- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT03833154
Durvalumab vs placebo se stereotaktickou radiační terapií těla u pacientů v časném stádiu neresekovaného nemalobuněčného karcinomu plic (NSCLC) / Osimertinib po SBRT u pacientů s časným stádiem neresekovaného NSCLC s mutací EGFR (PACIFIC-4)
Fáze III, randomizovaná, placebem kontrolovaná, dvojitě zaslepená, multicentrická, mezinárodní studie durvalumabu se stereotaktickou tělesnou radiační terapií (SBRT) pro léčbu pacientů s neresekovaným stadiem I/II, lymfatické uzliny s negativními nemalobuněčnými buňkami Rakovina plic (PACIFIC-4/RTOG-3515) Osimertinib po SBRT, jednoramenná kohorta pro pacienty s neresekovaným stadiem I/II, lymfatické uzliny negativní NSCLC se senzibilizující mutací EGFR
This is a Phase III, randomized, placebo-controlled, double-blind, multi-center study assessing the efficacy and safety of durvalumab with SoC SBRT versus placebo with SoC SBRT in patients with unresected clinical Stage I/II lymph node-negative (T1 to T3N0M0) NSCLC.
An additional cohort will assess Osimertinib following SBRT in patients with early stage unresected T1 to T3N0M0 NSCLC harbouring an EGFR mutation.
Přehled studie
Postavení
Podmínky
Detailní popis
Patients with Stage I/II lymph node negative NSCLC and confirmed to meet all eligibility criteria will be randomized 1:1 to receive either Durvalumab + SoC SBRT or placebo + SoC SBRT.
The primary objective of main cohort is to assess the efficacy of Durvalumab with SoC SBRT compared to placebo with SoC SBRT in terms of PFS. Key secondary is to assess the efficacy of Durvalumab with SoC SBRT compared to placebo with SoC SBRT in terms of Overall Survival (OS).
In addition, a study cohort with a sufficient number of patients harboring an EGFR-TKI sensitizing mutation, will receive Osimertinib treatment after completion of SoC SBRT as definitive treatment of Stage I/II lymph node-negative NSCLC. The primary objective of Osimertinib cohort is to assess efficacy of Osimertinib following SoC SBRT in terms of 4-year PFS. Key secondary objectives include safety, OS and efficacy of Osimertininb treatment with SBRT.
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 3
Kontakty a umístění
Studijní místa
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Clayton, Austrálie, 3168
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Aalst, Belgie, 9300
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Charleroi, Belgie, 6060
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Edegem, Belgie, 2650
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Ghent, Belgie, 9000
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Leuven, Belgie, 3000
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Barretos, Brazílie, 14784-400
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Porto Alegre, Brazílie, 90110-270
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Recife, Brazílie, 52010-075
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Rio de Janeiro, Brazílie, 22271-110
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São Paulo, Brazílie, 01327-001
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Volta Redonda, Brazílie, 27258-000
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Bron, Francie, 69677
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Dijon, Francie, 21079
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Lyon, Francie, 69317
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Nantes, Francie, 44202
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Pierre-Bénite, Francie, 69310
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Toulouse, Francie, 31000
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Villejuif, Francie, 94805
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Amsterdam, Holandsko, 1081 HV
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Groningen, Holandsko, 9713 GZ
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Utrecht, Holandsko, 3584 CX
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Florence, Itálie, 50134
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Genova, Itálie, 16132
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Milan, Itálie, 20132
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Orbassano, Itálie, 10043
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Padova, Itálie, 35128
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Pavia, Itálie, 27100
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Roma, Itálie, 00128
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Rozzano, Itálie, 20089
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Haifa, Izrael, 31096
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Jerusalem, Izrael, 91120
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Kfar Saba, Izrael, 95847
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Petah Tikva, Izrael, 49100
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Ramat Gan, Izrael, 52621
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Tel Aviv, Izrael, 64239
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Akashi-shi, Japonsko, 673-8558
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Bunkyō City, Japonsko, 113-8677
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Chūōku, Japonsko, 104-0045
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Fukuoka, Japonsko, 812-8582
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Hirosaki-shi, Japonsko, 036-8563
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Hiroshima, Japonsko, 734-8551
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Kobe, Japonsko, 650-0047
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Niigata, Japonsko, 951-8566
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Osaka, Japonsko, 541-8567
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Sakaishi, Japonsko, 591-8555
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Sapporo, Japonsko, 060-8648
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Sunto-gun, Japonsko, 411-8777
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Toyoake-shi, Japonsko, 470-1192
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Yokohama, Japonsko, 241-8515
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Cheongju-si, Jižní Korea, 28644
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Goyang-si, Jižní Korea, 10408
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Gyeonggi-do, Jižní Korea, 13620
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Seoul, Jižní Korea, 03722
