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    Summary
    EudraCT Number:2021-003369-37
    Sponsor's Protocol Code Number:D9077C00001
    National Competent Authority:France - ANSM
    Clinical Trial Type:EEA CTA
    Trial Status:Trial now transitioned
    Date on which this record was first entered in the EudraCT database:2022-02-09
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedFrance - ANSM
    A.2EudraCT number2021-003369-37
    A.3Full title of the trial
    A Phase II Open-label, Multicentre, Randomised Study of Neoadjuvant and Adjuvant Treatment in Patients with Resectable, Early-stage (II to IIIA) Non-small Cell Lung Cancer (NeoCOAST-2)
    Étude multicentrique de phase II, randomisée, en ouvert, évaluant un traitement néoadjuvant et adjuvant chez des patients présentant un cancer du poumon non à petites cellules de stade localisé (II à IIIA) opérable (NeoCOAST-2)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study of Neoadjuvant and Adjuvant Treatment in Patients with Resectable Non-small Cell Lung Cancer
    Étude évaluant un traitement néoadjuvant et adjuvant chez des patients présentant un cancer du poumon non à petites cellules, opérable
    A.3.2Name or abbreviated title of the trial where available
    NeoCOAST-2
    A.4.1Sponsor's protocol code numberD9077C00001
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAstraZeneca AB
    B.1.3.4CountrySweden
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportAstraZeneca AB
    B.4.2CountrySweden
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAstraZeneca
    B.5.2Functional name of contact pointClinical Study Information Center
    B.5.3 Address:
    B.5.3.1Street AddressNot applicable
    B.5.3.2Town/ cityNot applicable
    B.5.3.3Post codeNot applicable
    B.5.3.4CountrySweden
    B.5.6E-mailinformation.centre@astrazeneca.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDurvalumab
    D.3.2Product code MEDI4736
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDurvalumab
    D.3.9.1CAS number 1428935-60-7
    D.3.9.2Current sponsor codeMEDI4736
    D.3.9.3Other descriptive name01P009, C134
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameOleclumab
    D.3.2Product code MEDI9447
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNoleclumab
    D.3.9.1CAS number 1803176-05-7
    D.3.9.2Current sponsor codeMEDI9447
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameMonalizumab
    D.3.2Product code IPH2201
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNmonalizumab
    D.3.9.1CAS number 1228763-95-8
    D.3.9.2Current sponsor codeIPH2201
    D.3.9.3Other descriptive nameAnti-NKG2A, HumZ270, NNC141-0100, NN8765
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Resectable, Early-stage (II to IIIA) Non-small Cell Lung Cancer
    Cancer du poumon non à petites cellules de stade localisé (II à IIIA) opérable
    E.1.1.1Medical condition in easily understood language
    Lung Cancer
    Cancer du poumon
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10029519
    E.1.2Term Non-small cell lung cancer stage III
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10029518
    E.1.2Term Non-small cell lung cancer stage II
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10029520
    E.1.2Term Non-small cell lung cancer stage IIIA
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    - To assess the antitumour activity of neoadjuvant treatment administered prior to surgery in terms of pCR
    - To assess the safety and tolerability of neoadjuvant and adjuvant treatment
    - Évaluer l’activité antitumorale d’un traitement néoadjuvant administré avant la chirurgie en termes de RCp.
    - Évaluer la sécurité et la tolérance du traitement néoadjuvant et adjuvant.
    E.2.2Secondary objectives of the trial
    To assess the efficacy of neoadjuvant treatment administered prior to surgery followed by adjuvant treatment post-surgery in terms of EFS and DFS
    To assess the feasibility of receiving the planned surgical tumor resection in patients receiving neoadjuvant treatment
    To assess the antitumor activity of neoadjuvant treatment administered prior surgery in terms of mPR
    To assess the efficacy of neoadjuvant treatment administered prior to surgery in terms of ORR
    To assess the efficacy of neoadjuvant and adjuvant treatment in terms of OS
    To describe the PK of study drugs in patients receiving neoadjuvant/adjuvant treatment
    To assess the immunogenicity of study drugs in patients receiving neoadjuvant/adjuvant treatment
    To investigate baseline PD-L1 expression in patients treated with neoadjuvant and adjuvant treatment, and associations with clinical endpoints
    To evaluate changes in ctDNA during neoadjuvant treat in patients with evaluable ctDNA and associations with clinical endpoints
    Évaluer l’efficacité d’un traitement néoadjuvant administré avant la chirurgie, suivi d’un traitement adjuvant après la chirurgie en termes de SSE et de SSM (événement à partir de la chirurgie)
    Évaluer la faisabilité de la résection chirurgicale prévue de la tumeur chez les patients recevant un traitement néoadjuvant.
    Évaluer l’activité antitumorale d’un traitement néoadjuvant administré avant chirurgie en termes de RPM.
    Évaluer l’efficacité d’un traitement néoadjuvant administré avant la chirurgie en termes de TRO.
    Évaluer l’efficacité du traitement néoadjuvant et adjuvant en termes de SG.
    Décrire la PK des médicaments à l’étude chez les patients sous traitement néoadjuvant/adjuvant
    Évaluer l’immunogénicité des médicaments à l’étude chez les patients sous traitement néoadjuvant/adjuvant.
    Évaluer l’expression initiale de PD-L1 chez les patients sous traitement néoadjuvant/adjuvant, et associations aux critères d’évaluation cliniques.
    Évaluer les changements d’ADNtc
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF and in this protocol.
    2) Provision of signed and dated written ICF prior to any mandatory study specific procedures, sampling, and analyses.
    3) Provision of signed and dated written ICF prior to collection of samples for genetic analysis.
    4) Patients must be ≥ 18 years at the time of screening.
    5) Newly diagnosed and previously untreated patients with histologically or cytologically documented NSCLC. Patients should have resectable (Stage IIA to Stage IIIA) disease (according to Version 8 of IASLC Staging Manual in Thoracic Oncology 2016. For patients with N2 disease, only those with 1 single nodal station ≤ 3 cm are eligible) and be candidate for lobectomy, sleeve resection, or bilobectomy at the time of screening.
    - At screening, complete surgical resection of the primary NSCLC must be deemed achievable, as assessed by a multidisciplinary evaluation, which must include a thoracic surgeon who performs lung cancer surgery as a prominent part of his/her practice.

    6) WHO or ECOG performance status of 0 or 1 at enrolment.
    7) Adequate organ and marrow function as defined in protocol.
    8) Must have a life expectancy of at least 12 weeks.
    9) Body WT > 35 kg.
    10) Male and/or female.
    Females of childbearing potential should use an acceptable method of contraception from the time of screening throughout the total duration of the study and (for drugs that are potentially genotoxic) the drug washout period (180 days) after the last dose of study drugs) to prevent pregnancy.
    11) Negative pregnancy test (serum or urine) for women of childbearing potential.
    12) Provision of tumour samples (newly acquired or archival tumour tissue [≤ 6 months old]) to confirm PD-L1 status, EGFR, or ALK status where required during screening and prior to randomisation.
    13) Provision of tumour appropriate for exploratory biomarker analyses.

    Please refer to protocol for a complete list.
    1) Capacité à fournir un consentement éclairé signé, ce qui inclut le respect des exigences et restrictions présentées dans le FCE et dans le présent protocole.
    2) Fourniture du FCE écrit, daté et signé avant toute activité obligatoire spécifique à l’étude ( examens, prélèvements ou analyses).
    3) Fourniture du FCE écrit, daté et signé, avant tout recueil d’échantillons pour des analyses génétiques.
    4) Âge ≥ 18 ans au moment de la sélection.
    5) Patients ayant un CPNPC de diagnostic récent, documenté histologiquement et cytologiquement, et auparavant non traités. Les patients devront présenter une atteinte opérable (Stade II à IIIA, selon la Version 8 du manuel 2016 de stadification en oncologie thoracique de l’IASLC). Pour les patients ayant une atteinte N2, seuls les patients présentant 1 seule station ganglionnaire ≤ 3 cm sont éligibles) et peuvent être candidats à une lobectomie, une lobectomie avec bronchoplastie ou, une bilobectomie au moment de la sélection.
    − À la sélection, une résection chirurgicale complète du CPNPC primaire doit être jugée envisageable, d’après une évaluation multidisciplinaire, devant inclure un chirurgien thoracique dont l’essentiel de la pratique chirurgicale concerne le cancer du poumon.
    6) Score de performances OMS ou ECOG de 0 ou 1 au moment du recrutement.
    7) Fonction organique et médullaire appropriée définie selon le protocole.
    8) Espérance de vie d’au moins 12 semaines.
    9) Poids corporel > 35 kg.
    10) Hommes et/ou femmes.
    11) Test (sanguin ou urinaire) de grossesse négatif pour les femmes en âge de procréer.
    12)Fourniture d’échantillons tumoraux (tissu tumoral nouvellement acquis ou archivé [depuis ≤ 6 mois]) pour confirmer le statut PD-L1, EGFR ou ALK lorsque cela est nécessaire pendant la sélection et avant la randomisation.
    13) Fourniture d’un échantillon tumoral approprié pour des analyses de biomarqueurs exploratoires

