A Phase III Randomised, Double Blind, Placebo Controlled, Parallel, Multicentre Study to Assess the Efficacy and Safety of Continuing IRESSA 250 mg in Addition to Chemotherapy Versus Chemotherapy Alone in Patients Who Have Epidermal Growth Factor Receptor (EGFR) Mutation Positive Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) and Have Progressed on First Line IRESSA
Overview
- Phase
- Phase 3
- Intervention
- Gefitinib
- Conditions
- Non-Small Cell Lung Cancer
- Sponsor
- AstraZeneca
- Enrollment
- 265
- Locations
- 1
- Primary Endpoint
- Progression-Free Survival (Site Read, Investigator Assessment)
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
The purpose of this study is to assess the efficacy and safety of gefitinib in patients who have progressed on first line gefitinib, comparing continuing gefitinib in addition to cisplatin plus pemetrexed combination chemotherapy versus cisplatin plus pemetrexed combination chemotherapy alone.
Detailed Description
A Phase III Randomised, Double blind, Placebo controlled, Parallel, Multicentre Study to Assess the Efficacy and Safety of continuing IRESSA 250 mg in addition to Chemotherapy versus Chemotherapy alone in Patients who have Epidermal Growth Factor Receptor (EGFR) Mutation Positive Locally advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) and have progressed on First Line IRESSA.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Male or female patients aged 18 years or older (For Japan only- male or female patients aged 20 years or older)
- •Cytological or histological confirmation of NSCLC other than predominantly squamous cell histology with an activating EGFR TK mutation as determined locally
- •Patients with documented 'acquired resistance' on first line gefitinib
- •Patients suitable to start cisplatin based pemetrexed combination chemotherapy.
- •Provision of informed consent prior to any study specific procedures.
Exclusion Criteria
- •Prior chemotherapy or other systemic anti-cancer treatment (excluding gefitinib). Palliative bone radiotherapy must be completed at least 2 weeks before start of study treatment with no persistent radiation toxicity).
- •Past medical history of interstitial lung disease, drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease
- •Other co-existing malignancies or malignancies diagnosed within the last 5 years, with the exception of basal cell carcinoma or cervical cancer in situ or completely resected intramucosal gastric cancer
- •Any evidence of severe of uncontrolled systemic disease Treatment with an investigational drug within 4 weeks before randomization
Arms & Interventions
Gefitinib
Gefitinib and cisplatin plus pemetrexed combination chemotherapy
Intervention: Gefitinib
Gefitinib
Gefitinib and cisplatin plus pemetrexed combination chemotherapy
Intervention: Pemetrexed
Gefitinib
Gefitinib and cisplatin plus pemetrexed combination chemotherapy
Intervention: Cisplatin
Placebo
Placebo and cisplatin plus pemetrexed combination chemotherapy.
Intervention: Placebo
Placebo
Placebo and cisplatin plus pemetrexed combination chemotherapy.
Intervention: Pemetrexed
Placebo
Placebo and cisplatin plus pemetrexed combination chemotherapy.
Intervention: Cisplatin
Outcomes
Primary Outcomes
Progression-Free Survival (Site Read, Investigator Assessment)
Time Frame: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks
PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.
Median Progression-Free Survival (Site Read, Investigator Assessment)
Time Frame: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks
PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.
Secondary Outcomes
- Median Overall Survival (OS) at Time of PFS Analysis(Baseline and then every 6 weeks after randomization until objective disease progression. OS is then assessed 8 weekly following PFS progression up to PFS analysis data cut off.)
- Disease Control Rate (DCR)(Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.)
- Overall Survival (OS)(Following progression survival data was collected every 8 weeks until documentation of death, withdrawal of consent, loss to follow-up or the final data cut-off, whichever occurs first.)
- Objective Response Rate (ORR) (Site Read Data)(Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.)
- Improvement in Trial Outcome Index(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)
- Time to Worsening in Trial Outcome Index(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)
- Improvement in FACT-L Total Score(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)
- Time to Worsening in FACT-L Total Score(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)
- Time to Worsening in Lung Cancer Subscale(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)
- Improvement in Lung Cancer Subscale(At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.)