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    Clinical Trial Results:
    A Multicenter, Randomized, Open-Label, Phase 3 Trial Comparing Selpercatinib to Platinum-Based and Pemetrexed Therapy with or without Pembrolizumab as Initial Treatment of Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer

    Summary
    EudraCT number
    2019-001979-36
    Trial protocol
    DE   CZ   GR   FR   PL   NL   GB   ES   BE   IT   RO  
    Global end of trial date

    Results information
    Results version number
    v2(current)
    This version publication date
    07 Jul 2024
    First version publication date
    19 May 2024
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Revision to AE reporting group description requested per CTgov comment.

    Trial information

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    Trial identification
    Sponsor protocol code
    J2G-MC-JZJC
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04194944
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Trial Number: 17479
    Sponsors
    Sponsor organisation name
    Eli Lilly and Company
    Sponsor organisation address
    Lilly Corporate Center , Indianapolis, Estonia, 46285
    Public contact
    Available Mon - Fri 9 AM - 5 PM EST , Eli Lilly and Company , 1 877-CTLilly,
    Scientific contact
    Available Mon - Fri 9 AM - 5 PM EST , Eli Lilly and Company , 1 877‐285‐4559,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Interim
    Date of interim/final analysis
    01 May 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    01 May 2023
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    To compare PFS of LOXO-292 and platinum- based (carboplatin or cisplatin) and pemetrexed therapy with or without pembrolizumab in patients with advanced or metastatic RET fusion-positive NSCLC
    Protection of trial subjects
    This study was conducted in accordance with International Conference on Harmonization (ICH) Good Clinical Practice, and the principles of the Declaration of Helsinki, in addition to following the laws and regulations of the country or countries in which a study is conducted.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    17 Feb 2020
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy
    Long term follow-up duration
    48 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Hong Kong: 5
    Country: Number of subjects enrolled
    Russian Federation: 3
    Country: Number of subjects enrolled
    Korea, Republic of: 16
    Country: Number of subjects enrolled
    Brazil: 8
    Country: Number of subjects enrolled
    Argentina: 2
    Country: Number of subjects enrolled
    Japan: 25
    Country: Number of subjects enrolled
    Ukraine: 5
    Country: Number of subjects enrolled
    Canada: 3
    Country: Number of subjects enrolled
    Türkiye: 8
    Country: Number of subjects enrolled
    Taiwan: 6
    Country: Number of subjects enrolled
    Mexico: 5
    Country: Number of subjects enrolled
    Israel: 5
    Country: Number of subjects enrolled
    Australia: 4
    Country: Number of subjects enrolled
    China: 90
    Country: Number of subjects enrolled
    Netherlands: 3
    Country: Number of subjects enrolled
    Poland: 1
    Country: Number of subjects enrolled
    Spain: 16
    Country: Number of subjects enrolled
    Belgium: 6
    Country: Number of subjects enrolled
    Czechia: 1
    Country: Number of subjects enrolled
    France: 6
    Country: Number of subjects enrolled
    Germany: 9
    Country: Number of subjects enrolled
    Greece: 2
    Country: Number of subjects enrolled
    Italy: 32
    Worldwide total number of subjects
    261
    EEA total number of subjects
    76
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    157
    From 65 to 84 years
    102
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    If a participant has a recorded death on study, or is alive and being followed but off treatment, then the participant can be considered to be study completer.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Selpercatinib (TRT A)
    Arm description
    160 milligram (mg) Selpercatinib administered orally, twice daily (BID) continuously in 21-day cycles.
    Arm type
    Experimental

    Investigational medicinal product name
    Selpercatinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    160 milligram (mg) Selpercatinib administered orally, twice daily (BID) continuously in 21-day cycles.

    Arm title
    Pemetrexed and Platinum With or Without Pembrolizumab (TRT B)
    Arm description
    Pemetrexed 500 milligrams per meter squared (mg/m2) administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus at the investigator's choice of carboplatin area under the concentration versus time curve 5 (AUC 5 [maximum dose of 750 mg] IV), or cisplatin (75 mg/m2 cisplatin IV) on Day 1 Q3W for 4 cycles, plus investigator's choice with or without 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.
    Arm type
    Active comparator

    Investigational medicinal product name
    Pemetrexed
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Pemetrexed 500 mg/m2, IV on Day 1, every 3 Q3W

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Carboplatin AUC 5 (maximum dose of 750 mg) IV on Day 1 Q3W for 4 cycles.

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cisplatin 75 mg/m2, IV on Day 1 Q3W for 4 cycles.

    Investigational medicinal product name
    Pembrolizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    200 mg Pembrolizumab, IV on Day 1, Q3W up to 35 cycles.

    Number of subjects in period 1
    Selpercatinib (TRT A) Pemetrexed and Platinum With or Without Pembrolizumab (TRT B)
    Started
    159
    102
    Received at Leas One Dose of Study Drug
    158
    98
    Completed
    61
    70
    Not completed
    98
    32
         On Treatment
    93
    30
         Withdrawal by Subject
    2
    2
         Lost to follow-up
    3
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Selpercatinib (TRT A)
    Reporting group description
    160 milligram (mg) Selpercatinib administered orally, twice daily (BID) continuously in 21-day cycles.