    Veuillez vous se reporter au protocole pour une liste complète.
    E.4Principal exclusion criteria
    1) Patients with sensitising EGFR mutations or ALK translocations.
    2) History of allogeneic organ transplantation.
    3) Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [eg, colitis or Crohn’s disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [eg, granulomatosis with polyangiitis, Graves’ disease, rheumatoid arthritis, hypophysitis, or uveitis]). Exceptions to this criterion are defined in protocol.
    4) Uncontrolled intercurrent illness, including but not limited to, uncontrolled hypertension, unstable angina pectoris, uncontrolled cardiac arrhythmia, active ILD, serious chronic gastrointestinal conditions associated with diarrhoea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs, or compromise the ability of the patient to give written informed consent.
    5) History of another primary malignancy, with exceptions as defined in protocol.
    6) Patients with small-cell lung cancer or mixed small-cell lung cancer.
    7) History of active primary immunodeficiency.
    8) Active infection including tuberculosis, hepatitis B and HCV. More in protocol.
    9) Patients who have preoperative radiotherapy treatment as part of their care plan.
    10) Patients who require or may require pneumonectomy, segmentectomies, or wedge resections, as assessed by their surgeon, to obtain potentially curative resection of primary tumour.
    11) QTcF interval ≥ 470 ms (NOTE: If prolonged, then 2 additional ECGs should be obtained
    and the average QTcF interval should be used to determine eligibility).
    12) Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
    13) Any medical contraindication to treatment with chemotherapy as listed in the local labelling.
    14) Patients with moderate or severe cardiovascular disease as defined in protocol.
    15) Any concurrent chemotherapy, investigational product, biologic, or hormonal therapy for cancer treatment. Concurrent use of hormonal therapy for non-cancer-related conditions (eg, hormone replacement therapy) is acceptable.
    16) Receipt of live attenuated vaccine within 30 days prior to the first dose of study drugs.
    Note: Patients, if enrolled, should not receive live vaccine while receiving study drugs and up to 30 days after the last dose of study drugs.
    17) Major surgical procedure (as defined by the Investigator) within 30 days prior to the first dose of study drugs.
    18) Prior exposure to immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies. Patients who received agents targeting the adenosine pathway (eg, anti-CD73, anti-A2AR, anti-CD39) and anti-NKG2A agents are also excluded.
    19) Current or prior use of immunosuppressive medication within 14 days before the first dose of study drugs. The following are exceptions to this criterion:
    - Intranasal, inhaled, topical steroids, or local steroid injections (eg, intra articular injection).
    - Systemic corticosteroids ≤ 12 mg/day of prednisone or its equivalent.
    - Steroids as premedication for hypersensitivity reactions (eg, CT scan premedication).
    20) Participation in another clinical study with an investigational product administered within 30 days prior to enrolment.
    21) Previous study drugs (durvalumab, oleclumab, or monalizumab) assignment in the present study.
    Please refer to protocol for a complete list.
    1) Présence de mutations sensibilisantes de l’EGFR ou de translocations ALK.
    2) Antécédents de greffe d’organe allogénique.
    3)Pathologies auto-immunes ou inflammatoires actives ou précédentes documentées (y compris maladie intestinale inflammatoire [par exemple, colite ou maladie de Crohn], diverticulite [sauf diverticulose], lupus érythémateux disséminé, syndrome de sarcoïdose, ou syndrome de Wegener [par exemple, granulomatose avec polyangiite, maladie de Graves, polyarthrite rhumatoïde, hypophysite et uvéite]). Les situations constituent des exceptions sont définies dans le protocole.
    4) Maladie intercurrente non contrôlée, y compris notamment, hypertension artérielle non contrôlée, angor instable, arythmie cardiaque non contrôlée, pneumopathie interstitielle (PNI) active, pathologies gastro-intestinales (GI) chroniques graves associées à une diarrhée, situations sociales/de maladie psychiatrique susceptibles de limiter l’observance des exigences de l’étude, d’augmenter de façon importante le risque de survenue d’EI ou de compromettre la capacité du patient (de la patiente) de fournir son consentement éclairé écrit.
    5) Antécédents d’autres cancers primitifs
    6) Cancer du poumon à petites cellules ou cancer du poumon à petites cellules mixtes
    7)Antécédents d’immunodéficience primitive active.
