A Study of Atezolizumab With or Without Tiragolumab in Participants With Unresectable Esophageal Squamous Cell Carcinoma Whose Cancers Have Not Progressed Following Definitive Concurrent Chemoradiotherapy

Hoffmann-La Roche760 enrolled

Overview

The purpose of this study is to evaluate the efficacy and safety of tiragolumab plus atezolizumab compared with placebo in participants with unresectable esophageal squamous cell carcinoma (or those who are unable or unwilling to undergo surgery) and whose cancers have not progressed following definitive concurrent chemoradiotherapy (dCRT). Participants will be randomized in a 1:1:1 ratio to receive either tiragolumab plus atezolizumab (Arm A), tiragolumab matching placebo plus atezolizumab (Arm B), or double placebo (Arm C).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

760

Conditions

Esophageal Squamous Cell Carcinoma

Interventions

Tiragolumab

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Key Inclusion Criteria: * Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 * Histologically or cytologically confirmed diagnosis of squamous cell carcinoma of the esophagus * Unresectable disease ineligible for curative surgery based on the documented opinion of the qualified medical, surgical or radiation oncologist prior to dCRT and is not expected to undergo tumor resection during the course of the study * dCRT treatment according to regional oncology guidelines for esophageal cancer * Representative archival formalin-fixed, paraffin-embedded (FFPE) tumor specimens collected prior to initiation of dCRT * Adequate hematologic and end-organ function prior to randomization * Women of childbearing potential must remain abstinent or use contraceptive methods with a failure rate of \< 1% per year during the treatment period, for 5 months after the final dose of atezolizumab/placebo, and for 90 days after the final dose of tiragolumab/placebo, whichever is later * Men must agree to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agree to refrain from donating sperm during the treatment period and for 90 days after the final dose of tiragolumab/placebo. Key Exclusion Criteria: * Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-CTLA-4, anti-PD-1, anti-PD-L1 and anti-TIGIT therapeutic antibodies * Any unresolved toxicity of National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Grade ≥ 2 from the prior chemoradiation therapy with the exception of irreversible and manageable hearing loss * Prior allogeneic stem cell or solid organ transplantation * Active or history of autoimmune disease or immune deficiency * History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis * Malignancies other than esophageal cancer within 2 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death * Treatment with any other investigational agent, including epidermal growth factor receptor (EGFR) inhibitors, with therapeutic intent for esophageal cancer prior to randomization.

Locations (166)

Florida Cancer Specialists - Fort Myers (Broadway)

Fort Myers, Florida, United States

Cancer Center of Kansas

Wichita, Kansas, United States

Great Lakes Cancer Center

Williamsville, New York, United States

Instituto de Investigaciones Metabolicas (Idim)

Buenos Aires, Argentina

Fundacion Favaloro

Buenos Aires, Argentina

Outcomes

Primary Outcomes

Arm A vs Arm C: Investigator-Assessed Progression-Free Survival (PFS)

Time frame: From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)

Arm A vs Arm C: Overall Survival (OS)

Time frame: From randomization to death from any cause (up to approximately 6 years)

Arm B vs Arm C: OS

Time frame: From randomization to death from any cause (up to approximately 6 years)

Secondary Outcomes

Arm B vs Arm C: Investigator-Assessed PFS

Time frame: From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)

Arm A vs Arm B: Investigator-Assessed PFS

Time frame: From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)

Arm A vs Arm B: OS

Time frame: From randomization to death from any cause (up to approximately 6 years)

Independent Review Facility (IRF)-Assessed PFS

Time frame: From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)

Investigator-Assessed Confirmed Objective Response Rate (ORR)

Time frame: From randomization up to approximately 6 years

IRF-Assessed Confirmed ORR

Time frame: From randomization up to approximately 6 years

Investigator-Assessed Duration of Objective Response (DOR)

Time frame: From the first occurrence of a documented confirmed objective response to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)

IRF-Assessed DOR

Percentage of Participants With Clinically Meaningful Changes in Physical Functioning, Role Functioning, Quality of Life (QoL) as Measured by EORTC QLQ-C30

Clinically meaningful changes in physical functioning, role functioning, global health status (GHS)/QoL as measured by the European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire (EORTC QLQ-C30). EORTC QLQ-C30 is a self-reported measure, consisting of 30 questions that assess 5 aspects of participants functioning (physical, emotional, role, cognitive and social), 3 symptom scales (fatigue, nausea and vomiting, and pain), GHS and QoL, and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) within the previous week. Functioning and symptoms items are scored on a 4-point scale: 1=Not at all, 2=A little, 3=Quite a bit, 4=Very much. GHS and QoL items are scored on a 7-point scale: 1=Very poor, 2, 3, 4, 5, 6, 7=Excellent. Scores will be linearly transformed to a range of 0 to 100, with higher scores (i.e. closer to 100) reflecting better functioning, better GHS/QoL, and worse symptoms.

Time frame: Up to approximately 6 years

Percentage of Participants With Clinically Meaningful Changes in Dysphagia as Measured by EORTC QLQ-OES18

Clinically meaningful changes in dysphagia as measured by the EORTC Quality of Life-Esophageal Cancer, Module 18 Questionnaire (EORTC QLQ-OES18). EORTC QLQ-OES18 is a modular supplement to the EORTC QLQ-C30 questionnaire for use in participants with esophageal cancer. EORTC QLQ-OES18 consists of 4 multiple-item scale (dysphagia, eating, reflux, and pain) and 6 single items (trouble swallowing saliva, choked when swallowing, dry mouth, trouble with taste, trouble with coughing, and trouble talking) with a recall period of the previous week. Each symptom item is scored on a 4-point scale: 1=Not at all, 2=A little, 3=Quite a bit, 4=Very much. Scores will be linearly transformed to a range of 0 to 100, with higher transformed scores (i.e. closer to 100) reflecting worse symptoms.

Time frame: Up to approximately 6 years

Percentage of Participants With Adverse Events (AEs)

Time frame: Up to approximately 6 years

Serum Concentration of Tiragolumab

Time frame: Predose and postdose on Day 1 of Cycle 1 (each cycle=21 days) and predose on Day 1 of Cycles 2, 3, 4, 8, 12 and 16 and at treatment discontinuation (TD) visit (up to approximately 6 years)

Serum Concentration of Atezolizumab

Time frame: Predose and postdose on Day 1 of Cycle 1 (each cycle=21 days) and predose on Day 1 of Cycles 2, 3, 4, 8, 12 and 16 and at TD visit (up to approximately 6 years)

Percentage of Participants With Anti-drug Antibodies (ADAs) to Tiragolumab

Time frame: Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12 and 16 and at TD visit (up to approximately 6 years)

Percentage of Participants With ADAs to Atezolizumab

Time frame: Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12 and 16 and at TD visit (up to approximately 6 years)