A Study of Sintilimab or Placebo in Combination With Chemotherapy as Second-line Treatment for Patients With Stage IV Nonsquamous Non-small Cell Lung Cancer With Wild-type EGFR After Failure With Platinum-Containing Chemotherapy.
Primary Purpose
Nonsquamous Non-Small Cell Lung Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab
Docetaxel
Pemetrexed
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Nonsquamous Non-Small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- Volunteer to participate in clinical research; fully understand and know the research and sign informed consent;
- Age ≥ 18 years old and ≤ 75 years old, either sex;
- Eastern Collaborative Oncology Group Performance status (ECOG PS) 0, 1 or 2;
- Has a histologically or cytologically confirmed diagnosis of stage IV (according to the 8th edition of the International Association for the Study of Lung Cancer) nonsquamous NSCLC;
- Have at least one measurable lesion as defined by RECIST 1.1;
- Has progression of disease after treatment with at least two cycles of a platinum-containing doublet chemotherapy according to RECIST V.1.1;
- Patients without activating EGFR mutation;
- Normal hepatic function: total bilirubin≤1.5×normal upper limit (ULN); Alanine aminotransferase and Aspartate aminotransferase levels ≤2.5×ULN or ≤5×ULN if liver metastasis is present;
- Normal renal function: Creatinine ≤1.5×ULN or calculated creatinine clearance ≥45 mL/min (using Cockcroft/Gault formula to calculate );
- Normal hematological function: absolute neutrophil count ≥1.5×109/L, platelet count ≥70×109/L, hemoglobin≥80g/L [no blood transfusion or erythropoietin (EPO) within 7 days] Dependency];
- Has a life expectancy of at ≥3 months.
Exclusion Criteria:
- ECOG PS >2;
- Small cell lung cancer and squamous NSCLC;
- EGFR mutation or mutation status unknown;
- Known hypersensitivity or allergy to monoclonal antibody;
- Prior therapy with an anti-programmed cell death (PD)-1, anti-PD-L1, anti-PD-L2, anti-tumor necrosis factor CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways);
- Active autoimmune disease, or a documented history of autoimmune disease;
- Treatment with systemic corticosteroids (prednisone≥10mg per day or equivalent dose) or other systemic immunosuppressive medications within 2 weeks prior to the first dose;
- Known history or active human immunodeficiency virus (HIV);
- Known acute or chronic active hepatitis B (HBV DNA positive) infection or acute or chronic active hepatitis C (HCV antibody positive and HCV RNA positive) infection;
- Interstitial lung disease, or history of pneumonitis requiring systemic steroids for treatment;
- Active or poorly controlled severe infection;
- Have serious cardiovascular disease: Symptomatic congestive heart failure (New York Heart Association grade III-IV), unstable angina pectoris, unstable arrhythmia, myocardial infarction or cerebrovascular accident within 3 months before randomization;
- Received thoracic radiation therapy of >30 Gy within 6 months prior to first dose of study drug;
- Completed palliative radiotherapy within 7 days prior to first dose of study drug;
- Pregnant or lactating women.
Sites / Locations
- Department of Medical Oncology, Central Hospital of Yichang City, the First Clinical Medical College of Three Gorges UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Sintilimab plus chemotherapy
Placebo plus chemotherapy
Arm Description
Sintilimab (200 mg) plus chemotherapy (physicians' choice between docetaxel and pemetrexed) every 3 weeks.
Placebo plus chemotherapy (physicians' choice between docetaxel and pemetrexed) every 3 weeks.
Outcomes
Primary Outcome Measures
Compare Overall Survival (OS) between sintilimab +chemotherapy and placebo + chemotherapy.
To compare the efficacy of the combination of sintilimab and chemotherapy versus placebo and chemotherapy in terms of overall survival (OS) in patients with stage IV nonsquamous non-small cell lung cancer with wild-type EGFR after failure with platinum-containing chemotherapy. Overall Survival (OS) was defined as the time from the date of randomization to the date of death due to any cause. Data for participants who were not reported as dead at the time of analysis was censored at the date when they were last known to be alive.
Secondary Outcome Measures
Compare objective response rate between sintilimab +chemotherapy and placebo + chemotherapy.
