Brief Title: Study of Efficacy and Safety of Canakinumab as Adjuvant Therapy in Adult Subjects With Stages AJCC/UICC v. 8 II-IIIA and IIIB (T>5cm N2) Completely Resected Non-small Cell Lung Cancer Acronym: CANOPY-A (Canopy-A)
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| ClinicalTrials.gov Identifier: NCT03447769 |
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Recruitment Status :
Terminated
(Upon review of the primary analysis results, the benefit-risk was assessed by the Steering Committee Members with the decision that the study will be closed. No new safety signals were observed for canakinumab)
First Posted : February 27, 2018
Last Update Posted : March 3, 2023
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Non-Small Cell Lung Cancer | Drug: Canakinumab Drug: Placebo | Phase 3 |
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 1382 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
| Primary Purpose: | Treatment |
| Official Title: | A Phase III, Multicenter, Randomized, Double Blind, Placebo-controlled Study Evaluating the Efficacy and Safety of Canakinumab Versus Placebo as Adjuvant Therapy in Adult Subjects With Stages AJCC/UICC v. 8 II -IIIA and IIIB (T>5cm N2) Completely Resected (R0) Non-small Cell Lung Cancer (NSCLC) |
| Actual Study Start Date : | March 16, 2018 |
| Actual Primary Completion Date : | March 17, 2022 |
| Actual Study Completion Date : | February 7, 2023 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: canakinumab
Participants will receive canakinumab for 18 cycles (approximately 54 weeks).
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Drug: Canakinumab
Canakinumab will be administered periodically for approximately 54 weeks.
Other Name: ACZ885 |
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Placebo Comparator: Placebo
Participants will receive canakinumab placebo for 18 cycles (approximately 54 weeks).
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Drug: Placebo
Placebo will be administered periodically for approximately 54 weeks. |
- Disease free survival (DFS) by local investigator [ Time Frame: Up to approximately 5 years ]DFS is the time from the date of randomization to the date of the first documented NSCLC disease recurrence as assessed by local investigator radiologically or death due to any cause.
- Overall Survival (OS) [ Time Frame: Up to approximately 5 years ]Overall Survival (OS) is the time from the date of randomization to the date of death due to any cause.
- Disease free survival (DFS) by local investigator in PD-L1 subgroups [ Time Frame: Up to approximately 5 years ]
DFS is the time from the date of randomization to the date of the first documented NSCLC disease recurrence as assessed by local investigator radiologically or death due to any cause.
DFS analysis will be performed by programmed cell death-ligand 1 (PD-L1) status (positive, negative) where a positive status is defined as having ≥ 1% expression and a negative status is defined as having < 1% expression.
- Disease free survival (DFS) by local investigator in CD8 subgroups [ Time Frame: Up to approximately 5 years ]
DFS is the time from the date of randomization to the date of the first documented NSCLC disease recurrence as assessed by local investigator radiologically or death due to any cause.
DFS analysis will be performed by CD8 subgroups with the median and quartiles of baseline CD8 expression as cut-offs.
- Overall Survival (OS) by local investigator in PD-L1 subgroups [ Time Frame: up to approximately 5 years ]Overall Survival (OS) is the time from the date of randomization to the date of death due to any cause. OS analysis will be performed by programmed cell death-ligand 1 (PD-L1) status (positive, negative) where a positive status is defined as having ≥ 1% expression and a negative status is defined as having < 1% expression.
- Overall Survival (OS) by local investigator in CD8 subgroups [ Time Frame: up to approximately 5 years ]Overall Survival (OS) is the time from the date of randomization to the date of death due to any cause. OS analysis will be performed by CD8 subgroups with the median and quartiles of baseline CD8 expression as cut-offs.
- Lung Cancer Specific Survival (LCSS) [ Time Frame: up to approximately 5 years ]LCSS is defined as the time from date of randomization to the date of death due to lung cancer.
- Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUClast) of canakinumab [ Time Frame: Up to approximately 5 years ]To characterize the pharmacokinetics of canakinumab therapy. AUClast will be calculated from serum concentration-time data.
