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AzTrials

Non Small Cell Lung Carcinoma NSCLCPhase 3NEPTUNENCT02542293

Study of Durvalumab With Tremelimumab Versus SoC as 1st Line Therapy in Metastatic Non Small-Cell Lung Cancer (NSCLC) (NEPTUNE)

A Phase 3 study testing Durvalumab +Tremelimumab, Paclitaxel + carboplatin and Gemcitabine + cisplatin in people with Non Small Cell Lung Carcinoma NSCLC, run by AstraZeneca at 210 sites in 29 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record

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Trial summary

This is a randomized, open-label, multi-center, global, Phase III study to determine the efficacy and safety of durvalumab + tremelimumab combination therapy versus platinum-based SoC chemotherapy in the first-line treatment of patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK)… Read more about this study

Who is it for?
Ages 18 to 130 years
Conditions the study is for
Non Small Cell Lung Carcinoma NSCLC
What is being tested?
Durvalumab +Tremelimumab, Paclitaxel + carboplatin and Gemcitabine + cisplatin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
953 participants
Where
210 sitesin 29 countries
Study dates
3 Nov 2015to 31 Dec 2026
Phase
Phase 3

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

  • For inclusion in the study, patients should fulfill the following criteria:
  • Aged at least 18 years
  • Documented evidence of Stage IV NSCLC
  • No activating EGFR mutation or ALK rearrangement
  • No prior chemotherapy or any other systemic therapy for recurrent/metastatic NSCLC
  • World Health Organization (WHO) Performance Status of 0 or 1
  • No Prior exposure to Immune Mediated Therapy (IMT), including, but not limited to, other antiCTLA4, antiPD1, anti PDL1,or antiPDL2 antibodies, excluding therapeutic anticancer vaccines

Who cannot join

  • Patients should not enter the study if any of the following exclusion criteria are fulfilled:
  • Mixed small cell lung cancer and NSCLC histology, sarcomatoid variant
  • Brain metastases or spinal cord compression unless the patient is stable (asymptomatic; no evidence of new or emerging brain metastases) and off steroids for at least 14 days prior to start of study treatment.
  • Active or prior documented autoimmune or inflammatory disorders (e.g., Crohn's disease, ulcerative colitis)

Trial locations and contacts

210 sites in 29 countries.