    Reporting group title
    Pemetrexed and Platinum With or Without Pembrolizumab (TRT B)
    Reporting group description
    Pemetrexed 500 milligrams per meter squared (mg/m2) administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus at the investigator's choice of carboplatin area under the concentration versus time curve 5 (AUC 5 [maximum dose of 750 mg] IV), or cisplatin (75 mg/m2 cisplatin IV) on Day 1 Q3W for 4 cycles, plus investigator's choice with or without 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.

    Reporting group values
    Selpercatinib (TRT A) Pemetrexed and Platinum With or Without Pembrolizumab (TRT B) Total
    Number of subjects
    159 102 261
    Age categorical
    Units: Subjects
    Age continuous
    Intent to Treat Population (ITT): All randomized participants, even if a participant does not take the assigned treatment, does not receive the correct treatment, or otherwise does not follow the protocol.
    Units: years
        arithmetic mean (standard deviation)
    60.2 ( 11.3 ) 60.8 ( 11.4 ) -
    Gender categorical
    Units: Subjects
        Female
    86 57 143
        Male
    73 45 118
    Race
    Units: Subjects
        American Indian or Alaska Native
    2 1 3
        Asian
    92 52 144
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    2 0 2
        White
    58 43 101
        More than one race
    1 0 1
        Unknown or Not Reported
    4 6 10
    Region of Enrollment
    Units: Subjects
        Hong Kong
    4 1 5
        Russian Federation
    1 2 3
        Korea, Republic of
    8 8 16
        Brazil
    7 1 8
        Argentina
    2 0 2
        Japan
    15 10 25
        Ukraine
    0 5 5
        Canada
    2 1 3
        Turkiye
    8 0 8
        Taiwan
    2 4 6
        Mexico
    4 1 5
        Israel
    1 4 5
        Australia
    2 2 4
        China
    62 28 90
        Netherlands
    2 1 3
        Poland
    0 1 1
        Spain
    7 9 16
        Belgium
    3 3 6
        Czechia
    0 1 1
        France
    2 4 6
        Germany
    5 4 9
        Greece
    2 0 2
        Italy
    20 12 32

    End points

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    End points reporting groups
    Reporting group title
    Selpercatinib (TRT A)
    Reporting group description
    160 milligram (mg) Selpercatinib administered orally, twice daily (BID) continuously in 21-day cycles.

    Reporting group title
    Pemetrexed and Platinum With or Without Pembrolizumab (TRT B)
    Reporting group description
    Pemetrexed 500 milligrams per meter squared (mg/m2) administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus at the investigator's choice of carboplatin area under the concentration versus time curve 5 (AUC 5 [maximum dose of 750 mg] IV), or cisplatin (75 mg/m2 cisplatin IV) on Day 1 Q3W for 4 cycles, plus investigator's choice with or without 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.

    Subject analysis set title
    Pemetrexed with Pembrolizumab (TRT B)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    500 milligrams per meter squared (mg/m2) Pemetrexed administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus at the investigator's discretion, area under the concentration versus time curve 5 (maximum dose of 750 mg) carboplatin IV, or 75 mg/m2 cisplatin IV Day 1 Q3W for 4 cycles, and with 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.

    Subject analysis set title
    Pemetrexed With or Without Pembrolizumab (TRT B)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    500 mg/m2 Pemetrexed administered IV on Day 1, Q3W, plus at the investigator's discretion, area under the concentration versus time curve 5 (maximum dose of 750 mg) carboplatin IV, or 75 mg/m2 cisplatin IV Day 1, Q3W for 4 cycles, and with or without 200 mg pembrolizumab IV on Day 1, Q3W up to 35 cycles.

    Primary: Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) (With Pembrolizumab)

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    End point title
    Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) (With Pembrolizumab) [1]
    End point description
    PFS is defined as the time from randomization until the occurrence of documented disease progression by the BICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, or death from any cause in the absence of BICR-documented progressive disease. Analysis Population Description: Intent to Treat (ITT) Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. Participants censored: TRT A: 80, TRT B: 34.
    End point type
    Primary
    End point timeframe
    Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129 [2]
    83
    Units: Months
        median (confidence interval 95%)
    24.84 (16.89 to 9999)
    11.17 (8.77 to 16.76)
    Notes
    [2] - 9999 = N/A: Upper limit of 95% confidence interval is not evaluable due to high censoring.
    Statistical analysis title
    Selpercatinib, Pemetrexed with Pembrolizumab
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects included in analysis
    212
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0002
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.465
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.309
         upper limit
    0.699

    Primary: PFS by BICR (With or Without Pembrolizumab)

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    End point title
    PFS by BICR (With or Without Pembrolizumab) [3]
    End point description
    PFS is defined as the time from randomization until the occurrence of documented disease progression by the BICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, or death from any cause in the absence of BICR-documented progressive disease. APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received. Participants censored: TRT A: 98, TRT B:45.
    End point type
    Primary
    End point timeframe
    Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159 [4]
    102
    Units: Months
        median (confidence interval 95%)
    24.84 (17.31 to 9999)
    11.17 (8.77 to 16.76)
    Notes
    [4] - 9999 = N/A: Upper limit of 95% confidence interval is not evaluable due to high censoring.
    Statistical analysis title
    Selpercatinib, Pemetrexed with or without Pembro
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects included in analysis
    261
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0001
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.482
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.331
         upper limit
    0.7

