- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02759835
Local Ablative Therapy for Treatment of Oligoprogressive, EGFR-Mutated, Non-Small Cell Lung Cancer After Treatment With Osimertinib
A Pilot Study of Local Ablative Therapy for Treatment of Oligoprogressive, EGFR-mutated, Non-Small Cell Lung Cancer (NSCLC) After Treatment With Osimertinib (AZD9291, Tagrisso)
Background:
Some non-small-cell lung cancers (NSCLC) have a mutation in a gene that makes a protein called EGFR. This particular cancer can be treated with certain drugs such as erlotinib (Tarceva), gefitinib (Iressa) and osimertinib (Tagrisso). But many tumors become resistant to these drugs because of a second mutation. Researchers want to test if adding local ablative therapy (LAT) extends the benefits of the drug, osimertinib. LAT can include techniques such as surgery, radiofrequency ablation, cryotherapy or radiation therapy.
Objective:
To test if re-taking osimertinib after LAT is safe, tolerable, and effective for people whose NSCLC has progressed after initial treatment with osimertinib.
Eligibility:
Adults ages 18 and older with certain types of NSCLC. Participants will be divided into various groups as described below.
Design:
Participants will be screened with:
Medical history
Physical exam
Blood, urine, and heart tests
Tumor scans
Eye exam
Review of tumor sample.
Participants will take the study drug by mouth once a day. They will continue until they can no longer tolerate it or their disease worsens. They will keep a dosage diary.
All participants will start each 21-day course with physical exam; blood, urine, and saliva tests; and electrocardiogram. They will have scans every 6 weeks and echocardiogram every 3 months.
Groups 1 and 2 will:
Start osimertinib right away.
Have LAT if their disease progresses and is suitable for LAT. If LAT cannot be performed or LAT consists of a procedure other than surgery, a tumor biopsy will be performed.
Re-start osimertinib after LAT, or other treatments if not suitable for LAT.
Group 3 will:
Have LAT.
If LAT consists of a procedure other than surgery, a tumor biopsy will be performed.
Start osimertinib after LAT.
After participants stop taking the drugs, they will have a final visit. This will include:
Medical history
Physical exam
Blood tests
Participants will be called every year for follow-up.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
- Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) have significantly improved the response rate (RR) and survival in patients with tumors harboring EGFR-sensitizing mutations.
- An invariable consequence of treatment with EGFR-TKIs is the development of acquired resistance. The most common mechanism of resistance observed in approximately 50% of all cases in patients treated with 1st and 2nd generation EGFR-TKIs is the emergence of a secondary mutation (T790M) in exon 20.
- Osimertinib is a 3rd-generation EGFR-TKI designed to target the T790M mutation, which has shown impressive responses in both first- and second-line settings.
- Despite these developments, it is almost certain that selection pressure will lead to the emergence of newer clones that are resistant to treatment with osimertinib. One common mechanism of acquired resistance to osimertinib is the generation of EGFR C797S mutation.
- The use of local ablative therapies for patients who develop limited metastatic disease or oligoprogressive disease on EGFR-TKI therapy is promising.
- We hypothesize that following local ablative therapy to treat oligoprogressive disease after emergence of resistance, osimertinib can be resumed safely and re-initiation of osimertinib results in additional progression-free survival benefits.
Objectives:
- Determine the safety, tolerability, and efficacy (as assessed by progression free survival (PFS) upon re-initiation of osimertinib following local ablative therapy (LAT) for patients with oligoprogressive disease after treatment with osimertinib
- Assess mechanisms of acquired resistance to osimertinib
Eligibility:
- Histologically confirmed advanced lung adenocarcinoma with EGFR-sensitizing somatic mutations or a germline T790M mutation and no prior EGFR tyrosine kinase inhibitor (TKI) therapy (Cohort 1); OR progressive disease after 1st or 2nd generation EGFR TKI therapy harboring somatic T790M mutation (Cohort 2); or patients with progressive disease after treatment with osimertinib who are eligible for local ablative therapy (Cohort 3). If biopsy for EGFR mutation status confirmation is not clinically feasible, EGFR mutations may be confirmed by circulating tumor deoxyribonucleic acid (ctDNA) analysis using a Clinical Laboratory Improvement Amendments of 1988 (CLIA) certified assay.
