- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02654587
OSE2101 Versus Chemotherapy in HLA-A2 Positive Patients With Advanced NSCLC After Immune Checkpoint Inhibitor Failure (ATALANTE-1)
A Randomized Phase III Trial of OSE2101 Compared With Chemotherapy (Docetaxel or Pemetrexed) in HLA-A2 Positive Patients With Advanced Non-Small Cell Lung Cancer With Progressive Disease After Immune Checkpoint Inhibitors
The aim of this clinical trial was to determine if the therapeutic cancer vaccine OSE2101 (TEDOPI) was more effective than standard chemotherapy (docetaxel or pemetrexed) in treating HLA-A2 positive patients with metastatic NSCLC who progressed after sequential or concurrent chemotherapy and immune checkpoint inhibitor given in first or second-line treatment.
The main questions were to compare the survival, the tolerance to treatment and the quality of life of patients between the two arms of treatment (OSE2101 versus standard chemotherapy)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Jihlava, Czechia, 58633
- Nemocnice Jihlava, Onkologické oddelení
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Praha, Czechia, 12808
- Vseobecna Fakultní Nemocnice
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Avignon, France, 84918
- Institut Saint Catherine
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Bobigny, France, 93000
- Hôpital Avicenne
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Bordeaux, France, 33076
- Institut Bergonie
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Brest, France, 29200
- CHGU Morvan - Brest
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Bron, France, 69500
- Hôpital Louis Pradel
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Cholet, France, 49300
- Centre Hospitalier de Cholet
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Créteil, France, 94010
- Hôpital Intercommunal de Créteil
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Grenoble, France, 38043
- CHU Grenoble
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Le Mans, France, 72037
- Centre Hospitalier du Mans
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Le Mans, France, 72000
- Clinique Victor Hugo
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Lille, France, 59000
- Hôpital Albert Calmette
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Marseille, France, 13273
- Paoli-Calmettes Institute
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Montpellier, France, 34295
- CHU Montpellier
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Mulhouse, France, 68100
- Hôpital Emile Muller
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Nantes, France, 44277
- Centre Catherine de Sienne
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Paris, France, 75970
- Hopital Tenon
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Paris, France, 75010
- Hopital Saint-Louis
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Paris, France, 75018
- Hôpital Bichat - Claude-Bernard
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Saint Mandé, France, 94160
- Hôpital d'Instruction des Armées BEGIN
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Strasbourg, France, 67091
- CHU de Strasbourg - Hôpital Civil
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Toulouse, France, 31059
- Hôpital Larrey - CHU de Toulouse
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Tours, France, 37044
- Centre Hospitalier Régional Universitaire de Tours
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Troyes, France, 10003
- Centre Hospitalier Troyes
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Villejuif, France, 94805
- Institut Gustave Roussy (Igr)
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Cologne, Germany, 51109
- Krankenhaus Mehrheit - Kliniken der Stadt Köln - Lungenklinik
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Halle, Germany, 06120
- Klinik für Innere Medizin II Hospital Martha-Maria Halle-Dölau gGmbH
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Tubingen, Germany, 72076
- Universitätsklinikum Tübingen Medizinische Klinik II
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Ulm, Germany, 89081
- Klinik für Innere Medizin II Universitätsklinikum Ulm
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Budapest, Hungary, 1062
- Magyar Honvedseg Egeszsegugyi Kozpont II szamu telephely
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Budapest, Hungary, 1121
- Országos Korányi TBC és Pulmonológiai Intézet XI Tüdőbelosztály
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Budapest, Hungary, 1121
- Országos Korányi TBC és Pulmonológiai Intézet XIV Tüdőbelosztály
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Budapest, Hungary, 1125
- Semmelweis Egyetem Altalanos Orvostudományi Kar Pulmonologiai Klinika
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Deszk, Hungary, 6772
- Csongrad Megyei Mellkasi Betegsegek Szakkorháza I Tüdőosztály
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Mátraháza, Hungary, 3233
- Matrai Gyogyintezet
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Be'er Sheva, Israel, 84101
- Soroka University Medical Center
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Haifa, Israel, 3109601
- Rambam Health Care Campus
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Jerusalem, Israel, 9087200
- Hadassah Campus Ein Kerem
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Kefar Saba, Israel, 44281
- Meir Medical Center
