AZD9291 (Osimertinib) Versus Platinum-Based Doublet-Chemotherapy in Locally Advanced or Metastatic Non-Small Cell Lung Cancer (AURA3)
A Phase III, Open Label, Randomized Study of AZD9291 Versus Platinum-Based Doublet Chemotherapy for Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer Whose Disease Has Progressed With Previous Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy and Whose Tumours Harbour a T790M Mutation Within the Epidermal Growth Factor Receptor Gene (AURA3).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Darlinghurst, Australia, 2010
- Research Site
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Heidelberg, Australia, 3084
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Kogarah, Australia, 2217
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Nedlands, Australia, 6009
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Woolloongabba, Australia, 4102
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 4E6
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 1V7
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Ontario
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Ottawa, Ontario, Canada, K1H 8L6
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Toronto, Ontario, Canada, M5G 2M9
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Quebec
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Montreal, Quebec, Canada, H2L 4M1
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Beijing, China, 100142
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Beijing, China, 100021
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Changchun, China, 130000
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Chongqing, China, 400038
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Chongqing, China, 400042
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Fuzhou, China, 350014
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Guangzhou, China, 510060
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Guangzhou, China, 510100
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Hangzhou, China, 310003
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Harbin, China, 150049
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Nanchang, China, 330006
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Shanghai, China, 200030
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Shanghai, China, CN-200433
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Tianjin, China, 300060
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Zhengzhou, China, 450008
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Ürümqi, China, 830000
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Clermont Ferrand, France, 63003
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Dijon, France, 21079
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Lille, France, 59000
- Research Site
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Marseille Cedex 20, France, 13915
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Paris, France, 75020
- Research Site
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Strasbourg Cedex, France, 67091
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Toulouse Cedex 09, France, 31059
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Villejuif, France, 94800
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Essen, Germany, 45122
- Research Site
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Frankfurt, Germany, 60590
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Gerlingen, Germany, 70839
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Oldenburg, Germany, 26121
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Regensburg, Germany, 93053
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Würzburg, Germany, 97080
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Hong Kong, Hong Kong
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Shatin, Hong Kong, 00000
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Budapest, Hungary, 1121
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Avellino, Italy, 83100
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Meldola, Italy, 47014
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Milano, Italy, 20133
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Orbassano, Italy, 10043
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Roma, Italy, 00128
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Akashi-shi, Japan, 673-8558
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Bunkyo-ku, Japan, 113-8431
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Fukuoka, Japan, 812-8582
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Hirakata-shi, Japan, 573-1191
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Kanazawa, Japan, 920-8641
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Kitaadachi-gun, Japan, 362-0806
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Kobe-shi, Japan, 650-0047
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Kurashiki-shi, Japan, 710-8602
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Kyoto-shi, Japan, 606-8507
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Matsuyama-shi, Japan, 791-0280
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Nagoya-shi, Japan, 464-8681
- Research Site
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Natori-shi, Japan, 981-1293
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Niigata-shi, Japan, 951-8566
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Okayama-shi, Japan, 700-8558
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Osaka-shi, Japan, 541-8567
- Research Site
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Osaka-shi, Japan, 534-0021
- Research Site
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Osakasayama, Japan, 589-8511
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Sakai-shi, Japan, 591-8555
- Research Site
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Shinjuku-ku, Japan, 160-0023
- Research Site
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Sunto-gun, Japan, 411-8777
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Takatsuki-shi, Japan, 569-8686
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Wakayama-shi, Japan, 641-8510
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Yokohama-shi, Japan, 241-8515
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Yokohama-shi, Japan, 236-0024
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Yokohama-shi, Japan, 236-0051
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Busan, Korea, Republic of, 47392
- Research Site
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Cheongju-si, Korea, Republic of, 28644
- Research Site
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Goyang-si, Korea, Republic of, 10408
- Research Site
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Incheon, Korea, Republic of, 21565
- Research Site
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Jinju-si, Korea, Republic of, 660-702
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Seongnam-si, Korea, Republic of, 13620
- Research Site
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Seoul, Korea, Republic of, 03722
- Research Site
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Seoul, Korea, Republic of, 05505
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Seoul, Korea, Republic of, 156-707
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Seoul, Korea, Republic of, 06591
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Seoul, Korea, Republic of, 6351
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Suwon-si, Korea, Republic of, 16499
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Ulsan, Korea, Republic of, 44033
