A Study to Evaluate Chemotherapy Plus Osimertinib Against Chemotherapy Plus Placebo in Patients With Non-small Cell Lung Cancer (NSCLC) (COMPEL)
Non-small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Non-small Cell Lung Cancer focused on measuring Osimertinib, Platinum, Pemetrexed, Epidermal growth factor receptor mutation positive (EGFRm), Extracranial progression
Eligibility Criteria
Inclusion Criteria:
- Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol.
- Pathologically confirmed non-squamous NSCLC.
- Locally advanced (clinical stage IIIB or IIIC) or metastatic NSCLC (clinical stage IVA or IVB) or recurrent NSCLC), not amenable to curative surgery or radiotherapy.
- Evidence of radiological extracranial disease progression following response with first-line osimertinib treatment but who have not received further, subsequent treatment.
- World Health Organization performance status of 0 to 1 at screening with no clinically significant deterioration in the previous 2 weeks.
- Life expectancy >12 weeks at Day 1.
- At least 1 lesion, not previously irradiated.
- Females must be using highly effective contraceptive measures, and must have a negative pregnancy test prior to start of dosing if of child-bearing potential, or must have evidence of non-child-bearing potential by fulfilling criteria at screening.
- Male patients must be willing to use barrier contraception
Exclusion Criteria:
- Clinical or radiological evidence of CNS progression on first-line osimertinib.
- Past medical history of ILD (interstitial lung disease)/pneumonitis, drug-induced ILD/pneumonitis, radiation pneumonitis that required steroid treatment, or any evidence of clinically active ILD/pneumonitis.
- Any evidence of severe or uncontrolled extracranial diseases.
Any of the following cardiac criteria:
i) Mean resting QTc >470 msec ii) Any clinically important abnormalities in rhythm, conduction, or morphology of resting electrocardiogram iii) Any factors that increase the risk of QTc prolongation or risk of arrhythmic events
- Any concurrent and/or other active malignancy that has required treatment within 2 years of first dose of investigational product (IP).
- Any unresolved toxicities from prior extracranial therapy.
- 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.
- More than 4 weeks elapsed since last dose of osimertinib by date of randomization.
- Unable to tolerate osimertinib 80 mg first-line therapy.
- Prior treatment with any systemic anti-cancer therapy.
- Major surgery within 4 weeks of the first dose of IP.
- Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of radiation within 4 weeks of the first dose of IP.
- Current use of medications or herbal supplements known to be strong inducers of cytochrome P450 (CYP) 3A4.
- Participation in another clinical study with an IP other than first-line osimertinib.
Sites / Locations
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Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Treatment Arm A
Treatment Arm B
All randomized patients will receive osimertinib 80 mg QD with pemetrexed (500 mg/m^2) (with pre-treatment) plus either cisplatin (75 mg/m^2) or carboplatin ([AUC] 5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by osimertinib 80 mg QD plus pemetrexed maintenance (500 mg/m^2) on Day 1 of 21-day cycles
All randomized patients will receive placebo QD with pemetrexed (500 mg/m^2) (with pre-treatment) plus either cisplatin (75 mg/m^2) or carboplatin (AUC5), both administered on Day 1 of 21-day cycles for 4 cycles, followed by placebo QD plus pemetrexed maintenance (500 mg/m^2) on Day 1 of 21-day cycles