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Non-Small Cell Lung CancerPhase 3INSPIRENCT01015443

Cancer Vaccine Study for Stage III, Unresectable, Non-small Cell Lung Cancer (NSCLC) in the Asian Population

A Phase 3 study testing Tecemotide, Single low dose cyclophosphamide and Saline in people with Non-Small Cell Lung Cancer, run by Merck KGaA, Darmstadt, Germany at 47 sites in 5 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to determine whether the cancer vaccine tecemotide (L-BLP25) in addition to best supportive care is effective in prolonging the lives of Asian subjects with unresectable stage III non-small cell lung cancer in comparison to a placebo plus best supportive care (a so-called placebo… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-Small Cell Lung Cancer
What is being tested?
Tecemotide, Single low dose cyclophosphamide and Saline
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
285 participants
Where
47 sitesin 5 countries
Study dates
Dec 2009to Jun 2015
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically documented unresectable stage III non-small cell lung cancer (NSCLC)
  • Documented stable disease or objective response, according to Response Evaluation Criteria In Solid Tumors Version 1.0 (RECIST v1.0) after primary concomitant chemo-radiotherapy for unresectable stage III disease, within four weeks (28 days) prior to randomization
  • Receipt of concomitant chemo-radiotherapy. The chemotherapy-part must have been platinum-based, must have been administered with a minimum of two cycles overlap with radiotherapy (one cycle lasts either 3 or 4 weeks depending on the chemotherapy regimen), and a minimum of two platinum-based chemotherapy administrations must have been given during radiotherapy. Purely radio sensitizing doses of chemotherapy are not acceptable. Radiotherapy must have delivered a radiation dose of >= (greater than or equal to) 50 Gray (Gy). Induction or consolidation chemotherapy is allowed and if given, should be accounted as part of primary thoracic chemoradiotherapy. Subjects must have completed the primary thoracic chemo-radiotherapy at least four weeks (28 days) and no later than 12 weeks (84 days) prior to randomization. Subjects who received prophylactic brain irradiation as part of primary chemo-radiotherapy are eligible
  • Geographically accessible for ongoing follow-up, and committed to comply with the designated visits
  • An Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • A platelet count >= the lower limit of normal for the site or >= 100 x 10^9 per liter (/Liter) (whichever is greater); white blood cell (WBC) >= 2.5 x 10^9/Liter and haemoglobin >= 90 gram per liter (g/L)
  • >=18 years of age (or minimum age of legal consent consistent with local regulations, if minimum is greater than [>] 18 years of age)
  • Other protocol defined inclusion criteria could apply

Who cannot join

  • Pre-Therapies:
  • Prior sequential chemo-radiotherapy
  • Lung-cancer-specific therapy (including surgery) other than primary chemoradiotherapy
  • Immunotherapy (e.g., interferons, tumor necrosis factor [TNF], interleukins, or biological response modifiers [granulocyte macrophage colony stimulating factor {GMCSF}, granulocyte colony stimulating factor {G-CSF}, macrophage-colony stimulating factor {M-CSF}], monoclonal antibodies) within four weeks (28 days) prior to randomization
  • Investigational systemic drugs (including off-label use of approved products) within four weeks (28 days) prior to randomization
  • Disease Status:
Show all 28Show fewer
  • Metastatic disease
  • Malignant pleural effusion at initial diagnosis and/or at trial entry
  • Past or current history of neoplasm other than lung carcinoma, except for curatively treated non-melanoma skin cancer, in situ carcinoma of the cervix, or other cancer curatively treated and with no evidence of disease for at least 5 years
  • Autoimmune disease
  • A recognized immunodeficiency disease including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia; subjects who have hereditary or congenital immunodeficiencies
  • Any preexisting medical condition requiring chronic steroid or immunosuppressive therapy (steroids for the treatment of radiation pneumonitis are allowed)
  • Known active Hepatitis B infection and/or Hepatitis C infection
  • Signs and symptoms suggestive of transmissible spongiform encephalopathy, or of family members who suffer(ed) from such
  • Physiological Functions:
  • Clinically significant hepatic dysfunction
  • Clinically significant renal dysfunction
  • Clinically significant cardiac disease
  • Splenectomy
  • Infectious process that in the opinion of the investigator could compromise the subject's ability to mount an immune response
  • Standard Safety:
  • Pregnant or breastfeeding women, women of childbearing potential, unless using effective contraception as determined by the investigator
  • Known drug abuse or alcohol abuse
  • Participation in another clinical trial (excluding purely observational studies) within the past 28 days
  • Requires concurrent treatment with a non-permitted drug
  • Known hypersensitivity to any of the trial treatment ingredients
  • Legal incapacity or limited legal capacity
  • Any other reason that, in the opinion of the investigator precludes the subject from participating in the trial

Trial locations and contacts

47 sites in 5 countries.

47 sites in 5 countries

China29 sites
  • 307 Hospital of Chinese PLA

    Beijing

  • Beijing Cancer Hospital

    Beijing

  • Beijing Chest Hospital

    Beijing

  • Cancer Institue & Hospital, Chinese Academy of Medical Sciences

    Beijing

  • The First Hospital of Jilin University

    Changchun, 130021

  • Jillin Provincial Cancer Hospital

    Changchun

  • West China Hospital of Sichuan University

    Chengdu, Sichuan Province

  • Southwest Hospital of the Third Military Medical University

    Chongqing

  • The Second Affiliate Hospital of the Third Military Medical University

    Chongqing

  • Fujian Province Tumor Hospital

    Fuzhou

  • Guangdong General Hospital

    Guangzhou

  • The First Affilated Hospital of Guangzhou Medical College

    Guangzhou

  • Heilongjiang Cancer Hospital

    Haerbin

  • China PLA General Hospital

    Haidian Districk, Beijing

  • Sir Run Run Shaw Hospital

    Hangzhou, Zhejiang

  • Zhejiang Cancer Hospital

    Hangzhou, Zhejiang

  • The First Affiliated Hospital of Anhui Medical University

    Hefei

  • Yunan Tumor Hospital

    Kunming

  • The First Affiliated Hospital of Nanchang University

    Nanchang

  • PLA 81 Hospital

    Nanjing

  • Jiangsu Cancer Hospital

    Nanjing, Jiangsu

  • Fundan University Cancer Hospital

    Shanghai

  • Shangahi Pulmonary Hosptial

    Shanghai

  • Shanghai Chest Hospital

    Shanghai

  • Shanghai Chest Hosptial

    Shanghai

  • Cancer Hospital of Shantou University Medical College

    Shantou

  • Tongji Hospital of Tongji Medical Colleague of Huazhong University of Science and Technology

    Wuhan

  • Peking Union Medical College Hospital

    XiCheng District, Beijing

  • Subei People's Hospital

    Yangzhou

Other trials in China

Taiwan9 sites
  • Kaohsiung Medical University Chung-Ho Memorial Hospital

    Kaohsiung City

  • Chang Gung Medical Foundation, Kaohsiung

    Kaohsiung County

  • China Medical University Hospital

    Taichung

  • Taichung Veterans General Hospital

    Taichung

  • National Cheng Kung University Hospital

    Tainan

  • Chi Mei Hospital, Liouying

    Tainan County

  • National Taiwan University Hospital

    Taipei

  • Taipei Veterans General Hospital, Dept of Chest

    Taipei

  • Chang Gung medical Foundation, Linkou Branch

    Taoyuan

Other trials in Taiwan

Hong Kong4 sites
  • Queen Elizabeth Hospital

    Kowloon

  • Tuen Mun Hospital

    New Territories

  • Queen Mary Hospital

    Pok Fu Lam

  • Prince of Wales Hospital

    Shatin, N.T.

Other trials in Hong Kong

South Korea4 sites
  • Samsung Medical Center

    Seoul

  • Seoul National University Hospital

    Seoul

  • Severance Hospital, Yonsi University College of Medicine

    Seoul

  • St. Mary's Hospital, The Catholic University of Korea

    Seoul

Other trials in South Korea

Singapore1 site
  • National University Hospital

    Singapore

Other trials in Singapore

About this study

Official title: A Multi-national, Double-blind, Placebo-controlled, Randomized, Phase III Clinical Trial of the Cancer Vaccine Stimuvax® (L-BLP25 or BLP25 Liposome Vaccine) in Asian Subjects With Stage III, Unresectable, Non-small Cell Lung Cancer (NSCLC) Who Have Demonstrated Either Stable Disease or Objective Response Following Primary Chemo-radiotherapy

The purpose of this study is to determine whether the cancer vaccine tecemotide (L-BLP25) in addition to best supportive care is effective in prolonging the lives of Asian subjects with unresectable stage III non-small cell lung cancer in comparison to a placebo plus best supportive care (a so-called placebo controlled study).

Being tested
Tecemotide, Single low dose cyclophosphamide, Placebo, Saline, Best Supportive Care (BSC)
Keywords
Non-Small Cell Lung Carcinoma, Tecemotide, L-BLP25, Cyclophosphamide, placebo controlled, Non-Small Cell Lung Cancer
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TecemotideBiological

    Also called L-BLP25, Stimuvax

    Subjects will receive 8 consecutive weekly subcutaneous vaccinations with 918 microgram (mcg) of tecemotide (L-BLP25) at Week 1, 2, 3, 4, 5, 6, 7, and 8 (primary treatment phase) and then at 6-Week intervals, beginning at Week 14 (maintenance phase) until disease progression (PD) is documented or the subject discontinues for any other reason.

  • Single low dose cyclophosphamideDrug

    A single intravenous (IV) infusion of 300 milligram per square meter (mg/m^2) (to a maximum 600 mg) of cyclophosphamide will be given 3 days before the first administration of tecemotide.

  • PlaceboDrug

    Subjects will receive 8 consecutive weekly subcutaneous vaccinations of tecemotide (L-BLP25) matching placebo at Week 1, 2, 3, 4, 5, 6, 7 and 8 followed by maintenance treatment at 6-Week intervals, beginning at Week 14, until PD is documented or the subject discontinues for any other reason.

  • SalineOther

    A single IV infusion of 0.9 percent (%) sodium chloride (saline) will be given 3 days before first placebo vaccination.

  • Best Supportive Care (BSC)Other

    The BSC will be provided as per the investigator's discretion, and is not limited to palliative radiation, psychosocial support, analgesics and nutritional support.

Study groups in NCT01015443
Study groupRoleWhat they receive
Investigational ArmExperimentalTecemotide (L-BLP25) + Single low dose cyclophosphamide + Best supportive care (BSC)
Receives: Biological: Tecemotide; Drug: Single low dose cyclophosphamide; Other: Best Supportive Care (BSC)
Control ArmPlacebo comparatorSaline + Placebo + Best supportive care (BSC)
Receives: Drug: Placebo; Other: Saline; Other: Best Supportive Care (BSC)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Survival (OS) Time

    OS time was measured as the time (in months) between the date of randomization and the date of death. For subjects alive or lost to follow-up at time of analysis, the time between the date of randomization and the date on which the subject was last known alive was calculated and used as a censored observation in the analysis.

    Measured: From the date of randomization until death, assessed up to 5.6 years

Secondary outcomes (5)
  1. Time to Symptom Progression (TTSP)

    TTSP was measured from randomization to symptomatic progression by lung cancer symptom scale (LCSS) used to measure symptom changes relevant to quality of life (QoL).It consisted of 9 items focused on cancer symptoms (loss of appetite, fatigue, cough, shortness of breath, blood in sputum, pain, symptoms of cancer, illness affecting normal activity, QoL).For each symptom score distance from left boundary to point where subject has marked line was measured in millimeters (mm).Total scale length was 100 mm. Symptomatic progression was defined as increase/worsening of average symptomatic burden index (ASBI) (mean of 6 major lung cancer specific symptom scores);Worsening defined as 10% increase of scale breadth from baseline. Score 0 indicate no/minimum symptoms;100 indicates maximum level of symptoms. Subjects without symptomatic progression/lost to follow-up at time of analysis: time from date of randomization to date of last LCSS assessment was calculated \& used as censored observation.

    Measured: From the date of randomization to the date of symptomatic progression, assessed up to 5.6 years

  2. Time to Progression (TTP)

    Time from randomization to radiological confirmation of disease progression (PD) as determined by the investigator. PD was defined as at least a 20% increase in the sum of the longest diameter of target lesions from nadir, or the appearance of one or more new lesions as per RECIST version 1.0. For subjects without radiological confirmed PD who discontinued or died due to PD, the date of trial treatment discontinuation was used as event date. Subjects who missed 2 consecutive scheduled doses without evaluable assessment for the related visits and who were lost to follow-up thereafter were considered as having PD, TTP was calculated from the date of randomization to the date of their first missed treatment. Subjects without PD at time of analysis are censored at either date of last vaccination or death or discontinuation of treatment or lost to follow-up.

    Measured: From the date of randomization to the date of radiological confirmation of PD, assessed up to 5.6 years

  3. Progression Free Survival (PFS)

    Time from randomization to objective disease progression (PD) as determined by the investigator or death. PD was defined as at least a 20% increase in the sum of the longest diameter of target lesions from nadir, or the appearance of one or more new lesions as per RECIST version 1.0. Subjects who missed 2 consecutive scheduled doses without evaluable assessment for the related visits and who were lost to follow-up thereafter were considered as having PD, and the PFS was calculated from the date of randomization to the date of their first missed treatment. PFS time for subjects without an event was censored as of the date of last performed imaging.

    Measured: From the date of randomization to PD, assessed up to 5.6 years

  4. Time to Treatment Failure (TTF)

    TTF was time from randomization to discontinuation of trial treatment for any reason as reported by the investigator. For subjects still receiving treatment at the time of analysis, the time between the date of randomization and the last date of treatment will be used as a censored observation in the analysis. Subjects who missed 2 consecutive scheduled doses without evaluable assessment for the related visits and who were lost to follow-up thereafter were considered treatment failure and the TTF was calculated from the date of randomization to the date of their first missed treatment.

    Measured: From the date of randomization to the date of first missed treatment, assessed up to 5.6 years

  5. Number of Subjects With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs Leading to Discontinuation and TEAEs Leading to Death

    An Adverse Event (AE) was defined as any new untoward medical occurrences/worsening of pre-existing medical condition without regard to possibility of causal relationship. A Serious Adverse Event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. TEAEs were defined as the AEs that occur between first dose of study drug administration and 42 days after the last dose of study drug administration that were absent before treatment or that worsened relative to pretreatment state. Number of subjects with TEAE leading to death and permanent discontinuation of any trial treatment were presented.

    Measured: From the first dose of study drug administration until 42 days after the last dose of study drug administration, assessed up to 5.6 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Nov 2009 (estimated)
  2. Study startDec 2009
  3. Primary completionJun 2015
  4. Study completionJun 2015

Why it stopped: The study is terminated prematurely as the sponsor decided to discontinue program with Tecemotide in NSCLC.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
285 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01015443
Sponsor's protocol ID
EMR63325-012
Acronym
INSPIRE
Status last verified
Sep 2016
First submitted
1 Oct 2009
Last updated
26 Oct 2016
Data monitoring committee
Yes

Publications

  • Zhu J, Yuan Y, Wan X, Yin D, Li R, Chen W, Suo C, Song H. Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent. Cochrane Database Syst Rev. 2021 Dec 6;12(12):CD011300. doi: 10.1002/14651858.CD011300.pub3.

    PubMed 34870327
  • Wu YL, Park K, Soo RA, Sun Y, Tyroller K, Wages D, Ely G, Yang JC, Mok T. INSPIRE: A phase III study of the BLP25 liposome vaccine (L-BLP25) in Asian patients with unresectable stage III non-small cell lung cancer. BMC Cancer. 2011 Oct 7;11:430. doi: 10.1186/1471-2407-11-430.

    PubMed 21982342

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tecemotide, Single low dose cyclophosphamide and Saline in people with Non-Small Cell Lung Cancer, run by Merck KGaA, Darmstadt, Germany at 47 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 26 Oct 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 47 sites in China, Taiwan, Hong Kong, South Korea, Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Aug 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Survival (OS) Time (time frame: From the date of randomization until death, assessed up to 5.6 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01015443, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2016.

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