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A Global Study to Assess the Effects of Durvalumab With Oleclumab or Durvalumab With Monalizumab Following Concurrent Chemoradiation in Patients With Stage III Unresectable Non-Small Cell Lung Cancer (PACIFIC-9)

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ClinicalTrials.gov Identifier: NCT05221840
Recruitment Status : Recruiting
First Posted : February 3, 2022
Last Update Posted : October 12, 2022
Sponsor:
Information provided by (Responsible Party):
AstraZeneca

Study Description
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Brief Summary:
This is a Phase III, randomised, double-blind, multicentre, international study assessing the efficacy and safety of durvalumab (MEDI4736) in combination with oleclumab (MEDI9447) or durvalumab (MEDI4736) with monalizumab (IPH2201) in adults with locally advanced (Stage III), unresectable NSCLC, who have not progressed following platinum-based cCRT.

Condition or disease Intervention/treatment Phase
Non-Small Cell Lung Cancer Drug: Durvalumab Drug: Oleclumab Drug: Monalizumab Other: Placebo Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 999 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Double-Blind
Primary Purpose: Treatment
Official Title: A Phase III, Double-blind, Placebo-controlled, Randomised, Multicentre, International Study of Durvalumab Plus Oleclumab and Durvalumab Plus Monalizumab in Patients With Locally Advanced (Stage III), Unresectable Non-small Cell Lung Cancer (NSCLC) Who Have Not Progressed Following Definitive, Platinum-Based Concurrent Chemoradiation Therapy
Actual Study Start Date : February 7, 2022
Estimated Primary Completion Date : May 29, 2026
Estimated Study Completion Date : May 31, 2030

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lung Cancer
Drug Information available for: Durvalumab

Arms and Interventions
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Arm Intervention/treatment
Experimental: Arm A: Durvalumab and Oleclumab
Durvalumab on Day 1 of each 28-day cycle + Oleclumab on Days 1 and 15 of cycles 1 and 2, then on Day 1 of each subsequent 28-day cycle for up to 12 months
 Drug: Durvalumab
Durvalumab IV (intravenous infusion)

Drug: Oleclumab
Oleclumab IV (intravenous infusion)
Experimental: Arm B: Durvalumab and Monalizumab
Durvalumab + Monalizumab on Day 1 of each 28-day cycle for up to 12 months. Placebo infusion will be administered on Day 15 of cycles 1 and 2 only
 Drug: Durvalumab
Durvalumab IV (intravenous infusion)

Drug: Monalizumab
Monalizumab IV (intravenous infusion)

Other: Placebo
Placebo IV (intravenous infusion)
Active Comparator: Arm C: Durvalumab and Placebo
Durvalumab on Day 1 of each 28-day cycle + Placebo on Days 1 and 15 of cycles 1 and 2, then on Day 1 of each subsequent 28-day cycle for up to 12 months
 Drug: Durvalumab
Durvalumab IV (intravenous infusion)

Other: Placebo
Placebo IV (intravenous infusion)


Outcome Measures
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Primary Outcome Measures :
  1. Progression Free Surival (PFS) [ Time Frame: Up to 5 years after first patient randomized. ]
    Progression Free Survival (PFS) as assessed by BICR, per RECIST 1.1.


Secondary Outcome Measures :
  1. Overall Survival (OS) [ Time Frame: Up to 9 years after first patient randomized ]
    Overall survival (OS)

  2. Objective response rate (ORR) [ Time Frame: Up to 5 years after first patient randomized ]
    Objective response rate (ORR) per RECIST 1.1 as assessed by BICR

  3. Overall survival (OS) at 24 months [ Time Frame: Up to 9 years after first patient randomized ]
    Overall survival (OS) at 24 months

  4. Duration of response (DoR) [ Time Frame: Up to 5 years after first patient randomized ]
    Duration of response (DoR) per RECIST 1.1 as assessed by BICR

  5. Progression free survival (PFS) at 6, 12, 18, and 24 months [ Time Frame: From date of randomization until 24 months ]
    Progression free survival (PFS) at 6, 12, 18, and 24 months respectively, per RECIST 1.1 as assessed by BICR

  6. Time from randomization to second progression (PFS2) [ Time Frame: Up to 5 years after first patient randomized ]
    Time from randomization to second progression (PFS2)

  7. Time from randomization to first date of distant metastasis or death (TTDM) [ Time Frame: Up to 5 years after first patient randomized ]
    Time from randomization to first date of distant metastasis or death (TTDM)

  8. Time from randomization to start date of first subsequent therapy (TFST) [ Time Frame: Up to 9 years after first patient randomized ]
    Time from randomization to start date of first subsequent therapy (TFST)