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Petah tikva, Israel, 4941492
- Rabin (Belinson) Medical Center
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Bari, Italy, 70124
- IRCCS Oncologico Giovanni Paolo II
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Lecce, Italy, 73100
- Unità Operativa di Oncologia dell'Ospedale Vito Fazzi di Lecce, Piazza Muratore
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Legnano, Italy, 37045
- Oncologia Medica
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Lucca, Italy, 56124
- Azienda USL 2 Lucca - Dipartimento Oncologico
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Meldola, Italy, 47014
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T)
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Napoli, Italy, 80131
- U.O.C. Pneumologia a indirizzo oncologico, Presidio Ospedaliero Monaldi - Azienda Ospedaliera dei Colli - Via Leonardo Bianchi
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Padova, Italy, 35128
- Istituto Oncologico Veneto, IRCCS
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Perugia, Italy, 06126
- Ospedale di Perugia - Oncologia medica
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Rimini, Italy, 47923
- U.O. Oncologia Ospedale Infermi
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Roma, Italy, 00128
- UOC di Oncologia Medica, Policlinico Universitario Campus Biomedico
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Roma, Italy, 119
- IRCCS Regina Elena National Cancer Institute
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Siena, Italy, 53100
- Policlinico Santa Maria alle Scotte
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Verona, Italy, 37126
- Ospedale Civile Maggiore
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Gdańsk, Poland, 80-952
- Klinika Onkologii i Radioterapii , Uniwersyteckie Centrum Kliniczne
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Konin, Poland, 62-500
- Przychodnia Lekarska "Komed"
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Otwock, Poland
- Mazowieckie Centrum Leczenia chorób Płuc i Gruźlicy
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Toruń, Poland, 87-100
- Wojewódzki Szpital Zespolony , Oddział Chemioterapii Nowotworów
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Barcelona, Spain, 08035
- Hospital Universitari Vall d'Hebron
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Barcelona, Spain, 08916
- Hospital Universitario Germans Trias i Pujol
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Barcelona, Spain, 08028
- Hospital Universitari Quiron Dexeus
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Barcelona, Spain, 08304
- Hospital de Mataró
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La Coruña, Spain, 15006
- "Complejo Hospitalario Universitario A Coruna (CHUAC)"
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Madrid, Spain, 28046
- Hospital Universitario La Paz Servicio de Oncología Médica
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Madrid, Spain, 28220
- Hospital Universitario Puerta de Hierro Majadahonda Servicio de Oncología Médica Consultas externas, 2ª planta
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Mataró, Spain, 08304
- Hospital de Mataró
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Málaga, Spain, 29010
- Hospital Universitario Carlos Haya
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Milton Keynes, United Kingdom, MK6 5LD
- Milton Keynes Hospital
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California
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Burbank, California, United States, 91505
- East Valley Hematology and Oncology medical Group
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District of Columbia
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Washington, District of Columbia, United States, 20007
- Georgetown University Hospital
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Florida
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Boca Raton, Florida, United States, 33322
- BRCR Medical Center, Inc
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Louisiana
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Covington, Louisiana, United States, 70433
- Pontchartrain Cancer Center
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New York
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New York, New York, United States, 100001
- Meyer Cancer Center, Weill Cornell Medecine
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Ohio
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Canton, Ohio, United States, 44718
- Gabrail Cancer Center Research
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73104
- Stephenson Cancer Center
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Oregon
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Portland, Oregon, United States, 97225
- Robert W. Franz Cancer Center
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Pennsylvania
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Danville, Pennsylvania, United States, 17822
- Gesinger Medical Center
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Texas
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Houston, Texas, United States, 77090
- Millenium Oncology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed and dated informed consent
- Willingness and ability to comply with the clinical study procedures.
