ≥1%. 5. Change from baseline in Patient reported outcomes and time to deterioration 6. Concentration of durvalumab 7. Presence of ADAs for durvalumab |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
approximately 5.5 years after last patient randomized |
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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 | 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) | 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.8.4.1 | Number of sites anticipated in Member State concerned | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 75 |
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 |
Chile |
Costa Rica |
Peru |
Philippines |
Taiwan |
Brazil |
Canada |
China |
India |
Japan |
Korea, Republic of |
Mexico |
Russian Federation |
Thailand |
United States |
Viet Nam |
Austria |
Belgium |
Bulgaria |
France |
Germany |
Hungary |
Italy |
Netherlands |
Poland |
Romania |
Spain |
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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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LVLS |
LVLS (Last Visit Last Subject) |
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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 | 11 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 6 |