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Seoul, Jižní Korea, 05505
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Seoul, Jižní Korea, 06351
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Alberta
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Edmonton, Alberta, Kanada, T6G 1Z2
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Ontario
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London, Ontario, Kanada, N6A 5W9
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Toronto, Ontario, Kanada, M5G 2M9
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Toronto, Ontario, Kanada, M4N 3M5
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Quebec
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Montreal, Quebec, Kanada, H2X 3E4
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Dresden, Německo, 01307
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Göttingen, Německo, 37075
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Halle, Německo, 06120
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Hanover, Německo, 30459
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Heidelberg, Německo, 69126
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Homburg, Německo, 66424
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Regensburg, Německo, 93053
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Trier, Německo, 54292
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Bydgoszcz, Polsko, 85-796
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Elblag, Polsko, 02-300
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Gdansk, Polsko, 80-952
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Katowice, Polsko, 40-514
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Lodz, Polsko, 93-513
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Warsaw, Polsko, 02-781
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Hato Rey, Portoriko, 00917
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Kazan, Tatarstan, Rusko, 420029
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Moscow, Rusko, 115478
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Moscow, Rusko, 105229
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Moscow, Rusko, 119421
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Saint Petersburg, Rusko, 197758
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Ufa, Rusko, 450054
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Yekaterinburg, Rusko, 620905
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Birmingham, Spojené království, B9 5SS
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Leeds, Spojené království, LS9 7TF
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London, Spojené království, EC1A 7BE
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Manchester, Spojené království, M20 4BX
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Alabama
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Tuscaloosa, Alabama, Spojené státy, 35401
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Arizona
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Chandler, Arizona, Spojené státy, 85224
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Phoenix, Arizona, Spojené státy, 85004
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Tucson, Arizona, Spojené státy, 85719
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California
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Duarte, California, Spojené státy, 91010
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Long Beach, California, Spojené státy, 90806
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Los Angeles, California, Spojené státy, 90095
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San Diego, California, Spojené státy, 92123
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Delaware
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Newark, Delaware, Spojené státy, 10709
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District of Columbia
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Washington D.C., District of Columbia, Spojené státy, 20010
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Florida
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Bay Pines, Florida, Spojené státy, 33744
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Jacksonville, Florida, Spojené státy, 32256
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Miami Beach, Florida, Spojené státy, 33140
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Orlando, Florida, Spojené státy, 32804
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Georgia
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Atlanta, Georgia, Spojené státy, 30322
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Atlanta, Georgia, Spojené státy, 30342
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Illinois
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Chicago, Illinois, Spojené státy, 60612
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Chicago, Illinois, Spojené státy, 60637
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Chicago, Illinois, Spojené státy, 60611
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Decatur, Illinois, Spojené státy, 62526
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Elmhurst, Illinois, Spojené státy, 60126
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Naperville, Illinois, Spojené státy, 60540
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Indiana
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Fort Wayne, Indiana, Spojené státy, 46845
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Iowa
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Cedar Rapids, Iowa, Spojené státy, 52403
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Iowa City, Iowa, Spojené státy, 52242
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Kentucky
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Elizabethtown, Kentucky, Spojené státy, 42701
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Lexington, Kentucky, Spojené státy, 40503
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Louisville, Kentucky, Spojené státy, 40202
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Louisiana
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Metairie, Louisiana, Spojené státy, 70006
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New Orleans, Louisiana, Spojené státy, 70121
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Maine
