A Molecular Profiling Study of Patients With EGFR Mutation-positive Locally Advanced or Metastatic NSCLC Treated With Osimertinib

NCT ID: NCT03239340

Last Updated: 2024-10-21

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 154 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-05-30
• Study Completion Date: 2023-09-19

Brief Summary

A multicentre, open-label, single-arm, molecular profiling study of patients with EGFR mutation-positive locally advanced or metastatic NSCLC treated with osimertinib.

Detailed Description

Study design This is a phase II, open-label, single-arm tissue and plasma acquisition study assessing the efficacy, safety and underlying resistance mechanisms of osimertinib (80 mg orally, once daily) as first-line treatment in patients with locally advanced or metastatic EGFR mutation positive non-small cell lung cancer who are EGFR tyrosine kinase inhibitor treatment-naïve and eligible for first-line treatment. Participants with EGFR mutation-positive non-small cell lung cancer will be required to consent to 2 mandatory tumour biopsies to be considered for enrolment in this study. The first biopsy will be done prior to initiating treatment with osimertinib and the second biopsy will be obtained any time between Investigator assessed, Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1)-defined progression and before the start of any new anticancer treatment. A third optional biopsy may be taken during the course of treatment at the Investigator's discretion if the patient consents and if clinically feasible. Tumour tissue and plasma samples will be collected and examined for genetic and non genetic aberrations that may be important in determining response and resistance to the treatment that participants will receive as a part of their cancer care. Patients should continue on osimertinib until progression or until other treatment discontinuation criteria are met. However, if patients continue to show clinical benefit to treatment as judged by the Investigator, patients may continue to receive osimertinib beyond RECIST 1.1-defined progression. Therefore, there is no maximum duration of treatment. Tumour assessments will be performed at baseline and then every 8 weeks from study enrolment until 3.5 years, and then every 10 weeks until RECIST 1.1-defined. Patients will be followed up for a period of 28 days following discontinuation of osimertinib. Target patient population Male and female patients aged 18 years and over with locally advanced or metastatic pathologically confirmed adenocarcinoma of the lung, not amenable to curative surgery or radiotherapy. Patients will have a tumour that harbours one of the EGFR mutations known to be associated with EGFR tyrosine kinase inhibitor sensitivity, either alone or in combination with other EGFR mutations (EGFR mutation status determined by a local laboratory). Patients must be EGFR tyrosine kinase inhibitor treatment-naïve and eligible to receive first line treatment with osimertinib. Osimertinib is an oral, potent, selective, irreversible inhibitor of both EGFR tyrosine kinase inhibitor sensitizing and resistance mutations in non-small cell lung cancer with a significant selectivity margin over wild type EGFR. Osimertinib (80 mg orally, once daily) will be administered. Doses may be reduced to 40 mg if needed.

Conditions

EGFR Mutation Positive Locally Advanced or Metastatic Non-Small Cell Lung Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Osimertinib

An oral, potent, selective, irreversible inhibitor of both EGFR-tyrosine kinase inhibitor sensitizing and resistance mutations in non-small cell lung cancer

Group Type: EXPERIMENTAL

Osimertinib

Intervention Type: DRUG

Osimertinib is an oral, potent, selective, irreversible inhibitor of both EGFR-tyrosine kinase inhibitor sensitizing and resistance mutations in non-small cell lung cancer with a significant selectivity margin over wild type EGFR.

Interventions

Osimertinib

Osimertinib is an oral, potent, selective, irreversible inhibitor of both EGFR-tyrosine kinase inhibitor sensitizing and resistance mutations in non-small cell lung cancer with a significant selectivity margin over wild type EGFR.

Intervention Type: DRUG

Other Intervention Names

TAGRISSO, AZD9291

Eligibility Criteria

Inclusion Criteria

1. Provision of informed consent prior

2. Patients aged 18 years or older

3. Patients with histological confirmation of locally advanced or metastatic NSCLC

4. Patients with M1 stage according to the Tumor, Node and Metastasis Classification of Malignant Tumours (TNM)

5. Patients with an EGFR deletion or mutation known (from tumour biopsy or plasma) to be associated with EGFR TKI sensitivity

6. Existence of measurable or evaluable disease (as per RECIST 1.1 criteria).

7. Possibility of obtaining sufficient tissue sample, via a biopsy or surgical resection of the primary tumour or metastatic tumour tissue

8. WHO performance status 0-1

9. Life expectancy ≥12 weeks

10. Capacity to swallow

11. Patients able to complete study and within geographical proximity allowing for adequate follow up

12. Resolution of all acute toxic effects of previous anticancer therapy

13. Female patients must be using highly effective contraceptive measures, and must have a negative pregnancy test prior to start of dosing if of childbearing potential

14. Male patients must be willing to use barrier contraception

Exclusion Criteria

1. Locally advanced lung cancer candidate for curative treatment through radical surgery and/or radio(chemo)therapy

2. Patients diagnosed with another lung cancer subtype

3. Patients with an EGFR exon 20 insertion

4. Patients with just one measurable or evaluable tumour lesion that has been resected or irradiated prior to their enrolment in the study

