A Phase III Study of Ceralasertib Plus Durvalumab Versus Docetaxel in Patients With Non Small Cell Lung Cancer (NSCLC) Whose Disease Progressed On or After Prior Anti PD (L)1 Therapy And Platinum Based Chemotherapy
- Conditions
- Advanced or Metastatic Non-Small Cell Lung Cancer
- Interventions
- Registration Number
- NCT05450692
- Lead Sponsor
- AstraZeneca
- Brief Summary
This study will assess the efficacy and safety of the combination of ceralasertib and durvalumab versus standard of care docetaxel in patients with locally advanced and metastatic NSCLC after progression on prior anti-PD-(L)1 therapy and platinum-based chemotherapy.
- Detailed Description
This study will consist of two treatment arms (Groups A and B).
Participants will be randomised in a 1:1 ratio to one of the two treatment groups:
* Group A: Ceralasertib plus durvalumab combination therapy Each 28-day cycle will begin with ceralasertib administered orally followed by durvalumab administered intravenously.
* Group B: Docetaxel monotherapy Each 21-day cycle will begin with the administration of docetaxel.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 594
- Histologically or cytologically documented NSCLC that is locally advanced or metastatic according to Version 8 of the IASLC Staging Manual in Thoracic Oncology.
- Documented epidermal growth receptor factor (EGFR) and anaplastic lymphoma kinase (ALK) wild-type status as determined at a local laboratory.
- Documented radiological PD whilst on or after receiving the most recent treatment regimen.
- Eligible for second- or third-line therapy and must have received an anti-PD-(L)1 therapy and a platinum doublet containing therapy for locally advanced or metastatic NSCLC either separately or in combination.
- Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance status of 0 or 1.
- Adequate organ function and marrow reserve
- Minimum life expectancy of 12 weeks.
- Body weight > 30 kg and no cancer-associated cachexia.
- Negative pregnancy test (serum test) for women of childbearing potential (WOCBP).
-
Participant with mixed SCLC and NSCLC histology.
-
History of another primary malignancy except for malignancy treated with curative intent with no known active disease ≥ 5 years before the first dose of study intervention.
-
Persistent toxicities (CTCAE Grade > 2) caused by previous anticancer therapy.
-
Active or prior documented autoimmune or inflammatory disorders.
-
Participants who have received more than one line of prior anti-PD-(L)1, either alone or in any combination.
-
Participants:
- Must not have experienced a toxicity that led to permanent discontinuation of the prior anti-PD(L)1 therapy.
- All AEs while receiving prior anti-PD(L)1 therapy must have completely resolved.
- Must not have experienced a Grade ≥ 3 immune-mediated adverse event (imAE) or an immune-related neurologic or ocular AE of any grade while receiving prior anti-PD(L)1 therapy.
- Must not have required the use of additional immunosuppression other than corticosteroids for the management of an AE, not have experienced recurrence of an AE if re-challenged, and not currently require maintenance doses of > 10 mg prednisone or equivalent per day.
-
Participants who have received more than one prior line of platinum-based chemotherapy in metastatic setting.
-
Participants who have received a prior ataxia telangiectasia and Rad3-related protein (ATR) inhibitor.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group A: Ceralasertib plus durvalumab combination therapy Ceralasertib Participants will be administered ceralasertib orally followed by durvalumab administered intravenously. Group A: Ceralasertib plus durvalumab combination therapy Durvalumab Participants will be administered ceralasertib orally followed by durvalumab administered intravenously. Group B: Docetaxel monotherapy Docetaxel Participants will be administered docetaxel (standard of care) administered intravenously.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Every 3 months (± 1 week) following objective progression of disease (PD) or treatment discontinuation (up to three years) The superiority of ceralasertib plus durvalumab combination therapy relative to docetaxel will be demonstrated by assessment of OS (HR with 95% CI and p-value) in participants with advanced NSCLC after second- or third-line therapy and without actionable genomic alterations. OS is defined as time from randomisation until the date of death due to any cause.
- Secondary Outcome Measures
Name Time Method TTD of physical function Up to 3 years TTD in physical functioning is measured by the EORTC QLQ-C30 Physical Function subscale of the EORTC QLQ-C30.
Plasma concentrations for ceralasertib plus durvalumab combination therapy Up to 3 years The PK plasma concentration of ceralasertib when administered in combination with durvalumab will be assessed.
Time to second progression or death (PFS2) Up to 3 years Time from randomisation to PFS2 will be defined as the time from the randomisation to the earliest of the progression event (following the initial progression), subsequent to first subsequent therapy or death.
Progression-Free Survival (PFS) Up to 3 years PFS will be defined as the time from the date of randomisation until the date of objective PD.
Objective Response Rate (ORR) Up to 3 years ORR is defined as the proportion of participant who have a Complete Response (CR) or Partial Response (PR) per RECIST 1.1.
Duration of Response (DoR) Up to 3 years DoR is defined as the time from the date of first documented response until date of documented progression per RECIST 1.1.
Time To Response (TTR) Up to 3 years TTR is defined as the time from randomisation until the date of first documented objective response.
Disease Control Rate (DCR) At Week 18 DCR at 18 weeks is defined as the percentage of participants who have a CR or PR or who have stable disease (SD) for at least 17 weeks.
Time To Deterioration (TTD) of health-related quality of life (QoL) Up to 3 years TTD is defined as the time from randomisation until the date of first confirmed deterioration.
Overall Survival (OS) at 12 months At 12 months OS is defined as time from randomisation until the data of death due to any cause.
Number of participants with Adverse Evens (AEs) Up to 3 years The safety and tolerability of ceralasertib plus durvalumab combination therapy as compared with docetaxel will be assessed.
Trial Locations
- Locations (1)
Research Site
🇬🇧Wirral, United Kingdom