A trial to learn if different cancer treatment combinations are safe and work in people with advanced non-small cell lung cancer that has mutations in the EGFR gene and who have become resistant to osimertinib

2023-504624-25-00 Protocol D6186C00001 Therapeutic exploratory (Phase II) Ongoing, recruitment ended

Start 26 Sep 2019 · Status Ongoing, recruitment ended · 5 EU/EEA countries · 16 sites · Protocol D6186C00001

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruitment ended
Participants planned 99
Countries 5
Sites 16

Advanced Non-Small Cell Lung Cancer

To assess the efficacy of each treatment by evaluation of objective response rate.

Key facts

Sponsor
AstraZeneca AB
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
26 Sep 2019 → ongoing
Decision date (initial)
2024-08-20
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
AstraZeneca AB

External identifiers

EU CT number
2023-504624-25-00
EudraCT number
2018-003974-29
ClinicalTrials.gov
NCT03944772

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy

To assess the efficacy of each treatment by evaluation of objective response rate.

Secondary objectives 3

  1. To assess the efficacy of each treatment by evaluation of tumour response and overall survival: tumour response (Progression-free survival, Duration of response) and Overall survival.
  2. To assess the pharmacokinetics (PK) of each treatment: Plasma/Serum concentrations of specific agents at selected time points.
  3. To assess the safety and tolerability of each treatment.

Conditions and MedDRA coding

Advanced Non-Small Cell Lung Cancer

VersionLevelCodeTermSystem organ class
21.1 PT 10061873 Non-small cell lung cancer 100000004864

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 Modules
Study is modular in design, consisting of biomarker matched & biomarker non-matched cohorts
Not Applicable None Module 7: Etoposide + Carboplatin/Cisplatin + Durvalumab: The patients in this group will receive platinum-containing doublet (etoposide + carboplatin or cisplatin) taken in combination with durvalumab.
Module 9: Osimertinib + Selumetinib: The patients in this group will receive osimertinib taken in combination with selumetinib.
Module 10: Osimertinib + Datopotamab deruxtecan: The patients in this group will receive osimertinib taken in combination with datopotamab deruxtecan.

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. NSCLC with the following features: (a) Locally advanced or metastatic disease (ie, advanced NSCLC) not amenable to curative surgery or radiotherapy at study entry. (b) Histologically or cytologically confirmed adenocarcinoma of the lung (patients with mixed histology are eligible if adenocarcinoma is the predominant histology) harboring EGFR mutation(s) known to be associated with EGFR TKI sensitivity at diagnosis. (c) Received only one line of therapy, with single-agent osimertinib, for advanced NSCLC, with clinical benefit as judged by investigator discretion. (Note: a ‘line’ of therapy is defined as a daily anti-cancer treatment administered for >14 days, or a single infusion of an intravenous anti-cancer treatment. For instance, patients who have had <14 days of a first- or second- generation TKI prior to osimertinib, and stopped due to adverse events, would be eligible to enter this study, see also exclusion criteria 5). Patients previously treated adjuvantly or neo-adjuvantly are eligible per exclusion criterion 5. (d) Evidence of radiological disease progression on first-line monotherapy with osimertinib 80 mg po QD.
  2. Suitable for a mandatory biopsy defined as having an accessible tumor; by whichever modality the site uses and, ideally, confirmed by the person who will perform the procedure; and a stable clinical condition that will allow the patient to tolerate the procedure. The biopsy should be performed within 60 days of the planned first dose of study treatment.
  3. Patients must have measurable disease per RECIST 1.1, as defined by at least 1 lesion that can be accurately measured at baseline as ≥ 10 mm at the longest diameter (except lymph nodes which must have a short axis ≥ 15 mm) with computed tomography (CT) or magnetic resonance imaging (MRI), which is suitable for accurate repeated measurements. Previously irradiated lesions or a lesion in the field of radiation should not be used as measurable disease unless the lesion(s) has/have demonstrated unequivocal disease progression by RECIST 1.1. Target lesions should not be used for the baseline tumour biopsy, unless there are no other lesions suitable for biopsy and they fulfil requirements.
  4. Adequate coagulation parameters, defined as: International Normalisation Ratio (INR) < 1.5 × upper limit of normal (ULN) and activated partial thromboplastin time < 1.5 × ULN unless patients are receiving therapeutic anti-coagulation which affects these parameters.

