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Phase 2 Platform Study in Patients With Advanced Non-Small Lung Cancer Who Progressed on First-Line Osimertinib Therapy (ORCHARD)

Registration Number
NCT03944772
Lead Sponsor
AstraZeneca
Brief Summary

Phase 2 Platform Study in Patients with Advanced Non-Small Lung Cancer who progressed on First-Line Osimertinib Therapy. This study is modular in design, allowing evaluation of the efficacy, safety and tolerability of multiple study treatments.

Detailed Description

This is an open-label, multicentre, multi-drug, biomarker-directed Phase 2 platform study in patients with advanced non-small cell lung cancer (NSCLC) harbouring an epidermal growth factor receptor (EGFR)-sensitizing mutation whose disease has progressed on first-line monotherapy with osimertinib.Treatment options for these patients are limited. Novel treatments for these patients are urgently required.

This study is modular in design, allowing evaluation of the efficacy, safety and tolerability of multiple study treatments.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
247
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Module 3: Osimertinib + NecitumumabNecitumumabThe patients in this group will receive osimertinib taken in combination with necitumumab
Module 4: Carboplatin + Pemetrexed + Durvalumab)DurvalumabThe patients in this group will receive platinum-containing doublet (carboplatin + pemetrexed) taken in combination with durvalumab.
Module 4: Carboplatin + Pemetrexed + Durvalumab)CarboplatinThe patients in this group will receive platinum-containing doublet (carboplatin + pemetrexed) taken in combination with durvalumab.
Module 4: Carboplatin + Pemetrexed + Durvalumab)PemetrexedThe patients in this group will receive platinum-containing doublet (carboplatin + pemetrexed) taken in combination with durvalumab.
Module 5: Osimertinib + AlectinibAlectinibThe patients in this group will receive osimertinib taken in combination with alectinib
Module 8: Osimertinib + Pemetrexed + Carboplatin or Cisplatin.PemetrexedThe patients in this group will receive Osimertinib plus platinum-containing doublet (pemetrexed + carboplatin or cisplatin).
Module 8: Osimertinib + Pemetrexed + Carboplatin or Cisplatin.CisplatinThe patients in this group will receive Osimertinib plus platinum-containing doublet (pemetrexed + carboplatin or cisplatin).
Module 9: Osimertinib + SelumetinibOsimertinibThe patients in this group will receive osimertinib taken in combination with selumetinib
Module 9: Osimertinib + SelumetinibSelumetinibThe patients in this group will receive osimertinib taken in combination with selumetinib
Module 10: Osimertinib + datopotamab deruxtecanOsimertinibThe patients in this group will receive osimertinib taken in combination with datopotamab deruxtecan.
Module 10: Osimertinib + datopotamab deruxtecanDatopotamab deruxtecanThe patients in this group will receive osimertinib taken in combination with datopotamab deruxtecan.
Module 1: Osimertinib + SavolitinibOsimertinibThe patients in this group will receive osimertinib taken in combination with savolitinib
Module 1: Osimertinib + SavolitinibSavolitinibThe patients in this group will receive osimertinib taken in combination with savolitinib
Module 2: Osimertinib + GefitinibOsimertinibThe patients in this group will receive osimertinib taken in combination with gefitinib
Module 2: Osimertinib + GefitinibGefitinibThe patients in this group will receive osimertinib taken in combination with gefitinib
Module 3: Osimertinib + NecitumumabOsimertinibThe patients in this group will receive osimertinib taken in combination with necitumumab
Module 5: Osimertinib + AlectinibOsimertinibThe patients in this group will receive osimertinib taken in combination with alectinib
Module 6: Osimertinib + SelpercatinibOsimertinibThe patients in this group will receive osimertinib taken in combination with selpercatinib
Module 6: Osimertinib + SelpercatinibSelpercatinibThe patients in this group will receive osimertinib taken in combination with selpercatinib
Module 7: Etoposide + Durvalumab + Carboplatin or CisplatinDurvalumabThe patients in this group will receive platinum-containing doublet (etoposide + carboplatin or cisplatin) taken in combination with durvalumab.
Module 7: Etoposide + Durvalumab + Carboplatin or CisplatinCarboplatinThe patients in this group will receive platinum-containing doublet (etoposide + carboplatin or cisplatin) taken in combination with durvalumab.
Module 7: Etoposide + Durvalumab + Carboplatin or CisplatinEtoposideThe patients in this group will receive platinum-containing doublet (etoposide + carboplatin or cisplatin) taken in combination with durvalumab.
Module 7: Etoposide + Durvalumab + Carboplatin or CisplatinCisplatinThe patients in this group will receive platinum-containing doublet (etoposide + carboplatin or cisplatin) taken in combination with durvalumab.
Module 8: Osimertinib + Pemetrexed + Carboplatin or Cisplatin.OsimertinibThe patients in this group will receive Osimertinib plus platinum-containing doublet (pemetrexed + carboplatin or cisplatin).
Module 8: Osimertinib + Pemetrexed + Carboplatin or Cisplatin.CarboplatinThe patients in this group will receive Osimertinib plus platinum-containing doublet (pemetrexed + carboplatin or cisplatin).
Primary Outcome Measures
NameTimeMethod
Objective response rate (ORR)Measured from first dose until confirmed response or progression. For each patient this is expected to be 3 months on average

The percentage of patients with a confirmed investigator-assessed complete or partial response according to Response Evaluation Criteria In Solid Tumours (RECIST) 1.1. Patients will be followed up every 6 weeks (±1 week) for the first 24 weeks and every 9 weeks thereafter until RECIST 1.1 defined disease progression or cessation of study treatment (if treating beyond progression).

Secondary Outcome Measures
NameTimeMethod
Progression-free survival (PFS)Measured from first dose until progression. For each patient this is expected to be 6 months on average

The time from first dose until the date of objective disease progression or death (by any cause in the absence of progression). Patients will be followed up every 6 weeks (±1 week) for the first 24 weeks and every 9 weeks thereafter until RECIST (Response Evaluation Criteria In Solid Tumours)1.1 defined disease progression or cessation of study treatment (if treating beyond progression).

Duration of response (DoR)Measured from response until progression. For each patient this is expected to be 6 months on average

The time from the date of first response until date of disease progression or death in the absence of disease progression. Patients will be followed up every 6 weeks (±1 week) for the first 24 weeks and every 9 weeks thereafter until RECIST 1.1 defined disease progression or cessation of study treatment (if treating beyond progression).

Overall survival (OS)Measured from first dose until death or final cohort data cut-off. For each patient this is expected to be 20 months on average

The time from the date of the first dose of study treatment until death due to any cause.

Plasma/serum concentrations of therapeutic agentsPre-dose and serial post-dose blood samples (1 hour, 2 hours, 4 hours, 6 hours, 8 hours) on Day 15 of Cycle 1 for alectinib and selpercatinib only.

Blood samples will be collected at various timepoints to evaluate the serial pharmacokinetics of study therapeutic agents

Incidence of Treatment-emergent adverse events (AEs) and serious adverse events (SAEs) as characterized and graded by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Event [CTCAE] v5Continuously from first dose to end of safety follow up after study treatment discontinuation (approximately up to 21 Months)

To evaluate safety and tolerability of each study treatment

Trial Locations

Locations (1)

Research Site

🇸🇪

Stockholm, Sweden

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