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South Portland, Maine, Spojené státy, 04106
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Maryland
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Annapolis, Maryland, Spojené státy, 21401
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Baltimore, Maryland, Spojené státy, 21201
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Rosedale, Maryland, Spojené státy, 21237
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Silver Spring, Maryland, Spojené státy, 20910
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Towson, Maryland, Spojené státy, 21204
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Massachusetts
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Boston, Massachusetts, Spojené státy, 02215
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Michigan
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Ann Arbor, Michigan, Spojené státy, 48197
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Detroit, Michigan, Spojené státy, 48201
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Royal Oak, Michigan, Spojené státy, 48073
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Minnesota
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Duluth, Minnesota, Spojené státy, 55805
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Rochester, Minnesota, Spojené státy, 55905
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Missouri
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St Louis, Missouri, Spojené státy, 63110
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Nebraska
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Omaha, Nebraska, Spojené státy, 68105
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Nevada
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Las Vegas, Nevada, Spojené státy, 89169
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New Hampshire
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Lebanon, New Hampshire, Spojené státy, 03756
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New Jersey
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Camden, New Jersey, Spojené státy, 08103
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Paramus, New Jersey, Spojené státy, 07652
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New York
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Albany, New York, Spojené státy, 12206
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East Syracuse, New York, Spojené státy, 13057
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New Hyde Park, New York, Spojené státy, 11042
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New York, New York, Spojené státy, 10016
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Rochester, New York, Spojené státy, 14642
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Stony Brook, New York, Spojené státy, 11794
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Syracuse, New York, Spojené státy, 13210
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The Bronx, New York, Spojené státy, 10461
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The Bronx, New York, Spojené státy, 10467
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North Carolina
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Winston-Salem, North Carolina, Spojené státy, 27157
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North Dakota
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Grand Forks, North Dakota, Spojené státy, 58201
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Ohio
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Akron, Ohio, Spojené státy, 44304
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Blue Ash, Ohio, Spojené státy, 45242
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Cincinnati, Ohio, Spojené státy, 45219
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Cleveland, Ohio, Spojené státy, 44106
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Oregon
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Portland, Oregon, Spojené státy, 97213
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Portland, Oregon, Spojené státy, 97210
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 19107
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Pittsburgh, Pennsylvania, Spojené státy, 15212
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South Carolina
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Charleston, South Carolina, Spojené státy, 29425
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South Dakota
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Sioux Falls, South Dakota, Spojené státy, 57105
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Watertown, South Dakota, Spojené státy, 57201
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Texas
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Austin, Texas, Spojené státy, 78745
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Dallas, Texas, Spojené státy, 75235
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Houston, Texas, Spojené státy, 77030
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Sherman, Texas, Spojené státy, 75090
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Vermont
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Burlington, Vermont, Spojené státy, 05401
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Virginia
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Richmond, Virginia, Spojené státy, 23249
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Washington
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Bellingham, Washington, Spojené státy, 98225
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Seattle, Washington, Spojené státy, 98195
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Spokane Valley, Washington, Spojené státy, 99216
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Wisconsin
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Milwaukee, Wisconsin, Spojené státy, 53226
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Ankara, Turecko (Türkiye), 06520
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Ankara, Turecko (Türkiye), 06010
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Istanbul, Turecko (Türkiye), 34214
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Izmir, Turecko (Türkiye), 35340
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Kocaeli, Turecko (Türkiye), 41400