- Female or male, 18 years of age or older
- Histologically or cytologically proven diagnosis of Non-Small Cell Lung Cancer (NSCLC) that is locally advanced (stage III) unsuitable for radiotherapy or metastatic (stage IV) according to the 8th edition of tumor, node, metastasis (TNM) in Lung Cancer
Subjects with disease recurrence or progression after immune checkpoint inhibitor and platinum-based chemotherapy:
i) either 1st line chemotherapy followed by 2nd line immune checkpoint inhibitor, or ii) 1st line combination of immune checkpoint inhibitor and chemotherapy Patients with progression during or within 12 months after the end of immune checkpoint inhibitor given as sequential or concomitant platinum-based chemotherapy ± radiation for locally advanced disease (stage III) were eligible
- Subjects with measurable or non-measurable lesions according to RECIST 1.1
- Subjects must express HLA-A2 phenotype (central test in blood)
- Subjects must be considered suitable for chemotherapy with single-agent pemetrexed or single-agent docetaxel
- Subjects with brain metastases were eligible if treated (whole brain radiotherapy, stereotaxic radiotherapy, surgery) at least 3 weeks prior to initiation of study treatment and have no symptoms related to brain metastases for at least 2 weeks before initiation of study treatment and are not taking any forbidden medications
- Any prior chemotherapy, immunotherapy, hormonal therapy, radiation therapy or surgeries must have been completed at least 3 weeks prior to initiation of study treatment.
- Any toxicity from prior therapy must have recovered to ≤ Grade 1 (except alopecia)
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
Adequate organ function as defined by all the following criteria:
- Albuminemia > 25g/L
- Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) ≤ 1.5 x upper limit of normal (ULN) with alkaline phosphatase ≤ 2.5 x ULN, or AST and ALT ≤ 5 x ULN if liver function abnormalities are due to liver metastases
- Total serum bilirubin ≤ 1.5 x ULN
- Absolute neutrophil count (ANC) ≥ 1500/L
- Platelets ≥ 100000/L
- Hemoglobin ≥ 9.0 g/dL (in the absence of transfusion within 2 weeks before randomization)
- Creatinine clearance (based on modified Cockcroft-Gault formula) ≥ 45 ml/min.
Exclusion Criteria:
- Small-cell lung cancer/mixed NSCLC with small cell component or other neuroendocrine lung cancers (typical and atypical carcinoids, large-cell neuroendocrine carcinomas)
- Patients with squamous cell carcinoma histology, and who had docetaxel as part of his prior chemotherapy
- Current or previous treatment with investigational therapy in another therapeutic clinical trial (interrupted less than 4 weeks before study treatment initiation)
- Patients whose tumor harbors EGFR gene mutation that sensitizes tumors to Tyrosine-Kinase Inhibitor (TKI) (EGFR exon 18-21) or Anaplastic Lymphoma Kinase (ALK) rearrangement
- Ongoing immunotherapy (checkpoint inhibition, antigen immunotherapy that would be scheduled to continue concomitantly to the study)
- Spinal cord compression (unless treated with the patient attaining good pain control and stable or recovered neurologic function), carcinomatous meningitis, or leptomeningeal disease
- Patients with squamous cell histology or non-squamous cell histology previously treated by pemetrexed with a contraindication for docetaxel with grade ≥ 2 neuropathy or hypersensitivity reaction to medications formulated with polysorbate 80 (Tween 80)
- Patients with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications
- Treatment with corticosteroids in the last 3-week period before inclusion, except for topical, ocular, intra-articular, intranasal, and inhaled corticosteroids with minimal systemic absorption (e.g. with a dose ≤ 500 microgram beclomethasone equivalent for inhaled steroids), or steroid doses ≤ 10 mg daily prednisone equivalent which are permitted
- A recognized immunodeficiency disease including human immunodeficiency virus (HIV) infection (and other cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia; subjects who have hereditary, congenital or acquired immunodeficiencies)
- Patients with auto-immune disease, with the exception of type I diabetes or treated hypothyroidism
- Patients with interstitial lung disease
- Patients with active B or C hepatitis
- Other malignancy: patients will not be eligible if they have evidence of other active invasive cancer(s) (other than NSCLC) within 5 years prior to screening (except appropriately treated non-melanoma skin cancer or localized cervical cancer, or other local tumors considered cured (e.g.localized and presumed cured prostate cancer)
- Other severe acute or chronic medical or psychiatric conditions, or laboratory abnormalities that would impart, in the judgment of the investigator and/or sponsor, excess risk associated with study participation or study drug administration, and which would, therefore, make the patient inappropriate for entry into this study
- Female patients must be surgically sterile or be postmenopausal, or must agree to use effective contraception during the period of the trial and for at least 90 days after completion of treatment
- Male patients sexually active with a woman of childbearing potential must be surgically sterile or must agree to use effective contraception during the period of the trial and for at least 90 days after completion of treatment. The decision of effective contraception will be based on the judgment of the principal investigator
- Breastfeeding women
- Women with a positive pregnancy test.
