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Sintilimab or Placebo With Chemotherapy in Esophageal Squamous Cell Carcinoma ( ORIENT-15 )

Phase 3
Completed
Conditions
Esophageal Squamous Cell Carcinoma
Interventions
Biological: Sintilimab
Drug: Placebo
Registration Number
NCT03748134
Lead Sponsor
Innovent Biologics (Suzhou) Co. Ltd.
Brief Summary

This is a randomized, double-blind multi-center, phase III study comparing the efficacy and safety of sintilimab or placebo in combination with chemotherapy as first-line treatment in subjects with unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma.

After the interim analysis conducted by the iDMC, an open-label assignment of experimental arm therapy will continue in regions outside of China, in order to further evaluate the efficacy and safety of sintilimab in combination with chemotherapy in subjects representing the western population with advanced esophageal squamous cell carcinoma

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
746
Inclusion Criteria
  • Histopathologically confirmed unresectable, locally advanced, recurrent or metastatic ESCC (excluding mixed adenosquamous carcinoma and other histological subtypes)
  • ECOG PS of 0 or 1
  • Subject must be unsuitable for definitive treatment, such as definitive chemoradiotherapy and/or surgery. For subjects who have received (neo)adjuvant or definitive chemotherapy/radiochemotherapy, time from the completion of last treatment to disease recurrence must be > 6 months Could provide archival or fresh tissues for PD-L1 expression analysis with obtainable results
  • Have at least one measurable lesion as per RECIST v1.1

Key exclusion Criteria:

  • ESCC with endoscopy-confirmed near-complete obstruction requiring interventional therapy
  • Post stent implantation in the esophagus or trachea with risk of perforation
  • Received systemic treatment for advanced or metastatic ESCC.
  • Received a cumulative dose of cisplatin ≥ 300 mg/m2 and the last cisplatin dose was within 12 months of randomization or the first dose of study treatment in the open-label phase.
  • High risk of hemorrhage or perforations due to tumor invasion in adjacent organs (aorta or trachea), or have fistula formation.
  • Hepatic metastasis > 50% of the total liver volume.
  • Received palliative therapy for a local lesion within 2 weeks prior to the first dose.
  • Received systemic treatment with Chinese traditional medicines with anti-cancer indications or immunomodulators (including thymosins, interferons, and interleukins) within 2 weeks prior to the first dose of study treatment.
  • Received systemic immunosuppressants within 2 weeks prior to randomization, excluding local use of glucocorticoids administered by nasal, inhaled, or other routes, and systemic glucocorticoids at physiological doses (no more than 10 mg/day of prednisone or equivalents), or glucocorticoids to prevent allergies to contrast media.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Randomized Part: Experimental: Sintilimab + chemotherapySintilimabSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomized Part: Experimental: Sintilimab + chemotherapyCisplatinSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomized Part: Experimental: Sintilimab + chemotherapyPaclitaxelSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomised Part: Active Comparator: Placebo + chemotherapyCisplatinPlacebo in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomised Part: Active Comparator: Placebo + chemotherapyPaclitaxelPlacebo in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomised Part: Active Comparator: Placebo + chemotherapyFluorouracilPlacebo in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomised Part: Active Comparator: Placebo + chemotherapyPlaceboPlacebo in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Open-label part: Sintilimab+ chemotherapySintilimabSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Open-label part: Sintilimab+ chemotherapyCisplatinSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Open-label part: Sintilimab+ chemotherapyPaclitaxelSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Open-label part: Sintilimab+ chemotherapyFluorouracilSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Randomized Part: Experimental: Sintilimab + chemotherapyFluorouracilSintilimab in combination with investigator's choice of chemotherapy TP regimen: Cisplatin + paclitaxel or CP regimen: Cisplatin + fluorourcil
Primary Outcome Measures
NameTimeMethod
OS in overall populationFrom date of randomization until the date of death from any cause, assessed up to 40 months.

To compare the overall survival of sintilimab vs. placebo, in combination with chemotherapy, for first-line treatment in subjects with unresectable, locally advanced, recurrent or metastatic esophageal squamous cell carcinoma (ESCC)

OS in PD-L1 positive populationFrom date of randomization until the date of death from any cause, assessed up to 40 months.

To compare the OS of sintilimab vs. placebo, in combination with chemotherapy, for first-line treatment in subjects with PD-L1 positive, unresectable, locally advanced, recurrent or metastatic ESCC

Secondary Outcome Measures
NameTimeMethod
ORR in overall populationFrom date of randomization up to 28 months.

To compare the objective response rate between the two treatment arms in ITT population

PFS in overall populationsubjects in ITT populationFrom date of randomization up to 28 months

To compare the progression-free survival between the two treatment arms in ITT population

DCR in overall populationFrom date of randomization up to 28 months

To compare the disease control rate between the two treatment arms in ITT population

DoR in overall populationFrom date of randomization up to 28 months

To compare the duration of response between the two treatment arms in ITT population

ORR - PD-L1 positiveFrom date of randomization up to 28 months

To compare the objective response rate between the two treatment arms in PD-L1 positive subjects in ITT population

DCR - PD-L1 positiveFrom date of randomization up to 28 months

To compare the disease control rate between the two treatment arms in PD-L1 positive subjects in ITT population

DoR - PD-L1 positiveFrom date of randomization up to 28 months

To compare the duration of response between the two treatment arms in PD-L1 positive subjects in ITT population

PFS - PD-L1 positiveFrom date of randomization up to 28 months

To compare the progression-free survival between the two treatment arms in PD-L1 positive subjects in ITT population

Trial Locations

Locations (47)

St. Joseph Heritage Healthcare - Virginia K. Crosson Cancer Center

🇺🇸

Anaheim, California, United States

UC Irvine

🇺🇸

Orange, California, United States

Rocky Mountain Cancer Centers, LLP

🇺🇸

Denver, Colorado, United States

IACT Health - John B. Amos Cancer center

🇺🇸

Columbus, Georgia, United States

Stephenson Cancer Center

🇺🇸

Oklahoma City, Oklahoma, United States

Texas Oncology, P.A.

🇺🇸

Austin, Texas, United States

Northwest Cancer Specialists, P.C.

🇺🇸

Vancouver, Washington, United States

Border Medical Oncology

🇦🇺

East Albury, New South Wales, Australia

The Queen Elizabeth Hospital

🇦🇺

Woodville South, South Australia, Australia

Austin Hospital

🇦🇺

Heidelberg, Victoria, Australia

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St. Joseph Heritage Healthcare - Virginia K. Crosson Cancer Center
🇺🇸Anaheim, California, United States
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