Neoadjuvante en adjuvante behandeling bij resectabele niet-kleincellige longkanker (NeoCOAST-2)
Een open-label, multicenter, gerandomiseerde fase II-studie van neoadjuvante en adjuvante behandeling bij patiënten met resectabele, vroeg stadium (II tot IIIB) niet-kleincellige longkanker (NeoCOAST-2)
The study is intended to assess the safety and efficacy of perioperative treatment with Durvalumab in combination with Oleclumab, Monalizumab, or AZD0171 and platinum doublet chemotherapy (CTX); or Volrustomig or Rilvegostomig in combination with CTX; or Datopotamab deruxtecan (Dato-DXd) in combination with Durvalumab or Rilvegostomig and single agent platinum chemotherapy in participants with resectable, early-stage non-small cell lung cancer.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
- Geneesmiddel: Durvalumab
- Geneesmiddel: Oleclumab
- Geneesmiddel: Pemetrexed/Cisplatin
- Geneesmiddel: Pemetrexed/Carboplatin
- Geneesmiddel: Carboplatin/Paclitaxel
- Geneesmiddel: Monalizumab
- Geneesmiddel: Volrustomig
- Geneesmiddel: Dato-DXd
- Geneesmiddel: Carboplatin
- Geneesmiddel: Cisplatin
- Geneesmiddel: AZD0171
- Geneesmiddel: Rilvegostomig
Gedetailleerde beschrijving
This is an open-label, multi-arms, multicentre, randomised study, eligible participants will be enrolled and randomised to one of the following treatment regimens.
Arm 1: Participants will receive Oleclumab + durvalumab + CTX as neoadjuvant treatment and Oleclumab + durvalumab as adjuvant treatment.
Arm 2: Participants will receive Monalizumab + durvalumab + CTX as neoadjuvant treatment and Monalizumab + durvalumab as adjuvant treatment.
Arm 3: Participants will receive Volrustomig (Dose Exploration) + CTX as neoadjuvant treatment and Volrustomig as adjuvant treatment.
Arm 4: Participants will receive Dato-DXd + durvalumab + single agent platinum chemotherapy as neoadjuvant treatment and durvalumab as adjuvant treatment.
Arm 5: Participants will receive AZD0171 + durvalumab + CTX as neoadjuvant treatment and AZD0171 + durvalumab as adjuvant treatment.
Arm 6: Participants will receive Rilvegostomig + CTX as neoadjuvant treatment and Rilvegostomig as adjuvant treatment.
Arm 7: Participants will receive Dato-DXd + Rilvegostomig + single agent platinum chemotherapy as neoadjuvant treatment and Rilvegostomig as adjuvant treatment.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 2
Contacten en locaties
Studiecontact
Studiecontact
- Naam: AstraZeneca Clinical Study Information Center
- Telefoonnummer: 1-877-240-9479
- E-mail: information.center@astrazeneca.com
Studie Contact Back-up
- Naam: AstraZeneca Lung Cancer Study Locator Service
- Telefoonnummer: 1-884-432-3892
- E-mail: az-lcsl@careboxhealth.com
Studie Locaties
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Ghent, België, 9000
- Voltooid
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Ghent, België, 9000
- Werving
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Roeselare, België, 8800
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
- Voltooid
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Manitoba
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Winnipeg, Manitoba, Canada, R3E 0V9
- Werving
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Quebec
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Montreal, Quebec, Canada, H2X 3E4
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Montreal, Quebec, Canada, H2W 1S6
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Avignon, Frankrijk, 84902
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Bobigny, Frankrijk, 93009
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Bordeaux, Frankrijk, 33076
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Limoges, Frankrijk, 83000
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Rennes, Frankrijk, 35000
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Rouen, Frankrijk, 76031
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Suresnes, Frankrijk, 92150
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Toulon, Frankrijk, 83000
- Actief, niet wervend
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Kecskemét, Hongarije, 6000
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Székesfehérvár, Hongarije, 8000
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Tatabánya, Hongarije, 2800
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Törökbálint, Hongarije, 2045
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Dublin, Ierland, D08 NHY1
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Dublin, Ierland, D07 R2WY
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Dublin, Ierland, D09 V2N0
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Galway, Ierland, H91 YR71
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Aviano, Italië, 33081
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Brescia, Italië, 25123
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Catanzaro, Italië, 88100
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Florence, Italië, 50134
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Genova, Italië, 16100
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Meldola, Italië, 47014
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Milan, Italië, 20162
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Monza, Italië, 20900
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Padova, Italië, 35128
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Perugia, Italië, 06156
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Pisa, Italië, 56124
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Roma, Italië, 00144
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Rozzano, Italië, 20089
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Lisbon, Portugal, 1169-050
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Lisbon, Portugal, 1099-023
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Lisbon, Portugal, 1400-038
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Lisbon, Portugal, 1500-650
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Porto, Portugal, 4200-072
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Porto, Portugal, 4099-001
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Porto, Portugal, 4100-180
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A Coruña, Spanje, 15006
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Alicante, Spanje, 03010
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Barcelona, Spanje, 08036
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Barcelona, Spanje, 8035
- Beëindigd
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Córdoba, Spanje, 14004