Exclusion criteria 6

  1. Patients whose disease has progressed within the first 3 months of osimertinib treatment (refractory to osimertinib treatment).
  2. Patients must not have experienced a toxicity(-ies) that led to permanent discontinuation or dose reduction of prior osimertinib. (a) Patients who had dose reductions in the past, but were receiving a full dose of osimertinib at the time of pre-screening should be discussed with the Study Physician.
  3. Any unresolved toxicities from prior osimertinib treatment greater than CTCAE Grade 1 at the time of starting study treatment.
  4. Patients should not have discontinued osimertinib >60 days prior to the first dose of study treatment.
  5. Inadequate bone marrow reserve or organ function as demonstrated by any of the following laboratory values: a) Absolute neutrophil count < 1.5 × 109/L. b) Platelet count < 100 × 109/L. c) Haemoglobin < 9 g/dL. d) Alanine transaminase (ALT) > 2.5 × ULN. e) Aspartate aminotransferase (AST) > 2.5 × ULN. f) Total bilirubin (TBL) > 1.5 × ULN, or > 3 × ULN in the presence of documented Gilbert’s Syndrome (unconjugated hyperbilirubinaemia).
  6. Creatinine clearance (CrCl) < 50 mL/min, calculated using Cockcroft-Gault equation (Cockcroft and Gault 1976) or 24-hour urine collection.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. To assess the efficacy of each treatment by evaluation of objective response rate - Endpoint based on Response Evaluation Criteria in Solid Tumours (RECIST 1.1) • Objective response rate (ORR)

Secondary endpoints 3

  1. To assess the efficacy of each treatment by evaluation of tumour response and overall survival Overall survival (OS) - Endpoint based on Response Evaluation Criteria in Solid Tumours (RECIST 1.1): • Progression-free survival (PFS) • Duration of response (DoR)
  2. To assess the pharmacokinetics (PK) of each treatment: plasma/serum concentrations will be measured.
  3. To assess the safety and tolerability of each treatment - • Adverse events/serious adverse events (AEs/SAEs): • Physical examinations • Laboratory findings • Vital signs • Electrocardiogram (ECG). • Left ventricular ejection fraction (LVEF)

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 8

Etoposide

SUB07337MIG · Substance

Active substance
Etoposide
Pharmaceutical form
CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
IV INFUSION
Max daily dose
100 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Carboplatin

SUB06614MIG · Substance

Active substance
Carboplatin
Pharmaceutical form
INTRAVENOUS INFUSION
Route of administration
INTRAVENIOUS INFUSION
Max daily dose
750 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Datopotamab deruxtecan

PRD9684738 · Product

Active substance
Datopotamab Deruxtecan
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INFUSION
Max daily dose
6 mg/Kg milligram(s)/kilogram
Max total dose
00 mg/Kg milligram(s)/kilogram
Max treatment duration
999999 Month(s)
Authorisation status
Not Authorised
MA holder
DAIICHI SANKYO, INC.
Paediatric formulation
No
Orphan designation
No

TAGRISSO 80 mg film-coated tablets

PRD4954972 · Product

Active substance
Osimertinib
Substance synonyms
AZD9291
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
80 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L01XE35 — -
Marketing authorisation
EU/1/16/1086/004
MA holder
ASTRAZENECA AB
MA country
Liechtenstein
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
The clinical tablets are plain on both sides and packed in HDPE bottles, while the commercial tablets are debossed with a commercial image and packed in aluminium blisters. The supply chain is different for commercial and clinical product.

TAGRISSO 40 mg film-coated tablets

PRD4954971 · Product

Active substance
Osimertinib
Substance synonyms
AZD9291
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
80 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L01EB04 — -
Marketing authorisation
EU/1/16/1086/003
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
The clinical tablets are plain on both sides and packed in HDPE bottles, while the commercial tablets are debossed with a commercial image and packed in aluminium blisters. The supply chain is different for commercial and clinical product.