5. Second active neoplasia

6. Treatment with an investigational drug within five half-lives of the compound

7. Participation in another clinical study with an investigational product (IP) during the last 3 weeks before the first day of study treatment

8. Patients who have received prior immunotherapies

9. Patients who have received prior EGFR treatments for lung cancer

10. Patients who have received prior treatment with an EGFR TKI including in the adjuvant setting

11. Patients who have received previous treatment for metastatic or stage IV disease

12. Prior treatment with cytotoxic chemotherapy for advanced NSCLC

13. Patients with a history of cancer that has been completely treated, with no evidence of malignant disease currently cannot be enrolled in the study if their chemotherapy was completed less than 6 months prior and/or have received a bone marrow transplant less than 2 years before the first day of study treatment

14. Any unresolved toxicities from prior therapy greater than CTCAE grade 1 at the time of starting study treatment with the exception of alopecia and grade 2, prior platinum-therapy related neuropathy

15. Any evidence of severe or uncontrolled systemic diseases, including uncontrolled hypertension and active bleeding diatheses or active infection (eg, patients receiving treatment for infection) including hepatitis C and human immunodeficiency virus (HIV), or active uncontrolled Hepatitis B virus (HBV) infection.

16. Patients who have had a surgical procedure unrelated to the study within 14 days or major surgery within 1 month prior to the administration of the study drug

17. Past medical history of interstitial lung disease (ILD), drug-induced ILD, radiation pneumonitis

18. Any of the following cardiac criteria: Mean resting QT interval corrected for heart rate (QTc) more than 470 msec, obtained from 3 ECGs, using the screening clinic ECG machine derived QTc value. Any clinically important abnormalities in rhythm, conduction or morphology of resting ECG e.g. complete left bundle branch block, third degree heart block and second degree heart block. Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, hypokalaemia, hypomagnesaemia, hypocalcaemia, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age in first degree relatives or any concomitant medication known to prolong the QT interval

19. Spinal cord compression, symptomatic and unstable brain metastases except for those patients who have completed definitive therapy, and have had a stable neurological status for at least 2 weeks after completion of definitive therapy. 20.Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of osimertinib

21.Inadequate bone marrow reserve or organ function 22.Female patients who are breastfeeding 23.Patients currently receiving medications or herbal supplements known to be potent inducers of cytochrome (CYP) 3A4.

24.Patient unwilling to undergo a biopsy at the time of disease progression 25.History of hypersensitivity to active or inactive excipients of osimertinib or drugs with a similar chemical structure or class to osimertinib 26.Judgment by the Investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements 27.Involvement in the planning and/or conduct of the study 28.Previous enrolment in the present study

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 130 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Parexel

INDUSTRY

Sponsor Role: collaborator

AstraZeneca

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Zosia Piotrowska, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Locations

Research Site

Athens, Georgia, United States

Research Site

Atlanta, Georgia, United States

Research Site

Boston, Massachusetts, United States

Research Site

Brescia, , Italy

Research Site

Meldola, , Italy

Research Site

Monza, , Italy

Research Site

Parma, , Italy

Research Site

Roma, , Italy

Research Site

Terni, , Italy

Research Site

Johor Bahru, , Malaysia

Research Site

Kuantan, , Malaysia

Research Site

Kuching, , Malaysia

Research Site

Lembah Pantai, , Malaysia

Research Site

Pulau Pinang, , Malaysia

Research Site

Busan, , South Korea

Research Site

Cheongiu, , South Korea

Research Site

Seongnam, , South Korea

Research Site

Seoul, , South Korea

Research Site

Seoul, , South Korea

Research Site

Seoul, , South Korea

Research Site

Seoul, , South Korea

Research Site

A Coruña, , Spain

Research Site

Barcelona, , Spain

Research Site

Las Palmas de Gran Canaria, , Spain

Research Site

Madrid, , Spain

Research Site

Seville, , Spain

Countries

United States; Italy; Malaysia; South Korea; Spain

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=D5161C00003&attachmentIdentifier=0512bdf7-7e91-4862-b078-e8c798059269&fileName=235434_CSR_Synopsis_28-June-24_Redacted_Approved_PDF_A.pdf&versionIdentifier=

Redacted CSR synopsis

https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=D5161C00003&attachmentIdentifier=38f2807f-f212-4590-8e86-5b2d13cb3772&fileName=235434_Protocol_13Aug_24_Redacted_Approved_PDF_A.pdf&versionIdentifier=

Redacted CSP

https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=D5161C00003&attachmentIdentifier=806e2b73-bfa4-4a78-890a-f0655e38acb4&fileName=235434_SAP_13Aug_24_Redacted_Approved_PDF_A.pdf&versionIdentifier=

Redacted SAP

Other Identifiers

2017-002359-27

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

D5161C00003

Identifier Type: -

Identifier Source: org_study_id