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Madrid, Spanje, 28040
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Majadahonda, Spanje, 28250
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Málaga, Spanje, 29010
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Reus, Spanje, 43204
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Seville, Spanje, 41009
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Terrassa, Spanje, 08221
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Valencia, Spanje, 46010
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Liuying, Taiwan, 736
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New Taipei City, Taiwan, 235
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Tainan, Taiwan, 70403
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Taipei, Taiwan, 10002
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Taipei, Taiwan, 11217
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Ankara, Turkije (Türkiye), 06800
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Ankara, Turkije (Türkiye), 06010
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Ankara, Turkije (Türkiye), 06500
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Istanbul, Turkije (Türkiye), 34722
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Izmir, Turkije (Türkiye), 35575
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Arkansas
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Little Rock, Arkansas, Verenigde Staten, 72205
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California
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Los Angeles, California, Verenigde Staten, 90095
- Werving
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Oakland, California, Verenigde Staten, 94611
- Ingetrokken
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Connecticut
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New Haven, Connecticut, Verenigde Staten, 06510
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Florida
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Stuart, Florida, Verenigde Staten, 34994
- Voltooid
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Georgia
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Gainesville, Georgia, Verenigde Staten, 30501
- Ingetrokken
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Illinois
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Chicago, Illinois, Verenigde Staten, 60637
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21231
- Werving
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Baltimore, Maryland, Verenigde Staten, 21201
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02215
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Minnesota
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Saint Louis Park, Minnesota, Verenigde Staten, 55426
- Voltooid
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68124
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New York
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Buffalo, New York, Verenigde Staten, 14263
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Ohio
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Cleveland, Ohio, Verenigde Staten, 44195
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Pennsylvania
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Pittsburgh, Pennsylvania, Verenigde Staten, 15212
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Tennessee
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Chattanooga, Tennessee, Verenigde Staten, 37404
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Memphis, Tennessee, Verenigde Staten, 38120
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Nashville, Tennessee, Verenigde Staten, 37232
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Nashville, Tennessee, Verenigde Staten, 37203
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Nashville, Tennessee, Verenigde Staten, 37203
- Ingetrokken
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Texas
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Houston, Texas, Verenigde Staten, 77030
- Werving
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Houston, Texas, Verenigde Staten, 77090
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Virginia
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Fairfax, Virginia, Verenigde Staten, 22031
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Washington
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Edmonds, Washington, Verenigde Staten, 98026
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Seattle, Washington, Verenigde Staten, 98104
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Busan, Zuid -Korea, 48108
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Chungcheongbuk-do, Zuid -Korea, 28644
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Seongnam-si, Zuid -Korea, 13496
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Seoul, Zuid -Korea, 03080
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Seoul, Zuid -Korea, 05505
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Suwon, Zuid -Korea, 16247
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Suwon, Zuid -Korea, 440-746
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Newly diagnosed NSCLC patients with resectable disease (Stage IIA to Stage IIIB).
- WHO or Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Adequate organ and bone marrow function.
- Provision of tumour samples (newly acquired or archival tumour tissue [≤ 6 months old]) to confirm Programmed death-ligand 1 (PD-L1) status, epidermal growth factor receptor (EGFR), or anaplastic lymphoma kinase (ALK) status.
- Adequate pulmonary function.
Exclusion Criteria:
- Participants with sensitising EGFR mutations or ALK translocations.
- Participants with baseline PD-L1 expression status <1% (Arms 6 and 7 only).
- Active or prior documented autoimmune or inflammatory disorders.
- Uncontrolled intercurrent illness, uncontrolled hypertension, unstable angina pectoris, uncontrolled cardiac arrhythmia, active bleeding diseases, serious chronic gastrointestinal conditions associated with diarrhoea, or psychiatric illness/social situations that would limit compliance with study requirement.
- History of another primary malignancy.
- Participants with small-cell lung cancer or mixed small-cell lung cancer.
- History of active primary immunodeficiency.
- History of non-infectious interstitial lung disease (ILD) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at screening.
- Participants who have preoperative radiotherapy treatment as part of their care plan.
- Participants who require or may require pneumonectomy, segmentectomies, or wedge resections, as assessed by their surgeon at baseline, to obtain potentially curative resection of primary tumour.
- QTcF (QT interval corrected by Fridericia's formula) interval ≥ 470 ms.
- Any medical contraindication to treatment with chemotherapy as listed in the local labelling.
- Participants with moderate or severe cardiovascular disease.
- Any concurrent chemotherapy, investigational product, biologic, or hormonal therapy for cancer treatment.
- Receipt of live attenuated vaccine within 30 days prior to the first dose of study interventions.
- Prior exposure to approved or investigational immune-mediated therapy including, but not limited to, other anti-CTLA-4, anti-TIGIT (T cell immunoreceptor with Ig and ITIM domains), anti-PD-1, anti-PD-L1, and anti-PD-L2 antibodies. Participants who received agents targeting the adenosine pathway, anti-NKG2A, anti-HLA-E agents, and anti-LIF agents are also excluded. Participants who have received previous treatment with a TROP2 targeting ADC or with another ADC containing a chemotherapy agent that inhibits TOP1 activity are also excluded.
- Current or prior use of immunosuppressive medication within 14 days before the first dose of study interventions.
- Active or uncontrolled infections including HBA, HBV, HCV, and HIV.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: Arm 1: Oleclumab + Durvalumab + Platinum doublet chemotherapy (CTX)
Participants will receive Durvalumab + Oleclumab + CTX as neoadjuvant treatment and Durvalumab + Oleclumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin |
Participants will receive Durvalumab via intravenous route.
Andere namen:
Participants will receive Oleclumab via intravenous route.
Andere namen:
Pemetrexed/Cisplatin as chemotherapy Pemetrexed/Carboplatin as chemotherapy Carboplatin/Paclitaxel, as chemotherapy |
|
Experimenteel: Arm 2: Monalizumab + Durvalumab + CTX
Participants will receive Durvalumab + Monalizumab + CTX as neoadjuvant treatment and Durvalumab + Monalizumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin |
Participants will receive Durvalumab via intravenous route.
Andere namen:
Pemetrexed/Cisplatin as chemotherapy Pemetrexed/Carboplatin as chemotherapy Carboplatin/Paclitaxel, as chemotherapy Participants will receive Monalizumab via intravenous route.
Andere namen:
|
|
Experimenteel: Arm 3: Volrustomig (Dose Exploration) + CTX
Participants will receive Volrustomig + CTX as neoadjuvant treatment and Volrustomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin |
Pemetrexed/Cisplatin as chemotherapy Pemetrexed/Carboplatin as chemotherapy Carboplatin/Paclitaxel, as chemotherapy Participants will receive Volrustomig via intravenous route.
Andere namen:
|
|
Experimenteel: Arm 4: Dato-DXd + durvalumab + single agent platinum
Participants will receive Dato-DXd + durvalumab + single agent platinum as neoadjuvant treatment and durvalumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on physician choice of as part of their treatment regimen prior to surgery: Carboplatin or Cisplatin |
Participants will receive Durvalumab via intravenous route.
Andere namen:
Participants will receive datopotamab deruxtecan (Dato-DXd) via intravenous route. Carboplatin as chemotherapy Cisplatin as chemotherapy |
|
Experimenteel: Arm 5: AZD0171 + durvalumab + CTX
Participants will receive AZD0171 + durvalumab + CTX as neoadjuvant treatment and AZD0171 + durvalumab as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin |
Participants will receive Durvalumab via intravenous route.