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Beijing, Čína, 100142
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Beijing, Čína, 100021
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Changchun, Čína, 130021
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Changsha, Čína, 410013
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Chengdu, Čína, 610042
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Fuzhou, Čína, 350005
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Hangzhou, Čína, 310022
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Hangzhou, Čína, 310002
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Hefei, Čína, 230031
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Jinan, Čína, 250117
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Nanjing, Čína, 210009
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Shanghai, Čína, 200032
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Shanghai, Čína, 200433
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Shanghai, Čína, 200030
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Shanghai, Čína, 200002
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Shenyang, Čína, 100003
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Suzhou, Čína, 215006
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Wenzhou, Čína, 325000
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Wuhan, Čína, 430022
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Wuhan, Čína, 430030
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Zhengzhou, Čína, 450008
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Athens, Řecko, 11527
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Athens, Řecko, 11526
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Thessaloniki, Řecko, 55236
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Badajoz, Španělsko, 6006
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Barcelona, Španělsko, 08041
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L'Hospitalet de Llobregat, Španělsko, 08907
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Madrid, Španělsko, 28034
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Madrid, Španělsko, 28046
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Madrid, Španělsko, 28041
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Madrid, Španělsko, 28040
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Málaga, Španělsko, 29010
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San Sebastián, Španělsko, 20014
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Santiago de Compostela, Španělsko, 15706
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Seville, Španělsko, 41013
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Valencia, Španělsko, 46010
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Zaragoza, Španělsko, 50009
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Main Cohort Key Inclusion Criteria:
- Age ≥18 years
- Planned SoC SBRT as definitive treatment
- World Health Organization (WHO)/ECOG PS of 0, 1 or 2
- Life expectancy of at least 12 weeks
- Body weight >30 kg
- Submission of tumor tissue sample if available
- Adequate organ and marrow function required
- Patients with central or peripheral lesions are eligible
- Staging studies must be done during screening (PET-CT within 10 weeks)
- Patients with a history of metachronous NSCLC and synchronous lesions are eligible with some exceptions
Main Cohort Key Exclusion Criteria:
- Mixed small cell and non-small cell cancer
- History of allogeneic organ transplantation
- History of another primary malignancy with exceptions
- History of active primary immunodeficiency
- Epidermal growth factor receptor local testing is strongly recommended prior to enrollment. Patients with a tumor harboring an EGFRm per local testing will be excluded from the main cohort
- Prior exposure to immune-mediated therapy with exceptions
Osimertinib Cohort Key Inclusion Criteria
- Age ≥18 years
- Planned SoC SBRT as definitive treatment
- WHO/ECOG PS of 0, 1, or 2
- Patients with central or peripheral lesions are eligible
- Patients with a history of metachronous NSCLC and synchronous lesions are eligible with some exceptions
- Staging studies must be done during screening (PET-CT within 10 weeks)
- Submission of tumor tissue sample if available
- Confirmation by local laboratory that the tumor harbors one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R)
- Adequate bone marrow reserve or organ function required
- Female patients should be using highly effective contraceptive measures
- Male patients should be asked to use barrier contraceptives (ie, condoms) during sex with all partners during the trial and avoid procreation
Osimertinib Cohort Key Exclusion Criteria
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Mixed small cell and non-small cell cancer
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Patients with known or increased risk factor for QTc prolongation
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Treatment with any of the following:
- Preoperative or adjuvant platinum-based or other chemotherapy for the disease under investigation
- Prior treatment with neoadjuvant or adjuvant EGFR TKI
- 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 inducers of CYP3A4
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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
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Any of the following cardiac criteria
- Mean resting corrected QT interval >470 msec, obtained from 3 ECGs
- Any clinically important abnormalities in rhythm, conduction, or morphology of resting ECG.
- Any factors that increase the risk of QTc prolongation or risk of arrhythmic events, or unexplained -sudden death under 40 years of age in first-degree relatives or any concomitant medication known to prolong the QT interval
- Past medical history of ILD, drug-induced ILD, radiation pneumonitis which required steroid treatment, or any evidence of clinically active ILD
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Čtyřnásobek
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: SoC SBRT + Durvalumab Therapy (Main Cohort)
SBRT Durvalumab (PD-L1 monoclonal antibody) 1500 mg every 4 weeks [q4w] intravenously [iv] for up to 26 cycles or until progression or other discontinuation criteria are met. |
Durvalumab 1500 mg every 4 weeks [q4w] intravenously [iv] for up to 26 cycles or until progression or other discontinuation criteria are met.