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Mexico, Mexico, 52763
- Research Site
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Oaxaca, Mexico, 68000
- Research Site
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Amsterdam, Netherlands, 1066 CX
- Research Site
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Amsterdam, Netherlands, 1081 HV
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Groningen, Netherlands, 9713 GZ
- Research Site
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Ekaterinburg, Russian Federation, 620905
- Research Site
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Moscow, Russian Federation, 115478
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Omsk, Russian Federation, 644013
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Saint Petersburg, Russian Federation, 197342
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Saint Petersburg,, Russian Federation, 197758
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Saint-Petersburg, Russian Federation, 197183
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Madrid, Spain, 28034
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Madrid, Spain, 28041
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Madrid, Spain, 08035
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Málaga, Spain, 29010
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Sevilla, Spain, 41013
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Zaragoza, Spain, 50009
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Göteborg, Sweden, 413 45
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Lund, Sweden, 221 85
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Stockholm, Sweden, 171 76
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Changhua, Taiwan, 500
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Hsinchu, Taiwan, 300
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Kaohsiung, Taiwan, 82445
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Kaohsiung, Taiwan, 81362
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Kaohsiung City, Taiwan, 83301
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Taichung, Taiwan, 40705
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Taichung, Taiwan, 40447
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Tainan, Taiwan, 704
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Taipei, Taiwan, 10002
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Taipei, Taiwan, 112
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Taoyuan, Taiwan, 333
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Aberdeen, United Kingdom, AB2 2ZB
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Bristol, United Kingdom, BS2 8ED
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Edinburgh, United Kingdom, EH4 2XU
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Glasgow, United Kingdom, G12 0YN
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Huddersfield, United Kingdom, HD3 3EA
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London, United Kingdom, W1G 6AD
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London, United Kingdom, SW10 9NH
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Manchester, United Kingdom, M20 4BX
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Newcastle-Upon-Tyne, United Kingdom, NE7 7DN
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Nottingham, United Kingdom, NG5 1PB
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Wolverhampton, United Kingdom, WV10 0QP
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California
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Anaheim, California, United States, 92801
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Orange, California, United States, 92868
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Santa Rosa, California, United States, 95403
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Connecticut
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Norwalk, Connecticut, United States, 06856
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Florida
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Gainesville, Florida, United States, 32610
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Orlando, Florida, United States, 32804
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Pembroke Pines, Florida, United States, 33028
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Georgia
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Atlanta, Georgia, United States, 30322
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Illinois
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Park Ridge, Illinois, United States, 60068
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Indiana
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Indianapolis, Indiana, United States, 46202
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Louisiana
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Marrero, Louisiana, United States, 70072
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Maryland
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Chevy Chase, Maryland, United States, 20815
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New Hampshire
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Lebanon, New Hampshire, United States, 03756
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New Jersey
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Brick, New Jersey, United States, 08724
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New York
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New York, New York, United States, 10032
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Pennsylvania
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Hershey, Pennsylvania, United States, 17033-0850
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South Carolina
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Charleston, South Carolina, United States, 29425
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Texas
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Houston, Texas, United States, 77030
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Washington
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Lacey, Washington, United States, 98503
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Tacoma, Washington, United States, 98405
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects with histologically or cytologically documented NSCLC.
- Locally advanced or metastatic NSCLC
- Radiological documentation of disease progression following 1st line EGFR TKI Treatment without any further treatment
- Eligible to receive treatment with the selected doublet-chemotherapy
- Central confirmation of T790M+ mutation status
- World Health Organization (WHO) performance status 0-1
- At least one lesion, not previously irradiated.
Exclusion Criteria:
- • Prior neo-adjuvant or adjuvant chemotherapy treatment within 6 months prior of starting 1st EGFR TKI treatment
- Treatment with more than one prior line of treatment for advanced NSCLC
- Treatment with an approved EGFR-TKI (e.g.,erlotinib, gefitinib, afatinib) within 8 days or approximately 5x half-life of the first dose of study treatment
- Any investigational agents or other anticancer drugs from a previous treatment regimen or clinical study within 14 days of the first dose of study treatment
- Previous treatment with Osimertinib, or a 3rd generation EGFR TKI
For subjects who cross-over to Osimertinib:
- Once subjects on the platinum-based doublet chemotherapy arm are determined to have objective radiological progression according to RECIST 1.1 by the investigator and confirmed by independent central imaging review.