210 sites in 29 countries

Japan27 sites
  • Research Site

    Bunkyō City, 160-0023

  • Research Site

    Fukushima, 960-1295

  • Research Site

    Habikino-shi, 583-8588

  • Research Site

    Hirosaki-shi, 036-8545

  • Research Site

    Iizuka-shi, 820-8505

  • Research Site

    Iwakuni-shi, 740-8510

  • Research Site

    Kanazawa, 920-8641

  • Research Site

    Kishiwada-shi, 596-8501

  • Research Site

    Kobe, 650-0047

  • Research Site

    Kurume-shi, 830-0011

  • Research Site

    Kyoto, 607-8062

  • Research Site

    Mitaka-shi, 181-8611

  • Research Site

    Nagaoka-shi, 940-2085

  • Research Site

    Nagoya, 460-0001

  • Research Site

    Nagoya, 466-8560

  • Research Site

    Niigata, 951-8566

  • Research Site

    Okayama, 700-8607

  • Research Site

    Osaka, 541-8567

  • Research Site

    Saga, 840-8571

  • Research Site

    Sagamihara-shi, 252-0375

  • Research Site

    Sakaishi, 591-8555

  • Research Site

    Sendai, 980-0873

  • Research Site

    Tokushima, 770-8503

  • Research Site

    Ube-shi, 755-0241

  • Research Site

    Wakayama, 641-8510

  • Research Site

    Yokohama, 236-0004

  • Research Site

    Yokohama, 241-8515

Other trials in Japan

United States15 sites
  • Research Site

    Albuquerque, New Mexico, 87102

  • Research Site

    Anaheim, California, 92801

  • Research Site

    Canton, Ohio, 44710

  • Research Site

    Columbus, Ohio, 43219

  • Research Site

    East Setauket, New York, 11733

  • Research Site

    Florham Park, New Jersey, 07932

  • Research Site

    Fresh Meadows, New York, 11366

  • Research Site

    Houston, Texas, 77090

  • Research Site

    Louisville, Kentucky, 40202

  • Research Site

    Pittsburgh, Pennsylvania, 15212

  • Research Site

    Poughkeepsie, New York, 12601

  • Research Site

    San Diego, California, 92123

  • Research Site

    Santa Rosa, California, 95403

  • Research Site

    Stony Brook, New York, 11794

  • Research Site

    Zanesville, Ohio, 43701

Other trials in United States

Brazil14 sites
  • Research Site

    Barretos, 14784-400

  • Research Site

    Belo Horizonte, 30110-022

  • Research Site

    Belo Horizonte, 30380-472

  • Research Site

    Fortaleza, 60336-045

  • Research Site

    Ijuí, 98700-000

  • Research Site

    Itajaí, 88301-220

  • Research Site

    Porto Alegre, 90035-003

  • Research Site

    Porto Alegre, 90160-093

  • Research Site

    Porto Alegre, 91350-200

  • Research Site

    São José do Rio Preto, 15090-000

  • Research Site

    São Paulo, 01221-020

  • Research Site

    São Paulo, 01246-000

  • Research Site

    São Paulo, 01323 900

  • Research Site

    São Paulo, 03102-002

Other trials in Brazil

Ukraine14 sites
  • Research Site

    Chernivtsі, 58013

  • Research Site

    Dnipro, 49102

  • Research Site

    Ivano-Frankivsk, 76018

  • Research Site

    Kapitanivka Village, 08111

  • Research Site

    Kharkiv Region, 61070

  • Research Site

    Kirovohrad, 25006

  • Research Site

    Kyiv, 03115

  • Research Site

    Kyiv, 04107

  • Research Site

    Liutizh, 07352

  • Research Site

    Lviv, 79031

  • Research Site

    Odesa, 65055

  • Research Site

    Sumy, 40022

  • Research Site

    Uzhhorod, 88000

  • Research Site

    Vinnytsia, 21029

Other trials in Ukraine

China10 sites
  • Research Site

    Beijing, 100142

  • Research Site

    Changchun, 130000

  • Research Site

    Chongqing, 400030

  • Research Site

    Guangzhou, 510100

  • Research Site

    Hangzhou, 310022

  • Research Site

    Shanghai, 200030

  • Research Site

    Shanghai, 200032

  • Research Site

    Ürümqi, 830000

  • Research Site

    Wuhan, 430022

  • Research Site

    Wuhan, 430030

Other trials in China

Poland10 sites
  • Research Site

    Bydgoszcz, 85-796

  • Research Site

    Kielce, 25-734

  • Research Site

    Krakow, 31-202

  • Research Site

    Lodz, 93-513

  • Research Site

    Mrozy, 05-320

  • Research Site

    Olsztyn, 10-357

  • Research Site

    Poznan, 60-569

  • Research Site

    Warsaw, 01-138

  • Research Site

    Warsaw, 02-781

  • Research Site

    Wodzisław Śląski, 44-300

Other trials in Poland

Russia9 sites
  • Research Site

    Moscow, 105229

  • Research Site

    Moscow, 115280

  • Research Site

    Moscow, 125367

  • Research Site

    Omsk, 644013

  • Research Site

    Saint Petersburg, 194291

  • Research Site

    Saint Petersburg, 197022

  • Research Site

    Saint Petersburg, 197183

  • Research Site

    Saint Petersburg, 197342

  • Research Site

    Saint Petersburg, 197758

Other trials in Russia

Turkey (Türkiye)9 sites
  • Research Site

    Adana, 01120

  • Research Site

    Ankara, 06200

  • Research Site

    Ankara, 06230

  • Research Site

    Ankara, 06280

  • Research Site

    Ankara, 6500

  • Research Site

    Istanbul, 31755

  • Research Site

    Istanbul, 34030

  • Research Site

    Istanbul, 34349

  • Research Site

    Izmir, 35100

Other trials in Turkey (Türkiye)