    Secondary: Percentage of Participant With Disease Control Rate (DCR) by BICR (With Pembrolizumab)

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    End point title
    Percentage of Participant With Disease Control Rate (DCR) by BICR (With Pembrolizumab) [5]
    End point description
    DCR by BICR (with Pembrolizumab) is defined as the number of participants who achieve a BOR of clinical response (CR), partial response (PR), or stable disease (SD) lasting 16 or more weeks divided by the total number of participants randomized to each treatment arm. APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment.
    End point type
    Secondary
    End point timeframe
    Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129
    83
    Units: Percentage of participants
        number (confidence interval 95%)
    89.1 (82.5 to 93.9)
    84.3 (74.7 to 91.4)
    Statistical analysis title
    Selpercatinib (TRT A) Pemetrexed + Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects included in analysis
    212
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.3996
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.7
         upper limit
    3.4

    Secondary: Percentage of Participant With DCR by BICR (With or Without Pembrolizumab)

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    End point title
    Percentage of Participant With DCR by BICR (With or Without Pembrolizumab) [6]
    End point description
    DCR by BICR (with or without Pembrolizumab) is defined as the number of participants who achieve a BOR of CR, PR, or SD lasting 16 or more weeks divided by the total number of participants randomized to each treatment arm. APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
    End point type
    Secondary
    End point timeframe
    Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159
    102
    Units: Percentage of participants
        number (confidence interval 95%)
    89.3 (83.4 to 93.7)
    82.4 (73.6 to 89.2)
    Statistical analysis title
    Selpercatinib (TRT A), With/Without Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects included in analysis
    261
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.139
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.9
         upper limit
    3.6

    Secondary: PFS2 (With Pembrolizumab)

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    End point title
    PFS2 (With Pembrolizumab) [7]
    End point description
    PFS2 is defined as the time from randomization to disease progression on the next line of treatment or death from any cause in the absence of observed disease progression. APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. Participants censored: TRT A: 103; TRT B: 62.
    End point type
    Secondary
    End point timeframe
    Baseline to Second Disease Progression or Death from Any Cause Up to 38 Months.
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129 [8]
    83 [9]
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    9999 (9999 to 9999)
    Notes
    [8] - 9999 = N/A: Data not available due to high censoring.
    [9] - 9999= N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: PFS2 (With or Without Pembrolizumab)

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    End point title
    PFS2 (With or Without Pembrolizumab) [10]
    End point description
    PFS2 is defined as the time from randomization to disease progression on the next line of treatment or death from any cause in the absence of observed disease progression. APD: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received. Participants censored: TRT A: 126; TRT B: 77.
    End point type
    Secondary
    End point timeframe
    Baseline to Second Disease Progression or Death from Any Cause Up to 38 Months
    Notes
    [10] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159 [11]
    102 [12]
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    9999 (9999 to 9999)
    Notes
    [11] - 9999 = NA: Data not available due to high censoring.
    [12] - 9999 = NA: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: Overall Response Rate (ORR): Percentage of Participants With Complete Response (CR) or Partial Response (PR) by BICR (With Pembrolizumab)

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    End point title
    Overall Response Rate (ORR): Percentage of Participants With Complete Response (CR) or Partial Response (PR) by BICR (With Pembrolizumab) [13]
    End point description
    ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment.
    End point type
    Secondary
    End point timeframe
    Baseline through Disease Progression or Death Up to 31 Months
    Notes
    [13] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129
    83
    Units: Percentage of participants
        number (confidence interval 95%)
    83.7 (76.2 to 89.6)
    65.1 (53.8 to 75.2)
    Statistical analysis title
    Selpercatinib (TRT A), Pemetrexed + Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects included in analysis
    212
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0028
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.4
         upper limit
    5.1

    Secondary: ORR: Percentage of Participants With CR or PR by BICR (With or Without Pembrolizumab)

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    End point title
    ORR: Percentage of Participants With CR or PR by BICR (With or Without Pembrolizumab) [14]
    End point description
    ORR: Percentage of Participants with CR or PR by BICR (with or without Pembrolizumab) APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
    End point type
    Secondary
    End point timeframe
    Baseline through Disease Progression or Death Up to 31 Months
    Notes
    [14] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159
    102
    Units: Percentage of participants
        number (confidence interval 95%)
    83.6 (77.0 to 89.0)
    62.7 (52.6 to 72.1)
    Statistical analysis title
    Selpercatinib (TRT A), With/Without Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects included in analysis
    261
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0003
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.6
         upper limit
    5.2

    Secondary: Duration of Response (DoR) by BICR (With Pembrolizumab)

