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A Study of Tislelizumab (BGB-A317) in Combination With Chemotherapy as First Line Treatment in Participants With Advanced Esophageal Squamous Cell Carcinoma

A Randomized, Placebo-Controlled, Double-Blind Phase 3 Study to Evaluate the Efficacy and Safety of Tislelizumab (BGB-A317) in Combination With Chemotherapy as First-Line Treatment in Patients With Unresectable, Locally Advanced Recurrent or Metastatic Esophageal Squamous Cell Carcinoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03783442
Enrollment
649
Registered
2018-12-21
Start date
2018-12-11
Completion date
2024-08-22
Last updated
2025-07-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Esophageal Squamous Cell Carcinoma (ESCC)

Brief summary

The purpose of this study is to evaluate the efficacy and safety of tislelizumab as first line treatment in combination with chemotherapy in participants with advanced unresectable/metastatic esophageal squamous cell carcinoma (ESCC).

Interventions

DRUGCisplatin

Cisplatin 60-80 mg/m² administered by intravenous infusion every 3 weeks. Cisplatin was used as the platinum agent in China, Taiwan, and Japan.

DRUGOxaliplatin

Oxaliplatin 130 mg/m² administered by intravenous infusion every 3 weeks.

Fluorouracil 750-800 mg/m² administered by intravenous infusion on Days 1-5 of each treatment cycle.

DRUGCapecitabine

Capecitabine 1000 mg/m² administered orally twice daily on Days 1-14 of each treatment cycle

DRUGPaclitaxel

Paclitaxel 175 mg/m² administered by intravenous infusion every 3 weeks.

BIOLOGICALTislelizumab

Tislelizumab 200 mg administered by intravenous infusion every 3 weeks.

DRUGPlacebo

Placebo to match tislelizumab administered by intravenous infusion every 3 weeks.

Sponsors

BeiGene
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: 1. Pathologically (histologically) confirmed diagnosis of ESCC 2. Stage IV unresectable ESCC at first diagnosis OR unresectable, locally advanced recurrent or metastatic disease (per American Joint Committee on Cancer 7th Edition), if there is prior neoadjuvant/adjuvant therapy with platinum-based chemotherapy, a treatment-free interval of at least 6 months is required. Key

Exclusion criteria

1. Palliative radiation treatment for ESCC within 4 weeks of study treatment initiation 2. Prior systemic therapy for unresectable, locally advanced recurrent or metastatic ESCC 3. Received prior therapies targeting programmed cell death protein-1 (PD-1), programmed cell death protein ligand-1 (PD-L1) or PD-L2 4. Participants with evidence of fistula (either esophageal/bronchial or esophageal/aorta) 5. Uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage or medical intervention (clinically significant recurrence requiring an additional intervention within 2 weeks of intervention) 6. Evidence of complete esophageal obstruction not amenable to treatment 7. Unintentional weight loss ≥ 5% within one month prior to randomization or Nutritional Risk Index (NRI) \< 83.5 per investigator's choice 8. Locally advanced esophageal carcinoma that is resectable or potentially curable with radiation therapy per local investigator. 9. Participants with untreated chronic hepatitis B or chronic hepatitis B virus (HBV) carriers whose HBV DNA is ≥ 500 IU/mL or participants with active hepatitis C virus (HCV) NOTE: Other protocol defined Inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.Overall survival is defined as the time from the date of randomization until the date of death due to any cause. Median OS was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority.