United Kingdom9 sites
  • Research Site

    Guildford

  • Research Site

    London, EC1M 6BQ

  • Research Site

    London, NW1 2PG

  • Research Site

    London, W6 8RF

  • Research Site

    Manchester, M20 4BX

  • Research Site

    Metropolitan Borough of Wirral, CH63 4JY

  • Research Site

    Nottingham, NG5 1PB

  • Research Site

    Taunton, TA1 5DA

  • Research Site

    Wolverhampton, WV10 0QP

Other trials in United Kingdom

Argentina8 sites
  • Research Site

    Berazategui, B1884BBF

  • Research Site

    CABA, C1426ANZ

  • Research Site

    Ciudad de Buenos Aires, C1025ABI

  • Research Site

    Córdoba, 5000

  • Research Site

    La Rioja, 5300

  • Research Site

    Rosario, S2000KZE

  • Research Site

    San Salvador de Jujuy, 4600

  • Research Site

    Santa Rosa, 6300

Other trials in Argentina

Bulgaria8 sites
  • Research Site

    Plovdiv, 4004

  • Research Site

    Shumen, 9700

  • Research Site

    Sofia, 1303

  • Research Site

    Sofia, 1330

  • Research Site

    Sofia, 1431

  • Research Site

    Sofia, 1784

  • Research Site

    Varna, 9010

  • Research Site

    Vratsa, 3000

Other trials in Bulgaria

Chile7 sites
  • Research Site

    Santiago, 7500713

  • Research Site

    Santiago, 7500921

  • Research Site

    Santiago, 7520349

  • Research Site

    Santiago, 8380456

  • Research Site

    Santiago, 8420383

  • Research Site

    Temuco, 4810297

  • Research Site

    Viña del Mar, 2520612

Other trials in Chile

India7 sites
  • Research Site

    Ahmedabad, 380016

  • Research Site

    Bangalore, 560068

  • Research Site

    Bangalore, 560076

  • Research Site

    Chennai, 600035

  • Research Site

    Gūrgaon, 122001

  • Research Site

    Karamsad, 388325

  • Research Site

    New Delhi, 110 085

Other trials in India

Peru7 sites
  • Research Site

    Arequipa, AREQUIPA01

  • Research Site

    Bellavista, CALLAO 2

  • Research Site

    Lima, 15033

  • Research Site

    Lima, 41

  • Research Site

    Lima, L27

  • Research Site

    Lima, LIMA 34

  • Research Site

    Lima, LIMA 41

Other trials in Peru

Greece6 sites
  • Research Site

    Athens, 115 22

  • Research Site

    Athens, 11527

  • Research Site

    Athens, 14564

  • Research Site

    Heraklion, 71110

  • Research Site

    Holargos, Athens, 155 62

  • Research Site

    Ioannina, 45000

Other trials in Greece

Israel6 sites
  • Research Site

    Beersheba, 8410101

  • Research Site

    Jerusalem, 91031

  • Research Site

    Kfar Saba, 95847

  • Research Site

    Nahariya, 22100

  • Research Site

    Petah Tikva, 49100

  • Research Site

    Ramat Gan, 5265601

Other trials in Israel

Mexico6 sites
  • Research Site

    Acapulco, 39670

  • Research Site

    Aguascalientes, 20020

  • Research Site

    Mérida, 97134

  • Research Site

    México, 06100

  • Research Site

    México, 14080

  • Research Site

    Monterrey, 64710

Other trials in Mexico

Philippines6 sites
  • Research Site

    Baguio City, 2600

  • Research Site

    Cebu, 6000

  • Research Site

    Las Piñas, PH-1704

  • Research Site

    Manila, 1000

  • Research Site

    Manila, 1003

  • Research Site

    Quezon City, 1112

Other trials in Philippines

Portugal5 sites
  • Research Site

    Amadora, 2720-276

  • Research Site

    Lisbon, 1500-650

  • Research Site

    Porto, 4099-001

  • Research Site

    Porto, 4100-180

  • Research Site

    Porto, 4200-319

Other trials in Portugal

South Korea5 sites
  • Research Site

    Daegu, 41404

  • Research Site

    Hwasun-gun, 58128

  • Research Site

    Seoul, 05030

  • Research Site

    Seoul, 06273

  • Research Site

    Seoul, 08308

Other trials in South Korea

Singapore4 sites
  • Research Site

    Singapore, 119228

  • Research Site

    Singapore, 217562

  • Research Site

    Singapore, 258499

  • Research Site

    Singapore, 308433

Other trials in Singapore

Sweden4 sites
  • Research Site

    Eskilstuna, 63188

  • Research Site

    Linköping, 581 85

  • Research Site

