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Non-Small Cell Lung CancerPhase 3IMPRESSNCT01544179

A Study of IRESSA Treatment Beyond Progression in Addition to Chemotherapy Versus Chemotherapy Alone

A Phase 3 study testing Gefitinib, Pemetrexed and Cisplatin in people with Non-Small Cell Lung Cancer, run by AstraZeneca at 61 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the efficacy and safety of gefitinib in patients who have progressed on first line gefitinib, comparing continuing gefitinib in addition to cisplatin plus pemetrexed combination chemotherapy versus cisplatin plus pemetrexed combination chemotherapy alone. Read more about this study

Who is it for?
Ages 18 to 130 years
Conditions the study is for
Non-Small Cell Lung Cancer
What is being tested?
Gefitinib, Pemetrexed and Cisplatin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
265 participants
Where
61 sitesin 11 countries
Study dates
15 Mar 2012to 20 Nov 2019
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 to 130 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female patients aged 18 years or older (For Japan only- male or female patients aged 20 years or older)
  • Cytological or histological confirmation of NSCLC other than predominantly squamous cell histology with an activating EGFR TK mutation as determined locally
  • Patients with documented 'acquired resistance' on first line gefitinib
  • Patients suitable to start cisplatin based pemetrexed combination chemotherapy.
  • Provision of informed consent prior to any study specific procedures.

Who cannot join

  • Prior chemotherapy or other systemic anti-cancer treatment (excluding gefitinib). Palliative bone radiotherapy must be completed at least 2 weeks before start of study treatment with no persistent radiation toxicity).
  • Past medical history of interstitial lung disease, drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease
  • Other co-existing malignancies or malignancies diagnosed within the last 5 years, with the exception of basal cell carcinoma or cervical cancer in situ or completely resected intramucosal gastric cancer
  • Any evidence of severe of uncontrolled systemic disease Treatment with an investigational drug within 4 weeks before randomization

Trial locations and contacts

61 sites in 11 countries.

61 sites in 11 countries

China25 sites
  • Research Site

    Beijing, 100020

  • Research Site

    Beijing, 100021

  • Research Site

    Beijing, 100071

  • Research Site

    Beijing, 100730

  • Research Site

    Beijing, 100853

  • Research Site

    Beijing, 101149

  • Research Site

    Changchun, 130012

  • Research Site

    Changchun, 130021

  • Research Site

    Chengdu, 610041

  • Research Site

    Chengdu, 610042

  • Research Site

    Dalian, 116011

  • Research Site

    Guangzhou, 510000

  • Research Site

    Guangzhou, 510120

  • Research Site

    Hangzhou, 310003

  • Research Site

    Kunming, 650118

  • Research Site

    Nanjing, 210002

  • Research Site

    Shanghai, 200030

  • Research Site

    Shanghai, 200032

  • Research Site

    Shenyang, 110001

  • Research Site

    Shijiazhuang, 050011

  • Research Site

    Suzhou, 215004

  • Research Site

    Taiyuan, 030000

  • Research Site

    Ürümqi, 830000

  • Research Site

    Wuhan, 430022

  • Research Site

    Xi'an, 710061

Other trials in China

Italy7 sites
  • Research Site

    Genova, 16100

  • Research Site

    Parma, 43126

  • Research Site

    Perugia, 06132

  • Research Site

    Pisa, 56124

  • Research Site

    Roma, 00128

  • Research Site

    Roma, 00144

  • Research Site

    Rozzano, 20089

Other trials in Italy

Spain7 sites
  • Research Site

    Barcelona, 08003

  • Research Site

    Barcelona, 08025

  • Research Site

    Madrid, 28041

  • Research Site

    Majadahonda, 28222

  • Research Site

    Málaga, 29010

  • Research Site

    Seville, 41009

  • Research Site

    Zaragoza, 50009

Other trials in Spain

France5 sites
  • Research Site

    Clermont-Ferrand, 63003

  • Research Site

    Lille, 59037

  • Research Site

    Lyon, 69373

  • Research Site

    Paris, 75020

  • Research Site

    Villejuif, 94805

Other trials in France

Japan5 sites
  • Research Site

    Fukuoka, 811-1395

  • Research Site

    Kashiwa, 277-8577

  • Research Site

    Sakaishi, 591-8555

  • Research Site

    Sayama, 589-8511

  • Research Site

    Sunto-gun, 411-8777

Other trials in Japan

Germany3 sites
  • Research Site

    Hamburg, 21075

  • Research Site

    Löwenstein, 74245

  • Research Site

    Würzburg, 97067

Other trials in Germany

Hong Kong2 sites
  • Research Site

    Hong Kong

  • Research Site

    Shatin

Other trials in Hong Kong

Hungary2 sites
  • Research Site

    Budapest, 1121

  • Research Site

    Budapest, 1145

Other trials in Hungary

South Korea2 sites
  • Research Site

    Seoul, 05505

  • Research Site

    Seoul, 135-710

Other trials in South Korea

Taiwan2 sites
  • Research Site

    Taichung, 40705

  • Research Site

    Taipei, 10002

Other trials in Taiwan

Russia1 site
  • Research Site

    Saint Petersburg, 197022

Other trials in Russia

About this study

Official title: A Phase III Randomised, Double Blind, Placebo Controlled, Parallel, Multicentre Study to Assess the Efficacy and Safety of Continuing IRESSA 250 mg in Addition to Chemotherapy Versus Chemotherapy Alone in Patients Who Have Epidermal Growth Factor Receptor (EGFR) Mutation Positive Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) and Have Progressed on First Line IRESSA

The purpose of this study is to assess the efficacy and safety of gefitinib in patients who have progressed on first line gefitinib, comparing continuing gefitinib in addition to cisplatin plus pemetrexed combination chemotherapy versus cisplatin plus pemetrexed combination chemotherapy alone.