Secondary

MeasureTime frameDescription
Duration of Response (DOR)From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.DOR is defined as the time from the first determination of an objective response until the first documentation of progression assessed by the investigator per RECIST v1.1 or death, whichever occurred first. Median DOR was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.
Objective Response Rate (ORR)Response was assessed every 6 weeks for the first 48 weeks, then every 9 weeks thereafter; up to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.ORR is defined as the percentage of participants whose best overall response (BOR) was complete response (CR) or partial response (PR) assessed by the investigator per RECIST v1.1. Tumor assessments included computed tomography (CT) scans or magnetic resonance imaging (MRI), with preference for CT, of the neck, chest, and abdomen. CR: Disappearance of all target and nontarget lesions with no new lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm. PR: Disappearance of all target lesions with persistence of 1 or more nontarget lesion(s), no new lesions, and/or maintenance of tumor marker level above the normal limits, or, at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis (data cutoff date of 28 February 2022).
Overall Survival (OS) in Participants With a PD-L1 Score ≥ 10%From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.OS is defined as the time from the date of randomization until the date of death due to any cause. Median OS was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.
Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresBaseline, Cycle 6 (Week 15)The EORTC-QLQ-OES18 is the specific esophageal symptoms module of the QLQ-C30. QLQ-OES18 is comprised of 18 questions grouped into 4 multi-item subscales: Dysphagia (3 items), Eating (4 items), Reflux (2 items), and Pain (3 items) and 6 single item subscales (trouble swallowing saliva, choking, dry mouth, taste, coughing, and talking). Participants indicate the extent to which they have experienced symptoms on a scale from 1 (Not at all) to 4 (Very much). Scores are calculated as the average of the items that contribute to the scale, then transformed to a scale from 0 to 100. The OES18 index score is calculated as the average of the 4 multi-item subscales and 6 single-item subscales. Higher scores indicate a higher level of symptomatology or problems.
Progression-Free Survival (PFS)From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.Progression-free survival is defined as the time from the date of randomization to the date of first documentation of disease progression assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, or death, whichever occurred first. Median PFS was estimated using the Kaplan-Meier method. Progressive disease is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, and an absolute increase of at least 5 mm, or unequivocal progression of existing nontarget lesions, or the appearance of 1 or more new lesions. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.
Change From Baseline in EORTC QLQ-C30 Fatigue ScaleBaseline, Cycle 6 (Week 15)The EORTC QLQ-30 contains 30 questions that incorporate 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The participant answers questions about their health during the past week. There are 28 questions answered on a 4-point scale where 1 = Not at all (best) and 4 = Very Much (worst) and 2 global health quality of life (QOL) questions answered on a 7-point scale where 1 = Very poor and 7 = Excellent. Raw scores are transformed to a 0 to 100 scale via linear transformation. The fatigue symptom scale includes 3 items and ranges from 0 to 100, where higher scores indicate a higher level of symptoms.
Change From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS)Baseline, Cycle 6 (Week 15)The EQ-5D-5L measures health outcomes using a VAS to record a participant's self-rated health on a scale from 0 to 100, where 100 is 'the best health you can imagine' and 0 is 'the worst health you can imagine.' A higher score indicates better health outcomes.
Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)From first dose of study drug up to 30 days after last dose; maximum time on treatment was 63.5 months.An AE is defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drugs, whether related to study drugs or not. An SAE is any untoward medical occurrence that, at any dose met any of the following criteria: * Resulted in death * Was life-threatening * Required hospitalization or prolongation of existing hospitalization * Resulted in disability/incapacity * Was a congenital anomaly/birth defect * Was considered a significant medical AE by the Investigator based on medical judgement.
Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning ScalesBaseline, Cycle 6 (Week 15)The EORTC QLQ-30 contains 30 questions that incorporate 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The participant answers questions about their health during the past week. There are 28 questions answered on a 4-point scale where 1 = Not at all (best) and 4 = Very Much (worst) and 2 global health quality of life (QOL) questions answered on a 7-point scale where 1 = Very poor and 7 = Excellent. Raw scores are transformed to a 0 to 100 scale via linear transformation. Higher scores in GHS and functional scales indicate better quality of life.

Countries

Australia, Belgium, China, Czechia, France, Germany, Italy, Japan, Poland, Romania, Russia, South Korea, Spain, Taiwan, United Kingdom, United States

Participant flow

Recruitment details

This study was conducted at 162 centers in 16 countries/regions across Asia, Europe, North America, and Oceania.

Pre-assignment details

Participants were randomly assigned (1:1), using an interactive response technology system, to either tislelizumab plus investigator-chosen chemotherapy or placebo plus investigator-chosen chemotherapy. Randomization was stratified by investigator-chosen chemotherapy (platinum plus fluoropyrimidine vs platinum plus paclitaxel), region (Asia \[excluding Japan\] vs Japan vs other regions), and previous definitive therapy (yes vs no).