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    End point title
    Duration of Response (DoR) by BICR (With Pembrolizumab) [15]
    End point description
    DoR was defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) were first met until the first date that disease was recurrent or documented disease progression was observed, or the date of death from any cause in the absence of documented disease progression or recurrence. The DOR according to both BICR and investigator-assessed BOR was evaluated per RECIST 1.1 criteria. APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. Participants censored: TRT A:74; TRT B: 25.
    End point type
    Secondary
    End point timeframe
    Date of CR or PR to Date of Disease Progression or Death Due to Any Cause Up to 31 Months
    Notes
    [15] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    108 [16]
    54
    Units: Months
        median (confidence interval 95%)
    24.18 (17.94 to 9999)
    11.47 (9.66 to 23.26)
    Notes
    [16] - 9999 = N/A: Upper limit of 95% confidence interval not available due to high censoring.
    Statistical analysis title
    Selpercatinib (TRT A), Pemetrexed + Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0001
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.377
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.224
         upper limit
    0.633

    Secondary: DOR by BICR (With or Without Pembrolizumab)

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    End point title
    DOR by BICR (With or Without Pembrolizumab) [17]
    End point description
    DoR was defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) were first met until the first date that disease was recurrent or documented disease progression was observed, or the date of death from any cause in the absence of documented disease progression or recurrence. The DOR according to both BICR and investigator-assessed BOR was evaluated per RECIST 1.1 criteria. APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received. Participants censored: TRT A: 90; TRT B: 33.
    End point type
    Secondary
    End point timeframe
    Date of CR or PR to Date of Disease Progression or Death Due to Any Cause Up to 31 Months
    Notes
    [17] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    133 [18]
    64
    Units: Monts
        median (confidence interval 95%)
    24.18 (17.94 to 9999)
    11.99 (9.69 to 23.26)
    Notes
    [18] - 9999 = N/A: Upper limit of 95% Confidence Interval unavailable due to high censoring.
    Statistical analysis title
    Selpercatinib (TRT A), With/Without Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects included in analysis
    197
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0004
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.418
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.256
         upper limit
    0.684

    Secondary: Overall Survival (OS) (With Pembrolizumab)

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    End point title
    Overall Survival (OS) (With Pembrolizumab) [19]
    End point description
    Overall survival was defined as the time from randomization until death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data was censored on the last date the participant is known to be alive. APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. Participants censored: TRT A: 104; TRT B: 68.
    End point type
    Secondary
    End point timeframe
    Baseline to Date of Death from Any Cause Up to 38 Months
    Notes
    [19] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129 [20]
    83 [21]
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    9999 (9999 to 9999)
    Notes
    [20] - 9999 = NA: Median OS data not available due to high censoring
    [21] - 9999 = N/A: Median OS data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: OS (With or Without Pembrolizumab)

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    End point title
    OS (With or Without Pembrolizumab) [22]
    End point description
    Overall survival was defined as the time from randomization until death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data will be censored on the last date the participant is known to be alive. APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received. Participants censored: TRT A: 127; TRT B: 84.
    End point type
    Secondary
    End point timeframe
    Baseline to Date of Death from Any Cause Up to 38 Months
    Notes
    [22] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159 [23]
    102 [24]
    Units: Months
        median (confidence interval 95%)
    33.05 (33.05 to 9999)
    9999 (9999 to 9999)
    Notes
    [23] - 9999 = N/A: Upper limit of 95% Confidence Interval unavailable due to high censoring.
    [24] - 9999 = N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 by BICR (With Pembrolizumab)

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    End point title
    Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 by BICR (With Pembrolizumab) [25]
    End point description
    Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with Pembrolizumab) APD: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment who had baseline CNS assessment and who had CNS metastasis at baseline.
    End point type
    Secondary
    End point timeframe
    Baseline through Central Nervous System (CNS) Progression or Death up to 31 Months
    Notes
    [25] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    21
    21
    Units: Percentage of participants
        number (confidence interval 95%)
    81.0 (58.1 to 94.6)
    57.1 (34.0 to 78.2)
    Statistical analysis title
    Selpercatinib (TRT A), With Pembrolizumab (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects included in analysis
    42
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.1809
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    3.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.8
         upper limit
    12.8

    Secondary: Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST 1.1 by BICR (With or Without Pembrolizumab)

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    End point title
    Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST 1.1 by BICR (With or Without Pembrolizumab) [26]
    End point description
    Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with or without Pembrolizumab). APD: All participants included in the ITT population who had baseline CNS assessment and who had CNS metastasis at baseline.
    End point type
    Secondary
    End point timeframe
    Baseline through CNS Progression or Death Up to 31 Months
    Notes
    [26] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    25
    26
    Units: Percentage of participants
        median (confidence interval 95%)
    84.0 (63.9 to 95.5)
    50.0 (29.9 to 70.1)
    Statistical analysis title
    Selpercatinib (TRT A), With/Without Pembro (TRT B)
    Comparison groups
    Selpercatinib (TRT A) v Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects included in analysis
    51
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0167
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    5.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.4
         upper limit
    19.6

    Secondary: Median Intracranial DOR Per RECIST 1.1 by BICR (With Pembrolizumab)

