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Platinum Refractory Extensive-Stage Small Cell Lung CarcinomaPhase 2NCT02937818

A Phase II, Study to Determine the Preliminary Efficacy of Novel Combinations of Treatment in Patients With Platinum Refractory Extensive-Stage Small-Cell Lung Cancer

A Phase 2 study testing Durvalumab and Tremelimumab, AZD1775 and carboplatin (CBPT) and AZD6738 and olaparib in people with Platinum Refractory Extensive-Stage Small Cell Lung Carcinoma, run by AstraZeneca at 12 sites in 5 countries.

Completed

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

Official record
Search all trials

Trial summary

Study design This is a Phase II, open-label, multi-drug, multi-center, multi-arm, signal-searching study in patients with extensive-stage small-cell lung cancer (SCLC) who have refractory or resistant disease from prior platinum-based chemotherapy. Read more about this study

Who is it for?
Ages 18 to 130 years
What is being tested?
Durvalumab and Tremelimumab, AZD1775 and carboplatin (CBPT) and AZD6738 and olaparib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
72 participants
Where
12 sitesin 5 countries
Study dates
28 Nov 2016to 27 Nov 2023
Phase
Phase 2
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

  • Adults with histologically or cytologically documented ED SCLC who have demonstrated progressive disease either during first-line platinum-based chemotherapy (platinum refractory) or within 90 days of completing platinum based-chemotherapy (platinum resistant) and have not received further treatment.
  • Brain metastases must be asymptomatic or treated and stable off steroids and anti-convulsants for at least 1 month prior to study treatment.
  • At least 1 lesion, not previously irradiated, that can be accurately measured at baseline (per RECIST v 1.1 guidelines)
  • Life expectancy of at least 8 weeks.
  • WHO/ ECOG PS of 0-1 at enrollment.
  • Body weight >30 kg.
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  • No prior exposure to immune mediated therapy, excluding therapeutic anticancer vaccines.
  • Inclusion criteria (Arm B specific) • Able and willing to swallow oral medication.
  • Able and willing to swallow oral medication.

Who cannot join

  • Participation in another clinical study, major surgery, radiation therapy within 28 days.
  • Any condition that, in the opinion of the Investigator, would interfere with the evaluation of the IP or interpretation of patient safety or study results.
  • Uncontrolled intercurrent illness, including but not limited to interstitial lung disease.
  • History of another primary malignancy, leptomeningeal carcinomatosis or spinal cord compression.
  • Active autoimmune disease, including a paraneoplastic syndrome.
  • Active or prior documented autoimmune or inflammatory disorders.
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  • Any unresolved toxicity (CTCAE Grade >2) from previous anticancer therapy.
  • Active infection including tuberculosis, HIV, Hepatitis B or C.
  • Prior exposure to any WEE1 inhibitors.
  • Products known to be sensitive to CYP3A4 substrates or CYP3A4 substrates with a narrow therapeutic index, or to be moderate to strong inhibitors/inducers of CYP3A4. Co-administration of rosuvastatin, atorvastatin, simvastatin and lovastatin, aprepitant or fosaprepitant or any herbal preparations. Grapefruit and Seville oranges should be avoided while taking AZD1775.
  • Any known hypersensitivity or contraindication to IP or CBDP.
  • QTcF > 470 msec or congenital long QT syndrome.
  • Any current or within 6 months cardiac diseases NYHA ≥ Class 2: unstable angina pectoris, congestive heart failure, acute MI, conduction abnormality not controlled with pacemaker or medication, significant ventricular or supraventricular arrhythmias.
  • A recent history of Torsades de pointes.
  • Cytotoxic chemotherapy within 21 days of Cycle 1 Day 1 is not permitted
  • Previous treatment with a PARP inhibitor (including olaparib) or ATR inhibitor
  • Concomitant use of known strong CYP3A inhibitors and moderate CYP3A inhibitors
  • Concomitant use of known strong and moderate CYP3A inducers
  • Persisting (> 4 weeks) severe pancytopenia due to previous therapy
  • Cardiac dysfunction
  • Refractory nausea and vomitting, chronic gastrointenstinal diseases or previous significant bowel resection
  • Patients with uncontrolled seizures
  • Intenstinal obstruction or CTCAE grade 3 or grade 4 GI bleeding within 4 weeks before dosing

Trial locations and contacts

12 sites in 5 countries.