Andere namen:
Pemetrexed/Cisplatin as chemotherapy Pemetrexed/Carboplatin as chemotherapy Carboplatin/Paclitaxel, as chemotherapy Participants will receive AZD0171 via intravenous route. |
|
Experimenteel: Arm 6: Rilvegostomig + CTX
Participants will receive Rilvegostomig + CTX as neoadjuvant treatment and Rilvegostomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on the tumour histology and Investigator's discretion, as part of their treatment regimen prior to surgery: Carboplatin/Paclitaxel Pemetrexed/Cisplatin Pemetrexed/Carboplatin |
Pemetrexed/Cisplatin as chemotherapy Pemetrexed/Carboplatin as chemotherapy Carboplatin/Paclitaxel, as chemotherapy Participants will receive Rilvegostomig via intravenous route. |
|
Experimenteel: Arm 7: Dato-DXd + Rilvegostomig + single agent platinum
Participants will receive Dato-DXd + Rilvegostomig + single agent platinum as neoadjuvant treatment and Rilvegostomig as adjuvant treatment. Participants will receive one of the following chemotherapy regimens, based on physician choice of as part of their treatment regimen prior to surgery: Carboplatin or Cisplatin |
Participants will receive datopotamab deruxtecan (Dato-DXd) via intravenous route. Carboplatin as chemotherapy Cisplatin as chemotherapy Participants will receive Rilvegostomig via intravenous route. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
|
Aantal deelnemers met pathologische complete respons (pCR)
Tijdsspanne: Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
|
Aantal deelnemers met bijwerkingen (AE's) en ernstige bijwerkingen (SAE's)
Tijdsspanne: Tot dag 90 na de laatste dosis onderzoeksinterventies (tot ongeveer 3 jaar)
|
Tot dag 90 na de laatste dosis onderzoeksinterventies (tot ongeveer 3 jaar)
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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Aantal deelnemers dat een evenement zonder gebeurtenis (EFS) meemaakt
Tijdsspanne: Tot ongeveer 3 jaar
|
Tot ongeveer 3 jaar
|
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Aantal deelnemers dat een ziektevrije overlevingsgebeurtenis (DFS) doormaakt
Tijdsspanne: Tot ongeveer 3 jaar
|
Tot ongeveer 3 jaar
|
|
Aantal deelnemers met chirurgische resectie
Tijdsspanne: Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
|
Aantal deelnemers met ernstige pathologische respons (mPR)
Tijdsspanne: Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
|
Aantal deelnemers met objectief responspercentage (ORR)
Tijdsspanne: Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
Van randomisatie tot ongeveer 15 weken na de eerste dosis studie-interventies
|
|
Algehele overleving (OS)
Tijdsspanne: Tot ongeveer 3 jaar
|
Tot ongeveer 3 jaar
|
|
Aantal deelnemers met antistoffen tegen studiegeneesmiddelen (ADA)
Tijdsspanne: Van randomisatie tot 3 maanden na de laatste dosis studie-interventies (tot ongeveer 3 jaar)
|
Van randomisatie tot 3 maanden na de laatste dosis studie-interventies (tot ongeveer 3 jaar)
|
|
Baseline PD-L1-expressie
Tijdsspanne: Bij screening/baseline
|
Bij screening/baseline
|
|
Veranderingen in circulerend tumor-DNA (ctDNA)
Tijdsspanne: Van randomisatie tot maximaal 24 maanden na de laatste dosis studie-interventies (tot ongeveer 3 jaar)
|
Van randomisatie tot maximaal 24 maanden na de laatste dosis studie-interventies (tot ongeveer 3 jaar)
|
|
Serumconcentratie van onderzoeksinterventies (Durvalumab/Oleclumab/Monalizumab/Volrustomig/Rilvegostomig)
Tijdsspanne: Van randomisatie tot de laatste dosis onderzoeksinterventies (tot ongeveer 3 jaar)
|
Van randomisatie tot de laatste dosis onderzoeksinterventies (tot ongeveer 3 jaar)
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Tina Cascone, MD, MD Anderson Cancer Center Houston, TX 77030
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per site
- Neoplasmata
- Ziekten van de luchtwegen
- Longziekten
- Neoplasmata van de luchtwegen
- Thoracale neoplasmata
- Carcinoom, bronchogeen
- Bronchiale neoplasmata
- Longneoplasmata
- Carcinoom, niet-kleincellige long
- Aminozuren, peptiden en eiwitten
- Organische chemicaliën
- Heterocyclische verbindingen
- Heterocyclische verbindingen, 2-ring
- Heterocyclische verbindingen, gefuseerd ring
- Anorganische chemicaliën
- Chloorverbindingen
- Stikstofverbindingen
- Coördinatiecomplexen
- Guanine
- Hypoxanthines
- Purinones
- Purines
- Glutamaten
- Aminozuren, zuur
- Aminozuren
- Aminozuren, dicarbonylisch
- Platinumverbindingen
- Pemetrexed
- Carboplatine
- Cisplatine
- durvalumab
- monalizumab
- CP -protocol
Andere studie-ID-nummers
Andere studie-ID-nummers
- D9077C00001
- 2021-003369-37 (EudraCT-nummer)
- 2023-508852-21-00 (Register-ID: CTIS)
- 2023 (Subsidie/contract van de Amerikaanse NIH)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal Vivli.org. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
"Yes", indicates that AZ are accepting requests for IPD, but this does not mean all requests will be approved.
IPD-tijdsbestek voor delen
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA/PhRMA Data-Sharing Principles. For details of our timelines, please refer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD-toegangscriteria voor delen
When a request has been approved AstraZeneca will provide access to the anonymized individual patient-level data via secure research environment Vivli.org. A Signed Data Usage Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information.
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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