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 tests from investigator- identified laboratories compared to a single Lilly-designated RET 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 a. Participants must have undergone the available anti-cancer therapy (including chemotherapy or durvalumab) or not be suitable for it, based on the investigator's discretion. -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. Women of child-bearing potential must not be breastfeeding during treatment and for at least 2 weeks after the last dose of study drug -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 (e.g., hypertension, diabetes, clinically active diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, or peritoneal carcinomatosis, pericardial effusion, or pleural effusion). 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 -Have a known hypersensitivity to any of the excipients of selpercatinib -Prior treatment with selpercatinib or pralsetinib -Taking a concomitant medication that is known to cause QTc prolongation -Are currently enrolled in any other clinical study involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study. -have participated, within the last 30 days; (3 months in the UK), in a clinical study involving an investigational product. If the previous investigational product has a long half-life, 5 half-lives or 30 days (3 months in the UK),whichever is longer, should have passed. |
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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 RET tests from investigator-identified laboratories with respect to the Lilly-designated RET 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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
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 |
Singapore |
Ukraine |
Hong Kong |
Taiwan |
Australia |
Brazil |
Canada |
China |
India |
Israel |
Japan |
Korea, Republic of |
Mexico |
Russian Federation |
Turkey |
United Kingdom |
United States |
Austria |
Belgium |
Czechia |
Denmark |
France |
Germany |
Greece |
Italy |
Netherlands |
Norway |
Poland |
Romania |
Spain |
Sweden |
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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 | 11 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 14 |
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 |