LOGIK1604/NEJ032A (TAKUMI Trial)

JRCT ID: jRCTs071180062

Registered date:19/03/2019

Basic Information

• Recruitment status: Complete
• Health condition(s) or Problem(s) studied: Non-Small Cell Lung Cancer
• Date of first enrollment: 20/12/2016
• Target sample size: 90
• Study type: Interventional

Intervention(s)

Group A: Osimertinib monotherapy
Consecutively administer oral dose of osimertinib at 80 mg/day every day at almost the same time for 3 weeks as one course, and continue treatment unless any of the discontinuation criteria of protocol treatment is applicable.
Group B: Combination therapy with osimertinib
1.Combination therapy with osimertinib/carboplatin/pemetrexed
Three weeks of the following regimen will consist of one course and 4 courses will be repeated unless discontinuation criteria for protocol treatment is applicable. Qsimertinib at 80 mg/day will be orally administered every day at almost the same time.
Carboplatin (AUC=5) wiil be administered at day 1 every 3 weeks course.
Pemeterexed at 500 mg/m2 will be administered at day 1 every 3 weeks course.
2. Combination maintenance therapy with osimertinib/pemetrexed in the case of CR, PR SD
Three weeks of the following regimen will consist of one course and continue unless discontinuation criteria for protocol treatment is applicable.
Qsimertinib at 80 mg/day will be orally administered every day at almost the same time.
Pemeterexed at 500 mg/m2 will be administered at day 1 every 3 weeks course.

Outcome(s)

• Primary Outcome: progression free survival
• Secondary Outcome: response rate, overall survival, incidence of adverse events

Key inclusion & exclusion criteria

• Age minimum: >= 20age old
• Age maximum: Not applicable
• Gender: Both

Include criteria

1) Clinical stage IIIB or IV or postoperative recurrent non-squamous non-small cell lung cancer harbouring susceptible EGFR mutations (G719X mutation, exon 19 deletion, L858R mutation, L861Q mutation) that cannot be treated with curative radiotherapy
2) Aggravation confirmed by imaging diagnosis after treatment with the first- and second-generation EGFR-TKI and T790M mutation confirmed in tumor tissue specimens or blood specimen after exacerbation
3) No history of treatment with cytotoxic drugs. However, the patients who received the final dose more than one year prior to enrollment are eligible in case of recurrence after pre-or postoperative adjuvant chemotherapy.
4) At least 8 days passed after the final dose of EGFR-TKI.
5) Aged 20 years or older at the time of informed consent
6) ECOG performance status (PS): 0 or 1
7) No palliative radiotherapy for metastatic lesion(s) (including gamma knife therapy for brain metastasis within 7 days) within 14 days before enrollment
8) No Grade 3 or higher superior vena cava syndrome, pericardial effusion, pleural effusion, or ascites
9) Irrespective of measurable lesion
10) All of the following criteria are met based on the laboratory data at the start of treatment (The data obtained within 14 days of enrollment: the same day of the week 2 weeks before enrollment is allowed):
1.WBC count:>=3000 /mm3
2.Neutrophil count:>=1500 /mm3
3.Hemoglobin:>= 9.0 g/dL (no blood transfusion within 14 days of screening)
4.Platelet count:>=10X10,000/mm3
5.AST:=< 100 IU/L
6.ALT:=< 100 IU/L
7.Total bilirubin:=< 1.5 mg/dL
8.SpO2:>=92 % (room air). Patients with SpO2 <92% are eligible if PaO2 is >=60 torr.
9.Creatinine:=<1.2 mg/dL
10. Creatinine clearance >=45 mL/min However, Ccr shall not exceed 120 (ml/min).
11)Have given written consent to participate in the study after receiving detailed explanation of the study

Exclude criteria

1) Active double cancer (simultaneous double cancer/multiple cancer, and metachronous double cancer/multiple cancer within 5 years of disease-free period. However, carcinoma in situ and a lesion equivalent to intramucosal carcinoma judged cured by local therapy are not included as active double cancer/multiple cancer).
2) Evidence of interstitial pneumonia or pulmonary fibrosis by chest CT scan /Radiation pneumonitis which required steroid treatment
3) Not able to swallow oral medications
4) Previous treatment history of immune checkpoint inhibitors
5) Infection requiring systemic treatment
6) Fever of >=38(axillary temperature) at the time of enrollment
7) Psychosis or psychotic symptoms that may interfere with the patient's participation in the study
8) Symptomatic brain metastasis (clinically stable brain metastasis is eligible)
9) Adverse event of >=Grade 2 considered attributable to EGFR-TKI of the prior therapy
10) Receiving continuous systemic (oral or intravenous) immunosuppressant therapy
11) Complication of diabetes mellitus treated with continued use of insulin or poorly controlled diabetes mellitus
12) Complication of unstable angina (new-onset angina or exacerbation of angina within the last 3 weeks) or history of myocardial infarction within 6 months.
13) HBs antigen-positive
14) Pregnant or possibly pregnant women, lactating women, or patients who wish to become pregnant
15) Patients who, in the opinion of the attending physician, are inappropriate for the study

Related Information

• Primary Sponsor: Okamoto Isamu
• Source(s) of Monetary Support: AstraZeneca K.K.
• Secondary ID(s): UMIN000024438