Participants by arm

ArmCount
Tislelizumab + Chemotherapy
Participants received tislelizumab 200 mg administered IV on Day 1 of each 3-week treatment cycle together with an investigator-chosen chemotherapy doublet until unacceptable toxicity, disease progression or withdrawal for other reasons.
326
Placebo + Chemotherapy
Participants received placebo administered IV on Day 1 of each 3-week treatment cycle together with an investigator-chosen chemotherapy doublet until unacceptable toxicity, disease progression or withdrawal for other reasons.
323
Total649

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath252268
Overall StudyLost to Follow-up76
Overall StudySponsor Ended Study4828
Overall StudyWithdrawal by Subject1921

Baseline characteristics

CharacteristicTislelizumab + ChemotherapyPlacebo + ChemotherapyTotal
Age, Continuous64.0 years65.0 years64.0 years
Geographic Region
Asia (excluding Japan)
210 Participants210 Participants420 Participants
Geographic Region
Japan
33 Participants33 Participants66 Participants
Geographic Region
Rest of World
83 Participants80 Participants163 Participants
Investigator Chosen Chemotherapy
Platinum with Fluoropyrimidine
147 Participants146 Participants293 Participants
Investigator Chosen Chemotherapy
Platinum with Paclitaxel
179 Participants177 Participants356 Participants
Prior Definitive Therapy
No
174 Participants173 Participants347 Participants
Prior Definitive Therapy
Yes
152 Participants150 Participants302 Participants
Programmed Cell Death Protein Ligand-1 (PD-L1) Expression
PD-L1 Score < 10%
151 Participants168 Participants319 Participants
Programmed Cell Death Protein Ligand-1 (PD-L1) Expression
PD-L1 Score ≥ 10%
116 Participants107 Participants223 Participants
Programmed Cell Death Protein Ligand-1 (PD-L1) Expression
Unknown
59 Participants48 Participants107 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
243 Participants243 Participants486 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants3 Participants7 Participants
Race (NIH/OMB)
White
79 Participants76 Participants155 Participants
Sex: Female, Male
Female
44 Participants42 Participants86 Participants
Sex: Female, Male
Male
282 Participants281 Participants563 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
252 / 326268 / 323
other
Total, other adverse events
321 / 324314 / 321
serious
Total, serious adverse events
160 / 324128 / 321

Outcome results

Primary

Overall Survival (OS)

Overall survival is defined as the time from the date of randomization until the date of death due to any cause. Median OS was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority.

Time frame: From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.

Population: The ITT analysis set included all randomized participants

ArmMeasureValue (MEDIAN)
Tislelizumab + ChemotherapyOverall Survival (OS)17.2 months
Placebo + ChemotherapyOverall Survival (OS)10.6 months
p-value: <0.000195% CI: [0.54, 0.8]Stratified Log-rank Test
Secondary

Change From Baseline in EORTC QLQ-C30 Fatigue Scale

The EORTC QLQ-30 contains 30 questions that incorporate 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The participant answers questions about their health during the past week. There are 28 questions answered on a 4-point scale where 1 = Not at all (best) and 4 = Very Much (worst) and 2 global health quality of life (QOL) questions answered on a 7-point scale where 1 = Very poor and 7 = Excellent. Raw scores are transformed to a 0 to 100 scale via linear transformation. The fatigue symptom scale includes 3 items and ranges from 0 to 100, where higher scores indicate a higher level of symptoms.

Time frame: Baseline, Cycle 6 (Week 15)

Population: Participants in the ITT Analysis Set who completed the EORTC QLQ-C30 at Baseline and at least one post-baseline measurement.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Tislelizumab + ChemotherapyChange From Baseline in EORTC QLQ-C30 Fatigue Scale8.0 score on a scale
Placebo + ChemotherapyChange From Baseline in EORTC QLQ-C30 Fatigue Scale9.4 score on a scale
95% CI: [-4.7, 1.9]
Secondary

Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning Scales

The EORTC QLQ-30 contains 30 questions that incorporate 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The participant answers questions about their health during the past week. There are 28 questions answered on a 4-point scale where 1 = Not at all (best) and 4 = Very Much (worst) and 2 global health quality of life (QOL) questions answered on a 7-point scale where 1 = Very poor and 7 = Excellent. Raw scores are transformed to a 0 to 100 scale via linear transformation. Higher scores in GHS and functional scales indicate better quality of life.