12 sites in 5 countries

Hungary4 sites
  • Research Site

    Kecskemét, 6000

  • Research Site

    Miskolc, 3529

  • Research Site

    Székesfehérvár, 8000

  • Research Site

    Törökbálint, 2045

Other trials in Hungary

Ukraine3 sites
  • Research Site

    Dnipro, 49102

  • Research Site

    Ivano-Frankivsk, 76018

  • Research Site

    Sumy, 40022

Other trials in Ukraine

Poland2 sites
  • Research Site

    Poznan, 60-569

  • Research Site

    Warsaw, 02-781

Other trials in Poland

Spain2 sites
  • Research Site

    Seville, 41009

  • Research Site

    Valencia, 46009

Other trials in Spain

Germany1 site
  • Research Site

    Gauting, 82131

Other trials in Germany

About this study

Official title: A Phase II, Open-Label, Multi-Arm Study to Determine the Preliminary Efficacy of Novel Combinations of Treatment in Patients With Platinum Refractory Extensive-Stage Small-Cell Lung Cancer

Study design This is a Phase II, open-label, multi-drug, multi-center, multi-arm, signal-searching study in patients with extensive-stage small-cell lung cancer (SCLC) who have refractory or resistant disease from prior platinum-based chemotherapy.

Read the detailed description

This study is modular in design, allowing evaluation of the preliminary efficacy, safety, tolerability, and immunogenicity of novel combinations of immunotherapies and/or deoxyribonucleic acid (DNA) damage repair inhibitors in patients with platinum refractory or resistant extensive-stage-disease SCLC. Patients who have progressive disease (PD) during first-line platinum-based chemotherapy (platinum refractory) or PD within 90 days after completing first-line platinum-based chemotherapy (platinum resistant) will be enrolled to the study. The primary objective of the study is to assess the preliminary efficacy of each treatment arm based on objective response rate (ORR).

This study consists of a number of arms (sub-studies), each evaluating the efficacy, safety, and tolerability of a specific agent or combination. This study was initially open with 2 arms (Arms A and B), and additional arms may open, provided there is compelling rationale for the combination and safe and tolerable doses and schedules have been determined from ongoing Phase I studies. There are 2 pre-defined arms:

  1. Durvalumab + tremelimumab followed by durvalumab monotherapy B. AZD1775 + carboplatin (CBDP)

Further arm was added in amendment 3:

  1. AZD6738 + olaparib Amendment #4 was updated with possibility to allow expansion of any arm, to a total of 40 eligible subjects, based on Review Committee assessment of data from the first 20 subjects (from Stage 1 and Stage 2). Currently Arm A will enroll 20 additional patients into expansion.
Being tested
Durvalumab and Tremelimumab, AZD1775 and carboplatin (CBPT), AZD6738 and olaparib
Keywords
Platinum Refractory Extensive-Stage Carcinoma, Small Cell Lung, Platinum Refractory Extensive-Stage Oat Cell Carcinoma of Lung, Platinum Refractory Extensive-Stage Oat Cell Lung Cancer, Platinum Refractory Extensive-Stage Small Cell Cancer Of The Lung, Platinum Refractory Extensive-Stage Small Cell Lung Cancer

What participants receive

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

  • Durvalumab and TremelimumabDrug

    Durvalumab + tremelimumab via intravenous (IV) infusion every 4 weeks (q4w), starting on Week 0, for up to a total of 4 months (4 cycles) followed by durvalumab monotherapy via IV infusion q4w, starting on Week 16 until PD, or for other discontinuation criteria.

  • AZD1775 and carboplatin (CBPT)Drug

    AZD1775 twice daily (oral) for 2.5 days from Day 1 + CBDP area under the curve 5 (Day1) (IV); every 3 weeks.

  • AZD6738 and olaparibDrug

    AZD6738 once a day (oral) for 7 days from Day 1 + olaparib twice a day(oral) for 28 days from Day 1, every 4 weeks

Study groups in NCT02937818
Study groupRoleWhat they receive
ARM AExperimentalNot described
Receives: Drug: Durvalumab and Tremelimumab
ARM BExperimentalNot described
Receives: Drug: AZD1775 and carboplatin (CBPT)
ARM CExperimentalNot described
Receives: Drug: AZD6738 and olaparib

What is being measured

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

  1. Number of Participants With Overall Response

    Overall Response Rate (ORR) using Investigator assessments according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1. ORR was defined as the number (percentage) of participants with a confirmed Complete Response (CR) or confirmed Partial Response (PR) and was estimated for each treatment arm with corresponding 2-sided 95% exact confidence intervals (CIs). A confirmed response of CR/PR meant that a response of CR/PR was recorded at one visit and confirmed by repeat imaging, preferably at the next regularly scheduled imaging visit, and not less than 4 weeks after the visit when the response was first observed, with no evidence of progression between the initial and CR/PR confirmation visit.

    Measured: Until disease progression [PD] (Up to 3.5 Years)

Secondary outcomes (17)
  1. Duration of Response (DoR)

    The DoR was defined as the time from the date of first documented response (which was subsequently confirmed) CR/PR until the date of documented progression, or death in the absence of disease progression. The DoR in participants with confirmed objective response are reported.