    Stockholm, 171 64

  • Research Site

    Uppsala, 751 85

Other trials in Sweden

Hong Kong3 sites
  • Research Site

    Hong Kong

  • Research Site

    King's Park, 150001

  • Research Site

    Shatin, 00000

Other trials in Hong Kong

Malaysia3 sites
  • Research Site

    Kuala Lumpur, 59100

  • Research Site

    Kuantan, 25100

  • Research Site

    Kuching, 93586

Other trials in Malaysia

Saudi Arabia3 sites
  • Research Site

    Dammam, 31444

  • Research Site

    Riyadh, 11426

  • Research Site

    Riyadh, 12372

Other trials in Saudi Arabia

Finland2 sites
  • Research Site

    Oulu, FI-90029

  • Research Site

    Tampere, FI-33521

Other trials in Finland

Denmark1 site
  • Research Site

    Odense C, 5000

Other trials in Denmark

Qatar1 site
  • Research Site

    Doha, P.O. Box 3050

Other trials in Qatar

Romania1 site
  • Research Site

    Suceava, 720237

Other trials in Romania

About this study

Official title: A Phase III Randomized, Open-Label, Multi-Center, Global Study of MEDI4736 in Combination With Tremelimumab Therapy Versus Standard of Care Platinum-Based Chemotherapy in First-Line Treatment of Patients With Advanced or Metastatic Non Small-Cell Lung Cancer (NSCLC).

This is a randomized, open-label, multi-center, global, Phase III study to determine the efficacy and safety of durvalumab + tremelimumab combination therapy versus platinum-based SoC chemotherapy in the first-line treatment of patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) wild-type advanced or metastatic NSCLC.

Read the detailed description

Patients will be randomized in a 1:1 to receive treatment with durvalumab + tremelimumab combination therapy or SoC therapy. The primary objective of this study is to assess the efficacy of combination treatment compared with SoC in terms of Overall Survival (OS) in patients.

Being tested
Durvalumab +Tremelimumab, Paclitaxel + carboplatin, Gemcitabine + cisplatin, Gemcitabine + carboplatin, Pemetrexed + cisplatin
Keywords
NSCLC, PDL1, TMB, MEDI4736, Durvalumab, Tremelimumab, OS

What participants receive

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

  • Durvalumab +TremelimumabBiological

  • Paclitaxel + carboplatinDrug

    Also called Platinum based Standard of Care Chemotherapy

    Chemotherapy Agents

  • Gemcitabine + cisplatinDrug

    Also called Platinum based Standard of Care Chemotherapy

    Chemotherapy Agents

  • Gemcitabine + carboplatinDrug

    Also called Platinum based Standard of Care Chemotherapy

    Chemotherapy Agents

  • Pemetrexed + cisplatinDrug

    Also called Platinum based Standard of Care Chemotherapy

    Chemotherapy Agent

  • Pemetrexed + carboplatinDrug

    Also called Platinum based Standard of Care Chemotherapy

    Chemotherapy Agent

Study groups in NCT02542293
Study groupRoleWhat they receive
Combination TherapyExperimentalDurvalumab (PD-L1 monoclonal antibody) + Tremelimumab (monoclonal antibody directed against CTLA-4)
Receives: Biological: Durvalumab +Tremelimumab
Standard of CareActive comparatorStandard of Care chemotherapy treatment
Receives: Drug: Paclitaxel + carboplatin; Drug: Gemcitabine + cisplatin; Drug: Gemcitabine + carboplatin; Drug: Pemetrexed + cisplatin; Drug: Pemetrexed + carboplatin

What is being measured

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

  1. Overall Survival (OS); Global Cohort: Blood Tumor Mutational Burden (bTMB) ≥20 Mutations Per Megabase (Mut/Mb) Analysis Set

    The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on the last recorded date on which the participant was known to be alive. Median OS was calculated using the Kaplan-Meier technique.

    Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global cohort DCO date (a maximum of approximately 44 months).

  2. OS; China Cohort: China Programmed Cell Death Ligand 1 (PD-L1) Negative NSCLC Analysis Set

    The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on the last recorded date on which the participant was known to be alive. Median OS was calculated using the Kaplan-Meier technique.

    Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the China cohort DCO date (a maximum of approximately 44 months).

Secondary outcomes (18)
  1. OS; Global Cohort: bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, PD-L1-Negative NSCLC, bTMB <20 Mut/Mb, bTMB Non-Evaluable Population, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets

    OS was defined as time from date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at time of analysis was censored based on last recorded date on which participant was known to be alive.

    bTMB ≥16 mut/Mb, bTMB ≥12 mut/Mb and bTMB <20 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥16 mut/Mb, ≥12 mut/Mb and <20 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    bTMB non-evaluable analysis set included the subset of participants in FAS whose bTMB status at baseline could not be determined by the GuardantOMNI CDx assay or whose sample was not available.

    tTMB analysis sets are defined same as the bTMB analysis sets.

    Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global cohort DCO date (a maximum of approximately 44 months).

  2. OS; Global and China Cohorts: FAS, PD-L1 Tumor Cell (TC) ≥25%, and PD-L1 TC ≥50% Analysis Sets

    The OS was defined as time from date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on last recorded date on which participant was known to be alive.

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment. Any participants recruited in China, after global recruitment had ended, were not included in the FAS.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included the subset of participants in the FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.

    Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global or China cohort DCO dates, as applicable (a maximum of approximately 44 months) for each cohort.

  3. Progression-Free Survival (PFS); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets

    The PFS (per Response Evaluation Criteria in Solid Tumors, version 1.1 [RECIST 1.1] using Investigator assessments) was defined as the time from the date of randomization until the date of objective PD or death (by any cause in the absence of progression) regardless of whether the participant withdrew from randomized therapy or received another anticancer therapy prior to progression (ie, date of PFS event or censoring - date of randomization + 1).

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    tTMB ≥14 mut/Mb, tTMB ≥12 mut/Mb, tTMB ≥10 mut/Mb and tTMB ≥8 mut/Mb analysis sets included the subset of participants in FAS whose tTMB status was ≥14 mut/Mb, ≥12 mut/Mb, ≥10 mut/Mb and ≥8 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).

  4. PFS; Global and China Cohorts: PD-L1-Negative NSCLC, FAS, PD-L1 TC ≥25%, and PD-L1 TC ≥50% Analysis Sets

    PFS (per RECIST 1.1 using Investigator assessments) was defined as time from date of randomization until date of objective PD or death regardless of whether participant withdrew from randomized therapy or received another anticancer therapy prior to progression (ie, date of PFS event or censoring - date of randomization + 1).

    PD-L1-negative analysis set included subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: FAS included all randomized participants prior to end of global recruitment.

    China Cohort: China FAS included all randomized participants in China cohort and were used for all China only efficacy analyses.

    PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included subset of participants in FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.

  5. Objective Response Rate (ORR); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets

    The ORR (per RECIST 1.1 using Investigator assessments) was defined as the percentage of participants with at least 1 visit response of complete response (CR) or partial response (PR) prior to PD.

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    tTMB ≥14 mut/Mb, tTMB ≥12 mut/Mb, tTMB ≥10 mut/Mb and tTMB ≥8 mut/Mb analysis sets included the subset of participants in FAS whose tTMB status was ≥14 mut/Mb, ≥12 mut/Mb, ≥10 mut/Mb and ≥8 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).

  6. ORR; Global and China Cohorts: PD-L1-Negative NSCLC, FAS, PD-L1 TC ≥25%, and PD-L1 TC ≥50% Analysis Sets

    The ORR (per RECIST 1.1 using Investigator assessments) was defined as the percentage of participants with at least 1 visit response of CR or PR prior to PD.

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included the subset of participants in the FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.

  7. Duration of Response (DoR); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets

    DoR (per RECIST 1.1 using Investigator assessments) was defined as the time from the date of first documented response (CR or PR) until the first date of documented progression or death in the absence of PD (ie, date of PFS event or censoring - date of first response + 1).

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).

  8. DoR; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets

    DoR (per RECIST 1.1 using Investigator assessments) was defined as the time from the date of first documented response (CR or PR) until the first date of documented progression or death in the absence of PD (ie, date of PFS event or censoring - date of first response + 1).

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.

  9. Alive and Progression-Free at 12 Months (APF12); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets

    The APF12 was defined as the percentage of participants who were alive and progression free at 12 months from randomization (ie, PFS rate at 12 months).

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Tumour scans performed at baseline then every 6 weeks up to 12 months.

  10. APF12; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets

    The APF12 was defined as the percentage of patients who were alive and progression free at 12 months from randomization (ie, PFS rate at 12 months).

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    Measured: Tumour scans performed at baseline then every 6 weeks up to 12 months.

  11. Time From Randomization to Second Progression or Death (PFS2); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets

    The PFS2 was defined as the time from the date of randomization to the earliest of the progression events subsequent to that used for the primary variable PFS, or death (ie, date of PFS2 event or censoring - date of randomization + 1).

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).

  12. PFS2; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets

    The PFS2 was defined as the time from the date of randomization to the earliest of the progression events subsequent to that used for the primary variable PFS, or death (ie, date of PFS2 event or censoring - date of randomization + 1).

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.

  13. OS at Months 12, 18 and 24; Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets

    The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1).

    bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.

    Measured: Months 12, 18 and 24

  14. OS at Months 12, 18 and 24; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets

    The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1).

    PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).

    Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.

    China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.

    Measured: Months 12, 18 and 24

  15. Serum Concentrations of Durvalumab

    Blood samples were collected to determine the serum concentration of durvalumab.

    Measured: Pre-dose and within 1 hour after end of infusion at Week 0 and 12; pre-dose on Week 24 and at follow-up Month 3

  16. Serum Concentrations of Tremelimumab

    Blood samples were collected to determine the serum concentration of tremelimumab.

    Measured: Pre-dose and within 1 hour after end of infusion at Week 0 and 12, and at follow-up Month 3

  17. Number of Participants With Anti-Drug Antibody (ADA) Response to Durvalumab

    Blood samples were measured for the presence of ADAs and ADA-neutralizing antibodies (nAb) for durvalumab using validated assays. ADA prevalence is defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Treatment-emergent ADA is defined as the sum of treatment-induced ADA and treatment-boosted ADA. ADA incidence is the percentage of participants who were treatment-emergent ADA-positive. Treatment-boosted ADA is defined as baseline positive ADA titer that was boosted to >=4 fold during the study period. Persistently positive is defined as having at least 2 post baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. Transiently positive is defined as having at least 1 post baseline ADA positive measurement and not fulfilling the conditions for persistently positive.

    Measured: At Weeks 0, 12, and 24; 3 and 6 months after last dose of study treatment.

  18. Number of Participants With ADA Response to Tremelimumab

    Blood samples were measured for the presence of ADAs and ADA-nAb for tremelimumab using validated assays. ADA prevalence is defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Treatment-emergent ADA is defined as the sum of treatment-induced ADA and treatment-boosted ADA. ADA incidence is the percentage of participants who were treatment-emergent ADA-positive. Treatment-boosted ADA is defined as baseline positive ADA titer that was boosted to >=4 fold during the study period. Persistently positive is defined as having at least 2 post baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. Transiently positive is defined as having at least 1 post baseline ADA positive measurement and not fulfilling the conditions for persistently positive.

    Measured: At Weeks 0 and 12; 3 and 6 months after last dose of study treatment.

Timeline

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

  1. First posted7 Sep 2015 (estimated)
  2. Study start3 Nov 2015
  3. Primary completion21 Sep 2020
  4. Study completion31 Dec 2026 (estimated)

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
None (open label)
Enrolment
953 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02542293
Sponsor's protocol ID
D419AC00003
Other IDs
2015-002197-21, 2015
Acronym
NEPTUNE
Status last verified
Aug 2026
First submitted
26 Aug 2015
Last updated
6 Aug 2026
Data monitoring committee
Yes
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure

Publications

  • Cheng Y, Zhou Q, Han B, Fan Y, Shan L, Chang J, Sun S, Fang J, Chen Y, Sun J, Wu G, Mann H, Naicker K, Shire N, Mok T, de Castro G Jr. NEPTUNE China cohort: First-line durvalumab plus tremelimumab in Chinese patients with metastatic non-small-cell lung cancer. Lung Cancer. 2023 Apr;178:87-95. doi: 10.1016/j.lungcan.2023.01.013. Epub 2023 Feb 1.

    PubMed 36806898

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