E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Adjuvant Selpercatinib following definitive locoregional treatment in male or female patients with stage IB-IIIA RET fusion positive NSCLC |
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E.1.1.1 | Medical condition in easily understood language |
Non-Small Cell Lung Cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare EFS of participants in the primary analysis population with Stage II-IIIA RET fusion-positive NSCLC treated with selpercatinib versus placebo. |
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E.2.2 | Secondary objectives of the trial |
-To compare EFS of participants in the overall population with Stage IB-IIIA RET fusion-positive NSCLC treated with selpercatinib versus placebo -To compare other efficacy outcomes achieved with selpercatinib versus placebo in the primary analysis and overall populations -To evaluate the safety and tolerability of selpercatinib versus placebo in the primary analysis and overall populations -To assess/evaluate performance of RET laboratory developed tests compared to a single central test -To compare onset or worsening of NSCLC symptoms in participants treated with selpercatinib versus placebo -To compare physical functioning in participants treated with selpercatinib versus placebo |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Must have histologically confirmed Stage IB, II, or IIIA NSCLC. Staging will be according to the Tumor, Node, Metastasis staging system for lung cancer -Must have an activating RET gene fusion in tumor based on polymerase chain reaction (PCR) or next generation sequencing (NGS) -Must have received definitive locoregional therapy with curative intent (surgery or radiotherapy) for Stage IB, II, or IIIA NSCLC -Patients must have completely recovered from definitive therapy (surgery or radiotherapy) as well as adjuvant therapy at the time of randomization -Must have Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 -Adequate hematologic, hepatic and renal function -Willingness of men and women of reproductive potential to observe conventional and effective birth control for the duration of treatment and for 2 weeks after. Men must refrain from donating sperm and must agree to using condom. -Written informed consent. |
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E.4 | Principal exclusion criteria |
-Additional oncogenic driver mutations of NSCLC, e.g., ALK fusion, or activating mutations of EGFR -Evidence of small cell lung cancer -Clinical or radiologic evidence of disease recurrence or progression following definitive therapy -Known or suspected interstitial fibrosis or interstitial lung disease or history of (noninfectious) pneumonitis that required steroids -Clinically significant active cardiovascular disease or history of myocardial infarction within 6 months prior to planned start of study treatment or prolongation of the QT interval corrected for heart rate using Fridericia’s formula (QTcF) >470 msec on more than 1 ECG obtained during the baseline period -Uncontrolled human immunodeficiency virus (HIV)-1/2 infection -Has known active Hepatitis B or C -Active uncontrolled systemic bacterial, viral, or fungal infection or serious ongoing intercurrent illness, such as hypertension or diabetes, despite optimal treatment. Screening for chronic conditions is not required -Major surgery, excluding placement of vascular access, within 4 weeks of study drug -Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal absorption of the study drug -Other malignancy unless nonmelanoma skin cancer, carcinoma in situ of the cervix or other in situ cancers, or a malignancy diagnosed ≥2 years previously and not currently active -Prior treatment with selpercatinib or pralsetinib -Taking a concomitant medication that is known to cause QTc prolongation
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E.5 End points |
E.5.1 | Primary end point(s) |
EFS by investigator assessment in the primary analysis population. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Randomization to disease recurrence/progression or death from any cause (Estimated at up to 7 years) |
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E.5.2 | Secondary end point(s) |
1. Time to distant disease recurrence in the CNS by investigator assessment and BICR 2. PFS2 by investigator assessment 3. OS 4. Safety per CTCAE v5.0 (including, but not limited to): incidence and severity of TEAEs, SAEs, deaths, and clinical laboratory abnormalities 5. The positive predictive value of local laboratory tests with respect to the central test 6. Mean change from baseline over time in NSCLC symptoms as measured by NSCLC-SAQ. 7. Time to onset or worsening of NSCLC symptoms as measured by NSCLC-SAQ. 8. Mean change from baseline overtime in physical functioning as measured by EORTC-IL19 or Physical Functioning Scale (items 1-5) of the EORTC QLQ-C30. 9. Time to deterioration of physical functioning as measured by 'EORTC-IL19' or Physical Functioning Scale (items 1-5) of the EORTC QLQ-C30 10. EFS by investigator assessment in overall population as secondary endpoint 11. EFS by BICR |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Randomization to disease recurrence/progression or death from any cause (Estimated at up to 7 years) 2. Randomization to Second Disease Progression or Death from Any Cause (Estimated at up to 9 years) 3. Randomization to Date of Death from Any Cause (Estimated at up to 9 years) 4. Baseline to study discontinuation (Estimated at up to 3 years) 5. Baseline 6. Baseline to study discontinuation (Estimated at up to 3 years) 7. Baseline to study discontinuation (Estimated at up to 3 years) 8. Baseline to study discontinuation (Estimated at up to 3 years) 9. Baseline to study discontinuation (Estimated at up to 3 years) 10. Randomization to disease recurrence up to 7 years 11. Randomization to disease recurrence up to 7 years |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 58 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Brazil |
Canada |
China |
Hong Kong |
India |
Israel |
Japan |
Korea, Republic of |
Mexico |
Russian Federation |
Singapore |
Taiwan |
Turkey |
Ukraine |
United States |
Austria |
Belgium |
Denmark |
France |
Germany |
Greece |
Italy |
Netherlands |
Poland |
Romania |
Spain |
Sweden |
United Kingdom |
Czechia |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Per protocol LVLS or last scheduled procedure. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 11 |
E.8.9.2 | In all countries concerned by the trial months | 4 |
E.8.9.2 | In all countries concerned by the trial days | 14 |