- Presence of measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Adequate end organ function
- If patients are not eligible for LAT, they will be referred for standard of care chemotherapy as per treating physician's discretion. These patients may also be considered for other clinical trials.
Design:
- This is a single-institution, open-label phase II trial of osimertinib treatment in EGFR mutant lung cancer.
- Eligible patients not previously treated with osimertinib will be treated with osimertinib daily until disease progression. At the time of progression, patients with oligoprogressive disease (no more than 5 sites of progressive disease) will be assessed for LAT.
- If patients are eligible for LAT, osimertinib will be resumed after LAT and they will be followed for second progression on osimertinib (PFS2).
- If patients progress at the same site where LAT has been performed before, the progression will be considered to be a result of inadequate ablation and they will be considered for repeat LAT and again re-challenged with osimertinib if clinically feasible.
- Tumor samples will be obtained at baseline by a mandatory biopsy. At the time of first progression on osimertinib if a patient is eligible for surgery as a form of LAT, then a tissue sample will be obtained for genomic and proteomic studies to identify mechanisms of acquired resistance. For patients who are not eligible for LAT or a form of LAT that is not surgery (radiation, radiofrequency ablation, cryoablation), then a mandatory biopsy will be performed, if clinically safe, to obtain tissue for above studies.
- Re-treatment will be allowed for a small number of subjects.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- National Institutes of Health Clinical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
- INCLUSION CRITERIA:
For inclusion in the study subjects should fulfill the following criteria:
- Provision of informed consent prior to any study specific procedures
- Patients (male/female) must be greater than or equal to 18 years of age.
Patients with histologically confirmed, by the National Cancer Institute (NCI) Laboratory of Pathology or by Clinical Laboratory Improvement Amendments of 1988 (CLIA)-certified Next Generation Sequencing or Cobas estimated Epidermal Growth Factor Receptor (EGFR) Mutation Test v1/2 at an outside institution, advanced lung adenocarcinoma with EGFR-sensitizing somatic mutations or a germline T790M mutation (detected histologically or via circulating tumor deoxyribonucleic acid (ctDNA) analysis using a CLIA assay) with:
- No prior EGFR tyrosine kinase inhibitor (TKI) therapy (Cohort 1)
OR
-- Progressive disease after 1st or 2nd generation EGFR TKI therapy harboring somatic T790M mutation (Cohort 2)
OR
Progressive disease after treatment with osimertinib who are eligible for local ablative therapy (Cohort 3)
- Presence of measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
- In patients with suspected leptomeningeal disease, the diagnosis of leptomeningeal disease should be confirmed by the presence of neurological or imaging signs and/or positive cerebrospinal fluid (CSF) cytology.
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
- No uncontrolled arrhythmia; no myocardial infarction in the last 6 months.
- Females should not be breast feeding and must have a negative pregnancy test prior to start of dosing if of child-bearing potential or must have evidence of non-child-bearing potential by fulfilling one of the following criteria at screening:
- Post-menopausal defined as aged more than 50 years and amenorrheic for at least 12 months following cessation of all exogenous hormonal treatments
- Women under 50 years old would be consider postmenopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and with luteinizing Hormone (LH) and follicle stimulating hormone (FSH) levels in the post-menopausal range for the institution
Documentation of irreversible surgical sterilization by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation
- Females of child-bearing potential should use reliable methods of contraception from the time of screening until 3 months after discontinuing osimertinib. Acceptable methods of contraception include total and true sexual abstinence, tubal ligation, hormonal contraceptives that are not prone to drug-drug interactions (IUS Levonorgestrel Intra Uterine System (Mirena), Medroxyprogesterone injections (Depo-Provera), copper-banded intra-uterine devices, and vasectomized partner. All hormonal methods of contraception should be used in combination with the use of a condom by their male sexual partner for intercourse.
- Male patients should be willing to use barrier contraception. Male patients should be asked to use barrier contraceptives (i.e., by use of condoms) during sex with all of their female partners during the trial and for a washout period of 3 months. Patients should refrain from donating sperm from the start of dosing until 6 months after discontinuing osimertinib treatment. If male patients wish to father children, they should be advised to arrange for freezing of sperm samples prior to the start of osimertinib treatment.
- Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.
EXCLUSION CRITERIA:
Subjects should not enter the study if any of the following exclusion criteria are fulfilled:
- Any unresolved toxicities from prior therapy greater than Common Terminology Criteria for Adverse Events (CTCAE) grade 1 at the time of starting study treatment with the exception, of alopecia and grade 2, prior platinum-therapy related neuropathy.
- Treatment with an investigational drug within five half-lives of the compound.
- Major thoracic or abdominal surgery from which the patient has not sufficiently recovered yet.
- Untreated and uncontrolled second tumor in the past 2 years.
- Patients currently receiving (or unable to stop use prior to receiving the first dose of study treatment) medications or herbal supplements known to be potent inhibitors of CYP3A4 (at least 1 week prior) and potent inducers of cytochrome P450 3A4 (CYP3A4) (at least 3 weeks prior) will only be eligible at the PI's discretion.
- Any evidence of severe or uncontrolled systemic diseases, including uncontrolled hypertension and active bleeding diatheses, which in the investigator's opinion makes it undesirable for the patient to participate in the trial or which would jeopardize compliance with the protocol. Screening for chronic conditions is not required.
- Patients with central nervous system (CNS) metastases who are neurologically unstable.
- Past medical history of interstitial lung disease (ILD), drug induced ILD, radiation pneumonitis requiring steroid treatment, or any evidence of clinically active ILD
Inadequate bone marrow reserve or organ function as demonstrated by any of the following laboratory values:
- Absolute neutrophil count <1 x 10(9)/L
- Platelet count <100 x 10(9)/L
- Hemoglobin <90 g/L
- Alanine aminotransferase >2.5 times the 2.1.2.9.4 upper limit of normal (ULN) if no demonstrable liver metastases or >5 times ULN in the presence of liver metastases
- Aspartate aminotransferase >2.5 times ULN if no demonstrable liver metastases or >5 times ULN in the presence of liver metastases
- Total bilirubin >1.5 times ULN if no liver metastases or >3 times ULN in the presence of documented Gilbert's Syndrome (unconjugated hyperbilirubinemia) or liver metastases
- Creatinine >1.5 times ULN concurrent with creatinine clearance <30 ml/min (measured or calculated by Cockcroft and Gault equation); confirmation of creatinine clearance is only required when creatinine is >1.5 times ULN
Any of the following cardiac criteria
- Resting corrected QT interval (corrected QT interval (QTc) using Fredericia's formula) > 480 msec
- Any clinically important abnormalities in rhythm, conduction or morphology of resting electrocardiogram (ECG) (e.g., complete left bundle branch block, third degree heart block, second degree heart block)
- Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, hypokalemia, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age in first degree relatives or any concomitant medication known to prolong the QT interval
- Significant symptomatic congestive heart failure, per principal investigator (PI) judgement.
- Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of osimertinib
- History of hypersensitivity to osimertinib (or drugs with a similar chemical structure or class to osimertinib) or any excipients of these agents
- Judgment by the Investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions, and requirements
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Tyrosine Kinase Inhibitor Naïve Epidermal Growth Factor Receptor *mutated Non Small Cell Lung Cancer
Cohort 1 - Osimertinib followed by LAT followed by osimertinib. Single daily dose of osimertinib until progression. The starting dose of osimertinib will be 80 mg per day for participants without leptomeningeal disease and 160 mg per day for those with leptomeningeal disease at baseline. *including germline T790M mutation |
Single daily dose of osimertinib until progression.
The starting dose of osimertinib will be 80 mg per day for patients without leptomeningeal disease and 160 mg per day for those with leptomeningeal disease at baseline.
Other Names:
local ablative therapy.
Subjects may undergo 1 of 3 local ablative procedures after initial progression on osimertinib: surgery, radiotherapy, radiofrequency ablation
|
Experimental: EGFR mutated NSCLC Progressed on prior 1st/2nd Generation EGFR TKI therapy &acquired T790M Mutation
Cohort 2 - Osimertinib followed by LAT followed by osimertinib.
Participants may undergo 1 of 3 local ablative procedures after initial progression on osimertinib: surgery, radiotherapy, or radiofrequency ablation.
|
Single daily dose of osimertinib until progression.
The starting dose of osimertinib will be 80 mg per day for patients without leptomeningeal disease and 160 mg per day for those with leptomeningeal disease at baseline.
Other Names:
local ablative therapy.
Subjects may undergo 1 of 3 local ablative procedures after initial progression on osimertinib: surgery, radiotherapy, radiofrequency ablation
|
Experimental: Epidermal Growth Factor Receptor mutated Non Small Cell Lung Cancer Progressed on Osimertinib
Cohort 3 - LAT followed by Osimertinib.
Participants may undergo 1 of 3 local ablative procedures after initial progression on Osimertinib: surgery, radiotherapy, radiofrequency ablation.
The starting dose of Osimertinib will be 80 mg per day for participants without leptomeningeal disease and 160 mg per day for those with leptomeningeal disease at baseline.
Single daily dose of Osimertinib until progression.
|
Single daily dose of osimertinib until progression.
The starting dose of osimertinib will be 80 mg per day for patients without leptomeningeal disease and 160 mg per day for those with leptomeningeal disease at baseline.
Other Names:
local ablative therapy.
Subjects may undergo 1 of 3 local ablative procedures after initial progression on osimertinib: surgery, radiotherapy, radiofrequency ablation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression Free Survival 1 (PFS 1) for ALL Participants Who Started Osimertinib on Trial Until First Progression of Disease or Clinical Progression, or Death Any Cause
Time Frame: Cycle 1 Day 1 (each cycle is 28 days) to progression of disease, range 36-1231 days
|
PFS1 = time from initiation of osimertinib to first progression of disease or clinical progression, or death any cause.
Progression was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and reported using the Kaplan Meier curve.
Progressive Disease (PD) is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
The appearance of one or more new lesions is also considered progression).
|
Cycle 1 Day 1 (each cycle is 28 days) to progression of disease, range 36-1231 days
|
Progression Free Survival 2 (PFS 2) - Local Ablative Therapy (LAT Eligible Only)
Time Frame: Retreatment Cycle 1 Day 1 (cycle is 28 days) to progression of disease, range 29-721 days
|
PFS2 = time from osimertinib re-challenge after LAT following first progression on osimertinib until second progression on osimertinib.
Progression was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and reported using the Kaplan Meier curve.
Progressive Disease (PD) is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
The appearance of one or more new lesions is also considered progression).
|
Retreatment Cycle 1 Day 1 (cycle is 28 days) to progression of disease, range 29-721 days
|
Progression Free Survival 2 (PFS 2) - Local Ablative Therapy (LAT Eligible Only) - Cohort 1, Cohort 2, and Cohort 3
Time Frame: Retreatment Cycle 1 Day 1 (cycle is 28 days) to progression of disease, range 29-721 days
|
PFS2 = time from osimertinib re-challenge after LAT following first progression on osimertinib until second progression on osimertinib.
Progression was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and reported using the Kaplan Meier curve.
Progressive Disease (PD) is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
The appearance of one or more new lesions is also considered progression).
|
Retreatment Cycle 1 Day 1 (cycle is 28 days) to progression of disease, range 29-721 days
|
Serious Adverse Events Possibly, Probably, and/or Definitely Related to Treatment
Time Frame: Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Adverse events were assessed by the by the Common Terminology Criteria for Adverse Events (CTCAE v4.0).
A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.
|
Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
All Grades 1, Grade 2, Grade 3, Grade 4, and/or Grade 5 Adverse Events Possibly, Probably, and/or Definitely Related to Local Ablative Therapy (LAT)
Time Frame: Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0).
Grade 1 is mild.
Grade 2 is moderate.
Grade 3 is severe.
Grade 4 is life-threatening.
Grade 5 is death related to adverse events.
|
Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
All Grades 1, Grade 2, Grade 3, Grade 4, and/or Grade 5 Adverse Events Possibly, Probably, and/or Definitely Related to Osimertinib
Time Frame: Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0).
Grade 1 is mild.
Grade 2 is moderate.
Grade 3 is severe.
Grade 4 is life-threatening.
Grade 5 is death related to adverse events.
|
Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Number of Participants Who Had Osimertinib Acquired Resistant Mechanisms Identified on Tumors
Time Frame: up to 757 days
|
Whole-exome sequencing (WES), targeted sequencing and ribonucleic acid (RNA)-seq was performed on tumors to identify Osimertinib acquired resistant mechanisms.
Sequencing can help identify mutations/heterogeneity that may impact a participant prognosis.
|
up to 757 days
|
Number of Participants Who Had Osimertinib Acquired Resistant Mechanisms Identified on Tumors With First Line and/or Second Line Treatment
Time Frame: up to 757 days
|
Whole-exome sequencing (WES), targeted sequencing and ribonucleic acid (RNA)-seq was performed on tumors for first and second line Osimertinib treatment to identify Osimertinib acquired resistant mechanisms.
Sequencing can help identify mutations (i.e., NE-differentiation, ribonucleic acid (RNA), v-raf murine sarcoma viral oncogene homolog B1 (BRAF), other amps, etc.)/heterogeneity that may impact a participant prognosis.
|
up to 757 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Best Overall Response (BOR)
Time Frame: end of treatment, up to 693 days
|
Best Overall Response is defined as a Complete Response (CR) + Partial Response (PR) and is recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started).
The participant's best response assignment will depend on the achievement of both measurement and confirmation criteria.
Response was evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Complete Response (CR) is disappearance of all target lesions, determined by two separate observations conducted not less than 4 weeks apart.
Any pathological lymph nodes must have reduction in short axis to <10 mm.
Partial Response (PR) is at least a 30% decrease in the sum of target lesions, taking as reference the baseline sum diameters.
Progressive Disease (PD) is at least a 20% increase in the sum of the diameters of target lesions.
|
end of treatment, up to 693 days
|
Best Overall Response - All Participants
Time Frame: end of treatment, up to 693 days
|
Best Overall Response is defined as a Complete Response (CR) + Partial Response (PR) and is recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started).
The participant's best response assignment will depend on the achievement of both measurement and confirmation criteria.
Response was evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Complete Response (CR) is disappearance of all target lesions, determined by two separate observations conducted not less than 4 weeks apart.
Any pathological lymph nodes must have reduction in short axis to <10 mm.
Partial Response (PR) is at least a 30% decrease in the sum of target lesions, taking as reference the baseline sum diameters.
Progressive Disease (PD) is at least a 20% increase in the sum of the diameters of target lesions.
|
end of treatment, up to 693 days
|
Overall Survival
Time Frame: death
|
Overall survival is defined as the duration of time from start of treatment to death from any cause.
|
death
|
Disease Control Rate (DCR)
Time Frame: end of treatment, up to 693 days
|
DCR is defined as a Complete Response (CR) + Partial Response (PR) + Stable Disease (SD).
Response was evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Complete Response (CR) is disappearance of all target lesions, determined by two separate observations conducted not less than 4 weeks apart.
Any pathological lymph nodes must have reduction in short axis to <10 mm.
Partial Response (PR) is at least a 30% decrease in the sum of target lesions, taking as reference the baseline sum diameters.
Stable Disease (SD) is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease (PD), taking as reference the smallest sum diameters while on study.
PD is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study.
The appearance of one or more new lesions is also considered progression.
|
end of treatment, up to 693 days
|
Disease Control Rate (DCR) - All Participants
Time Frame: end of treatment, up to 693 days
|
DCR is defined as a Complete Response (CR) + Partial Response (PR) + Stable Disease (SD).
Response was evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
Complete Response (CR) is disappearance of all target lesions, determined by two separate observations conducted not less than 4 weeks apart.
Any pathological lymph nodes must have reduction in short axis to <10 mm.
Partial Response (PR) is at least a 30% decrease in the sum of target lesions, taking as reference the baseline sum diameters.
Stable Disease (SD) is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease (PD), taking as reference the smallest sum diameters while on study.
PD is at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study.
The appearance of one or more new lesions is also considered progression.
|
end of treatment, up to 693 days
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0)
Time Frame: Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Here is the number of participants with serious and/or non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0).
A non-serious adverse event is any untoward medical occurrence.
A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.
|
Date treatment consent signed to date off study, approximately 74 months and 16 days, 65 months and 16 days, and 40 months and 4 days for the first, second and third group respectively.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Azam Ghafoor, M.D., National Cancer Institute (NCI)
Publications and helpful links
General Publications
- Kim C, Xi L, Cultraro CM, Wei F, Jones G, Cheng J, Shafiei A, Pham TH, Roper N, Akoth E, Ghafoor A, Misra V, Monkash N, Strom C, Tu M, Liao W, Chia D, Morris C, Steinberg SM, Bagheri H, Wong DTW, Raffeld M, Guha U. Longitudinal Circulating Tumor DNA Analysis in Blood and Saliva for Prediction of Response to Osimertinib and Disease Progression in EGFR-Mutant Lung Adenocarcinoma. Cancers (Basel). 2021 Jul 3;13(13):3342. doi: 10.3390/cancers13133342.
