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This was a single-arm, open-label, multicenter, phase II study to evaluate the efficacy and safety of the ALK inhibitor LDK378 when used as single agent in patients with ALK-rearranged stage IIIB or IV NSCLC previously treated with alectinib. Treatment with LDK378 750 mg qd continued until the patient experienced disease progression as determined by the investigator according to RECIST 1.1, unacceptable toxicity that precluded further treatment, pregnancy, start of a new anticancer therapy, discontinued treatment at the discretion of the patient or investigator, lost to follow-up, death, or study was terminated by Sponsor.
Study completed as per protocol. 'Switched to commercial drug' implies that after the primary and secondary objectives were achieved, one patient continued the study treatment as they did not meet the progression disease or AE to be discontinued from the treatment. But after the regulatory approval, Novartis decided to close the study, the 1 patient switched to commercially available drug.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LDK378 (Ceritinib) | Experimental | Participants who received LDK378 750mg once daily on a 28 day cycle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LDK378 | Drug | Oral LDK378 750mg once daily |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response Rate (ORR) to LDK378 by Investigator Assessment | ORR, defined as the percentage of participants with a best overall confirmed response of complete response (CR) or partial response (PR) in the whole body as assessed per RECIST 1.1 by the investigator. CR: Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR: At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters. | Until disease progression or unacceptable toxicity occurs, or patient withdrawal up to 798 days |
| Measure | Description | Time Frame |
|---|---|---|
| Disease Control Rate (DCR) | DCR, calculated as the percentage of participants with best overall response of CR, PR, or stable disease (SD) evaluated by investigator per RECIST 1.1; CR: Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR: At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters; SD: Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for progressive disease (PD); PD: taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. |
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Key Inclusion Criteria:
Key Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Novartis Pharmaceuticals | Novartis Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novartis Investigative Site | Nagoya | Aichi-ken | 464 8681 | Japan | ||
| Novartis Investigative Site |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29959809 | Derived | Hida T, Seto T, Horinouchi H, Maemondo M, Takeda M, Hotta K, Hirai F, Kim YH, Matsumoto S, Ito M, Ayukawa K, Tokushige K, Yonemura M, Mitsudomi T, Nishio M. Phase II study of ceritinib in alectinib-pretreated patients with anaplastic lymphoma kinase-rearranged metastatic non-small-cell lung cancer in Japan: ASCEND-9. Cancer Sci. 2018 Sep;109(9):2863-2872. doi: 10.1111/cas.13721. Epub 2018 Jul 25. |
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Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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A total of 20 patients were enrolled and treated with ceritinib.
Approximately 20 patients were planned to be enrolled.
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| ID | Title | Description |
|---|---|---|
| FG000 | LDK378 (Ceritinib) | Participants who received LDK378 750mg once daily on a 28 day cycle. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib. Safety Set in this study is identical to FAS.
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| ID | Title | Description |
|---|---|---|
| BG000 | LDK378 (Ceritinib) | Participants who received LDK378 750mg once daily on a 28 day cycle. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Overall Response Rate (ORR) to LDK378 by Investigator Assessment | ORR, defined as the percentage of participants with a best overall confirmed response of complete response (CR) or partial response (PR) in the whole body as assessed per RECIST 1.1 by the investigator. CR: Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR: At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters. | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib. | Posted | Number | 95% Confidence Interval | Percentage of participants | Until disease progression or unacceptable toxicity occurs, or patient withdrawal up to 798 days |
|
On treatment deaths were collected from FPFT up to 30 days after study drug discontinuation, for a maximum duration of 24 months (treatment duration ranged from 0.4 to to 23.0 months).
AE: Any sign or symptom that occurs during the study treatment plus the 30 days post treatment
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | LDK378 (Ceritinib) | Participants who received LDK378 750mg once daily on a 28 day cycle. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA (21.0) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Novartis Pharmaceuticals | 862-778-8300 | Novartis.email@novartis.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| SAP | No | Yes | No | Statistical Analysis Plan | Jun 13, 2017 | May 22, 2019 | SAP_000.pdf |
| Prot | Yes | No | No | Study Protocol | Jul 28, 2016 | May 22, 2019 | Prot_001.pdf |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D008175 | Lung Neoplasms |
| D000077192 | Adenocarcinoma of Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
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| ID | Term |
|---|---|
| C586847 | ceritinib |
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| 6 cycles of 28 days up to 798 days |
| Time to Tumor Response (TTR) | TTR, calculated as the time from first dose of LDK378 to first documented response (CR or PR) evaluated by investigator per RECIST 1.1 for participants with confirmed PR or CR. | 6 cycles of 28 days up to 798 days |
| Duration of Response (DOR) | DOR, calculated as the time from the date of the first documented response (CR or PR) to the first documented disease progression evaluated by investigator per RECIST 1.1 or death due to any cause | 6 cycles of 28 days up to 798 days |
| Progression Free Survival (PFS) | PFS, calculated as the time from first dose of LDK378 to date of first documented disease progression evaluated by investigator per RECIST 1.1 or date of death due to any cause | 6 cycles of 28 days up to 798 days |
| Overall Survival (OS) | OS was defined as the time from the start date of study drug to the date of death due to any cause. | 6 cycles of 28 days up to 798 days |
| Overall Intracranial Response Rate (OIRR) | OIRR, calculated as the percentage of participants with a best overall confirmed response of CR or PR in the brain assessments for participants having measurable brain metastases at baseline | 6 cycles of 28 days up to 798 days |
| Kashiwa |
| Chiba |
| 277 8577 |
| Japan |
| Novartis Investigative Site | Fukuoka | Fukuoka | 811-1395 | Japan |
| Novartis Investigative Site | Sakyo Ku | Kyoto | 606 8507 | Japan |