- At least 14 days since last dose of platinum-based doublet chemotherapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Osimertinib
Osimertinib 80 mg, orally, once daily
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Randomization to either Osimertinib or platinum-based doublet-chemotherapy on Day 1 of every 21d cycle in a 2:1 (Osimertinib:platinum-based doublet-chemotherapy) ratio
Other Names:
Once subjects on the platinum-based doublet chemotherapy arm are determined to have objective radiological progression according to RECIST 1.1 by the investigator and confirmed by independent central imaging review, they will be given the opportunity to begin treatment with Osimertinib 80mg, once daily. These subjects may continue treatment with Osimertinib even after disease progression, as long as they are continuing to show clinical benefit, as judged by the investigator. Subjects who stop platinum-based doublet chemotherapy for reasons other than objective disease progression according to RECIST 1.1 will not be eligible to cross-over to Osimertinib. |
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Active Comparator: Platinum-based doublet chemotherapy
pemetrexed 500mg/m2 + carboplatin AUC5 or pemetrexed 500mg/m2 + cisplatin 75mg/m2
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Randomization to either Osimertinib or platinum-based doublet-chemotherapy on Day 1 of every 21d cycle in a 2:1 (Osimertinib:platinum-based doublet-chemotherapy) ratio
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Progression Free Survival (PFS) by Investigator Assessment
Time Frame: RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Progressive Disease (PD): >= 20% increase in the sum of diameters of TLs and an absolute increase in sum of diameters of >=5mm (compared to the previous minimum sum) or progression of NTLs or a new lesion.
PFS is the time from date of randomisation until the date of PD (by investigator assessment) or death (by any cause in the absence of progression) regardless of whether the patient withdrew from randomised therapy or received another anti-cancer therapy prior to progression.
Patients who had not progressed or died at the time of analysis were censored at the time of the latest date of assessment from their last evaluable RECIST 1.1 assessment.
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RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Objective Response Rate (ORR) by Investigator Assessment
Time Frame: RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions.
ORR is the percentage of patients with at least 1 visit response of CR or PR prior to progression or any further therapy.
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RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Duration of Response (DoR) by Investigator Assessment
Time Frame: RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions.
DoR is the time from the date of first documented response until the date of documented progression or death in the absence of disease progression.
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RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Disease Control Rate (DCR) by Investigator Assessment
Time Frame: RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Complete Response (CR): Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR): >= 30% decrease in the sum of diameters of Target Lesions (compared to baseline) and no new lesions; Stable disease (SD): Neither sufficient shrinkage to qualify as a response nor sufficient growth to qualify as progression; Progressive Disease (PD): >= 20% increase in the sum of diameters of TLs and an absolute increase in sum of diameters of >=5mm (compared to the previous minimum sum) or progression of NTLs or a new lesion.
DCR is the percentage of patients with best response of CR, PR or SD at >=6 weeks, prior to any progressive disease (PD).
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RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Tumour Shrinkage by Investigator Assessment
Time Frame: RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Per Response Evaluation Criteria in Solid Tumours (RECIST v1.1) assessed by MRI or CT: Tumour size was calculated as the sum of the longest diameters (SLD) of the Target Lesions.
Tumour shrinkage is percentage change in tumour size from baseline using RECIST v1.1 tumour response.
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RECIST tumour assessments every 6 weeks from randomisation until objective disease progression up to 19 months (at the time of the primary PFS analysis).
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Secondary: Overall Survival (OS)
Time Frame: From date of randomization until time of final OS analysis, a median follow-up of 43 months
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From date of randomization until time of final OS analysis, a median follow-up of 43 months
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Time to First Subsequent Therapy (TFST)
Time Frame: From date of randomisation until time of final OS analysis, a median follow-up of 43 months
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Time from randomisation to first subsequent anti-cancer therapy (FST) following randomised treatment discontinuation, or death if no FST administered.
Any patient not known to have died nor received any subsequent anti-cancer therapy (ST) was censored at the last time known not to have received ST, ie, the last follow-up visit this was confirmed.
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From date of randomisation until time of final OS analysis, a median follow-up of 43 months
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Time to Second Subsequent Therapy (TSST)
Time Frame: From date of randomisation until time of final OS analysis, a median follow-up of 43 months
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Time from randomisation to second subsequent anti-cancer therapy (SST) following randomised treatment discontinuation, or death if no SST administered.
Any patient not known to have died nor received any SST was censored at the last time known not to have received SST, ie, the last follow-up visit this was confirmed.
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From date of randomisation until time of final OS analysis, a median follow-up of 43 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Yilong Wu, MD, Guangdong General Hospital, Guangdong, 510030, China
- Principal Investigator: Vassiliki A Papadimitrakopoulou, MD, The University of Texas/M.D. Anderson Cancer Center, Houston, Tx, USA
Publications and helpful links
General Publications
- Soria JC, Wu YL, Nakagawa K, Kim SW, Yang JJ, Ahn MJ, Wang J, Yang JC, Lu Y, Atagi S, Ponce S, Lee DH, Liu Y, Yoh K, Zhou JY, Shi X, Webster A, Jiang H, Mok TS. Gefitinib plus chemotherapy versus placebo plus chemotherapy in EGFR-mutation-positive non-small-cell lung cancer after progression on first-line gefitinib (IMPRESS): a phase 3 randomised trial. Lancet Oncol. 2015 Aug;16(8):990-8. doi: 10.1016/S1470-2045(15)00121-7. Epub 2015 Jul 6.
