The study will evaluate the efficacy and safety of treatment with chemotherapy in combination with osimertinib compared to chemotherapy in combination with placebo in patients whose disease has progressed extracranially following first-line osimertinib treatment.
This is a Phase III, randomized, double-blind, placebo-controlled study of platinum plus pemetrexed chemotherapy plus osimertinib versus platinum plus pemetrexed chemotherapy plus placebo in patients with epidermal growth factor receptor mutation-positive (EGFRm), locally advanced or metastatic NSCLC with or wihout stable brain metastases who responded to first-line osimertinib therapy (complete response \[CR\] or partial response \[PR\]) or stable disease (SD) for ≥ 6 months during first-line osimertinib treatment, and subsequently experienced radiological, extracranial disease progression. Approximately 204 patients were to be randomized in a 1:1 ratio to treatment with platinum plus pemetrexed chemotherapy plus osimertinib (Treatment Arm A) or platinum plus pemetrexed chemotherapy plus placebo (Treatment Arm B). However, the number of patients has been reduced to approximately 80 patients due to treatment landscape changes which outpaced study recruitment. Patients will be stratified based on the presence of brain metastases (stable brain metastases based on central nervous system (CNS) Response Evaluation Criteria in Solid Tumors, Version 1.1 \[RECIST 1.1\] assessments versus no brain metastases). The 2 randomized treatment regimens are as follows: * Treatment Arm A: Osimertinib 80 mg once daily (QD) with pemetrexed (500 mg/m\^2) (with pre-treatment) plus either cisplatin (75 mg/m\^2) or carboplatin (area under the concentration-time curve \[AUC\] 5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by osimertinib 80 mg QD plus pemetrexed maintenance (500 mg/m\^2) on Day 1 of 21-day cycles * Treatment Arm B: Placebo QD with pemetrexed (500 mg/m\^2) (with pre-treatment) plus either cisplatin (75 mg/m\^2) or carboplatin (AUC5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by placebo QD plus pemetrexed maintenance (500 mg/m\^2) on Day 1 of 21-day cycles.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
98
Randomized patients will receive oral dose of osimertinib with intravenous (IV) pemetrexed plus either IV cisplatin or IV carboplatin
Randomized patients will receive oral dose of placebo matching osimertinib with IV pemetrexed plus either IV cisplatin or IV carboplatin
Progression Free Survival (PFS)
Progression free survival is defined as time from randomization until progression (intracranial or extracranial, whichever occurs first) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (for extracranial progression) and Central nervous system (CNS) RECIST 1.1 (for intracranial progression) as assessed by the Investigator at local site or death due to any cause.
Time frame: From date of first dose (Day 1) until date of progression at local site or death due to any cause or data cut-off date whichever occurred first (up to 3 years 1 month)
Intracranial Progression Free Survival With Brain Metastases at Baseline
Intracranial PFS (IC-PFS) is defined as time from randomization until intracranial progression per CNS RECIST 1.1 as assessed by the Investigator at local site or death due to any cause. For participants with brain metastases at baseline, the IC-PFS rate at specified timepoints was estimated using the Kaplan-Meier method which indicated the percentage of these participants who remain alive and free from intracranial progression per CNS RECIST 1.1 as assessed by the Investigator. The data was calculated throughout the study as per the below timeframe but IC-PFS rate at 6 months has been presented as it was clinically relevant.
Time frame: Assessed from date of first dose (Day 1) until date of intracranial progression at local site or death due to any cause or data cut off date whichever occurred first (up to 3 years 1 month), data for 6 months reported
Intracranial Progression Free Survival Without Brain Metastases at Baseline
Intracranial PFS (IC-PFS) is defined as time from randomization until intracranial progression per CNS RECIST 1.1 as assessed by the Investigator at local site or death due to any cause. For participants without brain metastases at baseline, the IC-PFS rate at specified timepoints was estimated using the Kaplan-Meier method which indicated the percentage of these participants who remain alive and free from intracranial progression per CNS RECIST 1.1 as assessed by the Investigator. The data was calculated throughout the study as per the below timeframe but IC-PFS rate at 6 months has been presented as it was clinically relevant.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Research Site
Silver Spring, Maryland, United States
Research Site
Boston, Massachusetts, United States
Research Site
Beijing, China
Research Site
Beijing, China
Research Site
Ganzhou, China
Research Site
Guangzhou, China
Research Site
Jinan, China
Research Site
Shenyang, China
Research Site
Tianjin, China
Research Site
Zhengzhou, China
...and 30 more locations
Time frame: Assessed from date of first dose (Day 1) until date of intracranial progression at local site or death due to any cause or data cut off date whichever occurred first (up to 3 years 1 month), data for 6 months reported
Extracranial Progression Free-survival
Extracranial PFS is defined as time from randomization until extracranial progression per RECIST 1.1 as assessed by the Investigator at local site or death due to any cause.
Time frame: From date of first dose (Day 1) until date of extracranial progression at local site or death due to any cause or data cut-off date whichever occurred first (up to 3 years 1 month)
Overall Survival (OS)
Overall survival is defined as the length of time from randomization until the date of death due to any cause.
Time frame: From date of first dose (Day 1) until post progression survival follow-up (up to 3 years 1 month)