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The Efficacy and Safety Study of TORIPALIMAB INJECTION Combined With Chemotherapy for Nasophapyngeal Cancer

Phase 3
Completed
Conditions
Recurrent or Metastatic NPC
Interventions
Drug: Placebos
Biological: TORIPALIMAB INJECTION(JS001 ) combine with chemotherapy
Registration Number
NCT03581786
Lead Sponsor
Shanghai Junshi Bioscience Co., Ltd.
Brief Summary

This is a randomized, placebo-controlled, multi-center, double blinded, Phase III study to determine the efficacy and safety of TORIPALIMAB INJECTIO(JS001) in combination with gemcitabine/cisplatin compared with placebo in combination with gemcitabine/cisplatin as first-line treatment in patients with histological/cytological confirmation of recurrent or metastatic NPC. The primary endpoint is PFS in all patients. Approximately 280 patients who fulfill all of the inclusion criteria and none of the exclusion criteria will be randomized in a 1:1 ratio to one of the two treatment arms. patients will be randomly assigned to the combination of JS001 (Arm A) or placebo (Arm B) with gemcitabine and cisplatin given every 3 weeks (Q3W) in 3-week cycles.

Detailed Description

Total 289 patients were enrolled and randomized in a 1:1 ratio to the group of JS001 (Arm A) with gemcitabine and cisplatin or placebo (Arm B) with gemcitabine and cisplatin every 3 weeks (Q3W) in the 'during chemotherapy' phase. During the 'post-chemotherapy' phase, patients randomized to Arm A or Arm B will continue treatment with JS001 or placebo as maintenance therapy Q3W until excessive toxicity or progressive disease, withdrawal of consent or Investigator's judgement or a maximum of 2 years. Tumor evaluation scans will be performed at screening (as baseline) then every 6weeks in the first 12 months then every 9 weeks thereafter until objective disease progression. The primary objective is to compare PFS as assessed by the IRC in ITT population (all randomized patients).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
289
Inclusion Criteria
  • 1. Age ≥ 18 years and ≤75 years.
  • 2. Histological/cytological confirmation of NPC.
  • 3. Primarily metastatic (stage IVB as defined by the International Union against Cancer and American Joint Committee on Cancer staging system for NPC, eighth edition) or recurrent NPC that is not amenable for local regional treatment or curative treatment.
  • 4. At least 1 measurable lesion according to RECIST version 1.1.
  • 5. Life expectancy ≥ 3 months
Exclusion Criteria
  • 1. History of severe hypersensitivity reactions to other mAbs or any ingredient of JS001.
  • 2. Prior therapy targeting PD-1 receptor, or its ligand PD-L1, or cytotoxic T lymphocyte associated protein 4 (CTLA4) receptor.
  • 3. Major surgical procedure other than for diagnosis of NPC within 28 days prior to randomization or anticipation of need for a major surgical procedure during the study
  • 4. History of hypersensitivity to gemcitabine or cisplatin or to any of the excipients.
  • 5. Female patients who are at pregnancy or lactation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebo combine with chemotherapyPlacebosGemcitabine 1000 mg/m² IV are given on Days 1 \& 8, and cisplatin 80 mg/m² IV are given on Day 1 of each cycle,placebo will be administered at the dose of 240 mg Q3W before that. Chemotherapy is given Q3W for up to 6 cycles and placebo for up to 2 years
TORIPALIMAB INJECTION(JS001 )combine with chemotherapyTORIPALIMAB INJECTION(JS001 ) combine with chemotherapyGemcitabine 1000 mg/m² IV are given on Days 1 \& 8, and cisplatin 80 mg/m² IV are given on Day 1 of each cycle,JS001 will be administered at the dose of 240 mg Q3W before that. Chemotherapy is given Q3W for up to 6 cycles and JS001 for up to2years
Primary Outcome Measures
NameTimeMethod
IRC-assessed Progression-Free Survival (PFS) According to RECIST v1.1up to 2 years

To evaluate the efficacy of JS001 plus chemotherapy compared with placebo plus chemotherapy as measured by IRC-assessed progression free survival (PFS) according to RECIST v1.1 in all patients.

The definition of Progressive Disease: At least a 20% increasein the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. or the appearance of one or more new lesions is also considered progression.

Secondary Outcome Measures
NameTimeMethod
OSThe time frame of OS collected is upto about 48months.

Overall survival was defined as the time from randomization to death from any cause.

Investigator-assessed ORR According to RECIST v1.1From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the efficacy of TORIPALIMAB INJECTION(JS001) plus chemotherapy compared with placebo plus chemotherapy, as measured by investigator-assessed overall response rate (ORR) according to RECIST v1.1.