    8. Infection active, y compris tuberculose,hépatite B et infection par le VHC.
    9) Administration d’une radiothérapie préopératoire dans le cadre du plan de traitement du patient.
    10) Patients nécessitant ou susceptibles de nécessiter une pneumonectomie, une segmentectomie ou une résection limitée atypique (« wedge resection »), d’après l’évaluation du chirurgien, pour obtenir une résection potentiellement curative de leur tumeur primitive.
    11) Intervalle QTcF ≥ 470 ms (REMARQUE : En cas d’allongement de l’intervalle QT, 2 ECG supplémentaires devront être obtenus et l’intervalle QTcF moyen devra être utilisé pour déterminer l’éligibilité).
    12)Allergie ou hypersensibilité connue aux médicaments à l’étude ou à tout excipient des médicaments à l’étude.
    13)Toute contre-indication médicale au traitement par chimiothérapie conformément aux mentions légales locales.
    14)Pathologie cardiovasculaire modérée ou sévère.
    15) Tout traitement concomitant (chimiothérapie, agent expérimental, agent biologique ou hormonothérapie) pour le traitement du cancer. L’utilisation concomitante d’une hormonothérapie pour des pathologies non liées au cancer (par exemple, hormonothérapie de substitution) est acceptable.
    16) Administration d’un vaccin vivant, atténué dans les 30 jours précédant la première dose de médicaments à l’étude. Remarque : S’ils sont recrutés, les patients ne devront pas recevoir de vaccin vivant pendant le traitement par les médicaments à l’étude et jusqu’à 30 jours après la dernière dose de médicaments à l’étude.
    17) Intervention chirurgicale majeure (telle que définie par l’investigateur) dans les 30 jours précédant la première dose de médicaments à l’étude.
    18) Exposition précédente à un traitement à médiation immunitaire, y compris notamment, tout autre traitement par anticorps anti-CTLA-4, anti-PD-1, anti-PD-L1 et anti-PD-L2. Les patients ayant reçu des agents ciblant la voie adénosine (par exemple, anti-CD73, anti-A2AR, anti-CD39) et des agents anti-NKG2A sont également exclus.
    19)Utilisation en cours ou antérieure d’un médicament immunosuppresseur dans les 14 jours précédant la première dose des médicaments à l’étude. Les situations suivantes constituent des exceptions à ce critère :
    − Corticoïdes par voie intranasale, inhalation ou topique, ou injections locales de corticoïdes (par exemple, injection intra-articulaire).
    − Corticoïdes systémiques à des doses ≤ 12 mg/jour de prednisone ou son équivalent.
    − Corticoïdes utilisés comme prémédication pour les réactions d’hypersensibilité (par exemple, prémédication de TDM).
    20)Participation à une autre étude clinique évaluant un produit expérimental administrés dans les 30 jours avant le recrutement.
    21)Affectation précédente aux médicaments à l’étude (durvalumab, oléclumab ou monalizumab) dans la présente étude.
    Veuillez vous se reporter au protocole pour une liste complète.
    E.5 End points
    E.5.1Primary end point(s)
    pCR is defined as lack of any viable tumour cells after complete evaluation in the resected lung cancer specimen and all sampled regional lymph nodes as determined by central BIPR and described by IASLC 2020.
    The measure of interest is the proportion of patients with 0% residual viable tumour cells within all resected tissue as assessed by the central blinded pathologist.
    Safety and tolerability will be evaluated in terms of AEs, vital signs, and clinical laboratory.
    La RCp est définie comme l’absence de cellules tumorales viables après une évaluation complète de l’échantillon de cancer pulmonaire réséqué et de tous les ganglions lymphatiques régionaux prélevés, d’après la détermination de l’EPIA central et conformément à la description de l’IASLC 2020 (Travis et al, 2020).
    La mesure d’intérêt est la proportion de patients ayant 0 % de cellules tumorales viables résiduelles dans tout le tissu réséqué, d’après l’évaluation de l’anatomo-pathologiste central en aveugle.
    La sécurité et la tolérance seront évaluées en termes d’EI, de signes vitaux et de résultats des analyses biologiques.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study design at various timepoints.
    Tout au long de la conception de l'étude à différents moments.
    E.5.2Secondary end point(s)
    EFS is defined as time from randomisation to the first of the following:
    • Documented disease progression of lung cancer as determined by Investigator using RECIST 1.1 assessment.
    • Death due to any cause (event date is date of death).
    • PD that precludes surgery (event date is the date of this determination) or PD discovered and reported by the Investigator upon attempting surgery (event date is the date of the first attempt at surgery).
    The measure of interest is the median of EFS and landmark EFS at 12 and 24 months

    DFS is defined as the time from the date of surgery until the first date of disease recurrence as determined by Investigator using RECIST 1.1 assessment (local or distant), or date of death due to any cause, whichever occurs first. Pathological confirmation from biopsied lesions will also be taken into consideration (as applicable). A new primary malignancy confirmed by pathology is not considered a DFS event.
    The measure of interest is the median of DFS and landmark DRS at 12 and 24 months

    Feasibility to surgery is defined as having the planned surgical resection within 40 days from the end of the last dose of neoadjuvant study drugs.
    The measure of interest is the proportion of patients that have intended surgery within 40 days from the end of last dose of study drugs.

    mPR is defined as ≤ 10% viable tumour cells in resected tumour after complete evaluation in the resected lung cancer specimen as determined by central BIPR as described by IASLC 2020. The measure of interest is the proportion of patients with ≤ 10% residual viable tumour cells within all resected tissue as assessed by the central blinded pathologist.

    ORR is defined as the proportion of patients who have a CR or PR as determined by Investigator using RECIST 1.1.
    Data obtained from randomisation up until surgery, or the last evaluable assessment in the absence of progression, prior to surgery, will be included in the assessment of ORR, regardless of whether the patient withdraws therapy. Patients who go off therapy prior to surgery, without a response, receive a subsequent therapy prior to surgery, and then respond will not be included as responders in the ORR.
    The measure of interest is the proportion of patients with OR.

    OS is defined as the time from randomisation until the date of death due to any cause.
    The measure of interest is the median of the overall OS and landmark OS at 12 and 24 months.

    Concentration of study drugs in plasma or serum.

    Presence of ADA for study drugs.

    Baseline PD-L1 expression.

    ctDNA clearance on-treatment prior to surgery.
    La SSE est définie comme le temps écoulé entre la randomisation et le premier des événements suivants :
    • Progression de la maladie (cancer du poumon) documentée, d’après la détermination de l’investigateur selon les critères RECIST 1.1.
    • Décès de quelque cause que ce soit (la date de l’événement est la date du décès).
    • PM empêchant toute chirurgie (la date de l’événement est la date de cette détermination) ou PM découverte et rapportée par l’investigateur lors d’une tentative d’intervention chirurgicale (la date de l’événement est la date de la première tentative d’intervention chirurgicale).
    La mesure d’intérêt est la médiane de la SSE et de la SSE de référence à 12 et 24 mois.

    La SSM est définie comme le temps écoulé entre la date de la chirurgie et la première date de récidive de la maladie selon la détermination de l’investigateur d’après les critères RECIST 1.1 (récidive locale ou à distance), ou la date du décès, de quelque cause que ce soit, selon l’événement survenant en premier. La confirmation anatomo-pathologique des lésions biopsiées sera également prise en considération (le cas échéant). Un nouveau cancer primitif confirmé par l’anatomo-pathologiste n’est pas considéré comme un événement de SSM.
    La mesure d’intérêt est la médiane de la SSM et de la SSM de référence à 12 et 24 mois.

    La faisabilité de la chirurgie est définie comme la réalisation de la résection chirurgicale programmée, dans un délai de 40 jours après la fin de la dernière dose de médicaments à l’étude néoadjuvants.
    La mesure d’intérêt est la proportion de patients ayant prévu une intervention chirurgicale dans les 40 jours après la fin de la dernière dose de médicaments à l’étude.

    La RPM est définie comme la présence de ≤ 10 % de cellules tumorales viables dans la tumeur réséquée après une évaluation complète de l’échantillon de cancer pulmonaire réséqué, d’après la détermination de l’EPIA central et conformément à la description de l’IASLC 2020. La mesure d’intérêt est la proportion de patients ayant ≤ 10 % de cellules tumorales viables résiduelles dans tout le tissu réséqué, d’après l’évaluation de l’anatomo-pathologiste central en aveugle.

    Le TRO est défini comme la proportion de patients ayant une RC ou une RP, d’après l’évaluation de l’investigateur selon les critères RECIST 1.1.
    Les données obtenues entre la randomisation et la chirurgie, ou le dernier examen évaluable en absence de progression, avant la chirurgie, seront incluses dans l’évaluation du TRO, indépendamment de l’arrêt éventuel du traitement par le (la) patient(e). Les patients arrêtant le traitement avant la chirurgie, qui n’ont pas de réponse, mais qui reçoivent un traitement ultérieur avant la chirurgie et ont ensuite une réponse, ne seront pas inclus comme des répondeurs dans l’évaluation du TRO.La mesure d’intérêt est la proportion de patients ayant une RG.

    La SG est définie comme le temps écoulé entre la randomisation et la date du décès de quelque cause que ce soit.
    La mesure d’intérêt est la médiane de la SG et de la SG de référence à 12 et 24 mois.

    Concentration de médicaments à l’étude dans le plasma ou le sérum.

    Présence d’AAM dirigés contre les médicaments à l’étude.

    Expression initiale de PD-L1.

    Élimination de l’ADNtc sous traitement avant la chirurgie.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the study design at various timepoints.
    Tout au long de la conception de l'étude à différents moments.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    durvalumab and oleclumab vs durvalumab and monalizumab
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA40
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    France
    Italy
    Korea, Republic of
    Portugal
    Russian Federation
    Spain
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of study is defined as the last expected visit/contact of the last patient completing the
    12-month survival follow-up visit
    La fin de l'étude est définie comme la dernière visite/ contact attendu du dernier patient complétant la visite de suivi de survie à 12 mois
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months8
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years5
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 120
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 20
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state14
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 100
    F.4.2.2In the whole clinical trial 140
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    In the event that a rollover or safety extension study is available at the time of the final DCO and database closure, patients may be transitioned to such a study, and the current study would reach its end.
    S’il existe une étude de reconduction (roll-over) ou d’extension de sécurité au moment de la DLRD finale et de la clôture de la base de données, une transition des patients sous traitement par médicaments de l’étude pourra être envisagée dans ce type d’étude et l’étude en cours atteindra son terme.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2022-04-14
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-03-22
    P. End of Trial
    P.End of Trial StatusTrial now transitioned
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