- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT03833154
Durvalumab vs placebo med stereootaktisk kroppsstrålebehandling i tidlig stadium uoperert ikke-småcellet lungekreft (NSCLC) pasienter / Osimertinib etter SBRT hos pasienter med tidlig stadium uoperert NSCLC som har en EGFR-mutasjon (PACIFIC-4)
En fase III, randomisert, placebokontrollert, dobbeltblind, multisenter, internasjonal studie av Durvalumab med stereootaktisk kroppsstrålebehandling (SBRT) for behandling av pasienter med uoperert stadium I/II, lymfeknute-negativ ikke-småcellet Lungekreft (PACIFIC-4/RTOG-3515) Osimertinib etter SBRT, en enkeltarmskohort for pasienter med uoperert stadium I/II, lymfeknute-negativ NSCLC med en sensibiliserende EGFR-mutasjon
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.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
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.
Studietype
Registrering (Faktiske)
Fase
- Fase 3
Kontakter og plasseringer
Studiesteder
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Clayton, Australia, 3168
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Aalst, Belgia, 9300
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Charleroi, Belgia, 6060
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Edegem, Belgia, 2650
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Ghent, Belgia, 9000
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Leuven, Belgia, 3000
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Barretos, Brasil, 14784-400
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Porto Alegre, Brasil, 90110-270
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Recife, Brasil, 52010-075
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Rio de Janeiro, Brasil, 22271-110
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São Paulo, Brasil, 01327-001
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Volta Redonda, Brasil, 27258-000
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
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Ontario
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London, Ontario, Canada, N6A 5W9
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Toronto, Ontario, Canada, M5G 2M9
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Toronto, Ontario, Canada, M4N 3M5
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Quebec
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Montreal, Quebec, Canada, H2X 3E4
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Alabama
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Tuscaloosa, Alabama, Forente stater, 35401
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Arizona
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Chandler, Arizona, Forente stater, 85224
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Phoenix, Arizona, Forente stater, 85004
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Tucson, Arizona, Forente stater, 85719
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California
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Duarte, California, Forente stater, 91010
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Long Beach, California, Forente stater, 90806
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Los Angeles, California, Forente stater, 90095
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San Diego, California, Forente stater, 92123
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Delaware
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Newark, Delaware, Forente stater, 10709
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District of Columbia
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Washington D.C., District of Columbia, Forente stater, 20010
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Florida
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Bay Pines, Florida, Forente stater, 33744
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Jacksonville, Florida, Forente stater, 32256
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Miami Beach, Florida, Forente stater, 33140
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Orlando, Florida, Forente stater, 32804
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Georgia
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Atlanta, Georgia, Forente stater, 30322
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Atlanta, Georgia, Forente stater, 30342
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Illinois
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Chicago, Illinois, Forente stater, 60612
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Chicago, Illinois, Forente stater, 60637
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Chicago, Illinois, Forente stater, 60611
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Decatur, Illinois, Forente stater, 62526
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Elmhurst, Illinois, Forente stater, 60126
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Naperville, Illinois, Forente stater, 60540
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Indiana
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Fort Wayne, Indiana, Forente stater, 46845
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Iowa
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Cedar Rapids, Iowa, Forente stater, 52403
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Iowa City, Iowa, Forente stater, 52242
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Kentucky
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Elizabethtown, Kentucky, Forente stater, 42701
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Lexington, Kentucky, Forente stater, 40503
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Louisville, Kentucky, Forente stater, 40202
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Louisiana
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Metairie, Louisiana, Forente stater, 70006
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New Orleans, Louisiana, Forente stater, 70121
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Maine
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South Portland, Maine, Forente stater, 04106
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Maryland
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Annapolis, Maryland, Forente stater, 21401
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Baltimore, Maryland, Forente stater, 21201
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Rosedale, Maryland, Forente stater, 21237
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Silver Spring, Maryland, Forente stater, 20910
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Towson, Maryland, Forente stater, 21204
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Massachusetts
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Boston, Massachusetts, Forente stater, 02215
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Michigan
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Ann Arbor, Michigan, Forente stater, 48197
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Detroit, Michigan, Forente stater, 48201
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Royal Oak, Michigan, Forente stater, 48073
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Minnesota
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Duluth, Minnesota, Forente stater, 55805
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Rochester, Minnesota, Forente stater, 55905
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Missouri
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St Louis, Missouri, Forente stater, 63110
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Nebraska
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Omaha, Nebraska, Forente stater, 68105
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Nevada
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Las Vegas, Nevada, Forente stater, 89169
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New Hampshire
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Lebanon, New Hampshire, Forente stater, 03756
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New Jersey