Koselugo 25 mg hard capsules

PRD9025878 · Product

Active substance
Selumetinib
Substance synonyms
AZD6244
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL USE
Max daily dose
150 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L01EE04 — -
Marketing authorisation
EU/1/21/1552/002
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
Yes
Orphan designation number
EU/3/18/2050
Modified vs. Marketing Authorisation
No

Cisplatin

SUB07483MIG · Substance

Active substance
Cisplatin
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
IV INFUSION
Max daily dose
80 mg/m2 milligram(s)/sq. meter
Max total dose
300 mg/m2 milligram(s)/sq. meter
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

IMFINZI 50 mg/mL concentrate for solution for infusion.

PRD6651398 · Product

Active substance
Durvalumab
Substance synonyms
MEDI4736
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
IV INFUSION
Max daily dose
1500 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L01XC28 — -
Marketing authorisation
EU/1/18/1322/001
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Auxiliary 6

Inflectra 100 mg powder for concentrate for solution for infusion

PRD6487529 · Product

Active substance
Infliximab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AB02 — -
Marketing authorisation
EU/1/13/854/005
MA holder
PFIZER EUROPE MA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Inflectra 100 mg powder for concentrate for solution for infusion

PRD6483369 · Product

Active substance
Infliximab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AB02 — -
Marketing authorisation
EU/1/13/854/001
MA holder
PFIZER EUROPE MA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Inflectra 100 mg powder for concentrate for solution for infusion

PRD6487527 · Product

Active substance
Infliximab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AB02 — -
Marketing authorisation
EU/1/13/854/003
MA holder
PFIZER EUROPE MA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Inflectra 100 mg powder for concentrate for solution for infusion

PRD6487528 · Product

Active substance
Infliximab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AB02 — -
Marketing authorisation
EU/1/13/854/004
MA holder
PFIZER EUROPE MA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Inflectra 100 mg powder for concentrate for solution for infusion

PRD6483619 · Product

Active substance
Infliximab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AB02 — -
Marketing authorisation
EU/1/13/854/002
MA holder
PFIZER EUROPE MA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Mycophenolate Mofetil Accord 250 mg capsules

PRD391904 · Product

Active substance
Mycophenolate Mofetil
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
999999 Month(s)
Authorisation status
Authorised
ATC code
L04AA06 — MYCOPHENOLIC ACID
Marketing authorisation
PA 2315/064/001
MA holder
ACCORD HEALTHCARE IRELAND LIMITED
MA country
Ireland
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

AstraZeneca AB

Sponsor organisation
AstraZeneca AB
Address
Astraallen Gartuna, Karlebyhus Byggnad 674 Karlebyhus Byggnad 674
City
Sodertalje
Postcode
151 85
Country
Sweden

Scientific contact point

Organisation
AstraZeneca AB
Contact name
AstraZeneca Clinical Study Information Center

Public contact point

Organisation
AstraZeneca AB
Contact name
AstraZeneca Clinical Study Information Center

Locations

5 EU/EEA countries · 16 investigational sites

By country

CountryMS statusPlanned subjectsSites
Italy Ended 15 3
Netherlands Ongoing, recruitment ended 13 4
Norway Ended 8 3
Spain Ended 7 5
Sweden Ongoing, recruitment ended 2 1
Rest of world
Japan, United States, Korea, Republic of
54

Investigational sites

Italy

3 sites · Ended
IRCCS Istituto Nazionale Tumori Fondazione Pascale
S.C. Oncologia Clinica Sperimentale Toraco-Polmonare, Via Mariano Semmola 52, 80131, Naples
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
Oncologia, Regione Gonzole 10, 10043, Orbassano
Istituto Oncologico Veneto
Oncology 2, Via Gattamelata 64, 35128, Padova

Netherlands

4 sites · Ongoing, recruitment ended
Stichting Amsterdam UMC
Afdeling Medische Oncologie, De Boelelaan 1117, 1081 HV, Amsterdam
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Afdeling Oncologie, Dr. Molewaterplein 40, 3015 GD, Rotterdam
Academisch Ziekenhuis Maastricht
longziekten, P Debyelaan 25, 6229 HX, Maastricht
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Thoraxoncologie, Plesmanlaan 121, 1066 CX, Amsterdam