ORR was defined as the percentage of participants with confirmed objective tumor response, complete response (CR) or partial response (PR), as determined by investigator using RECIST v1.1 criteria.
Compare Progression Free Survival (PFS) between sintilimab +chemotherapy and placebo + chemotherapy using RECIST 1.1.
PFS was defined as the time between the date of randomization and the date of first documented disease progression or death, whichever occurs first. Disease progression was determined based on investigator assessment using response evaluation criteria In solid tumors (RECIST) v1.1.
Compare duration of response between sintilimab +chemotherapy and placebo + chemotherapy.
DOR was defined as the duration from the first tumor assessment that supports the participant's objective response (CR or PR, whichever is first recorded) to disease progression or death due to any cause, whichever occurs first.
Number of Participants who Experience Treatment Related Adverse Events (AEs).
All Adverse Events and Serious Adverse events will be collected and collated according to grade and frequency. AEs graded using CTCAE (Version 4.0) criteria.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03863483
Brief Title
A Study of Sintilimab or Placebo in Combination With Chemotherapy as Second-line Treatment for Patients With Stage IV Nonsquamous Non-small Cell Lung Cancer With Wild-type EGFR After Failure With Platinum-Containing Chemotherapy.
Official Title
A Phase II, Prospective, Single-center, Randomized, Controlled Study to Investigate the Efficacy and Safety of Sintilimab or Placebo in Combination With Chemotherapy as Second-line Treatment for Patients With Stage IV Nonsquamous Non-small Cell Lung Cancer With Wild-type EGFR After Failure With Platinum-Containing Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
March 26, 2019 (Actual)
Primary Completion Date
December 31, 2021 (Anticipated)
Study Completion Date
December 31, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Xin-Hua Xu
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This prospective, single-center, randomized, controlled study will evaluate the efficacy and safety of sintilimab or placebo in combination with chemotherapy as second-line treatment for patients with stage IV nonsquamous non-small cell lung cancer with wild-type EGFR after failure with platinum-containing chemotherapy. Treatment may continue as long as participants are experiencing clinical benefit as assessed by the investigator, i.e., in the absence of unacceptable toxicity or symptomatic deterioration attributed to disease progression.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nonsquamous Non-Small Cell Lung Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
70 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Sintilimab plus chemotherapy
Arm Type
Experimental
Arm Description
Sintilimab (200 mg) plus chemotherapy (physicians' choice between docetaxel and pemetrexed) every 3 weeks.
Arm Title
Placebo plus chemotherapy
Arm Type
Active Comparator
Arm Description
Placebo plus chemotherapy (physicians' choice between docetaxel and pemetrexed) every 3 weeks.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Intervention Description
Sintilimab will be administered intravenously at a fixed dose of 200 milligrams (mg) on Day 1 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
Docetaxel 75 milligrams per square meter (mg/m^2) will be administered intravenously on Day 1 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Intervention Description
Pemetrexed 500 mg/m^2 will be administered intravenously on Day 1 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
0.9% sodium chloride injection as placebo will be administered intravenously at a fixed dose of 100 milliliters (mL) on Day 1 of each 21-day cycle.
Primary Outcome Measure Information:
Title
Compare Overall Survival (OS) between sintilimab +chemotherapy and placebo + chemotherapy.
Description
To compare the efficacy of the combination of sintilimab and chemotherapy versus placebo and chemotherapy in terms of overall survival (OS) in patients with stage IV nonsquamous non-small cell lung cancer with wild-type EGFR after failure with platinum-containing chemotherapy. Overall Survival (OS) was defined as the time from the date of randomization to the date of death due to any cause. Data for participants who were not reported as dead at the time of analysis was censored at the date when they were last known to be alive.
Time Frame
approximately 24 months
Secondary Outcome Measure Information:
Title
Compare objective response rate between sintilimab +chemotherapy and placebo + chemotherapy.
Description
ORR was defined as the percentage of participants with confirmed objective tumor response, complete response (CR) or partial response (PR), as determined by investigator using RECIST v1.1 criteria.
Time Frame
approximately 24 months
Title
Compare Progression Free Survival (PFS) between sintilimab +chemotherapy and placebo + chemotherapy using RECIST 1.1.
