START * Stimulating Targeted Antigenic Responses To NSCLC A multi-center phase III randomized, double-blind placebo-controlled study of the cancer vaccine Stimuvax® (L-BLP25 or BLP25 liposome vaccine) in non-small cell lung cancer (NSCLC) subjects with unresectable stage III disease

Phase 3

Completed

Conditions: non-small cell lung cancer
10038666

Registration Number: NL-OMON40067

Lead Sponsor: Merck

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 25

Inclusion Criteria

Both inpatient and outpatient, male and female subjects are eligible for randomization.
* Subject has given written informed consent before any study-related activities are carried out.
* Histologically or cytologically documented unresectable stage III NSCLC. All histological subtypes are acceptable, including bronchioalveolar carcinomas. Cancer stage must be confirmed and documented by computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET) scan.
* Documented stable disease or objective response, according to RECIST, after primary chemo-radiotherapy (either sequential or concomitant) for unresectable stage III disease, within 4 weeks (28 days) prior to randomization*.
* Receipt of concomitant or sequential chemo-radiotherapy, consisting of a minimum of two cycles of platinum-based chemotherapy and a minimum radiation dose of * 50 Gy. Subjects must have completed the primary thoracic chemo-radiotherapy at least four weeks (28 days) and no later than 12 weeks (84 days) prior to randomization. Subjects who received prophylactic brain irradiation as part of primary chemo-radiotherapy are eligible.
* Geographically accessible for ongoing follow-up, and committed to comply with the designated visits.
* An ECOG performance status of 0-1.
* A platelet count * 140 x (1E+9)/L; WBC * 2.5 x (1E+9)/L and hemoglobin * 90 g/L.
* * 18 years of age.
* If imaging after primary chemo-radiotherapy was earlier than 4 weeks prior to randomization, it must be repeated within 4 weeks prior to randomization, and the results of the second restaging after end of primary chemo-radiotherapy must be compared with the first restaging after end of primary chemo-radiotherapy. Subjects that show progression between these two assessments are not eligible for this trial.

Exclusion Criteria

Pre-Therapies:
* Undergone lung cancer specific therapy (including surgery) other than primary chemo-radiotherapy.
* Receipt of immunotherapy (e.g. interferons, tumor necrosis factor [TNF], interleukins, or biological response modifiers [granulocyte macrophage colony stimulating factor {GM-CSF}, granulocyte colony stimulating factor {G-CSF}, macrophage-colony stimulating factor {M-CSF}], monoclonal antibodies) within 4 weeks (28 days) prior to randomization. Note: Subjects who have received monoclonal antibodies for imaging are acceptable.
* Receipt of investigational systemic drugs (including off-label use of approved products) within 4 weeks (28 days) prior to randomization.
Disease Status:
* Metastatic disease.
* Malignant pleural effusion at initial diagnosis and/or at study entry.
* Past or current history of neoplasm other than lung carcinoma, except for curatively treated non-melanoma skin cancer, in situ carcinoma of the cervix or other cancer curatively treated and with no evidence of disease for at least 5 years.
* Autoimmune disease
* A recognized immunodeficiency disease including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia; subjects who have hereditary or congenital immunodeficiencies.
* Any preexisting medical condition requiring chronic steroid or immunosuppressive therapy (steroids for the treatment of radiation pneumonitis are allowed).
* Known Hepatitis B and/or C.
Physiological Functions:
* Clinically significant hepatic dysfunction (i.e. Alanine aminotransferase [ALT] > 2.5 times normal upper limit [ULN]; or Aspartate aminotransferase [AST] > 2.5 times ULN; or bilirubin * 1.5 x ULN).
* Clinically significant renal dysfunction (i.e. serum creatinine * 1.5 x ULN).
* Clinically significant cardiac disease, e.g. New York Heart Association (NYHA) classes III-IV; uncontrolled angina, uncontrolled arrhythmia or uncontrolled hypertension, myocardial infarction in the previous 6 months as confirmed by an electrocardiogram (ECG).
* Splenectomy.
* Infectious process that in the opinion of the investigator could compromise the subject*s ability to mount an immune response.
Standard Safety:
* Pregnant or breast-feeding women, women of childbearing potential, unless using effective contraception as determined by the investigator. Subjects whom the investigator considers may be at risk of pregnancy will have a pregnancy test performed per institutional standard.
* Known drug abuse/alcohol abuse.
* Participation in another clinical study within the past 28 days.
* Requires concurrent treatment with a non-permitted drug*.
* Known hypersensitivity to any of the study treatment ingredients.
* Legal incapacity or limited legal capacity.
* Any other reason that, in the opinion of the investigator precludes the subject from participating in the study.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The primary variable of this study is the survival duration. Survival will be<br /><br>measured as the number of months between the date of randomization and the date<br /><br>of death.<br /><br>Survival will be analyzed in the intention-to-treat (ITT) population (primary<br /><br>analysis) and in the per protocol (PP) population.</p><br>

Secondary Outcome Measures

Name	Time	Method
<p>* TTSP as measured by the LCSS.<br /><br>* TTP as determined by the investigator.<br /><br>* One-, two- and three-year survival.<br /><br><br /><br><br /><br>Reactions on the injection site, side effects, vital functions and clinical<br /><br>laboratorium testing:<br /><br>* Progression free survival (PFS).<br /><br>* QoL index (EQ-5D).<br /><br>* Healthcare resource utilization and work status.<br /><br>* Additional QoL analyses utilizing the LCSS.<br /><br>* Time to treatment failure (TTF).<br /><br>* HLA-typing.<br /><br>* Molecular markers.</p><br>