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Efficacy and Safety of Selumetinib in Adults With NF1 Who Have Symptomatic, Inoperable Plexiform Neurofibromas (KOMET)

Primary Purpose

Neurofibromatosis 1, Plexiform Neurofibroma (PN)

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Selumetinib
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neurofibromatosis 1 focused on measuring Neurofibromatosis Type 1, NF1, Plexiform Neurofibroma (PN), PNs, Selumetinib, MEK inhibitor

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Adults ≥ 18 years at enrollment with diagnosis of NF1 with symptomatic, inoperable PN
  • At least one inoperable target PN measurable by volumetric MRI analysis
  • Chronic target PN pain score documented for minimum period during screening period
  • Stable chronic PN pain medication use at enrollment
  • Adequate organ and marrow function

Key Exclusion Criteria:

  • Confirmed or suspected malignant glioma or MPNST (low grade glioma, including optic glioma not requiring systemic therapy or radiation therapy are exempt from this exclusion)
  • History of malignancy except for malignancy treated with curative intent with no known active disease ≥ 5 years before the first dose of study intervention and of low potential risk for recurrence
  • Clinically significant cardiovascular disease, including inherited coronary disease, acute coronary syndrome within 6 months prior to enrollment, uncontrolled angina, symptomatic heart failure, cardiomyopathy, severe valvular heart disease, abnormal LVEF and uncontrolled hypertension
  • Ophthalmological findings/conditions including intraocular pressure > 21 mmHg, RPED/CSR or RVO
  • Prior exposure to MEK inhibitors

Sites / Locations

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Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm A

Arm B

Arm Description

Selumetinib

Placebo

Outcomes

Primary Outcome Measures

Confirmed Objective Response Rate (ORR) for Arm A versus Arm B
ORR will be defined as the proportion of patients who have a confirmed complete response or confirmed partial response as determined by ICR per REiNS criteria

Secondary Outcome Measures

Change in chronic target PN pain intensity from baseline for Arm A versus Arm B as assessed using a PRO questionnaire
Difference in mean change from baseline in chronic target PN pain intensity score between Arm A and Arm B, obtained using an NRS-11 scale to assess pain intensity of a target plexiform neurofibroma
Duration of response (DoR) for Arm A
DoR will be defined as the time from the date of first documented response (which is subsequently confirmed) until progression by ICR per REiNS criteria or death due to any cause
Progression Free Survival (PFS) for Arm A
PFS will be defined as the time from first selumetinib dose until date of disease progression by ICR per REiNS criteria or death due to any cause
Time to progression (TTP) for Arm A
TTP is defined as the time from the date of first selumetinib dose until date of disease progression by ICR per REiNS criteria
Time to Response (TTR) for Arm A
TTR is defined as the time from date of first selumetinib dose until the date of objective response by ICR per REiNS criteria
Target PN volume for Arm A vs Arm B
Difference in best percentage change from baseline in target PN volume by ICR per REiNS criteria
Physical functioning assessed using PROMIS physical function items
Difference in change from baseline between Arm A and Arm B
Health Related Quality of Life (HRQoL) outcomes assessed using PlexiQoL
Difference in change from baseline between Arm A and Arm B