Description
PFS was defined as the time between the date of randomization and the date of first documented disease progression or death, whichever occurs first. Disease progression was determined based on investigator assessment using response evaluation criteria In solid tumors (RECIST) v1.1.
Time Frame
approximately 24 months
Title
Compare duration of response between sintilimab +chemotherapy and placebo + chemotherapy.
Description
DOR was defined as the duration from the first tumor assessment that supports the participant's objective response (CR or PR, whichever is first recorded) to disease progression or death due to any cause, whichever occurs first.
Time Frame
approximately 24 months
Title
Number of Participants who Experience Treatment Related Adverse Events (AEs).
Description
All Adverse Events and Serious Adverse events will be collected and collated according to grade and frequency. AEs graded using CTCAE (Version 4.0) criteria.
Time Frame
approximately 24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Volunteer to participate in clinical research; fully understand and know the research and sign informed consent;
Age ≥ 18 years old and ≤ 75 years old, either sex;
Eastern Collaborative Oncology Group Performance status (ECOG PS) 0, 1 or 2;
Has a histologically or cytologically confirmed diagnosis of stage IV (according to the 8th edition of the International Association for the Study of Lung Cancer) nonsquamous NSCLC;
Have at least one measurable lesion as defined by RECIST 1.1;
Has progression of disease after treatment with at least two cycles of a platinum-containing doublet chemotherapy according to RECIST V.1.1;
Patients without activating EGFR mutation;
Normal hepatic function: total bilirubin≤1.5×normal upper limit (ULN); Alanine aminotransferase and Aspartate aminotransferase levels ≤2.5×ULN or ≤5×ULN if liver metastasis is present;
Normal renal function: Creatinine ≤1.5×ULN or calculated creatinine clearance ≥45 mL/min (using Cockcroft/Gault formula to calculate );
Normal hematological function: absolute neutrophil count ≥1.5×109/L, platelet count ≥70×109/L, hemoglobin≥80g/L [no blood transfusion or erythropoietin (EPO) within 7 days] Dependency];
Has a life expectancy of at ≥3 months.
Exclusion Criteria:
ECOG PS >2;
Small cell lung cancer and squamous NSCLC;
EGFR mutation or mutation status unknown;
Known hypersensitivity or allergy to monoclonal antibody;
Prior therapy with an anti-programmed cell death (PD)-1, anti-PD-L1, anti-PD-L2, anti-tumor necrosis factor CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways);
Active autoimmune disease, or a documented history of autoimmune disease;
Treatment with systemic corticosteroids (prednisone≥10mg per day or equivalent dose) or other systemic immunosuppressive medications within 2 weeks prior to the first dose;
Known history or active human immunodeficiency virus (HIV);
Known acute or chronic active hepatitis B (HBV DNA positive) infection or acute or chronic active hepatitis C (HCV antibody positive and HCV RNA positive) infection;
Interstitial lung disease, or history of pneumonitis requiring systemic steroids for treatment;
Active or poorly controlled severe infection;
Have serious cardiovascular disease: Symptomatic congestive heart failure (New York Heart Association grade III-IV), unstable angina pectoris, unstable arrhythmia, myocardial infarction or cerebrovascular accident within 3 months before randomization;
Received thoracic radiation therapy of >30 Gy within 6 months prior to first dose of study drug;
Completed palliative radiotherapy within 7 days prior to first dose of study drug;
Pregnant or lactating women.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xinhua Xu, Master
Phone
+8613986747496
Ext
+8613986747496
Email
2732774352@qq.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yan Wang, Master
Phone
+8615997550081
Ext
+8615997550081
Email
wangyan82033@163.com
Facility Information:
Facility Name
Department of Medical Oncology, Central Hospital of Yichang City, the First Clinical Medical College of Three Gorges University
City
Yichang
State/Province
Hubei
ZIP/Postal Code
443003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xinhua Xu
Phone
+8613986747496
Ext
+8613986747496
Email
2732774352@qq.com
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Study of Sintilimab or Placebo in Combination With Chemotherapy as Second-line Treatment for Patients With Stage IV Nonsquamous Non-small Cell Lung Cancer With Wild-type EGFR After Failure With Platinum-Containing Chemotherapy.
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