- Roper N, Brown AL, Wei JS, Pack S, Trindade C, Kim C, Restifo O, Gao S, Sindiri S, Mehrabadi F, El Meskini R, Ohler ZW, Maity TK, Venugopalan A, Cultraro CM, Akoth E, Padiernos E, Chen H, Kesarwala A, Smart DK, Nilubol N, Rajan A, Piotrowska Z, Xi L, Raffeld M, Panchenko AR, Sahinalp C, Hewitt S, Hoang CD, Khan J, Guha U. Clonal Evolution and Heterogeneity of Osimertinib Acquired Resistance Mechanisms in EGFR Mutant Lung Cancer. Cell Rep Med. 2020 Apr 21;1(1):100007. doi: 10.1016/j.xcrm.2020.100007.
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 by Histologic Type
- Neoplasms
- Lung Diseases
- Neoplasms by Site
- Adenocarcinoma
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Lung Neoplasms
- Adenocarcinoma of Lung
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Tyrosine Kinase Inhibitors
- Osimertinib
Other Study ID Numbers
- 160092
- 16-C-0092
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
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Lung Neoplasms
-
UNC Lineberger Comprehensive Cancer CenterSivan Innovation Ltd.CompletedLung Cancer | Neoplasms, Lung | Pulmonary Neoplasms | Neoplasms, Pulmonary | Pulmonary Cancer | Cancer of LungUnited States
-
Baptist Health South FloridaWithdrawnLung Cancer | Lung TumorUnited States
-
Portsmouth Hospitals NHS TrustCompletedLung Cancer | Interstitial Lung DiseaseUnited Kingdom
-
Oliver JonasMassachusetts General HospitalCompletedLung Cancer | Lung TumorUnited States
-
C. R. BardCompleted
-
Point TherapeuticsTerminatedCarcinoma, Non-Small-Cell Lung | Lung Cancer | Neoplasms, Lung | Neoplasms, PulmonaryUnited States
-
University of UtahRecruitingLung Cancer | Lung Neoplasms/DiagnosisUnited States
-
Azienda Sanitaria-Universitaria Integrata di UdineRecruitingLung Diseases | Lung Cancer | Lung Adenocarcinoma | Lung Transplant Rejection | Lung; Node | Lung TBItaly
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)CompletedLung Carcinoma | Lung Neoplasm | Malignant Lung NeoplasmUnited States
-
Keimyung University Dongsan Medical CenterCompletedLung Cancer | Lung Diseases, Interstitial
Clinical Trials on osimertinib
-
Li ZhangHubei Cancer HospitalNot yet recruitingStage IV Non-small Cell Lung CancerChina
-
Qingdao Central HospitalRecruiting
-
Wuhan Union Hospital, ChinaNot yet recruitingNon Small Cell Lung Cancer
-
Vestre Viken Hospital TrustActive, not recruitingLung CancerDenmark, Sweden, Lithuania, Norway
-
AstraZenecaActive, not recruitingNon Small Cell Lung Cancer (Stage III)United States, Spain, Taiwan, Thailand, Vietnam, Turkey, Korea, Republic of, Brazil, Hungary, India, Japan, Mexico, Peru, Russian Federation, China, Malaysia, Argentina
-
AstraZenecaTerminated
-
Istituto Oncologico Veneto IRCCSActive, not recruitingEGF-R Positive Non-Small Cell Lung CancerItaly
-
Shanghai JMT-Bio Inc.CSPC ZhongQi Pharmaceutical Technology Co., Ltd.Not yet recruitingLocally Advanced or Metastatic Non-Small Cell Lung Cancer | EGFR Exon20 Insertion Mutations
-
Qingdao Central HospitalRecruiting
-
Suzhou Genhouse Bio Co., Ltd.RecruitingNon-Small Cell Lung Cancer With EGFR MutationChina