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    End point title
    Median Intracranial DOR Per RECIST 1.1 by BICR (With Pembrolizumab) [27]
    End point description
    Intracranial DOR is defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) are first met until the first date that disease is recurrent or documented disease progression is observed, or the date of death from any cause in the absence of documented disease progression or recurrence). APD: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment who had baseline CNS assessment and who had CNS metastasis at baseline. Participants censored: TRT A: 13; TRT B: 9.
    End point type
    Secondary
    End point timeframe
    Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
    Notes
    [27] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    17 [28]
    12 [29]
    Units: Months
        median (confidence interval 95%)
    9999 (14.75 to 9999)
    9999 (8.74 to 9999)
    Notes
    [28] - 9999 = N/A: Median and upper limit of 95% CI unavailable due to high censoring.
    [29] - 9999 = N/A: Median and upper limit of 95% CI unavailable due to high censoring.
    No statistical analyses for this end point

    Secondary: Median Intracranial DOR Per RECIST 1.1 by BICR (With or Without Pembrolizumab)

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    End point title
    Median Intracranial DOR Per RECIST 1.1 by BICR (With or Without Pembrolizumab) [30]
    End point description
    Intracranial DOR is defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) are first met until the first date that disease is recurrent or documented disease progression is observed, or the date of death from any cause in the absence of documented disease progression or recurrence). APD: All participants included in the ITT population who had baseline CNS assessment and who had CNS metastasis at baseline. Participants censored: TRT A: 15; TRT B: 9.
    End point type
    Secondary
    End point timeframe
    Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
    Notes
    [30] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    21 [31]
    13 [32]
    Units: Median
        median (confidence interval 95%)
    9999 (9.53 to 9999)
    13.40 (4.17 to 9999)
    Notes
    [31] - 9999 = N/A: Median and upper limit of 95% Confidence Interval unavailable due to high censoring.
    [32] - 9999 = N/A: Upper limit of 95% Confidence Interval unavailable due to high censoring.
    No statistical analyses for this end point

    Secondary: Time to Deterioration of Pulmonary Symptoms (With Pembrolizumab)

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    End point title
    Time to Deterioration of Pulmonary Symptoms (With Pembrolizumab) [33]
    End point description
    Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-Symptom Assessment Questionnaire (SAQ) (with Pembrolizumab). APD: ITT Pembrolizumab: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment. Participants censored: TRT A: 99; TRT B: 47.
    End point type
    Secondary
    End point timeframe
    Baseline to Deterioration of Pulmonary Symptoms Up to 31 Months
    Notes
    [33] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    129 [34]
    83
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    1.9 (0.7 to 6.6)
    Notes
    [34] - 9999 = N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: Time to Deterioration of Pulmonary Symptoms (With or Without Pembrolizumab)

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    End point title
    Time to Deterioration of Pulmonary Symptoms (With or Without Pembrolizumab) [35]
    End point description
    Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-SAQ (with or without Pembrolizumab). APD: ITT Population: All randomized participants, even if a participant did not take the assigned treatment, did not receive the correct treatment, or otherwise did not follow the protocol. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received. Participants censored: TRT A: 121; TRT B: 58.
    End point type
    Secondary
    End point timeframe
    Baseline to Deterioration of Pulmonary Symptoms Up to 31 Months
    Notes
    [35] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    159 [36]
    102
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    1.6 (0.7 to 4.9)
    Notes
    [36] - 9999 = N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: Median Time to CNS Progression Per RECIST 1.1 by BICR (With Pembrolizumab)

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    End point title
    Median Time to CNS Progression Per RECIST 1.1 by BICR (With Pembrolizumab) [37]
    End point description
    Time to CNS Progression is defined as the time from randomization to the occurrence of documented CNS progression by the BICR. Central nervous system progression is defined as progression due to newly developed intracranial lesions and/or progression of pre-existing intracranial lesions per RECIST 1.1. APD: Participants included in the ITT population who were stratified with the intent to receive pembrolizumab in the event of the control-arm assignment who had baseline CNS assessment and who had CNS metastasis at baseline. Number of participants censored: TRT A = 112; TRT B = 59.
    End point type
    Secondary
    End point timeframe
    Baseline through CNS Progression or Death Up to 31 Months
    Notes
    [37] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed with Pembrolizumab (TRT B)
    Number of subjects analysed
    120 [38]
    72 [39]
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    9999 (9999 to 9999)
    Notes
    [38] - 9999 = N/A: Data not available due to high censoring.
    [39] - 9999 = N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Secondary: Median Time to CNS Progression Per RECIST 1.1 by BICR (With or Without Pembrolizumab)