Full Information

First Posted
May 14, 2021
Last Updated
August 23, 2023
Sponsor
AstraZeneca
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04924608
Brief Title
Efficacy and Safety of Selumetinib in Adults With NF1 Who Have Symptomatic, Inoperable Plexiform Neurofibromas
Acronym
KOMET
Official Title
A Phase III, Multicentre, International Study With a Parallel, Randomised, Double-blind, Placebo-controlled, 2 Arm Design to Assess the Efficacy and Safety of Selumetinib in Adult Participants With NF1 Who Have Symptomatic, Inoperable Plexiform Neurofibromas (KOMET)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 19, 2021 (Actual)
Primary Completion Date
October 24, 2024 (Anticipated)
Study Completion Date
May 22, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
A global study to demonstrate the effectiveness of selumetinib in participants with NF1 who have symptomatic, inoperable plexiform neurofibromas.
Detailed Description
This is a randomized, double-blind, placebo-controlled, 2 arm multicentre, global Phase III study to assess the efficacy and safety of selumetinib compared with placebo in adult participants with NF1 who have symptomatic, inoperable PN.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neurofibromatosis 1, Plexiform Neurofibroma (PN)
Keywords
Neurofibromatosis Type 1, NF1, Plexiform Neurofibroma (PN), PNs, Selumetinib, MEK inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
146 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Experimental
Arm Description
Selumetinib
Arm Title
Arm B
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Selumetinib
Other Intervention Name(s)
AZD6244
Intervention Description
Selumetinib oral capsules (10 mg and 25 mg)
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo oral capsules for Selumetinib masking (10 mg and 25 mg)
Primary Outcome Measure Information:
Title
Confirmed Objective Response Rate (ORR) for Arm A versus Arm B
Description
ORR will be defined as the proportion of patients who have a confirmed complete response or confirmed partial response as determined by ICR per REiNS criteria
Time Frame
Approximately 3 years
Secondary Outcome Measure Information:
Title
Change in chronic target PN pain intensity from baseline for Arm A versus Arm B as assessed using a PRO questionnaire
Description
Difference in mean change from baseline in chronic target PN pain intensity score between Arm A and Arm B, obtained using an NRS-11 scale to assess pain intensity of a target plexiform neurofibroma
Time Frame
Approximately 3 years
Title
Duration of response (DoR) for Arm A
Description
DoR will be defined as the time from the date of first documented response (which is subsequently confirmed) until progression by ICR per REiNS criteria or death due to any cause
Time Frame
Approximately 3 years
Title
Progression Free Survival (PFS) for Arm A
Description
PFS will be defined as the time from first selumetinib dose until date of disease progression by ICR per REiNS criteria or death due to any cause
Time Frame
Approximately 3 years
Title
Time to progression (TTP) for Arm A
Description
TTP is defined as the time from the date of first selumetinib dose until date of disease progression by ICR per REiNS criteria
Time Frame
Approximately 3 years
Title
Time to Response (TTR) for Arm A
Description
TTR is defined as the time from date of first selumetinib dose until the date of objective response by ICR per REiNS criteria
Time Frame
Approximately 3 years
Title
Target PN volume for Arm A vs Arm B
Description
Difference in best percentage change from baseline in target PN volume by ICR per REiNS criteria
Time Frame
Approximately 3 years
Title
Physical functioning assessed using PROMIS physical function items
Description
Difference in change from baseline between Arm A and Arm B
Time Frame
Approximately 3 years
Title
Health Related Quality of Life (HRQoL) outcomes assessed using PlexiQoL
Description
Difference in change from baseline between Arm A and Arm B
Time Frame
Approximately 3 years
Other Pre-specified Outcome Measures:
Title
Safety and tolerability of selumetinib as assessed by number and grade of adverse events
Description
Adverse events are defined according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0
Time Frame
Approximately 3 years
Title
Pharmacokinetics (PK) of selumetinib for exposure-response analyses
Description
Selumetinib and N-desmethyl selumetinib plasma concentrations assessment
Time Frame
Approximately 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Adults ≥ 18 years at enrollment with diagnosis of NF1 with symptomatic, inoperable PN At least one inoperable target PN measurable by volumetric MRI analysis Chronic target PN pain score documented for minimum period during screening period Stable chronic PN pain medication use at enrollment Adequate organ and marrow function Key Exclusion Criteria: Confirmed or suspected malignant glioma or MPNST (low grade glioma, including optic glioma not requiring systemic therapy or radiation therapy are exempt from this exclusion) History of malignancy except for malignancy treated with curative intent with no known active disease ≥ 5 years before the first dose of study intervention and of low potential risk for recurrence Clinically significant cardiovascular disease, including inherited coronary disease, acute coronary syndrome within 6 months prior to enrollment, uncontrolled angina, symptomatic heart failure, cardiomyopathy, severe valvular heart disease, abnormal LVEF and uncontrolled hypertension Ophthalmological findings/conditions including intraocular pressure > 21 mmHg, RPED/CSR or RVO Prior exposure to MEK inhibitors
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Geraldine O'Sullivan Coyne, MD PhD
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Research Site
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20852
Country
United States
Facility Name
Research Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63156
Country
United States
Facility Name
Research Site
City
Commack
State/Province
New York
ZIP/Postal Code
11725
Country
United States
Facility Name
Research Site
City
Melbourne
ZIP/Postal Code
3000
Country
Australia
Facility Name
Research Site
City
St Leonards
ZIP/Postal Code
2065
Country
Australia
Facility Name
Research Site
City
Porto Alegre
ZIP/Postal Code
90035-903
Country
Brazil
Facility Name
Research Site
City
Ribeirão Preto
ZIP/Postal Code
14051-140
Country
Brazil
Facility Name
Research Site
City
São Paulo
ZIP/Postal Code
045202-001
Country
Brazil
Facility Name
Research Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2C4
Country
Canada
Facility Name
Research Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H4A 3J1
Country
Canada
Facility Name
Research Site
City
Beijing
ZIP/Postal Code
100070
Country
China
Facility Name
Research Site
City
Beijing
ZIP/Postal Code
100730
Country
China
Facility Name
Research Site
City
Guangzhou
ZIP/Postal Code
510060
Country
China
Facility Name
Research Site
City
Shenyang
ZIP/Postal Code
110001
Country
China
Facility Name
Research Site
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
Research Site
City
Lyon
ZIP/Postal Code
69008
Country
France
Facility Name
Research Site
City
Toulouse Cedex 09
ZIP/Postal Code
31059
Country
France
Facility Name
Research Site
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Research Site
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Research Site
City
Würzburg
ZIP/Postal Code
97080
Country
Germany
Facility Name
Research Site
City
Milano
ZIP/Postal Code
20133
Country
Italy
Facility Name
Research Site
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Research Site
City
Roma
ZIP/Postal Code
00165
Country
Italy
Facility Name
Research Site
City
Minato-ku
ZIP/Postal Code
105-8471
Country
Japan
Facility Name
Research Site
City
Nagoya-shi
ZIP/Postal Code
466-8560
Country
Japan
Facility Name
Research Site
City
Shinjuku-ku
ZIP/Postal Code
160-8582
Country
Japan
Facility Name
Research Site
City
Bydgoszcz
ZIP/Postal Code
85-094
Country
Poland
Facility Name
Research Site
City
Gdańsk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Research Site
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Facility Name
Research Site
City
Moscow
ZIP/Postal Code
125412
Country
Russian Federation
Facility Name
Research Site
City
Badalona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Research Site
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Facility Name
Research Site
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
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 Sharing Time Frame
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.
IPD Sharing Access Criteria
When a request has been approved AstraZeneca will provide access to the deidentified 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 Sharing URL
https://astrazenecagroup-dt.pharmacm.com/DT/Home

Learn more about this trial

Efficacy and Safety of Selumetinib in Adults With NF1 Who Have Symptomatic, Inoperable Plexiform Neurofibromas

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