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A Study to Compare Ociperlimab Plus Tislelizumab Versus Durvalumab Following Concurrent Chemoradiotherapy (cCRT) in Participants With Stage III Unresectable Non-Small Cell Lung Cancer

Phase 3
Terminated
Conditions
Non Small Cell Lung Cancer
Interventions
Drug: Chemotherapy
Radiation: Radiotherapy
Registration Number
NCT04866017
Lead Sponsor
BeiGene
Brief Summary

The purpose of this study was to evaluate the safety and efficacy of ociperlimab in combination with tislelizumab compared to durvalumab in adults with stage III unresectable PD-L1-selected non-small cell lung cancer whose disease has not progressed after cCRT.

Detailed Description

The study initiated with Protocol Amendment 1.0 (PA 1; dated on 16 April 2021). In April 2022 Protocol Amendment 2 (PA 2) was implemented. In PA 1, participants with newly diagnosed, histologically confirmed, unresectable locally advanced NSCLC and evaluable PD-L1 expression all comers were enrolled; cCRT was given within the study. In PA 2, the enrollment of the target population was revised into participants with unresectable locally advanced NSCLC whose disease has not progressed after definitive, platinum-based cCRT and with PD-L1 expression on ≥ 1% of tumor cells as assessed by the central lab; cCRT was given outside of the study.

After implementation of PA 2, participants who were randomized under PA 1 were given the option to continue assigned study treatment or to discontinue assigned treatment and begin standard of care treatment outside of the study. Participants enrolled under PA 1 were excluded from the primary and secondary analysis specified by PA 2.

This study was subsequently terminated by the Sponsor prior to enrollment of any participants under PA 2.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
63
Inclusion Criteria
  1. Age ≥ 18 years on the day of signing the informed consent form (or the legal age of consent in the jurisdiction in which the study is taking place).
  2. Participant has histologically or cytologically confirmed, locally advanced, unresectable Stage III NSCLC (AJCC Cancer Staging Manual 2017, derived from IASLC) prior to initiation of cCRT.
  3. Participant must have completed at least 2 cycles of platinum-based chemotherapy concurrent with radiotherapy
  4. Participants must have not experienced PD following definitive, platinum-based cCRT.
  5. Eastern Co-operative Oncology Group (ECOG) Performance Status of 0 or 1.
  6. Participants must have adequate organ function
  7. Agree to provide archival tissue (formalin-fixed paraffin-embedded block containing tumor [preferred] or approximately 6 to 15 freshly cut unstained slides) or fresh biopsy obtained prior to cCRT (if archival tissue is not available) for prospective central evaluation of PD-L1 levels and retrospective analysis of other biomarkers.

Key

Exclusion Criteria
  1. Prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, TIGIT, or any other antibody or drugs specifically targeting T-cell co-stimulation or checkpoint pathways.
  2. Diagnosed with NSCLC that harbors an epidermal growth factor receptor (EGFR) sensitizing mutation, anaplastic lymphoma kinase (ALK) gene translocation, ROS1 gene translocation or RET gene rearrangement.
  3. Participants who received systemic anticancer treatment besides the specified cCRT.
  4. Any unresolved toxicity CTCAE > Grade 2 from the prior cCRT.
  5. Active autoimmune diseases or history of autoimmune diseases that may relapse.
  6. Any condition that required systemic treatment with either corticosteroids (> 10 mg daily of prednisone [in Japan, prednisolone] or equivalent) or other immunosuppressive medication ≤ 14 days before the first dose of study treatment.
  7. Infection (including tuberculosis infection, etc) requiring systemic antibacterial, antifungal, or antiviral therapy within 14 days before the first dose of study treatment.

Note: Antiviral therapy is permitted for participants with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.

NOTE: Other protocol Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ociperlimab + Tislelizumab + cCRTTislelizumabParticipants enrolled under PA1 recieved two cycles of ociperlimab combined with tislelizumab and cCRT, followed by ociperlimab combined with tislelizumab up to 1 year after the cCRT phase
Ociperlimab + Tislelizumab + cCRTOciperlimabParticipants enrolled under PA1 recieved two cycles of ociperlimab combined with tislelizumab and cCRT, followed by ociperlimab combined with tislelizumab up to 1 year after the cCRT phase
Ociperlimab + Tislelizumab + cCRTChemotherapyParticipants enrolled under PA1 recieved two cycles of ociperlimab combined with tislelizumab and cCRT, followed by ociperlimab combined with tislelizumab up to 1 year after the cCRT phase
Ociperlimab + Tislelizumab + cCRTRadiotherapyParticipants enrolled under PA1 recieved two cycles of ociperlimab combined with tislelizumab and cCRT, followed by ociperlimab combined with tislelizumab up to 1 year after the cCRT phase
Tislelizumab + cCRTTislelizumabParticipants enrolled under PA1 recieved two cycles of tislelizumab combined with cCRT, followed by tislelizumab up to 1 year after the cCRT phase
Tislelizumab + cCRTChemotherapyParticipants enrolled under PA1 recieved two cycles of tislelizumab combined with cCRT, followed by tislelizumab up to 1 year after the cCRT phase
Tislelizumab + cCRTRadiotherapyParticipants enrolled under PA1 recieved two cycles of tislelizumab combined with cCRT, followed by tislelizumab up to 1 year after the cCRT phase
cCRT followed by DurvalumabDurvalumabParticipants enrolled under PA1 recieved two cycles of cCRT, followed by durvalumab to 1 year after the cCRT phase
cCRT followed by DurvalumabChemotherapyParticipants enrolled under PA1 recieved two cycles of cCRT, followed by durvalumab to 1 year after the cCRT phase
cCRT followed by DurvalumabRadiotherapyParticipants enrolled under PA1 recieved two cycles of cCRT, followed by durvalumab to 1 year after the cCRT phase
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) as Assessed by the Independent Review Committee (IRC)From randomization through to the end of study, planned duration was 20 months