Ostatní jména:
|
|
Komparátor placeba: SoC SBRT + Placebo Therapy (Main Cohort)
SBRT Placebo (matching placebo for infusion) every 4 weeks iv for up to 26 cycles or until progression or other discontinuation criteria are met. |
Matching placebo for infusion every 4 weeks iv for up to 26 cycles or until progression or other discontinuation criteria are met. |
|
Experimentální: SoC SBRT + Osimertinib Therapy (Osimertinib cohort, single-arm, open-label separate cohort)
SBRT Osimertinib 80mg every day [qd] for oral administration up to 36 months or until progression. Osimertinib treatment should start within 7 to 14 days after completion of SBRT |
Osimertinib 80 mg every day [qd] orally for up to 36 months or until progression or other discontinuation criteria are met. Osimertinib treatment should start from 7 to 14 days after completion of SBRT |
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Progression-Free Survival (PFS) assessed by Blinded Independent Central Review (BICR) according to RECIST 1.1 in subpopulation of patients with Stage I/II NSCLC
Časové okno: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
4-year Progression-Free Survival (4y-PFS) by ICR according to RECIST 1.1 criteria
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Progression-Free Survival (PFS) assessed by BICR per RECIST 1.1 in all randomised patients with Stage I/II NSCLC
Časové okno: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
Overall Survival (OS)
Časové okno: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
|
|
Concentration of durvalumab in serum such as peak concentration and trough
Časové okno: 12 weeks after last dose
|
Main Cohort |
12 weeks after last dose
|
|
Detection of ADA neutralising antibodies titers
Časové okno: up to 6 months after last dose
|
Main Cohort |
up to 6 months after last dose
|
|
Health-related quality of life in patients treated with durvalumab with SoC SBRT compared to placebo with SoC SBRT using the EORTC QLQ-C30
Časové okno: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
|
|
Proportion of patients alive and progression free at 24 months from randomisation (PFS24) assessed by BICR according to RECIST 1.1
Časové okno: at 24 months following randomization
|
Main Cohort |
at 24 months following randomization
|
|
Time to progression (TTP) assessed by BICR according to RECIST 1.1
Časové okno: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
Time to death or distant metastasis (TTDM) assessed by BICR according to RECIST 1.1
Časové okno: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
Time from randomisation to second progression (PFS2) as defined by local standard clinical practice
Časové okno: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
|
|
Assessment of AEs by CTCAE v 5.0 as measures of the safety and tolerability of Durvalumab with SoC SBRT compared to placebo with SoC SBRT
Časové okno: up to 3 months after last dose
|
Main Cohort |
up to 3 months after last dose
|
|
Assessment of AEs by CTCAE v 5.0 as measures of the safety, tolerability and compliance of osimertinib with SoC SBRT therapy
Časové okno: Up to 35 days after last dose
|
Osimertinib Cohort |
Up to 35 days after last dose
|
|
WHO performance status
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
ECG QT interval
Časové okno: Up to 156 weeks of treatment or treatment discontinuation
|
Osimertinib Cohort |
Up to 156 weeks of treatment or treatment discontinuation
|
|
Overall Survival
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time To Progression (TTP)
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time to CNS progression
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS2
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Site(s) of disease progression
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS by ICR using RECIST 1.1
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Lung cancer mortality
Časové okno: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Lung Cancer Mortality
Časové okno: from randomization Up to 5 years
|
Main Cohort |
from randomization Up to 5 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Publikace a užitečné odkazy
Užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- D9103C00001
- 2018 (Grant/smlouva NIH USA)
- 2018-002572-41 (Číslo EudraCT)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Časový rámec sdílení IPD
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Kritéria přístupu pro sdílení IPD
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Typ podpůrných informací pro sdílení IPD
- PROTOKOL STUDY
- MÍZA
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .