Neoadjuvant Osimertinib + Chemotherapy for EGFR-mutant Stage III NSCLC

Official title

Neoadjuvant Osimertinib Plus Chemotherapy for EGFR-mutant Stage III N2 Non-squamous Non-small Cell Lung Cancer

Overview

This is a phase II, single-arm, multi-center study of neoadjuvant osimertinib in combination with chemotherapy for the treatment of patients with resectable EGFR-mutant stage III (N2) non-squamous non-small cell lung cancer

Interventions

• Drug Osimertinib
  80mg/qd oral for 60 days
• Drug Cisplatin
  Cisplatin (75mg/m2) to be administered with pemetrexed on Day 1 of every 3-week cycle for 2 cycles.
• Drug Pemetrexed
  Pemetrexed (500 mg/m2) to be administered with cisplatin on Day 1 of every 3-week cycle for 2 cycles

Primary outcome measures

• complete lymph node clearance rate [Time frame: From date of enrollment to an average of 12 weeks after the first dose]

Secondary outcome measures (4)

• Major Pathological Response (MPR) [Time frame: From date of enrollment to an average of 12 weeks after the first dose]
• Pathological complete response (pCR) [Time frame: From date of enrollment to an average of 12 weeks after the first dose]
• Downstaging [Time frame: From date of enrollment to an average of 12 weeks after the first dose]
• Disease free survival (DFS) [Time frame: From date of enrollment up to approximately 42 months after date of resection]

Eligibility criteria

Inclusion criteria

• Histologically or cytologically documented N2 positive non-squamous NSCLC with resectable (Stage IIIA or T3-4N2 IIIB) disease (according to Version 8 of the IASLC Cancer Staging Manual \[IASLC Staging Manual in Thoracic Oncology 2016\]).
• Complete surgical resection of the primary NSCLC must be deemed achievable, as assessed by a MDT evaluation (which should include a thoracic surgeon, specialized in oncologic procedures).
• Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1 at enrolment, with no deterioration over the previous 2 weeks prior to baseline or day of first dosing
• A tumour which harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations (ie, T790M, G719X, Exon20 insertions, S7681 and L861Q).

Exclusion criteria

• Past medical history of ILD, drug-induced ILD, radiation pneumonitis which required steroid treatment, or any evidence of clinically active ILD.
• History of another primary malignancy, except for the following: Malignancy treated with curative intent and with no known active disease ≥2 years before the first dose of investigational product (IP) and of low potential risk for recurrence; Adequately treated non-melanoma skin cancer or lentigo malignancy without evidence of disease; Adequately treated carcinoma in situ without evidence of disease
• Patients who have pre-operative radiotherapy treatment as part of their care plan
• Mixed small cell and NSCLC histology
• T4 tumours infiltrating the aorta, the oesophagus and/or the heart; and/or any bulky N2 disease deemed unresectable
• Patients who are candidates to undergo only segmentectomies or wedge resections
• Prior treatment with any systemic anti-cancer therapy for NSCLC including chemotherapy, biologic therapy, immunotherapy, or any investigational drug
• Prior treatment with EGFR-TKI therapy
• Current use of (or unable to stop use prior to receiving the first dose of study treatment) medications or herbal supplements known to be strong inducers of cytochrome P450 (CYP) 3A4 (at least 3 weeks prior)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Questions to ask your doctor

• Is this trial appropriate for my diagnosis and stage?
• What is known about the study treatment and its risks?
• Would participation interfere with my current treatment?
• Which tests are needed to check the eligibility criteria?
• Are there similar trials closer to home?

What information a coordinator may need

• the exact diagnosis and stage (briefly, as in the medical report);
• previous and current treatment with dates;
• recent tests and reports (CT/MRI/PET, pathology) — when the coordinator asks, not in the first request;
• age, country of residence and ability to travel;
• the NCT number of this trial (filled in automatically when you apply from this page).

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• Sun Yat-sen University Cancer Center — Guangzhou

Identifiers

NCT: NCT05011487 · SYSUCC B2021-167-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