| Novartis Investigative Site | Natori-shi | Miyagi | 981-1293 | Japan |
| Novartis Investigative Site | Okayama | Okayama-ken | 700-8558 | Japan |
| Novartis Investigative Site | ÅŒsaka-sayama | Osaka | 589 8511 | Japan |
| Novartis Investigative Site | Chuo Ku | Tokyo | 104 0045 | Japan |
| Novartis Investigative Site | Koto Ku | Tokyo | 135 8550 | Japan |
| Subject/guardian decision |
|
| Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Number | Participants |
|
|
|
| Secondary | Disease Control Rate (DCR) | DCR, calculated as the percentage of participants with best overall response of CR, PR, or stable disease (SD) evaluated by investigator per RECIST 1.1; CR: Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR: At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters; SD: Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for progressive disease (PD); PD: taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib. | Posted | Number | 95% Confidence Interval | Percentage of participants | 6 cycles of 28 days up to 798 days |
|
|
|
| Secondary | Time to Tumor Response (TTR) | TTR, calculated as the time from first dose of LDK378 to first documented response (CR or PR) evaluated by investigator per RECIST 1.1 for participants with confirmed PR or CR. | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib - participants with confirmed PR or CR. | Posted | Mean | Standard Deviation | Months | 6 cycles of 28 days up to 798 days |
|
|
|
| Secondary | Duration of Response (DOR) | DOR, calculated as the time from the date of the first documented response (CR or PR) to the first documented disease progression evaluated by investigator per RECIST 1.1 or death due to any cause | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib - participants with confirmed PR or CR. | Posted | Median | 95% Confidence Interval | Months | 6 cycles of 28 days up to 798 days |
|
|
|
| Secondary | Progression Free Survival (PFS) | PFS, calculated as the time from first dose of LDK378 to date of first documented disease progression evaluated by investigator per RECIST 1.1 or date of death due to any cause | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib. | Posted | Median | 95% Confidence Interval | Months | 6 cycles of 28 days up to 798 days |
|
|
|
| Secondary | Overall Survival (OS) | OS was defined as the time from the start date of study drug to the date of death due to any cause. | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib. | Posted | Number | 95% Confidence Interval | Months | 6 cycles of 28 days up to 798 days |
|
|
|
| Secondary | Overall Intracranial Response Rate (OIRR) | OIRR, calculated as the percentage of participants with a best overall confirmed response of CR or PR in the brain assessments for participants having measurable brain metastases at baseline | Full Analysis Set (FAS) consists of all patients who received at least one dose of ceritinib - participants with measurable brain disease at baseline | Posted | Number | 95% Confidence Interval | Percentage of participants | 6 cycles of 28 days up to 798 days |
|
|
|
| Post-Hoc | All Collected Deaths | On treatment deaths were collected from FPFT up to 30 days after study drug discontinuation, for a maximum duration of 24 months (treatment duration ranged from 0.4 to to 23.0 months). Deaths post treatment survival follow up were collected after the on treatment period, up to 33 months. Patients who didn't die during the on-treatment period and had not stopped study participation at the time of data cut-off (end of study) were censored. | Clinical Database Population: all treated patients and patients who died during screening | Posted | Number | Participants | approx. 24 months, approx. 33 months |
|
|
|
| 0 |
| 20 |
| 9 |
| 20 |
| 20 |
| 20 |
| Hepatobiliary disease | Hepatobiliary disorders | MedDRA (21.0) | Systematic Assessment |
|
| Pneumonia | Infections and infestations | MedDRA (21.0) | Systematic Assessment |
|
| Spinal compression fracture | Injury, poisoning and procedural complications | MedDRA (21.0) | Systematic Assessment |
|
| Decreased appetite | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
|
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA (21.0) | Systematic Assessment |
|
| Metastases to central nervous system | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (21.0) | Systematic Assessment |
|
| Acute kidney injury | Renal and urinary disorders | MedDRA (21.0) | Systematic Assessment |
|
| Pleurisy | Respiratory, thoracic and mediastinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Embolism | Vascular disorders | MedDRA (21.0) | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA (21.0) | Systematic Assessment |
|
| Pyrexia | General disorders | MedDRA (21.0) | Systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | MedDRA (21.0) | Systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | MedDRA (21.0) | Systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | MedDRA (21.0) | Systematic Assessment |
|
| Amylase increased | Investigations | MedDRA (21.0) | Systematic Assessment |
|
| Aspartate aminotransferase increased | Investigations | MedDRA (21.0) | Systematic Assessment |
|
| Blood alkaline phosphatase increased | Investigations | MedDRA (21.0) | Systematic Assessment |
|
| Blood cholesterol increased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Blood creatinine increased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Electrocardiogram QT prolonged | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Gamma-glutamyltransferase increased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Weight decreased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| Weight increased | Investigations | MedDRA (21.0) | Systematic Assessment |
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| White blood cell count decreased | Investigations | MedDRA (21.0) | Systematic Assessment |
|
| Decreased appetite | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
|
| Hyperglycaemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
|
| Hyperkalaemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
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| Hypokalaemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
|
| Hypomagnesaemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (21.0) | Systematic Assessment |
|
| Dysgeusia | Nervous system disorders | MedDRA (21.0) | Systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Hiccups | Respiratory, thoracic and mediastinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA (21.0) | Systematic Assessment |
|
| Dry skin | Skin and subcutaneous tissue disorders | MedDRA (21.0) | Systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA (21.0) | Systematic Assessment |
|
| Rash maculo-papular | Skin and subcutaneous tissue disorders | MedDRA (21.0) | Systematic Assessment |
|
The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of pooled data (i.e.,data from all sites) in clinical trial or disclosure of trial results in their entirety.
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| Title | Measurements |
|---|---|
|