    Measured: Until disease progression or data cut-off or Death (Up to 3.5 Years)

  2. Percentage of Participants With Disease Control at 12 Weeks

    The disease control rate (DCR) at 12 weeks was defined as the percentage of participants who had a best objective response of CR or PR in the first 13 weeks or who had demonstrated stable disease (SD) for a minimum interval of 11 weeks following the start of study treatment. The DCR was determined programmatically based on RECIST 1.1 using site Investigator data and all data up until the first progression event.

    Measured: At 12 Weeks

  3. Time to Response (TTR)

    The TTR (per RECIST 1.1 as assessed by the Investigator) was defined as the time from the date of first dose until the first date of documented response.

    Measured: Until disease progression or data cut-off or Death (Up to 3.5 Years)

  4. Progression Free Survival (PFS)

    The PFS (per RECIST 1.1 according to the Investigator's assessment) was defined as the time from the date of the first dose of study treatment until the date of objective disease progression or death (by any cause in the absence of progression) regardless of whether the participant withdrew from allocated therapy or received another anti-cancer therapy prior to progression.

    Measured: Until disease progression or data cut-off or Death (Up to 3.5 Years)

  5. Overall Survival (OS)

    The OS was defined as the time from the date of the first dose of study treatment until death due to any cause.

    Measured: Until disease progression or data cut-off or Death (Up to 3.5 Years)

  6. Time to Maximum Concentration (Tmax)

    Time to maximum concentration for ceralasertib and olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 1 (post-dose)

  7. Maximum Concentration (Cmax)

    Maximum concentration for ceralasertib and olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 1 (post-dose)

  8. Partial Area Under the Concentration-time Curve (AUC0-6)

    Partial area under the concentration-time curve for ceralasertib and olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 1 (post-dose) and Cycle 1 Day 7 (pre-dose and post-dose)

  9. Area Under the Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUC0-t)

    Area under the concentration-time curve from time zero to the last measurable concentration for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 1 (post-dose) and Cycle 1 Day 7 (pre-dose and post-dose)

  10. Time to Maximum Concentration at Steady State (Tmax,ss)

    Time to maximum concentration at steady state for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 7 (pre-dose and post-dose)

  11. Maximum Concentration at Steady State (Cmax,ss)

    Maximum concentration at steady state for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 7 (pre-dose and post-dose)

  12. Minimum Concentration at Steady State (Cmin,ss)

    Minimum concentration at steady state for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 7 (pre-dose and post-dose)

  13. Area Under the Concentration-time Curve at Steady State (AUCss)

    Area under the concentration-time curve at steady state at steady state for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 7 (pre-dose and post-dose)

  14. Apparent Clearance of Drug at Steady State at Steady State (CLss/F)

    Area under the concentration-time curve at steady state at steady state for Ceralasertib and Olaparib are reported.

    Measured: Cycle 1 (each cycle was 28 days in length) Day 7 (pre-dose and post-dose)

  15. Serum Concentrations of Durvalumab and Tremelimumab

    Serum concentrations of Durvalumab and Tremelimumab are reported.

    Measured: Durvalumab: Cycle 1 (each cycle was 4 weeks) Day 1(post-dose); Cycle 2 Day 1(pre-dose); Cycle 5 Day 1 (pre-dose); Tremelimumab: Cycle 1 (each cycle was 4 weeks) Day 1 (post-dose); Cycle 2 Day 1 (pre-dose); Cycle 5 Day 1 (No dose); Cycle 7 Day 1 (No dose)

  16. Plasma Concentrations of Adavosertib and Carboplatin

    Plasma concentrations of Adavosertib and Carboplatin are reported.

    Measured: Adavosertib: Cycle 1 (each cycle was 21 days) Day 3 (pre-dose and post-dose); Cycle 3 Day 3 (pre-dose and post-dose); Carboplatin: Cycle 1 (each cycle was 21 days) Day 1 (post-dose)

  17. Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. SAE is an AE that results in any untoward medical occurrence that results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability, or is a significant medical event.

    Measured: Day 1 until disease progression, and follow-up visit (Up to 3.5 Years)

Timeline

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

  1. First posted19 Oct 2016 (estimated)
  2. Study start28 Nov 2016
  3. Primary completion22 Jun 2020
  4. Study completion27 Nov 2023

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
72 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02937818
Sponsor's protocol ID
D419QC00002
Other IDs
2016-001202-42, 2016
Status last verified
May 2024
First submitted
5 Oct 2016
Last updated
7 Jun 2024
Data monitoring committee
No
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 request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Durvalumab and Tremelimumab, AZD1775 and carboplatin (CBPT) and AZD6738 and olaparib in people with Platinum Refractory Extensive-Stage Small Cell Lung Carcinoma, run by AstraZeneca at 12 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 9 inclusion and 23 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 7 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Hungary, Ukraine, Poland, Spain, Germany. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 9 Sep 2021). 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?

Number of Participants With Overall Response (time frame: Until disease progression [PD] (Up to 3.5 Years)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 7 Jun 2024.

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