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    End point title
    Median Time to CNS Progression Per RECIST 1.1 by BICR (With or Without Pembrolizumab) [40]
    End point description
    Time to CNS Progression is defined as the time from randomization to the occurrence of documented CNS progression by the BICR. Central nervous system progression is defined as progression due to newly developed intracranial lesions and/or progression of pre-existing intracranial lesions per RECIST 1.1. APD: All participants included in the ITT population who had baseline CNS assessment and who had CNS metastasis at baseline. Participants censored: TRT A: 137; TRT B: = 73.
    End point type
    Secondary
    End point timeframe
    Baseline through CNS Progression or Death Up to 31 Months
    Notes
    [40] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Participants in the Treatment B arm were in one of two subject analysis sets: "With Pembrolizumab" arm or "With or Without Pembrolizumab" arm.
    End point values
    Selpercatinib (TRT A) Pemetrexed With or Without Pembrolizumab (TRT B)
    Number of subjects analysed
    146 [41]
    88 [42]
    Units: Months
        median (confidence interval 95%)
    9999 (9999 to 9999)
    9999 (999 to 9999)
    Notes
    [41] - 9999 = N/A: Data not available due to high censoring.
    [42] - 9999 = N/A: Data not available due to high censoring.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline Up to 38 Months
    Adverse event reporting additional description
    Safety population is defined as all participants who received study drug regardless of strata and as pre-specified, adverse events were collected for the TRT B treatment arm as a whole. Analysis of safety data will be based on the actual treatment a participant received on the first study treatment administration regardless of allocation.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    Selpercatinib (TRT A)
    Reporting group description
    160 milligram (mg) Selpercatinib administered orally, twice daily (BID continuously in 21-day cycles.

    Reporting group title
    Carboplatin or Cisplatin + Pemetrexed+/-Pembrolizumab (TRT B)
    Reporting group description
    Pemetrexed 500 milligrams per meter squared (mg/m2) administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus at the investigator's choice of carboplatin area under the concentration versus time curve 5 (AUC 5 [maximum dose 750 mg]) IV, or cisplatin 75mg/m2 IV on Day 1 Q3W for 4 cycles, plus investigator's choice with or without 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.