  9. Progression free survival (PFS) as assessed by Investigator [ Time Frame: Up to 5 years after first patient randomized ]
    Progression free survival (PFS) as assessed by Investigator

  10. IHC analysis of PD-L1 TC expression [ Time Frame: Up to 5 years after first patient randomized ]
    IHC analysis of PD-L1 TC expression relative to efficacy outcomes

  11. Concentration of Durvalumab [ Time Frame: From date of randomization until 3 months after date of last IP dose ]
    To assess the Pharmacokinetics of Durvalumab when in combination with Monalizumab or Oleclumab - serum peak and trough concentrations

  12. Anti-drug antibodies (ADAs) [ Time Frame: From date of randomization until 3 months after date of last IP dose ]
    The immunogenicity of durvalumab, oleclumab, and monalizumab as assessed by presence of anti-drug antibodies (ADAs)

  13. Time to deterioration in pulmonary symptoms (TTFCD) [ Time Frame: Up to 5 years after last patient randomized ]
    Time to deterioration in pulmonary symptoms (TTFCD)

  14. Concentration of Oleclumab [ Time Frame: From date of randomization until 3 months after last dose of IP ]
    To assess the Pharmacokinetics of Oleclumab when in combination with Durvulumab - serum peak and trough concentrations

  15. Concentration of Monalizumab [ Time Frame: From date of randomization until 3 months after last dose of IP ]
    To assess the Pharmacokinetics of Monalizumab when in combination with Durvalumab - serum peak and trough concentrations


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

INCLUSION CRITERIA:

  • Participant must be ≥ 18 years at the time of screening.
  • Histologically- or cytologically-documented NSCLC and have been treated with concurrent CRT for locally advanced, unresectable (Stage III) disease
  • Provision of a tumour tissue sample obtained prior to CRT
  • Documented tumour PD-L1 status by central lab
  • Documented EGFR and ALK wild-type status (local or central).
  • Patients must not have progressed following definitive, platinum based, concurrent chemoradiotherapy
  • Participants must have received at least 2 cycles of platinum-based chemotherapy concurrent with radiation therapy,
  • Participants must have received a total dose of radiation of 60 Gy ±10% (54 Gy to 66 Gy) as part of the chemoradiation therapy, to be randomised. Radiation therapy should be administered by intensity modulated RT (preferred) or 3D-conforming technique.
  • WHO performance status of 0 or 1 at randomization
  • Adequate organ and marrow function

EXCLUSION CRITERIA:

  • History of another primary malignancy except for malignancy treated with curative intent with no known active disease > 5 years before the first dose of study intervention and of low potential risk for recurrence, basal cell carcinoma of the skin, squamous cell carcinoma of the skin or lentigo maligna that has undergone potentially curative therapy, adequately treated carcinoma in situ or Ta tumours treated with curative intent and without evidence of disease.
  • Mixed small cell and non-small cell lung cancer histology.
  • Participants who receive sequential (not inclusive of induction) chemoradiation therapy for locally advanced (Stage III) unresectable NSCLC.
  • Participants with locally advanced (Stage III) unresectable NSCLC who have progressed during platinum-based cCRT.
  • Any unresolved toxicity CTCAE >Grade 2 from the prior chemoradiation therapy (excluding alopecia).
  • Participants with ≥grade 2 pneumonitis from prior chemoradiation therapy.
  • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis, ILD, pleural effusion, or pulmonary fibrosis diagnosed in the past 6 months prior to randomization.
  • Active or prior documented autoimmune or inflammatory disorders (with exceptions)
  • Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab.
Contacts and Locations
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Information from the National Library of Medicine

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): NCT05221840


Contacts
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Contact: AstraZeneca Clinical Study Information Center 1-877-240-9479 information.center@astrazeneca.com

Locations
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Sponsors and Collaborators
AstraZeneca
Investigators
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Principal Investigator: Fabrice Barlesi, MD Gustave Roussy, Cancer Campus, Grand Paris
More Information
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Responsible Party: AstraZeneca
ClinicalTrials.gov Identifier: NCT05221840    
Other Study ID Numbers: D9078C00001
2021-004346-37 ( EudraCT Number )
First Posted: February 3, 2022    Key Record Dates
Last Update Posted: October 12, 2022
Last Verified: October 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description:

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. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Access Criteria: When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
URL: https://astrazenecagroup-dt.pharmacm.com/DT/Home

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by AstraZeneca:
Non-Small Cell Lung Cancer
Locally Advanced NSCLC
Additional relevant MeSH terms:
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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
Durvalumab
Antineoplastic Agents, Immunological
Antineoplastic Agents