Time frame: Baseline, Cycle 6 (Week 15)

Population: Participants in the ITT Analysis Set who completed the EORTC QLQ-C30 at Baseline and at least one post-baseline measurement.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)
Tislelizumab + ChemotherapyChange From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning ScalesGlobal Health Status/ QOL-0.3 score on a scale
Tislelizumab + ChemotherapyChange From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning ScalesPhysical Functioning-4.8 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning ScalesPhysical Functioning-7.3 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) and Physical Functioning ScalesGlobal Health Status/ QOL-3.6 score on a scale
Comparison: Analysis of Change from Baseline in Global Health Status/QoL at Cycle 695% CI: [0.4, 6.2]
Comparison: Analysis of Change from Baseline in Physical Functioning at Cycle 695% CI: [0, 5.1]
Secondary

Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index Scores

The EORTC-QLQ-OES18 is the specific esophageal symptoms module of the QLQ-C30. QLQ-OES18 is comprised of 18 questions grouped into 4 multi-item subscales: Dysphagia (3 items), Eating (4 items), Reflux (2 items), and Pain (3 items) and 6 single item subscales (trouble swallowing saliva, choking, dry mouth, taste, coughing, and talking). Participants indicate the extent to which they have experienced symptoms on a scale from 1 (Not at all) to 4 (Very much). Scores are calculated as the average of the items that contribute to the scale, then transformed to a scale from 0 to 100. The OES18 index score is calculated as the average of the 4 multi-item subscales and 6 single-item subscales. Higher scores indicate a higher level of symptomatology or problems.

Time frame: Baseline, Cycle 6 (Week 15)

Population: Participants in the ITT Analysis Set who completed the EORTC QLQ-OES18 at Baseline and at least one post-baseline measurement.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)
Tislelizumab + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresPain-5.2 score on a scale
Tislelizumab + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresDysphagia-0.5 score on a scale
Tislelizumab + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresIndex Score-1.0 score on a scale
Tislelizumab + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresReflux-1.3 score on a scale
Tislelizumab + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresEating-0.9 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresReflux0.2 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresEating-1.5 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresPain-3.3 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresIndex Score-0.6 score on a scale
Placebo + ChemotherapyChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Oesophageal Cancer 18 Question Module (QLQ-OES18) Dysphagia, Eating, Reflux, Pain, and Index ScoresDysphagia-4.9 score on a scale
Comparison: Analysis of Change from Baseline in EORTC QLQ-OES18 Dysphagia Score at Cycle 6p-value: 0.137295% CI: [-1.4, 10.3]Mixed Models Analysis
Comparison: Analysis of Change from Baseline in EORTC QLQ-OES18 Eating Score at Cycle 6p-value: 0.71395% CI: [-2.5, 3.7]Mixed Models Analysis
Comparison: Analysis of Change from Baseline in EORTC QLQ-OES18 Reflux Score at Cycle 6p-value: 0.300195% CI: [-4.1, 1.3]Mixed Models Analysis
Comparison: Analysis of Change from Baseline in EORTC QLQ-OES18 Pain Score at Cycle 695% CI: [-3.9, 0.2]
Comparison: Analysis of Change from Baseline in EORTC QLQ-OES18 Index Score at Cycle 695% CI: [-2.1, 1.4]
Secondary

Change From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS)

The EQ-5D-5L measures health outcomes using a VAS to record a participant's self-rated health on a scale from 0 to 100, where 100 is 'the best health you can imagine' and 0 is 'the worst health you can imagine.' A higher score indicates better health outcomes.

Time frame: Baseline, Cycle 6 (Week 15)

Population: Participants in the ITT Analysis Set with EQ-5D-5L measurement at both Baseline and Cycle 6.

ArmMeasureValue (MEAN)Dispersion
Tislelizumab + ChemotherapyChange From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS)-1.1 score on a scaleStandard Deviation 15.82
Placebo + ChemotherapyChange From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS)-3.1 score on a scaleStandard Deviation 14.01
Secondary

Duration of Response (DOR)

DOR is defined as the time from the first determination of an objective response until the first documentation of progression assessed by the investigator per RECIST v1.1 or death, whichever occurred first. Median DOR was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.