Norway

3 sites · Ended
St. Olavs Hospital HF
Onkologisk avdeling, Prinsesse Kristinas G. 3, 7030, Trondheim
Oslo University Hospital HF
Onkologisk avdeling, Montebello, Ullernchausséen 70, Oslo
Vestre Viken HF
Onkologisk avdeling, Dronninggata 28, 3004, Drammen

Spain

5 sites · Ended
Hospital Universitario La Paz
Oncología, Paseo De La Castellana 261, 28046, Madrid
Hospital De La Santa Creu I Sant Pau
Oncología, Carrer De San Quinti 89, 08041, Barcelona
Hospital Clinic De Barcelona
Oncología, Calle Villarroel 170, 08036, Barcelona
Complexo Hospitalario Universitario A Coruna
Oncología, Lugar Jubias De Arriba 84, 15006, A Coruna
Hospital Universitario 12 De Octubre
Oncología, Bloque D, Avenida De Cordoba Sn, Madrid

Sweden

1 site · Ongoing, recruitment ended
Karolinska University Hospital
Cancerstudieenheten, Eugeniavagen 3, 171 64, Solna

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Italy 2022-11-15 2025-07-04 2022-11-25 2023-09-22
Netherlands 2019-11-13 2020-05-28 2023-07-20
Norway 2019-11-05 2025-04-14 2019-12-18 2023-09-12
Spain 2019-09-26 2024-11-04 2019-10-08 2023-08-01
Sweden 2019-12-03 2020-05-04 2023-08-02

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 38 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol core_2023-504624-25-00_redacted 7.0
Protocol (for publication) D1_Protocol M10_2023-504624-25-00_redacted 7.0
Protocol (for publication) D1_Protocol M7_2023-504624-25-00_redacted 7.0
Protocol (for publication) D1_Protocol M9_2023-504624-25-00_redacted 7.0
Recruitment arrangements (for publication) K_Recruitment Arrangements_CTIS Blank Document NA
Recruitment arrangements (for publication) K_Recruitment Arrangements_CTIS Blank Document NA
Recruitment arrangements (for publication) K_Recruitment Arrangements_CTIS Blank Document NA
Recruitment arrangements (for publication) K_Recruitment Arrangements_CTIS Blank Document NA
Recruitment arrangements (for publication) K1_Recruitment Arrangements_Placeholder_NL 1.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_Mod 10_NL_Redacted 4.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_Mod 7_NL_Redacted 6.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_Mod 9_NL_Redacted 6.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Pregnant Partner_SE 6.0
Subject information and informed consent form (for publication) L1_SIS and ICF Adults_TBP_NL 1.0
Subject information and informed consent form (for publication) L1_SIS and ICF pre-screening_NL_Redacted 7.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF Module 10_IT_Redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF Module 7_IT_Redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF Module 9_IT_Redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF_Module 10_ES_Redacted 3.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF_Module 7_ES_Redacted 4.1
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult Subject ICF_Module 9_ES_Redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF_ICF for treatment beyond progression_IT 1.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Main_NO_Redacted 5
Subject information and informed consent form (for publication) L1_SIS and ICF_Main_SE_Redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Pregnant Partner_IT 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF_Pregnant Partners_NO 3
Subject information and informed consent form (for publication) L1_SIS and ICF_Pregnat Partner ICF_ES 4.0
Subject information and informed consent form (for publication) L2_SIS and ICF_ Addendum_NO 1.0
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC_carboplatin N/A
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC_cisplatin N/A
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC_etoposide N/A
Synopsis of the protocol (for publication) D1_Protocol Synopsis_IT_2023-504624-25-00_redacted 3.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_ENG_2023-504624-25 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_ES_2023-504624-25 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_IT_2023-504624-25 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_NLD_2023-504624-25 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_NO_2023-504624-25 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_Lay Language_SE_2023-504624-25 1.0

Application history

3 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-07-05 Norway Acceptable
2024-08-13
2024-08-14
2 SUBSTANTIAL MODIFICATION SM-1 2024-09-27 Norway Acceptable
2024-12-02
2024-12-05
3 NON SUBSTANTIAL MODIFICATION NSM-2 2025-02-26 Norway Acceptable
2024-12-02
2025-02-26