Lung Cancer
Conditions
Brief summary
The purpose of this study is to compare the overall survival of nivolumab versus chemotherapy in subjects with relapsed SCLC.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Histologically or cytologically confirmed small cell lung cancer (SCLC) * Subjects with either limited or extensive disease stage at the initial diagnosis * Must have recurrence or progression after platinum-based first-line chemotherapy or chemoradiation therapy for the treatment of limited or extensive disease stage SCLC * Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
Exclusion criteria
* Untreated or symptomatic central nervous system (CNS) metastases * Prior therapy with anti-PD-1, anti-PDL1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody * Inadequate hematologic or hepatic function
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 15.8 months | The time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression Free Survival (PFS) | From randomization to the date of first documented tumor progression, or death due to any cause. Tumor response assessed every 6 weeks from first dose until week 30, and every 12 weeks (Up to approximately 80 months) | PFS is defined as the time from randomization to the date of the first documented tumor progression based on investigator assessment (per RECIST 1.1), or death due to any cause. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die will be censored on the date they were randomized. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to initiation of the subsequent anti-cancer therapy. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm. |
| Objective Response Rate (ORR) | From randomization to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (Up to approximately 80 months) | ORR is defined as the percentage of randomized participants whose best overall response (BOR) from baseline is either a complete response (CR) or partial response (PR) based on investigator assessment per RECIST 1.1 criteria. For participants without documented progression or subsequent anti-cancer therapy, all available response designations will contribute to the BOR determination. For participants who continue nivolumab beyond progression, the BOR should be determined based on tumor assessments before initial RECIST 1.1 defined progression. CR= Disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR= At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm. |
Countries
Australia, Austria, Belgium, Brazil, Chile, China, Czechia, Denmark, France, Germany, Greece, Hungary, Israel, Italy, Japan, Norway, Poland, Romania, Russia, South Korea, Spain, Switzerland, Taiwan, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Group A Nivolumab 240mg IV on Day 1 of a 14-day cycle | 284 |
| Group B Chemotherapy (Topotecan 1.5 mg/m\^2 IV or 2.3 mg/m\^2 oral once daily on Days 1 to 5 of a 21-day cycle / Amrubicin 40 mg/m\^2 IV once daily on Days 1 to 3 of a 21-day cycle) | 285 |
| Total | 569 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Pre-treatment | Disease Progression | 1 | 1 |
| Pre-treatment | Other reasons | 0 | 1 |
| Pre-treatment | Participant no longer meets Study Criteria | 1 | 4 |
| Pre-treatment | Participant request to discontinue study treatment | 0 | 4 |
| Pre-treatment | Withdrawal by Subject | 0 | 10 |
| Treatment | Administrative reason by sponsor | 1 | 1 |
| Treatment | Adverse Event unrelated to Study drug | 14 | 11 |
| Treatment | Death | 1 | 1 |
| Treatment | Disease Progression | 233 | 171 |
| Treatment | Lost to Follow-up | 1 | 0 |
| Treatment | Maximum Clinical Benefit | 0 | 5 |
| Treatment | Other reasons | 6 | 1 |
| Treatment | Participants request to discontinue Study treatment | 6 | 34 |
| Treatment | Study drug toxicity | 18 | 38 |
| Treatment | Withdrawal by Subject | 2 | 3 |
Baseline characteristics
| Characteristic | Group B | Total | Group A |
|---|---|---|---|
| Age, Continuous | 61.6 Years STANDARD_DEVIATION 8.4 | 61.6 Years STANDARD_DEVIATION 8.8 | 61.5 Years STANDARD_DEVIATION 9.2 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants | 10 Participants | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 142 Participants | 267 Participants | 125 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 137 Participants | 292 Participants | 155 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 71 Participants | 141 Participants | 70 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 3 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 2 Participants | 2 Participants |
| Race (NIH/OMB) White | 211 Participants | 422 Participants | 211 Participants |
| Sex: Female, Male Female | 108 Participants | 218 Participants | 110 Participants |
| Sex: Female, Male Male | 177 Participants | 351 Participants | 174 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 251 / 284 | 256 / 285 |
| other Total, other adverse events | 249 / 282 | 248 / 265 |
| serious Total, serious adverse events | 183 / 282 | 171 / 265 |
Outcome results
Overall Survival (OS)
The time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive.
Time frame: OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 15.8 months
Population: All Randomized Participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Group A | Overall Survival (OS) | 7.46 Months |
| Group B | Overall Survival (OS) | 8.38 Months |
Objective Response Rate (ORR)
ORR is defined as the percentage of randomized participants whose best overall response (BOR) from baseline is either a complete response (CR) or partial response (PR) based on investigator assessment per RECIST 1.1 criteria. For participants without documented progression or subsequent anti-cancer therapy, all available response designations will contribute to the BOR determination. For participants who continue nivolumab beyond progression, the BOR should be determined based on tumor assessments before initial RECIST 1.1 defined progression. CR= Disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR= At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.
Time frame: From randomization to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (Up to approximately 80 months)
Population: All Randomized Participants
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Group A | Objective Response Rate (ORR) | 13.7 Percentage of Participants |
| Group B | Objective Response Rate (ORR) | 16.8 Percentage of Participants |
Progression Free Survival (PFS)
PFS is defined as the time from randomization to the date of the first documented tumor progression based on investigator assessment (per RECIST 1.1), or death due to any cause. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die will be censored on the date they were randomized. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to initiation of the subsequent anti-cancer therapy. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.
Time frame: From randomization to the date of first documented tumor progression, or death due to any cause. Tumor response assessed every 6 weeks from first dose until week 30, and every 12 weeks (Up to approximately 80 months)
Population: All Randomized Participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Group A | Progression Free Survival (PFS) | 1.45 Months |
| Group B | Progression Free Survival (PFS) | 3.71 Months |
Overall Survival (OS) - Extended Collection
The time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive.
Time frame: OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 64 months (Up to approximately 80 months)
Population: All Randomized Participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Group A | Overall Survival (OS) - Extended Collection | 7.46 Months |
| Group B | Overall Survival (OS) - Extended Collection | 8.38 Months |