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 |
|---|---|
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Active Comparator: Docetaxel or Pemetrexed
Patients receiving docetaxel: Docetaxel 75 mg/m2 will be administered by intravenous infusion over 1 hour on Day 1 of a 21-day cycle. Patients receiving pemetrexed: Pemetrexed, 500 mg/m2, will be administered by intravenous infusion over 10 minutes on Day 1 of a 21-day cycle. Docetaxel and pemetrexed will be continued until unequivocal RECIST 1.1-defined disease progression as determined by the investigator, unacceptable toxicity, or consent withdrawal. |
Other Names:
Other Names:
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Experimental: OSE2101
OSE2101 was administered as a 1 mL-subcutaneous injection on Day 1 every three weeks for six cycles, then every eight weeks for the remainder of year one and finally every twelve weeks beyond year one until unequivocal RECIST 1.1-defined disease progression as determined by the investigator, unacceptable toxicity, or consent withdrawal.
Should pseudo progression or delayed response to treatment suspected in arm A, investigator may continue treatment beyond the time of RECIST-defined progression, if the patient is perceived to be experiencing clinical benefit of OSE2101.
OSE2101 dose was 5 mg of peptides (0.5 mg for each peptide).
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Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Overall Survival (OS)
Time Frame: Approx. 24 months
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OS defined as the time from randomisation to death from any cause in patients with ICI secondary resistance
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Approx. 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Post-Progression Survival
Time Frame: approximately 24 months
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Post-progression survival was defined as the time from the earliest date of progression according to RECIST 1.1 until death in patients with ICI secondary resistance
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approximately 24 months
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Time to Worsening ECOG PS
Time Frame: Approx. 24 months
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Time to Worsening ECOG PS was defined as the time from randomization to the earliest date when ECOG PS was >1 in patients with ICI secondary resistance.
Time to worsening ECPG PS was summarized by treatment arm using the Kaplan-Meier method.
The median event time for each treatment arm and the corresponding 2-sided 95% confidence interval were provided.
By protocol, ECOG PS was not collected when a patient permanenetly discontinued the study treatment.
Patients without ECOG PS worsening were censored at the last time when an ECOG value was recorded.
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Approx. 24 months
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Mean Changes in Functional Subscales of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) From Baseline to Treatment Discontinuation in Patients With ICI Secondary Resistance
Time Frame: Approx. 24 months
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Mean change from baseline to treatment discontinuation in Quality of Life (QoL) score of the following functional subscales analyzed separately: global health status, physical, role, cognitive, emotional and social functioning.
Each score range from 0 to 100 after normalisation.
Highest scores correspond to a better quality of life.
The mean score change was assessed using a mixed-effects model for repeated measures analysis with the patient as the random effect, treatment, visit and treatment-by-visit interaction as explanatory variables and baseline score as covariates.
If the mean score change is negative, it means a deterioration of QoL.
If the mean score change is positive or 0, it means an improvement or stability of QoL
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Approx. 24 months
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Mean Changes in Symptoms Subscales of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) From Baseline to Treatment Discontinuation in Patients With ICI Secondary Resistance
Time Frame: Approx. 24 months
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Mean change from baseline to treatment discontinuation in Quality of Life (QoL) score of the following symptoms subscales analyzed separately: Fatigue, Constipation, Dyspnea, Nausea and Vomiting, Pain, Insomnia, Appetite loss, Diarrhea, Financial Difficulties.
Each score range from 0 to 100 after normalisation.
Lowest scores correspond to a better QoL.
