- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02470065
Neoadjuvant Afatinib in Early Stage Non Small Cell Lung Cancer. (REMNANT)
Resectable EGFR Mutant NSCLC With (or Without) Afatinib as Neoadjuvant Treatment; REMNANT an Exploratory Study of the EORTC Lung Cancer Group
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a multicenter, prospective, open-label, randomized, non-comparative, two-arm phase II trial aiming to evaluate afatinib treatment in pre-operative setting in patients with EGFR mutated NSCLC.
After signing of the informed consent, patients will be registered and screened for eligibility and upon confirmation of all eligibility criteria, patients will be randomized 1:1 to:
- Arm A: once daily afatinib at a dose of 40 mg for 8 weeks followed by surgery with curative intent (anatomical resection and systematic lymph node dissection).
- Arm B: immediate surgery with curative intent (anatomical resection and systematic lymph node dissection).
Response evaluation in the pre-operative arm will be performed through CT scans at baseline, 4 and 8 weeks.
The first 5 patients enrolled in arm A will be part of a safety run-in to check that afatinib treatment doesn't delay surgery.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histological or cytological diagnosis of NSCLC;
- Patients considered operable and with resectable tumor with curative intent (anatomical resection and systematic lymph node dissection) based on evaluation by a thoracic multi-disciplinary team composed of at least a thoracic surgeon, oncologist and radiologist;
- Stage I-III (T1a-3, N0-1, M0 according to UICC version 7) NSCLC by local staging criteria potentially treatable by radical (curative) surgery. Patients with T1 tumor at baseline will be limited to 20%;
- Radiologically measurable disease according to RECIST criteria 1.1; assessed by chest and upper abdomen CT scan within 2 weeks (+1 week) prior to registration); brain CT scan or MRI according to local practice;
- No prior treatment for NSCLC is allowed;
- Adequate tissue in terms of quality and quantity for EGFR local testing.
Exclusion Criteria:
- no adequate bone marrow function within 2 weeks prior to randomization
- no adequate liver function. Patients with Gilbert's syndrome total bilirubin must be below 4 times institutional upper limit of normal; within 2 weeks prior to randomization
- no adequate renal function within 2 weeks prior to randomization
- known positivity to human immunodeficiency virus (HIV), hepatitis B or hepatitis C;
- known history of allergic reactions attributed to compounds of similar chemical or biological composition;
- history of a hematologic or primary solid tumor malignancy, unless no evidence of that disease for 5 years, except pT1-2 prostatic cancer Gleason score < 6, superficial bladder cancer, non melanoma skin cancer or carcinoma in situ of the cervix;
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Neo adjuvant afatinib
once daily afatinib at a dose of 40 mg for 8 weeks followed by surgery with curative intent (anatomical resection and systematic lymph node dissection).
|
once daily afatinib at a dose of 40 mg for 8 weeks
anatomical resection and systematic lymph node dissection
|
Active Comparator: Immediate surgery
immediate surgery with curative intent (anatomical resection and systematic lymph node dissection).
|
anatomical resection and systematic lymph node dissection
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Decrease in cT-stage
Time Frame: 8 weeks
|
decrease in cT-stage descriptor measured according to RECIST 1.1
|
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Response Rate
Time Frame: 8 weeks
|
proportion of patients whose response is either complete response (CR) or partial response (PR) using RECIST 1.1;
|
8 weeks
|
Change in surgical treatment intent and technique
Time Frame: 8 weeks
|
8 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Sanjay Popat, PhD, Royal Marsden NHS Foundation Trust
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Neoplasms
- Lung Diseases
- Neoplasms by Site
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Lung Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Afatinib
Other Study ID Numbers
- EORTC-08115
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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