Read the detailed description

A Phase III Randomised, Double blind, Placebo controlled, Parallel, Multicentre Study to Assess the Efficacy and Safety of continuing IRESSA 250 mg in addition to Chemotherapy versus Chemotherapy alone in Patients who have Epidermal Growth Factor Receptor (EGFR) Mutation Positive Locally advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) and have progressed on First Line IRESSA.

Being tested
Gefitinib, Placebo, Pemetrexed, Cisplatin
Keywords
Non Small Cell Lung Cancer, Gefitinib, Pemetrexed, Treatment Beyond Progression
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.

  • GefitinibDrug

    Investigational Drug

  • PlaceboDrug

    Matching placebo as comparator

  • PemetrexedDrug

    Chemotherapy (concomitant therapy)

  • CisplatinDrug

    Chemotherapy (concomitant therapy)

Study groups in NCT01544179
Study groupRoleWhat they receive
GefitinibExperimentalGefitinib and cisplatin plus pemetrexed combination chemotherapy
Receives: Drug: Gefitinib; Drug: Pemetrexed; Drug: Cisplatin
PlaceboPlacebo comparatorPlacebo and cisplatin plus pemetrexed combination chemotherapy.
Receives: Drug: Placebo; Drug: Pemetrexed; Drug: Cisplatin

What is being measured

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

  1. Progression-Free Survival (Site Read, Investigator Assessment)

    PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.

    Measured: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks

  2. Median Progression-Free Survival (Site Read, Investigator Assessment)

    PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.

    Measured: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks

Secondary outcomes (10)
  1. Overall Survival (OS)

    OS is the time from the date of randomisation until death due to any cause. Any subject not known to have died at the time of analysis will be censored based on the last recorded date on which the subject was known to be alive.

    Measured: Following progression survival data was collected every 8 weeks until documentation of death, withdrawal of consent, loss to follow-up or the final data cut-off, whichever occurs first.

  2. Median Overall Survival (OS) at Time of PFS Analysis

    Measured: Baseline and then every 6 weeks after randomization until objective disease progression. OS is then assessed 8 weekly following PFS progression up to PFS analysis data cut off.

  3. Objective Response Rate (ORR) (Site Read Data)

    ORR rate is defined as the number (%) of subjects with at least one visit response of Complete Response (CR) or Partial Response (PR) , as defined by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) for target lesions and assessed by CT or MRI. CR, Disappearance of all target lesions; PR, ≥30% decrease in the sum of the longest diameter of target lesions. Data obtained up until progression, or last evaluable assessment in the absence of progression, was included in the assessment of ORR.

    Measured: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.

  4. Disease Control Rate (DCR)

    DCR is the percentage of patients who achieve disease control at 6 weeks following randomisation. DCR is defined as a Best Objective Response (BOR) of Complete Response, Partial Response or Stable Disease, as defined by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) for target lesions and assessed by CT or MRI. CR, Disappearance of all target lesions; PR, ≥30% decrease in the sum of the longest diameter of target lesions; SD, neither sufficient shrinkage to qualify for PR not sufficient increase to qualify for Progressive Disease (PD); PD, ≥20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, and the sum must have shown an absolute increase of ≥5mm

    Measured: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.

  5. Improvement in Trial Outcome Index

    An improvement is defined as a change from baseline of ≥ +6 (0-84 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire.

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

  6. Time to Worsening in Trial Outcome Index

    A worsening is defined as a change from baseline of ≤ -6 (0-84 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

  7. Improvement in FACT-L Total Score

    An improvement is defined as a change from baseline of ≥ +6 (0-136 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

  8. Time to Worsening in FACT-L Total Score

    A worsening is defined as a change from baseline of ≤ -6 (0-136 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

  9. Improvement in Lung Cancer Subscale

    An improvement is defined as a change from baseline of ≥ +2 (0-28 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

  10. Time to Worsening in Lung Cancer Subscale

    A worsening is defined as a change from baseline of ≤ -2 (0-28 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

    Measured: At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

Timeline

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

  1. First posted5 Mar 2012 (estimated)
  2. Study start15 Mar 2012
  3. Primary completion5 May 2014
  4. Study completion20 Nov 2019

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
265 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01544179
Sponsor's protocol ID
D791LC00001
Acronym
IMPRESS
Status last verified
Sep 2020
First submitted
15 Feb 2012
Last updated
25 Sep 2020
Data monitoring committee
Yes

Publications

  • Soria JC, Wu YL, Nakagawa K, Kim SW, Yang JJ, Ahn MJ, Wang J, Yang JC, Lu Y, Atagi S, Ponce S, Lee DH, Liu Y, Yoh K, Zhou JY, Shi X, Webster A, Jiang H, Mok TS. Gefitinib plus chemotherapy versus placebo plus chemotherapy in EGFR-mutation-positive non-small-cell lung cancer after progression on first-line gefitinib (IMPRESS): a phase 3 randomised trial. Lancet Oncol. 2015 Aug;16(8):990-8. doi: 10.1016/S1470-2045(15)00121-7. Epub 2015 Jul 6.

    PubMed 26159065

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Gefitinib, Pemetrexed and Cisplatin in people with Non-Small Cell Lung Cancer, run by AstraZeneca at 61 sites in 11 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 5 inclusion and 4 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: finished, as of the sponsor's last update on 25 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 61 sites in China, Italy, Spain, France, Japan and 6 more countries. 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 15 Feb 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?

Progression-Free Survival (Site Read, Investigator Assessment) (time frame: Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks). The study lists 2 primary outcomes in all. 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 NCT01544179, which also lists 1 linked publication.

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 25 Sep 2020.

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