Clinical trial • Phase III • Oncology

OSIMERTINIB for Stage IA2-IA3 non-small cell lung cancer | EGFR-mutant non-small cell lung cancer

Phase III trial of OSIMERTINIB for Stage IA2-IA3 non-small cell lung cancer | EGFR-mutant non-small cell lung cancer.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Stage IA2-IA3 non-small cell lung cancer | EGFR-mutant non-small cell lung cancer
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
09-08-2024
First CTIS Authorization Date
25-09-2024

Trial design

Randomised, osimertinib 80 mg once daily (dose may be reduced to 40 mg once daily at investigator discretion) versus matching placebo once daily (matching placebo if dose reduction to 40 mg).-controlled Phase III trial in Germany, Italy, Poland and others.

Randomised
Yes
Comparator
Osimertinib 80 mg once daily (dose may be reduced to 40 mg once daily at Investigator discretion) versus matching placebo once daily (matching placebo if dose reduction to 40 mg).
Target Sample Size
361
Trial Duration For Participant
1095

Eligibility

Recruits 361 Vulnerable population is selected. Participants are adult patients (≥18 years). Informed consent is required from each adult participant using the Subject Information Sheet and Adult Subject Informed Consent Form; separate pre-screening ICF, optional genetic research ICF and Pregnant Partner ICF documents are provided. No assent/parental consent procedures (minors are excluded). ICFs are provided in relevant country/language-specific versions (documents available for IT, PL and other local versions)..

Pregnancy Exclusion
Females must be using highly effective contraceptive measures, and must have a negative pregnancy test prior to start of dosing if of child-bearing potential, or must have evidence of non-child-bearing potential. Male subjects must be willing to use barrier contraception.
Vulnerable Population
Vulnerable population is selected. Participants are adult patients (≥18 years). Informed consent is required from each adult participant using the Subject Information Sheet and Adult Subject Informed Consent Form; separate pre-screening ICF, optional genetic research ICF and Pregnant Partner ICF documents are provided. No assent/parental consent procedures (minors are excluded). ICFs are provided in relevant country/language-specific versions (documents available for IT, PL and other local versions).

Inclusion criteria

  • {"criterion_text":"- Male or female, at least ≥ 18 years.\n- Females must be using highly effective contraceptive measures, and must have a negative pregnancy test prior to start of dosing if of child-bearing potential, or must have evidence of non-child-bearing potential. Male subjects must be willing to use barrier contraception.\n- NSCLC, of non-squamous histology.\n- Stage IA2 or IA3 disease, based on TNM8 classification.\n- Complete surgical resection (R0) of the primary NSCLC by lobectomy, bilobectomy, segmentectomy or sleeve resection.\n- Complete recovery from surgery at the time of randomisation. Study intervention cannot commence within 4 weeks following surgery. No more than 12 weeks may have elapsed between surgery and randomisation for participants.\n- World Health Organization performance status of 0 or 1.\n- Provision of tumour sample for central pathology assessment of pathologic risk factors and to assess EGFR mutation status prior to randomisation.\n- A tumour which harbours one of the 2 EGFR mutations (Ex19del, L858R).\n- Minimum life expectancy of > 6 months."}

Exclusion criteria

  • {"criterion_text":"- Mixed small cell and non-small cell cancer history.\n- Major surgery or significant traumatic injury within 4 weeks of the first dose of study intervention.\n- Participants currently receiving medications or herbal supplements known to be strong inducers of CYP3A4.\n- Participants with incomplete (R1/R2) resection, or who have undergone pneumonectomy or only wedge resection.\n- Any evidence of severe or uncontrolled systemic diseases, including uncontrolled hypertension and active bleeding diatheses; or active infection including HCV and HIV or active uncontrolled HBV infection.\n- History of another primary malignancy, including any known or suspected synchronous primary lung cancer, 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.\n- Any of the following cardiac criteria: Mean resting QTcF interval > 470 ms, obtained from triplicate ECGs performed at screening / Any abnormalities in rhythm, conduction, or morphology of resting ECG / Any factors that increase the risk of QTcF prolongation or risk of arrhythmic events.\n- History of interstitial lung disease.\n- Inadequate bone marrow reserve or organ function.\n- Any unresolved toxicities from prior therapy greater than CTCAE Grade 1 at the time of starting study intervention.\n- Prior treatment with any anticancer therapy for NSCLC (including chemotherapy, radiotherapy, immunotherapy, and EGFR-TKIs)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Disease free survival (DFS) in the high-risk stratum by investigators' assessment.","definition_or_measurement_approach":"DFS measured by investigators' assessment (disease-free survival assessment performed by investigators in the high-risk stratum)."}

Secondary endpoints

  • {"endpoint_text":"- Disease free survival (DFS) in the overall population by investigator's assessment.","definition_or_measurement_approach":"DFS measured by investigator's assessment in the overall population."}
  • {"endpoint_text":"- Disease free survival (DFS) in both the high-risk stratum and overall population.","definition_or_measurement_approach":"DFS measured in both the high-risk stratum and the overall population (method: investigator assessment as specified)."}
  • {"endpoint_text":"- Overall survival (OS) in participants in both the high-risk stratum and overall population.","definition_or_measurement_approach":"Overall survival assessed in both high-risk stratum and overall population (time to death from any cause)."}
  • {"endpoint_text":"- Impact of osimertinib versus placebo on physical functioning in both the high-risk stratum and overall population.","definition_or_measurement_approach":"Assessment of physical functioning (patient-reported / functional scales as defined in protocol) in both strata/population."}
  • {"endpoint_text":"- Effectiveness of osimertinib versus placebo by assessment of central nervous system disease free survival (DFS) in both the high-risk stratum and the overall population.","definition_or_measurement_approach":"CNS disease-free survival measured in both the high-risk stratum and overall population (assessment method per protocol imaging/clinical criteria)."}
  • {"endpoint_text":"- Characterise the pharmacokinetics of osimertinib and its metabolites (AZ13575104 [AZ5104]) in the overall population.","definition_or_measurement_approach":"Pharmacokinetic characterisation of osimertinib and metabolites (PK sampling and analysis per protocol)."}
  • {"endpoint_text":"- Safety and tolerability profile of osimertinib versus placebo in the overall population.","definition_or_measurement_approach":"Safety and tolerability assessed via adverse event reporting, CTCAE grading, laboratory assessments and other safety measures per protocol."}

Recruitment

Planned Sample Size
361
Recruitment Window Months
99
Consent Approach
Informed consent is obtained from adult participants (≥18 years) via Subject Information Sheets and Informed Consent Forms. Separate ICFs are provided for pre-screening, pregnant partners and optional genetic research. Consent is provided by the participant; no assent/parental consent provisions (minors excluded). Local/country-specific language ICFs are available (documents for Italy (IT), Poland (PL), Spain and other local versions are included).

Geography

Total Number Of Sites
29
Total Number Of Participants
21

Germany

Earliest CTIS Part Ii Submission Date
01-08-2024
Latest Decision Or Authorization Date
08-01-2026
Processing Time Days
525
Number Of Sites
6
Number Of Participants
1

Sites

Site Name
Evangelische Lungenklinik Berlin Krankenhausbetriebs gGmbH
Department Name
Klinik fuer Pneumologie
Contact Person Name
Christian Grohe
Contact Person Email
christian.grohe@jsd.de
Site Name
Klinikum Wuerzburg Mitte gGmbH
Department Name
Standort Missioklinik
Contact Person Name
Jens Kern
Contact Person Email
jens.kern@kwm-klinikum.de
Site Name
Klinikum Esslingen GmbH
Department Name
Klinik fuer Kardiologie und Pneumologie
Contact Person Name
Martin Faehling
Site Name
Universitaetsklinikum Schleswig-Holstein AöR
Department Name
Studienzentrum Pneumologie – Infektiologie – Onkologie
Contact Person Name
Sabine Bohnet
Contact Person Email
sabine.bohnet@uksh.de
Site Name
Ludwig-Maximilians-Universitaet Muenchen
Department Name
Campus Innenstadt Medizinische Klinik V
Contact Person Name
Amanda Tufman
Site Name
Franziskus Hospital Harderberg
Department Name
Zentrum fuer Internistische Onkologie und Haematologie
Contact Person Name
Petra Hoffknecht

Italy

Earliest CTIS Part Ii Submission Date
01-08-2024
Latest Decision Or Authorization Date
08-01-2026
Processing Time Days
525
Number Of Sites
10
Number Of Participants
14

Sites

Site Name
Careggi University Hospital
Department Name
Oncologia
Contact Person Name
Lorenzo Livi
Contact Person Email
lorenzo.livi@unifi.it
Site Name
Istituto Europeo Di Oncologia S.r.l.
Department Name
Oncologia
Contact Person Name
Filippo De Marinis
Contact Person Email
filippo.demarinis@ieo.it
Site Name
Istituto Tumori Bari Giovanni Paolo II
Department Name
Oncologia
Contact Person Name
Domenico Galetta
Contact Person Email
galetta@oncologico.bari.it
Site Name
IRCCS Ospedale Policlinico San Martino
Department Name
Oncologia
Contact Person Name
Carlo Genova
Contact Person Email
carlo.genova@hsanmartino.it
Site Name
I.F.O. Istituti Fisioterapici Ospitalieri
Department Name
Oncologia
Contact Person Name
Federico Cappuzzo
Contact Person Email
federico.cappuzzo@ifo.it
Site Name
ARNAS Garibaldi Di Catania
Department Name
Oncologia
Contact Person Name
Concetta Sergi
Contact Person Email
consergi1974@gmail.com
Site Name
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
Department Name
Oncologia
Contact Person Name
Silvia Novello
Contact Person Email
silvia.novello@unito.it
Site Name
Azienda Ospedaliera Dei Colli
Department Name
Oncologia
Contact Person Name
Danilo Rocco
Contact Person Email
danilorocc@yahoo.it
Site Name
Azienda Ospedaliero Universitaria Parma
Department Name
Oncologia
Contact Person Name
Marcello Tiseo
Contact Person Email
marcello.tiseo@unipr.it
Site Name
Istituto Oncologico Veneto
Department Name
Oncologia
Contact Person Name
Laura Bonanno
Contact Person Email
laura.bonanno@iov.veneto.it

Poland

Earliest CTIS Part Ii Submission Date
01-08-2024
Latest Decision Or Authorization Date
08-01-2026
Processing Time Days
525
Number Of Sites
3
Number Of Participants
3

Sites

Site Name
Uniwersytecki Szpital Kliniczny Nr 4 W Lublinie
Department Name
Katedra i Klinika Chirurgii Klatki Piersiowej
Contact Person Name
Marek Sawicki
Contact Person Email
marek.sawicki@umlub.pl
Site Name
National Institute Of Tuberculosis And Lung Diseases
Department Name
Zaklad Genetyki i Immunologii Klinicznej
Contact Person Name
Joanna Chorostowska-Wynimko
Contact Person Email
j.chorostowska@gmail.com
Site Name
Wielkopolskie Centrum Pulmonologii I Torakochirurgii Im. Eugenii I Janusza Zeylandow
Department Name
Oddzial Onkologii Klinicznej
Contact Person Name
Katarzyna Stencel
Contact Person Email
kstencel@wcpit.org

Romania

Earliest CTIS Part Ii Submission Date
01-08-2024
Latest Decision Or Authorization Date
08-01-2026
Processing Time Days
525
Number Of Sites
5
Number Of Participants
1

Sites

Site Name
Ovidius Clinical Hospital S.R.L.
Department Name
Medical Oncology
Contact Person Name
Laura Mazilu
Contact Person Email
lauragrigorov@gmail.com
Site Name
Institutul Oncologic Prof. Dr. Alexandru Trestioreanu Bucuresti
Department Name
Medical Oncology
Contact Person Name
Aurelia Alexandru
Contact Person Email
auralexandru@yahoo.com
Site Name
Oncolab S.R.L.
Department Name
Medical Oncology
Contact Person Name
Dan Stelian Stefan Lungulescu
Contact Person Email
dan.lungulescu@yahoo.com
Site Name
Radiotherapy Center Cluj S.R.L.
Department Name
Medical Oncology
Contact Person Name
Andrei Ungureanu
Site Name
Spitalul Universitar De Urgenta Bucuresti
Department Name
Medical Oncology
Contact Person Name
Georgeta Polixenia Iorga
Contact Person Email
polixeniaiorga@yahoo.com

Spain

Earliest CTIS Part Ii Submission Date
01-08-2024
Latest Decision Or Authorization Date
08-01-2026
Processing Time Days
525
Number Of Sites
5
Number Of Participants
2

Sites

Site Name
Hospital De La Santa Creu I Sant Pau
Department Name
Oncologia
Contact Person Name
Margarita Majem
Contact Person Email
mmajem@santpau.cat
Site Name
Hospital Clinico Universitario Lozano Blesa
Department Name
Oncologia
Contact Person Name
Maria Dolores Isla
Contact Person Email
lola.isla@gmail.com
Site Name
Hospital Universitario Regional De Malaga
Department Name
Oncologia
Contact Person Name
Manuel Cobo
Contact Person Email
manuelcobodols@yahoo.es
Site Name
Hospital Clinico Universitario De Valencia
Department Name
Oncologia
Contact Person Name
Maria Amelia Insa
Contact Person Email
ameliainsamolla@gmail.com
Site Name
Hospital Alvaro Cunqueiro
Department Name
Oncologia
Contact Person Name
Martin Emilio Lazaro Quintela

Sponsor

Primary sponsor

Full Name
AstraZeneca AB
Organisation Type
Pharmaceutical company
Country Of Registered Address
Sweden

Investigational products

Investigational Product Name
TAGRISSO 80 mg film-coated tablets
Active Substance
OSIMERTINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Marketing authorisation present (EU/1/16/1086/004)
Starting Dose
80 mg once daily
Dose Levels
80 mg (can be reduced to 40 mg if required)
Frequency
Once daily
Maximum Dose
80 mg daily
Investigational Product Name
TAGRISSO 40 mg film-coated tablets
Active Substance
OSIMERTINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Marketing authorisation present (EU/1/16/1086/003)
Starting Dose
40 mg (used as dose reduction from 80 mg)
Dose Levels
40 mg (dose reduction level)
Frequency
Once daily
Maximum Dose
80 mg daily
Investigational Product Name
Placebo
Modality
Other
Starting Dose
Matching placebo once daily
Frequency
Once daily (matching active dosing schedule)

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