PFS is defined as the time from the date of randomization to the date of first documentation of disease progression as assessed by the IRC per Response Evaluation Criteria in Solid Tumors (RECIST) Version (v) 1.1 or death, whichever occurred first.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)From randomization through to the end of study, planned duration was 20 months

Defined as the time from the date of randomization until the date of death due to any cause

Overall Response Rate (ORR)From randomization through to the end of study, planned duration was 20 months

Defined as the percentage of participants who achieved a complete response (CR) or partial response (PR) assessed by both the IRC and investigators per RECIST v1.1.

Duration of Response (DOR)From randomization through to the end of study, planned duration was 20 months

defined as the time from the first determination of a confirmed objective response assessed by both the IRC and investigators per RECIST v1.1 until the first documentation of disease progression or death, whichever occurs first

Time to Death or Distant Metastasis (TTDM) as Assessed by the InvestigatorFrom randomization through to the end of study, planned duration was 20 months

defined as the time from the date of randomization until the first date of distant metastasis assessed by both the IRC and investigators, or death. Distant metastasis is defined as any new lesion that is outside of the radiation field per RECIST v1.1 or proven by biopsy.

Progression-Free Survival 2 (PFS2)From randomization through to the end of study, planned duration was 20 months

defined as the time from randomization to the disease progression after next line of treatment, or death from any cause, whichever occurs first

Number of Participants Experiencing Adverse Events (AEs)From first dose to 30 days after the last dose or initiation of a new anticancer therapy, whichever occured first; through study completion data cut-off date of October 17th, 2023 (maximum time on treatment was 16 months)

Number of participants with treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) determined according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE v5.0)

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health StatusBaseline and Cycle 6 (Each cycle is 21 days)

Change from baseline in EORTC QLQ-C30 Global Health Status/Quality of Life score. The EORTC QLQ-C30 v3.0 is a questionnaire that assesses quality of life of participants with cancer. It includes global health status and quality of life questions related to overall health in which participants respond based on a 7-point scale, where 1 is very poor and 7 is excellent. Raw scores are transformed into a 0 to 100 scale via linear transformation. A higher score indicates better health outcomes.

Change From Baseline in Health Related Quality of Life (HRQoL) as Assessed by Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13)Baseline and Cycle 6 (Each cycle is 21 days)

Change from baseline in QLQ-CL13 scores for coughing, dyspnea, and chest pain. The QLQ-LC13 is a questionnaire that measures lung cancer-specific disease and treatment symptoms. It includes questions about specific symptoms in which participants respond based on a 4-point scale, where 1 is "not at all" and 4 is "very much". Raw scores are transformed into a 0 to 100 scale via linear transformation. A lower score indicates an improvement in symptoms.

Change From Baseline in Health Related Quality of Life (HRQoL) as Assessed by European Quality of Life-5 Dimensions (EQ-5D-5L)Baseline and Cycle 6 (Each cycle is 21 days)

The EuroQol 5D-5L a descriptive system that comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The participant is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the participant's health state.

Serum Concentration of OciperlimabPredose at Day 1 of Cycles 1, 2, 5, 9, and 17; postdose on Day 1 of Cycles 1, 5 and EOT visit (Each Cycle was 21 days)

Serum concentrations of ociperlimab were measured for participants in the Ociperlimab + Tislelizumab + cCRT treatment group at predose (within 60 minutes before starting infusion) and postdose (within 30 minutes after the end of infusion). End of Treatment (EOT) visits occurred within 7 days after the date the investigator determined that study treatment would no longer be used, or before the initiation of a new anticancer treatment, whichever occurred first.

Serum Concentration of Tislelizumab for Participants in the Ociperlimab + Tislelizumab + cCRT Treatment GroupPredose at Day 1 of Cycles 1, 2, 5, 9, 17; postdose on Day 1 of Cycles 1 and 5, and EOT visit (each cycle was 21 days)

Serum concentrations of tislelizumab were collected for participants in the Ociperlimab + Tislelizumab + cCRT treatment group at predose (within 60 minutes before starting infusion) and postdose (within 30 minutes after the end of infusion). End of Treatment (EOT) visits occurred within 7 days after the date investigator determined that study treatment would no longer be used, or before the initiation of a new anticancer treatment, whichever occurred first.