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Camden, New Jersey, Forente stater, 08103
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Paramus, New Jersey, Forente stater, 07652
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New York
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Albany, New York, Forente stater, 12206
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East Syracuse, New York, Forente stater, 13057
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New Hyde Park, New York, Forente stater, 11042
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New York, New York, Forente stater, 10016
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Rochester, New York, Forente stater, 14642
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Stony Brook, New York, Forente stater, 11794
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Syracuse, New York, Forente stater, 13210
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The Bronx, New York, Forente stater, 10461
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The Bronx, New York, Forente stater, 10467
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North Carolina
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Winston-Salem, North Carolina, Forente stater, 27157
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North Dakota
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Grand Forks, North Dakota, Forente stater, 58201
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Ohio
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Akron, Ohio, Forente stater, 44304
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Blue Ash, Ohio, Forente stater, 45242
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Cincinnati, Ohio, Forente stater, 45219
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Cleveland, Ohio, Forente stater, 44106
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Oregon
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Portland, Oregon, Forente stater, 97213
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Portland, Oregon, Forente stater, 97210
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Pennsylvania
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Philadelphia, Pennsylvania, Forente stater, 19107
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Pittsburgh, Pennsylvania, Forente stater, 15212
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South Carolina
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Charleston, South Carolina, Forente stater, 29425
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South Dakota
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Sioux Falls, South Dakota, Forente stater, 57105
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Watertown, South Dakota, Forente stater, 57201
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Texas
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Austin, Texas, Forente stater, 78745
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Dallas, Texas, Forente stater, 75235
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Houston, Texas, Forente stater, 77030
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Sherman, Texas, Forente stater, 75090
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Vermont
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Burlington, Vermont, Forente stater, 05401
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Virginia
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Richmond, Virginia, Forente stater, 23249
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Washington
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Bellingham, Washington, Forente stater, 98225
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Seattle, Washington, Forente stater, 98195
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Spokane Valley, Washington, Forente stater, 99216
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Wisconsin
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Milwaukee, Wisconsin, Forente stater, 53226
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Bron, Frankrike, 69677
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Dijon, Frankrike, 21079
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Lyon, Frankrike, 69317
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Nantes, Frankrike, 44202
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Pierre-Bénite, Frankrike, 69310
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Toulouse, Frankrike, 31000
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Villejuif, Frankrike, 94805
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Athens, Hellas, 11527
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Athens, Hellas, 11526
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Thessaloniki, Hellas, 55236
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Haifa, Israel, 31096
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Jerusalem, Israel, 91120
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Kfar Saba, Israel, 95847
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Petah Tikva, Israel, 49100
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Ramat Gan, Israel, 52621
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Tel Aviv, Israel, 64239
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Florence, Italia, 50134
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Genova, Italia, 16132
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Milan, Italia, 20132
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Orbassano, Italia, 10043
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Padova, Italia, 35128
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Pavia, Italia, 27100
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Roma, Italia, 00128
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Rozzano, Italia, 20089
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Akashi-shi, Japan, 673-8558
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Bunkyō City, Japan, 113-8677
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Chūōku, Japan, 104-0045
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Fukuoka, Japan, 812-8582
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Hirosaki-shi, Japan, 036-8563
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Hiroshima, Japan, 734-8551
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Kobe, Japan, 650-0047
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Niigata, Japan, 951-8566
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Osaka, Japan, 541-8567
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Sakaishi, Japan, 591-8555
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Sapporo, Japan, 060-8648
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Sunto-gun, Japan, 411-8777
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Toyoake-shi, Japan, 470-1192
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Yokohama, Japan, 241-8515
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Beijing, Kina, 100142
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Beijing, Kina, 100021
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Changchun, Kina, 130021
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Changsha, Kina, 410013
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Chengdu, Kina, 610042
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Fuzhou, Kina, 350005
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Hangzhou, Kina, 310022
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Hangzhou, Kina, 310002
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Hefei, Kina, 230031
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Jinan, Kina, 250117
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Nanjing, Kina, 210009
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Shanghai, Kina, 200032
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Shanghai, Kina, 200433
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Shanghai, Kina, 200030
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Shanghai, Kina, 200002