- Maximum Observed Plasma Concentration (Cmax) of canakinumab [ Time Frame: Up to approximately 5 years ]To characterize the pharmacokinetics of canakinumab therapy. Cmax will be calculated from serum concentration-time data.
- Trough Concentration (Cmin) of canakinumab [ Time Frame: Up to approximately 5 years ]To characterize the pharmacokinetics of canakinumab therapy. Cmin will be calculated from serum concentration-time data.
- Anti-drug Antibody (ADA) prevalence at baseline [ Time Frame: Baseline ]Immunogenicity to canakinumab prior to canakinumab exposure. ADA prevalence at baseline wil be calculated as the proportion of participants who had an ADA positive result at baseline
- Anti-drug Antibody (ADA) incidence [ Time Frame: Up to approximately 5 years ]ADA incidence on treatment will be calculated as the proportion of participants who were treatment-induced ADA positive (post-baseline ADA positive with ADA-negative sample at baseline) and treatment-boosted ADA positive (post-baseline ADA positive with titer that is at least the fold titer change greater than the ADA-positive baseline titer)
- Time to definitive 10 point deterioration symptom scores of pain,cough and dyspnea per EORTC QLQ-LC13 questionnaire [ Time Frame: Up to approximately 5 years ]
The Lung Cancer module of the EORTC's quality of life questionnaire (EORTC QLQ-LC13) is used in conjunction with the EORTC QLQ-C30 and provides information on an additional 13 items specifically related to lung cancer. The lung cancer module incorporates one multi-item scale to assess dyspnea, and 9 single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All of the domain scores range from 0 to 100. A high score indicates a high level of symptoms.
The time to definitive 10 point deterioration symptom scores of pain, cough and dyspnea is defined as the time from the date of randomization to the date of event, which is defined as at least 10 points relative to baseline worsening of the EORTC QLQ-LC13 symptom score with no later change below this thereshold or death due to any cause, whichever occurs earlier
- Time to definitive 10 point deterioration of global health status/QoL, shortness of breath and pain per EORTC QLQ-C30 questionnaire [ Time Frame: Up to approximately 5 years ]
The EORTC QLQ-C30 is a questionnaire developed to assess the health-related quality of life of cancer participants. It assesses 15 domains consisting of 5 functional domains (physical, role, emotional, cognitive, social) and 9 symptom domains (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) and a global health status/quality of life (QoL) scale. All of the domain scores range from 0 to 100. A high score for a functional scale indicates a high and healthy level of functioning but a high score for a symptom scale indicates a high level of symptoms.
The time to definitive 10 point deterioration of global health status/QoL, shortness of breath and pain is defined as the time from the date of randomization to the date of event, which is defined as at least 10 points relative to baseline worsening of the EORTC QLQ-C30 score with no later change below this threshold or death due to any cause, whichever occurs earlier.
- Time to first 10 point deterioration for symptom scores of pain, cough and dyspnea per EORTC QLQ-LC13 questionnaire [ Time Frame: Up to approximately 5 years ]
The Lung Cancer module of the EORTC's quality of life questionnaire (EORTC QLQ-LC13) is used in conjunction with the EORTC QLQ-C30 and provides information on an additional 13 items specifically related to lung cancer. The lung cancer module incorporates one multi-item scale to assess dyspnea, and 9 single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All of the domain scores range from 0 to 100. A high score indicates a high level of symptoms.
The time to first 10 point deterioration symptom scores of pain, cough and dyspnea is defined as the time from the date of randomization to the first onset of at least 10 points absolute increase from baseline (worsening) in symptoms scores or death due to any cause, whichever occurs earlier.
- Time to first 10 point deterioration of global health status/QoL, shortness of breath and pain per EORTC QLQ-C30 questionnaire [ Time Frame: Up to approximately 5 years ]
The EORTC QLQ-C30 is a questionnaire developed to assess the health-related quality of life of cancer participants. It assesses 15 domains consisting of 5 functional domains (physical, role, emotional, cognitive, social) and 9 symptom domains (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) and a global health status/quality of life (QoL) scale. All of the domain scores range from 0 to 100. A high score for a functional scale indicates a high and healthy level of functioning but a high score for a symptom scale indicates a high level of symptoms.
The time to first 10 point deterioration of global health status/QoL, shortness of breath and pain scores is defined as the time from the date of randomization to the first onset of at least 10 points absolute increase from baseline (worsening) in symptoms scores or death due to any cause, whichever occurs earlier.
- Utility scores of the EQ-5D-5L [ Time Frame: Up to approximately 5 years ]EQ-5D-5L is a standardized participant completed questionnaire that measures health-related quality of life and translates that score into an index value or utility score. EQ-5D-5L consists of two components: a health state profile and an optional visual analogue scale (VAS). EQ-5D health state profile is comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: 1= no problems, 2= slight problems, 3= moderate problems, 4= severe problems, and 5= extreme problems. Higher scores indicated greater levels of problems across each of the five dimensions.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Have completely resected (R0) NSCLC AJCC/UICC v. 8 stage IIA-IIIA and IIIB (N2 disease only) OR have NSCLC Stage IIA-IIIA, IIIB (N2 disease only) and are candidates for complete resection surgery
- Cisplatin-based chemotherapy is mandatory for all subjects (Exception: In subjects with stage IIA disease with no nodal involvement, cisplatin-based chemotherapy can be administered if recommended by the treating physician). When required, a minimum of two cycles of cisplatin-based chemotherapy is mandatory, after which additional therapies can be given based upon local clinical practice and/or guidelines. Typically, chemotherapy is initiated within 60 days of surgery.
- Must have recovered from all toxicities related to prior systemic therapy to grade ≤ 1 (CTCAE v 4.03). Exception to this criterion: subjects with any grade of alopecia and grade 2 or less neuropathy are allowed to enter the study
- Have ECOG performance status (PS) of 0 or 1
Exclusion Criteria:
- Have unresectable or metastatic disease, positive microscopic margins on the pathology report, and/or gross disease remaining at the time of surgery
- Have received any neoadjuvant therapy
- Presence or history of a malignant disease, other than the resected NSCLC, that has been diagnosed and/or required therapy within the past 3 years Exceptions to this exclusion include the following: completely resected basal cell and squamous cell skin cancers, completely resected carcinoma in situ of any type and hormonal maintenance for breast and prostate cancer > 3 years.
- Have a history of current diagnosis of cardiac disease
- Have uncontrolled diabetes
- Have known active or recurrent hepatic disorder including cirrhosis, hepatitis B and C (positive or indeterminate central laboratory results)
- Subjects must be evaluated for tuberculosis as per local treatment guidelines or clinical practice. Subjects with active tuberculosis are not eligible.
- Have suspected or proven immunocompromised state as described in the protocol
- Had Live and attenuated vaccination within 3 months prior to first dose of study drug (e.g. MMR, Yellow Fever, Rotavirus, Smallpox, etc.).
Other inclusion/exclusion criteria may apply
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03447769
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| Study Director: | Novartis Pharmaceuticals | Novartis Pharmaceuticals |
| Responsible Party: | Novartis Pharmaceuticals |
| ClinicalTrials.gov Identifier: | NCT03447769 |
| Other Study ID Numbers: |
CACZ885T2301 2017-004011-39 ( EudraCT Number ) |
| First Posted: | February 27, 2018 Key Record Dates |
| Last Update Posted: | March 3, 2023 |
| Last Verified: | February 2023 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | Yes |
| Plan Description: | Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data will be available according to the process described on www.clinicalstudydatarequest.com. |
| Studies a U.S. FDA-regulated Drug Product: | Yes |
| Studies a U.S. FDA-regulated Device Product: | No |
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Non-Small Cell Lung Cancer NSCLC ACZ885 |
canakinumab adjuvant AJCC/UICC v. 8 stages II-IIIA and IIIB (T>5cm N2) |
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Lung Neoplasms Carcinoma, Non-Small-Cell Lung Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site |
Neoplasms Lung Diseases Respiratory Tract Diseases Carcinoma, Bronchogenic Bronchial Neoplasms |