    Serious adverse events
    Selpercatinib (TRT A) Carboplatin or Cisplatin + Pemetrexed+/-Pembrolizumab (TRT B)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    55 / 158 (34.81%)
    23 / 98 (23.47%)
         number of deaths (all causes)
    32
    17
         number of deaths resulting from adverse events
    2
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    malignant pleural effusion
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    transitional cell carcinoma
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    hypertension
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    jugular vein thrombosis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    venous thrombosis limb
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    chest pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    asthenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    malaise
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pyrexia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    oedema peripheral
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    sudden death
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Immune system disorders
    anaphylactic shock
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hypersensitivity
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    acute respiratory failure
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    chylothorax
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    dyspnoea
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    interstitial lung disease
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    respiratory failure
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    pulmonary embolism
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pleural effusion
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    7 / 158 (4.43%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 11
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    alanine aminotransferase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    blood creatinine increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    aspartate aminotransferase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    electrocardiogram t wave abnormal
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hepatic enzyme increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    neutrophil count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    platelet count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    1 / 1
    12 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    femur fracture
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    procedural haemorrhage
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    cardiac arrest
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    cardiac failure
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    atrial fibrillation
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    angina pectoris
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    myocardial infarction
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    myocardial ischaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pericardial effusion
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    cerebral infarction
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    dizziness
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    spinal cord compression
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    anaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    febrile neutropenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    neutropenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    abdominal pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ascites
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    3 / 158 (1.90%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    5 / 7
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    enterocolitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    gastritis erosive
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    haematemesis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ileus
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    inguinal hernia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    intestinal obstruction
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    small intestinal haemorrhage
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pancreatitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pancreatitis acute
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    volvulus
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    cholecystitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    3 / 158 (1.90%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hepatic function abnormal
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    4 / 158 (2.53%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    immune-mediated hepatic disorder
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    5 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    dermatitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    drug eruption
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    acute kidney injury
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    back pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    covid-19
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    covid-19 pneumonia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    erysipelas
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    herpes zoster
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    infectious pleural effusion
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    meningitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    sepsis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pneumonia viral
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    peritonitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pneumonia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    3 / 158 (1.90%)
    2 / 98 (2.04%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    urinary tract infection
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    soft tissue infection
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    urosepsis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    decreased appetite
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    2 / 158 (1.27%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    electrolyte imbalance
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hyperglycaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hypocalcaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hypokalaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hypomagnesaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    1 / 98 (1.02%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hyponatraemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    malnutrition
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    1 / 158 (0.63%)
    0 / 98 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Selpercatinib (TRT A) Carboplatin or Cisplatin + Pemetrexed+/-Pembrolizumab (TRT B)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    156 / 158 (98.73%)
    97 / 98 (98.98%)
    Vascular disorders
    hypertension
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    76 / 158 (48.10%)
    7 / 98 (7.14%)
         occurrences all number
    167
    18
    General disorders and administration site conditions
    asthenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    25 / 98 (25.51%)
         occurrences all number
    53
    73
    chest pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    13 / 98 (13.27%)
         occurrences all number
    9
    15
    face oedema
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    12 / 158 (7.59%)
    4 / 98 (4.08%)
         occurrences all number
    14
    4
    fatigue
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    24 / 158 (15.19%)
    26 / 98 (26.53%)
         occurrences all number
    40
    47
    malaise
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    5 / 98 (5.10%)
         occurrences all number
    9
    8
    oedema
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    8 / 98 (8.16%)
         occurrences all number
    16
    10
    oedema peripheral
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    41 / 158 (25.95%)
    13 / 98 (13.27%)
         occurrences all number
    57
    15
    pyrexia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    21 / 158 (13.29%)
    22 / 98 (22.45%)
         occurrences all number
    39
    41
    Respiratory, thoracic and mediastinal disorders
    dyspnoea
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    5 / 158 (3.16%)
    14 / 98 (14.29%)
         occurrences all number
    9
    18
    cough
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    16 / 158 (10.13%)
    15 / 98 (15.31%)
         occurrences all number
    19
    22
    hiccups
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    0 / 158 (0.00%)
    6 / 98 (6.12%)
         occurrences all number
    0
    11
    oropharyngeal pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    4 / 98 (4.08%)
         occurrences all number
    10
    4
    Psychiatric disorders
    insomnia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    5 / 98 (5.10%)
         occurrences all number
    10
    5
    Investigations
    alanine aminotransferase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    95 / 158 (60.13%)
    39 / 98 (39.80%)
         occurrences all number
    324
    108
    aspartate aminotransferase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    97 / 158 (61.39%)
    39 / 98 (39.80%)
         occurrences all number
    322
    94
    blood thyroid stimulating hormone increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    6 / 98 (6.12%)
         occurrences all number
    14
    8
    electrocardiogram qt prolonged
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    32 / 158 (20.25%)
    1 / 98 (1.02%)
         occurrences all number
    58
    1
    blood bilirubin increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    59 / 158 (37.34%)
    1 / 98 (1.02%)
         occurrences all number
    230
    1
    blood alkaline phosphatase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    8 / 98 (8.16%)
         occurrences all number
    36
    12
    bilirubin conjugated increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    19 / 158 (12.03%)
    1 / 98 (1.02%)
         occurrences all number
    54
    1
    blood creatinine increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    36 / 158 (22.78%)
    15 / 98 (15.31%)
         occurrences all number
    76
    38