The mean score change was assessed using a mixed-effects model for repeated measures analysis with the patient as the random effect, treatment, visit and treatment-by-visit interaction as explanatory variables and baseline score as covariates.
If the mean score change is negative, it means a deterioration of QoL.
If the mean score change is positive or 0, it means an improvement or stability of QoL.
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Approx. 24 months
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Mean Changes in Symptoms Subscales of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Lung Cancer (QLQ-LC13) From Baseline to Treatment Discontinuation in Patients With ICI Secondary Resistance
Time Frame: Approx. 24 months
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Mean change from baseline to treatment discontinuation in Quality of Life (QoL) score of the following symptoms subscales analyzed separately: Alopecia, Peripheral Neuropathy, Sore mouth, Dysphagia, Dyspnea, Pain in arm or shoulder, Pain in chest, Pain in other parts, Hemoptysis, Coughing.
Each score range from 0 to 100 after normalisation.
Lowest scores correspond to a better QoL.
The mean score change was assessed using a mixed-effects model for repeated measures analysis with the patient as the random effect, treatment, visit and treatment-by-visit interaction as explanatory variables and baseline score as covariates.
If the mean score change is negative, it means a deterioration of QoL.
If the mean score change is positive or 0, it means an improvement or stability of QoL.
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Approx. 24 months
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Disease Control Rate (DCR) at 6 Months
Time Frame: Approx. 6 months
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DCR at 6 months defined as the number of patients with Complete Response (CR), Partial Response (PR) or Stable Disease (SD) assessed by investigator per "Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions based on CT scan in patients with ICI secondary resistance.
Complete Response (CR) defined as disappearance of all target lesions; Partial Response (PR) as >=30% decrease in the sum of the longest diameter of target lesions; Stable disease (SD) defined as neither sufficient shrinkage (compared to baseline) to qualify for CR or PR nor sufficient increase (taking as reference the smallest sum of diameters at baseline or while on study, whichever is smallest) to qualify for progressive disease (PD) (e.g.
decrease of the sum of the longest diameters of target lesions <30% or increase up to 20%)
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Approx. 6 months
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Progression Free Survival (PFS) in Patients With ICI Secondary Resistance
Time Frame: Approx. 24 months
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PFS was defined as the time from randomization to the earliest date of progression assessed by investigator per "Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions based on CT scan in patients with ICI secondary resistance.
Progressive disease (PD) defined as increase of target lesions >=20% taking as reference the smallest sum of diameters at baseline or while on study, whichever is smallest)
|
Approx. 24 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Objective Response Rate (ORR) in ICI Secondary Resistance
Time Frame: Approx. 24 months
|
Objective Response rate (OOR) was defined as number of patients with Complete Response (CR) + Partial Response (PR) assessed by investigator per "Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions based on CT scan in patients with ICI secondary resistance.
Complete Response (CR) defined as disappearance of all target lesions; Partial Response (PR) as >=30% decrease in the sum of the longest diameter of target lesions.
Investigator-assessed ORR was an exploratory endpoint as not relevant as primary, nor secondary endpoints to evaluate a cancer vaccine.
|
Approx. 24 months
|
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Percentage of Patients With Objective Response at 6 Months in ICI Secondary Resistance
Time Frame: Approx. 6 months
|
Duration of Objective Response (OOR) was defined as number of patients with Complete Response (CR) or Partial Response (PR) at 6 months assessed by investigator per "Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions based on CT scan in patients with ICI secondary resistance.
Complete Response (CR) defined as disappearance of all target lesions; Partial Response (PR) as >=30% decrease in the sum of the longest diameter of target lesions
|
Approx. 6 months
|
|
Time to Next Lung Cancer Therapy in ICI Secondary Resistance
Time Frame: Approx. 24 months
|
Time to next lung cancer therapy was defined as the time from randomisation to the date of initiation of the first lung cancer therapy during the survival follow-up form
|
Approx. 24 months
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Dominique Costantini, Dr, OSE Immunotherapeutics
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
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
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Folic Acid Antagonists
- Docetaxel
- Pemetrexed
Other Study ID Numbers
- OSE2101C301
- 2015-003183-36 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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