Serum Concentration of Tislelizumab for Participants in the Tislelizumab + cCRT Treatment GroupPredose at Day 1 of Cycles 1, 2, 5, 9, and 17; postdose on Day 1 of Cycles 1 and 5, and EOT visit (Each Cycle is 21 days)

Serum concentrations of tislelizumab were collected for participants in the Tislelizumab + cCRT treatment group at predose (within 60 minutes prior to infusion initiation) and postdose (within 30 minutes after the completion of infusion). End of Treatment (EOT) visits occurred within 7 days after the date investigator determined that study treatment would no longer be used, or before the initiation of a new anticancer treatment, whichever occurred first.

Immunogenic Responses to Ociperlimab as Assessed by the Detection of Treatment Emergent Anti-Drug Antibodies (ADAs)Predose (within 60 minutes before dose) on Day 1 of Cycles 1, 2, 5, 9, 17, and the EOT Visit (Each cycle is 21 days). Maximum number of treatment cycles was 19

Defined as the sum of treatment-boosted and treatment-induced ADA participants as a proportion percentage of the ADA-evaluable participants population and is synonymous with 'ADA Incidence'. ADA samples were collected for participants randomized to Arm A (ociperlimab and tislelizumab)

Immunogenic Responses to Tislelizumab as Assessed by the Detection of Treatment Emergent Anti-Drug Antibodies (ADAs)Predose (within 60 minutes before dose) on Day 1 of Cycles 1, 2, 5, 9, 17, and the EOT Visit (Each cycle is 21 days, maximum number of treatment cycles was 19)

Defined as the sum of treatment-boosted and treatment-induced ADA participants as a proportion percentage of the ADA-evaluable participants population and is synonymous with 'ADA Incidence'. ADA samples were collected for participants randomized to Arm A (Ociperlimab + Tislelizumab + cCRT) and Arm B (Tislelizumab + cCRT)

Programmed Death-Ligand 1 (PD-L1) and T-cell Immunoreceptor With Ig and ITIM Domains (TIGIT) Expression in Archival and/or Fresh Tumor TissuesFrom randomization through to the end of study, planned duration was 20 months

Trial Locations

Locations (32)

XCancer/Centeral Care Center

🇺🇸

Bolivar, Missouri, United States

Southern Medical Day Care Centre

🇦🇺

Wollongong, New South Wales, Australia

Townsville Hospital

🇦🇺

Douglas, Queensland, Australia

Hunan Cancer Hospital - GCP Office

🇨🇳

Changsha, Hunan, China

Chongqing University Cancer Hospital

🇨🇳

Chongqing, Chongqing, China

Nanfang Hospital of Southern Medical University

🇨🇳

Guangzhou, Guangdong, China

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Changhua Christian Hospital

🇨🇳

Changhua, Taiwan

Jilin Cancer Hospital

🇨🇳

Changchun, Jilin, China

West China Hospital, Sichuan University

🇨🇳

Chengdu, Sichuan, China

Jieyang People'S Hospital (Jieyang Affiliated Hospital, Sun Yat-Sen University )

🇨🇳

Jieyang, China

Hollywood Private Hospital

🇦🇺

Perth, Australia

Lyell McEwin Hospital

🇦🇺

Elizabeth Vale, South Australia, Australia

Royal Hobart Hospital

🇦🇺

Hobart, Tasmania, Australia

Beijing Cancer Hospital

🇨🇳

Beijing, Beijing, China

Cabrini Hospital

🇦🇺

Malvern, Victoria, Australia

Gold Coast University Hospital

🇦🇺

Gold Coast, Australia

The First Affiliated Hospital, Sun Yat-sen University

🇨🇳

Guangzhou, Guangdong, China

Nanjing First Hospital

🇨🇳

Nanjing, Jiangsu, China

The First Affiliated Hospital of Soochow University Branch Shizi

🇨🇳

Suzhou, Jiangsu, China

The First Affiliated Hospital of Nanchang University Branch Donghu

🇨🇳

Nanchang, Jiangxi, China

Shandong Cancer Hospital and Institute, Shandong First Medical University

🇨🇳

Jinan, Shandong, China

The First Hospital of Jilin University

🇨🇳

Changchun, Jilin, China

Tianjin Medical University Cancer Institute & Hospital

🇨🇳

Tianjin, Tianjin, China

Peking University Third Hospital

🇨🇳

Beijing, China

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

General Hospital of Ningxia Medical University

🇨🇳

Yinchuan, Ningxia, China

Fudan University Shanghai Cancer Center

🇨🇳

Shanghai, Shanghai, China

Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

Chung Shan Medical University Hospital

🇨🇳

Taichung, Taiwan

Changzhou Cancer Hospital

🇨🇳

Changzhou, China

Fujian Cancer Hospital

🇨🇳

Fuzhou, Fujian, China

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