    gamma-glutamyltransferase increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    10 / 98 (10.20%)
         occurrences all number
    56
    15
    lymphocyte count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    7 / 158 (4.43%)
    6 / 98 (6.12%)
         occurrences all number
    21
    28
    weight decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    9 / 98 (9.18%)
         occurrences all number
    31
    11
    neutrophil count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    31 / 158 (19.62%)
    25 / 98 (25.51%)
         occurrences all number
    126
    90
    platelet count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    32 / 158 (20.25%)
    18 / 98 (18.37%)
         occurrences all number
    92
    46
    weight increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    23 / 158 (14.56%)
    7 / 98 (7.14%)
         occurrences all number
    44
    20
    white blood cell count decreased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    32 / 158 (20.25%)
    25 / 98 (25.51%)
         occurrences all number
    142
    72
    Nervous system disorders
    dizziness
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    11 / 158 (6.96%)
    8 / 98 (8.16%)
         occurrences all number
    12
    13
    dysgeusia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    12 / 98 (12.24%)
         occurrences all number
    10
    22
    headache
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    22 / 158 (13.92%)
    10 / 98 (10.20%)
         occurrences all number
    30
    13
    Blood and lymphatic system disorders
    anaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    18 / 158 (11.39%)
    57 / 98 (58.16%)
         occurrences all number
    35
    209
    leukopenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    11 / 158 (6.96%)
    8 / 98 (8.16%)
         occurrences all number
    22
    37
    neutropenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    6 / 158 (3.80%)
    18 / 98 (18.37%)
         occurrences all number
    13
    61
    thrombocytopenia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    11 / 158 (6.96%)
    10 / 98 (10.20%)
         occurrences all number
    17
    20
    Eye disorders
    lacrimation increased
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    3 / 158 (1.90%)
    13 / 98 (13.27%)
         occurrences all number
    5
    16
    Gastrointestinal disorders
    abdominal pain upper
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    13 / 98 (13.27%)
         occurrences all number
    31
    30
    ascites
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    0 / 98 (0.00%)
         occurrences all number
    10
    0
    abdominal distension
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    3 / 98 (3.06%)
         occurrences all number
    11
    3
    abdominal discomfort
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    3 / 98 (3.06%)
         occurrences all number
    9
    3
    abdominal pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    18 / 158 (11.39%)
    7 / 98 (7.14%)
         occurrences all number
    34
    11
    diarrhoea
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    69 / 158 (43.67%)
    24 / 98 (24.49%)
         occurrences all number
    218
    33
    dry mouth
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    61 / 158 (38.61%)
    6 / 98 (6.12%)
         occurrences all number
    73
    6
    constipation
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    34 / 158 (21.52%)
    39 / 98 (39.80%)
         occurrences all number
    46
    67
    nausea
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    43 / 98 (43.88%)
         occurrences all number
    26
    93
    stomatitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    19 / 158 (12.03%)
    9 / 98 (9.18%)
         occurrences all number
    28
    13
    vomiting
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    20 / 158 (12.66%)
    23 / 98 (23.47%)
         occurrences all number
    38
    35
    Hepatobiliary disorders
    hepatic function abnormal
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    1 / 98 (1.02%)
         occurrences all number
    41
    3
    Skin and subcutaneous tissue disorders
    alopecia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    11 / 158 (6.96%)
    6 / 98 (6.12%)
         occurrences all number
    12
    6
    dermatitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    1 / 98 (1.02%)
         occurrences all number
    11
    2
    dry skin
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    6 / 98 (6.12%)
         occurrences all number
    10
    6
    pruritus
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    16 / 158 (10.13%)
    22 / 98 (22.45%)
         occurrences all number
    27
    26
    rash
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    35 / 158 (22.15%)
    21 / 98 (21.43%)
         occurrences all number
    54
    30
    rash maculo-papular
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    6 / 158 (3.80%)
    5 / 98 (5.10%)
         occurrences all number
    16
    7
    Endocrine disorders
    hyperthyroidism
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    4 / 158 (2.53%)
    7 / 98 (7.14%)
         occurrences all number
    8
    7
    hypothyroidism
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    5 / 158 (3.16%)
    6 / 98 (6.12%)
         occurrences all number
    7
    10
    Musculoskeletal and connective tissue disorders
    arthralgia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    17 / 158 (10.76%)
    9 / 98 (9.18%)
         occurrences all number
    22
    10
    back pain
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    14 / 158 (8.86%)
    12 / 98 (12.24%)
         occurrences all number
    22
    19
    myalgia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    7 / 98 (7.14%)
         occurrences all number
    10
    8
    pain in extremity
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    12 / 158 (7.59%)
    6 / 98 (6.12%)
         occurrences all number
    16
    8
    Infections and infestations
    conjunctivitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    3 / 158 (1.90%)
    5 / 98 (5.10%)
         occurrences all number
    3
    15
    covid-19
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    30 / 158 (18.99%)
    18 / 98 (18.37%)
         occurrences all number
    34
    18
    nasopharyngitis
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    5 / 98 (5.10%)
         occurrences all number
    15
    9
    paronychia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    0 / 98 (0.00%)
         occurrences all number
    10
    0
    pneumonia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    6 / 98 (6.12%)
         occurrences all number
    14
    8
    upper respiratory tract infection
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    9 / 158 (5.70%)
    3 / 98 (3.06%)
         occurrences all number
    12
    3
    urinary tract infection
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    14 / 158 (8.86%)
    4 / 98 (4.08%)
         occurrences all number
    24
    4
    Metabolism and nutrition disorders
    decreased appetite
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    27 / 158 (17.09%)
    33 / 98 (33.67%)
         occurrences all number
    35
    56
    hyperglycaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    5 / 158 (3.16%)
    9 / 98 (9.18%)
         occurrences all number
    8
    17
    hyperuricaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    10 / 158 (6.33%)
    6 / 98 (6.12%)
         occurrences all number
    15
    20
    hypoalbuminaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    23 / 158 (14.56%)
    6 / 98 (6.12%)
         occurrences all number
    63
    9
    hypocalcaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    13 / 158 (8.23%)
    0 / 98 (0.00%)
         occurrences all number
    34
    0
    hypokalaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    23 / 158 (14.56%)
    8 / 98 (8.16%)
         occurrences all number
    33
    25
    hypomagnesaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    5 / 98 (5.10%)
         occurrences all number
    24
    8
    hyponatraemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    14 / 158 (8.86%)
    6 / 98 (6.12%)
         occurrences all number
    47
    10
    hypoproteinaemia
    alternative dictionary used: MedDRA 26.0
         subjects affected / exposed
    8 / 158 (5.06%)
    3 / 98 (3.06%)
         occurrences all number
    24
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Nov 2019
    Amendment A: This amendment incorporates changes requested by regulatory authorities to the inclusion/exclusion criteria, dose modifications and the addition of a secondary objective to assess/evaluation performance of RET local laboratory tests compared to a single, central test. In addition, this amendment includes changes made to correct and clarify information for sites.
    10 Jun 2020
    Amendment B: This amendment incorporates changes to the primary endpoint to satisfy certain country-specific regulatory and payer expectations. In response to regulatory agency feedback and additional data gleaned from LIBRETTO-001, changes to the sample size and randomization ratio were made to minimize the number of patients treated on the control arm, while still maintaining the ability to test the central hypothesis. In addition, this amendment includes changes to align with the latest version of the IB, incorporate feedback from EC/IRBs, and to correct and clarify information in order for sites to improve the conduct to the study.
    26 Jun 2020
    Amendment C: This amendment clarifies key secondary analyses and supportive secondary analyses. In addition, it corrects typographical errors and inconsistencies that were noted in JZJC amendment (b).
    18 Nov 2020
    Amendment D: This amendment incorporates changes to include additional endpoints to further characterize the intracranial activity of selpercatinib compared to the control arm. In addition, this amendment includes changes made to correct and clarify information for sites. This amendment also corrects typographical errors and inconsistencies that were noted in JZJC amendment (c).
    15 Aug 2023
    Amendment E: The primary purpose of this amendment is to update as per the latest Investigator Brochure (IB) and to align with EU Clinical Trial Regulation (EU-CTR) requirements. In addition, this amendment includes changes made to correct and clarify information for sites. This amendment also corrects typographical errors and inconsistencies that were noted in JZJC amendment(d).

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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