- King-Kallimanis BL, Bhatnagar V, Horodniceanu EG, Chen TY, Kluetz PG. Timing is everything: The importance of patient-reported outcome assessment frequency when characterizing symptomatic adverse events. Clin Trials. 2022 Jun;19(3):267-273. doi: 10.1177/17407745221093935. Epub 2022 May 15.
- Singh J, Bourke S, Dyer M, Devlin N, Longworth L. An Analysis of 5-Level Version of EQ-5D Adjusting for Treatment Switching: The Case of Patients With Epidermal Growth Factor Receptor T790M-Positive Nonsmall Cell Lung Cancer Treated With Osimertinib. Value Health. 2022 Jul;25(7):1205-1211. doi: 10.1016/j.jval.2022.01.022. Epub 2022 Apr 2.
- Papadimitrakopoulou VA, Mok TS, Han JY, Ahn MJ, Delmonte A, Ramalingam SS, Kim SW, Shepherd FA, Laskin J, He Y, Akamatsu H, Theelen WSME, Su WC, John T, Sebastian M, Mann H, Miranda M, Laus G, Rukazenkov Y, Wu YL. Osimertinib versus platinum-pemetrexed for patients with EGFR T790M advanced NSCLC and progression on a prior EGFR-tyrosine kinase inhibitor: AURA3 overall survival analysis. Ann Oncol. 2020 Nov;31(11):1536-1544. doi: 10.1016/j.annonc.2020.08.2100. Epub 2020 Aug 27.
- Papadimitrakopoulou VA, Han JY, Ahn MJ, Ramalingam SS, Delmonte A, Hsia TC, Laskin J, Kim SW, He Y, Tsai CM, Hida T, Maemondo M, Kato T, Jenkins S, Patel S, Huang X, Laus G, Markovets A, Thress KS, Wu YL, Mok T. Epidermal growth factor receptor mutation analysis in tissue and plasma from the AURA3 trial: Osimertinib versus platinum-pemetrexed for T790M mutation-positive advanced non-small cell lung cancer. Cancer. 2020 Jan 15;126(2):373-380. doi: 10.1002/cncr.32503. Epub 2019 Nov 26.
- Wu YL, Ahn MJ, Garassino MC, Han JY, Katakami N, Kim HR, Hodge R, Kaur P, Brown AP, Ghiorghiu D, Papadimitrakopoulou VA, Mok TSK. CNS Efficacy of Osimertinib in Patients With T790M-Positive Advanced Non-Small-Cell Lung Cancer: Data From a Randomized Phase III Trial (AURA3). J Clin Oncol. 2018 Sep 10;36(26):2702-2709. doi: 10.1200/JCO.2018.77.9363. Epub 2018 Jul 30.
- Lee CK, Novello S, Ryden A, Mann H, Mok T. Patient-Reported Symptoms and Impact of Treatment With Osimertinib Versus Chemotherapy in Advanced Non-Small-Cell Lung Cancer: The AURA3 Trial. J Clin Oncol. 2018 Jun 20;36(18):1853-1860. doi: 10.1200/JCO.2017.77.2293. Epub 2018 May 7.
- Akamatsu H, Katakami N, Okamoto I, Kato T, Kim YH, Imamura F, Shinkai M, Hodge RA, Uchida H, Hida T. Osimertinib in Japanese patients with EGFR T790M mutation-positive advanced non-small-cell lung cancer: AURA3 trial. Cancer Sci. 2018 Jun;109(6):1930-1938. doi: 10.1111/cas.13623. Epub 2018 May 31.
- Mok TS, Wu Y-L, Ahn M-J, Garassino MC, Kim HR, Ramalingam SS, Shepherd FA, He Y, Akamatsu H, Theelen WS, Lee CK, Sebastian M, Templeton A, Mann H, Marotti M, Ghiorghiu S, Papadimitrakopoulou VA; AURA3 Investigators. Osimertinib or Platinum-Pemetrexed in EGFR T790M-Positive Lung Cancer. N Engl J Med. 2017 Feb 16;376(7):629-640. doi: 10.1056/NEJMoa1612674. Epub 2016 Dec 6.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Respiratory Tract Diseases
- Lung Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Lung Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Tyrosine Kinase Inhibitors
- Antineoplastic Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Kinase Inhibitors
- Osimertinib
Other Study ID Numbers
Other Study ID Numbers
- D5160C00003
- 2014-000594-39 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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