Time frame: From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.

Population: Participants in the ITT Analysis Set with an objective response

ArmMeasureValue (MEDIAN)
Tislelizumab + ChemotherapyDuration of Response (DOR)7.1 months
Placebo + ChemotherapyDuration of Response (DOR)5.7 months
Secondary

Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)

An AE is defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drugs, whether related to study drugs or not. An SAE is any untoward medical occurrence that, at any dose met any of the following criteria: * Resulted in death * Was life-threatening * Required hospitalization or prolongation of existing hospitalization * Resulted in disability/incapacity * Was a congenital anomaly/birth defect * Was considered a significant medical AE by the Investigator based on medical judgement.

Time frame: From first dose of study drug up to 30 days after last dose; maximum time on treatment was 63.5 months.

Population: Safety analysis set included all participants who received at least 1 dose of study drug

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Tislelizumab + ChemotherapyNumber of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)Treatment-emergent adverse event323 Participants
Tislelizumab + ChemotherapyNumber of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)Serious adverse events160 Participants
Placebo + ChemotherapyNumber of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)Treatment-emergent adverse event319 Participants
Placebo + ChemotherapyNumber of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)Serious adverse events128 Participants
Secondary

Objective Response Rate (ORR)

ORR is defined as the percentage of participants whose best overall response (BOR) was complete response (CR) or partial response (PR) assessed by the investigator per RECIST v1.1. Tumor assessments included computed tomography (CT) scans or magnetic resonance imaging (MRI), with preference for CT, of the neck, chest, and abdomen. CR: Disappearance of all target and nontarget lesions with no new lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to \< 10 mm. PR: Disappearance of all target lesions with persistence of 1 or more nontarget lesion(s), no new lesions, and/or maintenance of tumor marker level above the normal limits, or, at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis (data cutoff date of 28 February 2022).

Time frame: Response was assessed every 6 weeks for the first 48 weeks, then every 9 weeks thereafter; up to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Tislelizumab + ChemotherapyObjective Response Rate (ORR)63.5 percentage of participants
Placebo + ChemotherapyObjective Response Rate (ORR)42.4 percentage of participants
p-value: <0.000195% CI: [1.73, 3.27]Cochran-Mantel-Haenszel
Secondary

Overall Survival (OS) in Participants With a PD-L1 Score ≥ 10%

OS is defined as the time from the date of randomization until the date of death due to any cause. Median OS was estimated using the Kaplan-Meier method. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.

Time frame: From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.

Population: ITT Analysis Set participants with PD-L1 score ≥ 10%

ArmMeasureValue (MEDIAN)
Tislelizumab + ChemotherapyOverall Survival (OS) in Participants With a PD-L1 Score ≥ 10%16.6 months
Placebo + ChemotherapyOverall Survival (OS) in Participants With a PD-L1 Score ≥ 10%10.0 months
p-value: 0.002995% CI: [0.44, 0.87]Stratified Log-rank test
Secondary

Progression-Free Survival (PFS)

Progression-free survival is defined as the time from the date of randomization to the date of first documentation of disease progression assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, or death, whichever occurred first. Median PFS was estimated using the Kaplan-Meier method. Progressive disease is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, and an absolute increase of at least 5 mm, or unequivocal progression of existing nontarget lesions, or the appearance of 1 or more new lesions. Primary analysis (data cut-off date of 28 February 2022) was the pre-defined analysis at which the primary endpoint was tested for superiority. Testing for all secondary efficacy endpoints was conducted at the time of the primary analysis.

Time frame: From randomization to the primary analysis cutoff date of 28 February 2022; maximum time on follow-up was 3 years and 2 months.

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Tislelizumab + ChemotherapyProgression-Free Survival (PFS)7.3 months
Placebo + ChemotherapyProgression-Free Survival (PFS)5.6 months
p-value: <0.000195% CI: [0.52, 0.75]Stratified Log-rank test

Source: ClinicalTrials.gov · Data processed: Apr 2, 2026