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Shenyang, Kina, 100003
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Suzhou, Kina, 215006
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Wenzhou, Kina, 325000
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Wuhan, Kina, 430022
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Wuhan, Kina, 430030
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Zhengzhou, Kina, 450008
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Amsterdam, Nederland, 1081 HV
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Groningen, Nederland, 9713 GZ
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Utrecht, Nederland, 3584 CX
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Bydgoszcz, Polen, 85-796
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Elblag, Polen, 02-300
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Gdansk, Polen, 80-952
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Katowice, Polen, 40-514
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Lodz, Polen, 93-513
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Warsaw, Polen, 02-781
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Hato Rey, Puerto Rico, 00917
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Kazan, Tatarstan, Russland, 420029
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Moscow, Russland, 115478
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Moscow, Russland, 105229
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Moscow, Russland, 119421
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Saint Petersburg, Russland, 197758
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Ufa, Russland, 450054
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Yekaterinburg, Russland, 620905
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Badajoz, Spania, 6006
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Barcelona, Spania, 08041
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L'Hospitalet de Llobregat, Spania, 08907
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Madrid, Spania, 28034
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Madrid, Spania, 28046
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Madrid, Spania, 28041
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Madrid, Spania, 28040
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Málaga, Spania, 29010
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San Sebastián, Spania, 20014
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Santiago de Compostela, Spania, 15706
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Seville, Spania, 41013
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Valencia, Spania, 46010
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Zaragoza, Spania, 50009
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Birmingham, Storbritannia, B9 5SS
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Leeds, Storbritannia, LS9 7TF
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London, Storbritannia, EC1A 7BE
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Manchester, Storbritannia, M20 4BX
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Cheongju-si, Sør -Korea, 28644
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Goyang-si, Sør -Korea, 10408
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Gyeonggi-do, Sør -Korea, 13620
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Seoul, Sør -Korea, 03722
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Seoul, Sør -Korea, 05505
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Seoul, Sør -Korea, 06351
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Ankara, Tyrkia (Türkiye), 06520
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Ankara, Tyrkia (Türkiye), 06010
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Istanbul, Tyrkia (Türkiye), 34214
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Izmir, Tyrkia (Türkiye), 35340
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Kocaeli, Tyrkia (Türkiye), 41400
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Dresden, Tyskland, 01307
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Göttingen, Tyskland, 37075
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Halle, Tyskland, 06120
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Hanover, Tyskland, 30459
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Heidelberg, Tyskland, 69126
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Homburg, Tyskland, 66424
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Regensburg, Tyskland, 93053
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Trier, Tyskland, 54292
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
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
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: 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.
Andre navn:
|
|
Placebo komparator: 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. |
|
Eksperimentell: 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 |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
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
Tidsramme: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
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|
4-year Progression-Free Survival (4y-PFS) by ICR according to RECIST 1.1 criteria
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Progression-Free Survival (PFS) assessed by BICR per RECIST 1.1 in all randomised patients with Stage I/II NSCLC
Tidsramme: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
Overall Survival (OS)
Tidsramme: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
|
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Concentration of durvalumab in serum such as peak concentration and trough
Tidsramme: 12 weeks after last dose
|
Main Cohort |
12 weeks after last dose
|
|
Detection of ADA neutralising antibodies titers
Tidsramme: 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
Tidsramme: 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
Tidsramme: at 24 months following randomization
|
Main Cohort |
at 24 months following randomization
|
|
Time to progression (TTP) assessed by BICR according to RECIST 1.1
Tidsramme: 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
Tidsramme: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
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Time from randomisation to second progression (PFS2) as defined by local standard clinical practice
Tidsramme: 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
Tidsramme: 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
Tidsramme: Up to 35 days after last dose
|
Osimertinib Cohort |
Up to 35 days after last dose
|
|
WHO performance status
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
ECG QT interval
Tidsramme: Up to 156 weeks of treatment or treatment discontinuation
|
Osimertinib Cohort |
Up to 156 weeks of treatment or treatment discontinuation
|
|
Overall Survival
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time To Progression (TTP)
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time to CNS progression
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS2
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Site(s) of disease progression
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS by ICR using RECIST 1.1
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Lung cancer mortality
Tidsramme: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Lung Cancer Mortality
Tidsramme: from randomization Up to 5 years
|
Main Cohort |
from randomization Up to 5 years
|
Samarbeidspartnere og etterforskere
Sponsor
Publikasjoner og nyttige lenker
Hjelpsomme linker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- D9103C00001
- 2018 (U.S. NIH-stipend/kontrakt)
- 2018-002572-41 (EudraCT-nummer)
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
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.
IPD-delingstidsramme
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.
Tilgangskriterier for IPD-deling
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.
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .