E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
The target population of interest in this study is participants with locally advanced (Stage III), unresectable NSCLC, whose tumours express PD L1 TC ≥ 1% as assessed by a central reference laboratory using the VENTANA PD-L1 (SP263) IHC assay, and who did not progress after definitive platinum based cCRT. |
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E.1.1.1 | Medical condition in easily understood language |
Unresectable, locally advanced (Stage III) lung cancer (non-small cell lung cancer) with PD-L1 biomarker expression |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate superiority of durvalumab plus domvanalimab relative to durvalumab plus placebo in participants with locally advanced, unresectable NSCLC who have not progressed on prior platinum-based cCRT, with PD-L1 TC ≥ 50%, progression free survival (PFS) assessed by blind independent committee review (BICR). |
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E.2.2 | Secondary objectives of the trial |
To demonstrate superiority of durvalumab plus domvanalimab relative to durvalumab plus placebo in participants with TC ≥ 1%, progression free survival (PFS) assessed by Blinded Independent Central Review (BICR).
To demonstrate superiority of durvalumab plus domvanalimab relative to durvalumab plus placebo in participants with TC ≥ 1% or TC ≥ 50% in the following outcomes: • Overall response rate (ORR) • Duration of response (DoR) • Time to second progression (PFS2) • Time to death or distant metastatis (TTDM) • Time to First Subsequent Therapy (TFST) • PFS at 6, 12, 18 and 24 months • Overall Survival at 24 months (OS 24) • Overall Survival (OS) • PFS as assessed by investigator • Time to deterioration in pulmonary symptoms Test the above objectives using an alternative PD-L1 IHC assay, PD-L1 IHC 22C3 pharmDx
PK and immunogenicity of durvalumab and domvanalimab To assess the safety and tolerability of durvalumab plus domvanalimab as compared to durvalumab plus placebo. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Participant must be ≥ 18 years at the time of screening. 2. Histologically- or cytologically-documented NSCLC and have been treated with concurrent CRT for locally advanced, unresectable (Stage III) disease 3. Provision of a tumour tissue sample obtained prior to CRT 4. Documented tumour PD-L1 status ≥ 1% by central lab 5. Documented EGFR and ALK wild-type status (local or central). 6. Patients must not have progressed following definitive, platinum-based, concurrent chemoradiotherapy 7. Participants must have received at least 2 cycles of platinum-based chemotherapy concurrent with radiation therapy 8. Participants must have received a total dose of radiation of 60 Gy ±10% (54 Gy to 66 Gy) as part of the chemoradiation therapy, to be randomised. Radiation therapy should be administered by intensity modulated RT (preferred) or 3D-conforming technique. 9. WHO performance status of 0 or 1 at randomization 10. Adequate organ and marrow function |
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E.4 | Principal exclusion criteria |
Participants are excluded from the study if any of the following criteria apply: 1. History of another primary malignancy except for malignancy treated with curative intent with no known active disease > 5 years before the first dose of study intervention and of low potential risk for recurrence, basal cell carcinoma of the skin, squamous cell carcinoma of the skin or lentigo maligna that has undergone potentially curative therapy, adequately treated carcinoma in situ or Ta tumours treated with curative intent and without evidence of disease. 2. Mixed small cell and non-small cell lung cancer histology. 3. Participants who receive sequential (not inclusive of induction) chemoradiation therapy for locally advanced (Stage III) unresectable NSCLC. 4. Participants with locally advanced (Stage III) unresectable NSCLC who have progressed during platinum-based cCRT. 5. Any unresolved toxicity CTCAE >Grade 2 from the prior chemoradiation therapy (excluding alopecia). 6. Participants with ≥grade 2 pneumonitis from prior chemoradiation therapy. 7. History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis, ILD, pleural effusion, or pulmonary fibrosis diagnosed in the past 6 months prior to randomization. 8. Active or prior documented autoimmune or inflammatory disorders (with exceptions) 9. Active EBV infection, or known or suspected chronic active EBV infection at screening 10. Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab.
Reproduction 11. Negative pregnancy test (serum) for WOCBP: 12. Female participants must be 1 year post menopausal, surgically sterile, or using 1 highly effective form of birth control 13. Male participants who intend to be sexually active with a WOCBP must be surgically sterile or using an acceptable method of contraception |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression Free Survival (PFS) using Blinded Independent Central Review (BICR) assessment according to RECIST 1.1 with participants with PD-L1 TC>=50%. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
PFS will be evaluated every 8 weeks (±7 days) from randomisation through 48 weeks, and q12w (± 7 days) thereafter until RECIST 1.1 defined radiological progression, plus 1 or more follow-up scans. |
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E.5.2 | Secondary end point(s) |
PFS measured by hazard ratio (HR), in participants with PD-L1 TC ≥ 1% as assessed by BICR.
Comparison of durvalumab plus domvanalimab relative to durvalumab plus placebo in participants with TC ≥ 1% or TC ≥ 50% in the following outcomes
1. Overall Survival (OS) 2. PFS assessment by investigator according to RECIST 1.1 3. PFS6, PFS12, PFS18, PFS24 4. Overall Survival at 24 months (OS 24) 5. Objective response rate (ORR) using BICR assessment according to RECIST 1.1. 6. Duration of response (DoR) using BICR assessment according to RECIST 1.1 7. Time from randomization to second progression (PFS2) 7. Time from randomization until the first date of distant metastasis or death in the absence o distant metastasis (TTDM). 9. Time to first subsequent therapy (TFST) 10. The pharmacokinetics (PK) of durvalumab and domvanalimab as determined by concentration. 11. The immunogenicity of Durvalumab and domvanalimab as assessed by presence of anti-drug antibodies (ADAs) 12. Time to First Confirmed Deterioration (TTFCD) in pulmonary symptoms measured by the NSCLC-SAQ. 13. Test the above objectives using an alternative PD-L1 IHC assay, PD-L1 IHC 22C3 pharmDx |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
PFS will be evaluated every 8 weeks (±7 days) from randomisation through 48 weeks, and q12w (± 7 days) thereafter until RECIST 1.1 defined radiological progression, plus 1 or more follow-up scans.
ORR, DoR, PFS by investigator, PFS2, PFS6, PFS12, PFS18, PFS24, TTDM, TFST, TTFCD, up to approximately 8 years after first patient randomized
OS and OS24, up to approximately 8 years after first patient randomized.
ADA and PK: from date of randomization to approximately 12 weeks after last IP dose. |
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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 | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability Symptoms and Health-related quality of life |
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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 | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 57 |
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 |
Brazil |
Chile |
China |
India |
Japan |
Korea, Republic of |
Malaysia |
Mexico |
Philippines |
South Africa |
Taiwan |
United States |
France |
Poland |
Romania |
Spain |
Germany |
Greece |
Belgium |
Hungary |
Norway |
Russian Federation |
Turkey |
Ukraine |
United Kingdom |
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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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The end of study is defined as the date of the last visit for the last participant in the study globally. A participant is considered to have completed the study if he/she has completed all phases of the study including the last expected visit. Participants may be withdrawn from the study if the study itself is stopped. The study may be stopped if, in the judgement of AstraZeneca, participants are placed at undue risk because of clinically significant findings. |
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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 | 7 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 8 |
E.8.9.2 | In all countries concerned by the trial days | 0 |