Investigator-assessed DoR According to RECIST v1.1From date of response until progressive disease. Up to 2 approximately years

To evaluate the efficacy of TORIPALIMAB INJECTION(JS001 )plus chemotherapy compared with placebo plus chemotherapy, as measured by investigator-assessed duration of response (DoR) according to RECIST v1.1.

Investigator-assessed DCR According to RECIST v1.1From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the efficacy of TORIPALIMAB INJECTION(JS001) plus chemotherapy compared with placebo plus chemotherapy, as measured by investigator-assessed disease control rate (DCR) according to RECIST v1.1.

Investigator-assessed PFS According to RECIST v1.1From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the efficacy of JS001 plus chemotherapy compared with placebo plus chemotherapy, as measured by Investigators-assessed PFS according to RECIST v1.1

Investigator-assessed PFS Rate at 1 Yearup to approximately 1years

To evaluate the PFS rate at 1 year in each treatment arm by investigator

OS Rate at 1 YearUp to approximately 1 years

To evaluate the OS rate at 1 year in each treatment arm

IRC-assessed ORR According to RECIST v1.1From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

health related quality of life (HRQoL) in patients treated with JS001 plus chemotherapy compared with placebo plus chemotherapy using the EORTC QLQ-H\&N35

IRC-assessed DoR According to RECIST v1.1From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the efficacy of JS001 plus chemotherapy compared with placebo plus chemotherapy, as measured by IRC-assessed duration of response (DoR) according to RECIST v1.1.

IRC-assessed DCR According to RECIST v1.1From date of consent informed until 60 days after the last investigational product administration. Up to 2 approximately years

To evaluate the efficacy of JS001 plus chemotherapy compared with placebo plus chemotherapy, as measured by IRC-assessed disease control rate (DCR) according to RECIST v1.1.

Number of Participants Experiencing an Adverse Event(AE)From date of consent informed until 60 days after the last investigational product administration. Up to 2 approximately years

Incidence of adverse events(AE) as assessed by CTCAE version 5.0

Anti-drug Antibody(ADA)From date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the incidence of ADAs against JS001

PFS IRC-assessed Per irRECISTFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate PFS of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

ORR IRC-assessed Per irRECISTFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate ORR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

DoR IRC-assessed Per irRECISTFrom date of response until progressive disease. Up to 2 approximately years

To evaluate DoR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

DCR IRC-assessed Per irRECISTFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate DCR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

Investigator-assessed PFS Rate at 2 YearsFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate the PFS rate at 2 years in each treatment arm by investigator

OS Rate at 2 YearsUp to approximately 2 years

To evaluate the OS rate at 2 years in each treatment arm

PFS Investigator-assessed Per irRECISTFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate PFS of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

ORR Investigator-assessed Per irRECISTFrom date of randomization, until disease progression , loss of clinical benefit ,withdrawal of consent, death, or study termination by the Sponsor, whichever occurs first. Up to 2 approximately years

To evaluate ORR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

DoR Investigator-assessed Per irRECISTFrom date of response until progressive disease. Up to 2 approximately years

To evaluate DoR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

DCR Investigator-assessed Per irRECISTUp to approximately 42 months

To evaluate DCR of JS001 plus chemotherapy compared with placebo plus chemotherapy according to irRECIST.

Trial Locations

Locations (32)

The Affiliated Cancer Hospital of Guizhou Medical University

🇨🇳

Guiyang, Guizhou, China

Shanghai General Hospital

🇨🇳

Shanghai, Shanghai Municipality, China

Cancer Hospital, Chinese Academy of Medical Sciences

🇨🇳

Beijing, Beijing Municipality, China

Fujian Medical University Union Hospital

🇨🇳

Fuzhou, Fujian, China

Fujian Provincial Cancer Hospital

🇨🇳

Fuzhou, Fujian, China

Sun Yat-Sen University Cancer Center

🇨🇳

Guangzhou, Guangdong, China

Affiliated Cancer Hospital & Institute of Guangzhou Medical University

🇨🇳

Guangzhou, Guangdong, China

Nanfang Hospital

🇨🇳

Guangzhou, Guangdong, China

Shenzhen People's Hospital

🇨🇳

Shenzhen, Guangdong, China

Liuzhou Worker's Hospital

🇨🇳

Liuzhou, Guangxi, China

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The Affiliated Cancer Hospital of Guizhou Medical University
🇨🇳Guiyang, Guizhou, China

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