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| Name | Class |
|---|---|
| Cancer Institute and Hospital, Chinese Academy of Medical Sciences | OTHER |
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This is a prospective, randomised, open-label, positive-controlled study to investigate the efficacy and safety of Osimertinib plus Carboplatin/Pemetrexed versus Osimertinib monotherapy in metastatic EGFRm NSCLC patients with EGFRm persistence in ctDNA at 3 weeks after first-line therapy with Osimertinib.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Osimertinib 80 mg QD and platinum-based chemotherapy | Experimental | Osimertinib 80 mg in combination with pemetrexed (500 mg/m2) plus carboplatin (AUC5) on Day 1 of 21day cycles (every 3 weeks) for up to 6 cycles, followed by Osimertinib daily with pemetrexed maintenance (500 mg/m2) every 3 weeks. |
|
| Osimertinib 80mg QD | Active Comparator | All patients randomized into this will only receive Osimertinib 80mg. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Osimertinib | Drug | Pemetrexed (500 mg/m2) plus carboplatin (AUC5) on Day 1 of 21day cycles (every 3 weeks) for up to 6 cycles, followed by Osimertinib daily with pemetrexed maintenance (500 mg/m2) every 3 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | Progression-free survival (PFS) using Investigator assessment as defined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). | The primary analysis of Progression-free survival (PFS) based on investigator assessment will occur when PFS maturity is observed at approximately 30 months after the first patient is randomized. |
| Measure | Description | Time Frame |
|---|---|---|
| OS rate at 18 months | Proportion of patients alive at 18 months | The OS rate at 18 months will be defined as the Kaplan-Meier estimate of OS at 18 months. |
| Objective Response Rate (ORR) | ORR (per RECIST 1.1 using Investigator assessments) is defined as the number (percent) of patients with at least 1 visit response of CR or PR. |
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Inclusion Criteria:
A. Prior to 1L osimertinib:
B. Prior to randomization: Patients after 3 weeks of 1L osimertinib treatment who have persistence ctDNA EGFRm by SuperARMS at 3 weeks will be considered to be enrolled. They will need to further meet the criteria below before randomization:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Hospital Chinese Academy of Medical Sciences | Beijing | China |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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| ID | Term |
|---|---|
| C000596361 | osimertinib |
| D000068437 | Pemetrexed |
| D016190 | Carboplatin |
| ID | Term |
|---|---|
| D006147 | Guanine |
| D007042 | Hypoxanthines |
| D011688 | Purinones |
| D011687 | Purines |
| D006574 |
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|
| Pemetrexed/Carboplatin | Drug | Pemetrexed (500 mg/m2) plus carboplatin (AUC5) on Day 1 of 21day cycles (every 3 weeks) for up to 6 cycles, followed by Osimertinib daily with pemetrexed maintenance (500 mg/m2) every 3 weeks. |
|
| Objective Response Rate analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| Disease Control Rate (DCR) | Disease control rate (DCR) is defined as the percentage of subjects who have a best overall response of CR or PR or SD by RECIST 1.1 as assessed by the Investigator. | Disease control rate analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| Duration of Response (DoR) | DoR is defined as the time from the date of first documented response until the date of documented progression or death in the absence of disease progression. | Duration of Response analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| Depth of Response | Depth of response by Investigator is defined as the relative change in the sum of the longest diameters of RECIST target lesions at the nadir in the absence of NLs or progression of NTLs when compared to baseline. | Depth of Response analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| Safety and tolerability: Adverse event | All Adverse events/≥grade 3 AE/SAE incidence rate (AE/SAE graded by CTCAE v5); All ADR incidence rate; AESI: ILD/pneumonitis-like event, Cardiac failure | Safety and tolerability analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| Molecular resistance mechanism | To evaluate potential molecular resistance mechanism by biomarker analysis of plasma at baseline and disease progression and tissue samples (if applicable) by next-generation sequencing (NGS). | Molecular resistance mechanism analysis will occur when Progression-free survival (PFS) maturity is observed at approximately 30 months from the first patient being randomized. |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D005971 | Glutamates |
| D024342 | Amino Acids, Acidic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000600 | Amino Acids, Dicarboxylic |
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |