Esophageal Squamous Cell Carcinoma (ESCC)
Conditions
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
Cisplatin 60-80 mg/m² administered by intravenous infusion every 3 weeks. Cisplatin was used as the platinum agent in China, Taiwan, and Japan.
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.
Capecitabine 1000 mg/m² administered orally twice daily on Days 1-14 of each treatment cycle
Paclitaxel 175 mg/m² administered by intravenous infusion every 3 weeks.
Tislelizumab 200 mg administered by intravenous infusion every 3 weeks.
Placebo to match tislelizumab administered by intravenous infusion every 3 weeks.
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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 Scores | Baseline, 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 Scale | Baseline, 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 Scales | Baseline, 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
| Arm | Count |
|---|---|
| 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 |
| Total | 649 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 252 | 268 |
| Overall Study | Lost to Follow-up | 7 | 6 |
| Overall Study | Sponsor Ended Study | 48 | 28 |
| Overall Study | Withdrawal by Subject | 19 | 21 |
Baseline characteristics
| Characteristic | Tislelizumab + Chemotherapy | Placebo + Chemotherapy | Total |
|---|---|---|---|
| Age, Continuous | 64.0 years | 65.0 years | 64.0 years |
| Geographic Region Asia (excluding Japan) | 210 Participants | 210 Participants | 420 Participants |
| Geographic Region Japan | 33 Participants | 33 Participants | 66 Participants |
| Geographic Region Rest of World | 83 Participants | 80 Participants | 163 Participants |
| Investigator Chosen Chemotherapy Platinum with Fluoropyrimidine | 147 Participants | 146 Participants | 293 Participants |
| Investigator Chosen Chemotherapy Platinum with Paclitaxel | 179 Participants | 177 Participants | 356 Participants |
| Prior Definitive Therapy No | 174 Participants | 173 Participants | 347 Participants |
| Prior Definitive Therapy Yes | 152 Participants | 150 Participants | 302 Participants |
| Programmed Cell Death Protein Ligand-1 (PD-L1) Expression PD-L1 Score < 10% | 151 Participants | 168 Participants | 319 Participants |
| Programmed Cell Death Protein Ligand-1 (PD-L1) Expression PD-L1 Score ≥ 10% | 116 Participants | 107 Participants | 223 Participants |
| Programmed Cell Death Protein Ligand-1 (PD-L1) Expression Unknown | 59 Participants | 48 Participants | 107 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 243 Participants | 243 Participants | 486 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 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 | 4 Participants | 3 Participants | 7 Participants |
| Race (NIH/OMB) White | 79 Participants | 76 Participants | 155 Participants |
| Sex: Female, Male Female | 44 Participants | 42 Participants | 86 Participants |
| Sex: Female, Male Male | 282 Participants | 281 Participants | 563 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 252 / 326 | 268 / 323 |
| other Total, other adverse events | 321 / 324 | 314 / 321 |
| serious Total, serious adverse events | 160 / 324 | 128 / 321 |
Outcome results
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Tislelizumab + Chemotherapy | Overall Survival (OS) | 17.2 months |
| Placebo + Chemotherapy | Overall Survival (OS) | 10.6 months |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Tislelizumab + Chemotherapy | Change From Baseline in EORTC QLQ-C30 Fatigue Scale | 8.0 score on a scale |
| Placebo + Chemotherapy | Change From Baseline in EORTC QLQ-C30 Fatigue Scale | 9.4 score on a scale |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Tislelizumab + Chemotherapy | 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 | Global Health Status/ QOL | -0.3 score on a scale |
| Tislelizumab + Chemotherapy | 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 | Physical Functioning | -4.8 score on a scale |
| Placebo + Chemotherapy | 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 | Physical Functioning | -7.3 score on a scale |
| Placebo + Chemotherapy | 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 | Global Health Status/ QOL | -3.6 score on a scale |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Tislelizumab + Chemotherapy | 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 | Pain | -5.2 score on a scale |
| Tislelizumab + Chemotherapy | 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 | Dysphagia | -0.5 score on a scale |
| Tislelizumab + Chemotherapy | 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 | Index Score | -1.0 score on a scale |
| Tislelizumab + Chemotherapy | 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 | Reflux | -1.3 score on a scale |
| Tislelizumab + Chemotherapy | 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 | Eating | -0.9 score on a scale |
| Placebo + Chemotherapy | 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 | Reflux | 0.2 score on a scale |
| Placebo + Chemotherapy | 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 | Eating | -1.5 score on a scale |
| Placebo + Chemotherapy | 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 | Pain | -3.3 score on a scale |
| Placebo + Chemotherapy | 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 | Index Score | -0.6 score on a scale |
| Placebo + Chemotherapy | 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 | Dysphagia | -4.9 score on a scale |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tislelizumab + Chemotherapy | Change From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS) | -1.1 score on a scale | Standard Deviation 15.82 |
| Placebo + Chemotherapy | Change From Baseline in European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS) | -3.1 score on a scale | Standard Deviation 14.01 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Tislelizumab + Chemotherapy | Duration of Response (DOR) | 7.1 months |
| Placebo + Chemotherapy | Duration of Response (DOR) | 5.7 months |
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
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Tislelizumab + Chemotherapy | Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | Treatment-emergent adverse event | 323 Participants |
| Tislelizumab + Chemotherapy | Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | Serious adverse events | 160 Participants |
| Placebo + Chemotherapy | Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | Treatment-emergent adverse event | 319 Participants |
| Placebo + Chemotherapy | Number of Participants Experiencing Treatment-emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | Serious adverse events | 128 Participants |
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Tislelizumab + Chemotherapy | Objective Response Rate (ORR) | 63.5 percentage of participants |
| Placebo + Chemotherapy | Objective Response Rate (ORR) | 42.4 percentage of participants |
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%
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Tislelizumab + Chemotherapy | Overall Survival (OS) in Participants With a PD-L1 Score ≥ 10% | 16.6 months |
| Placebo + Chemotherapy | Overall Survival (OS) in Participants With a PD-L1 Score ≥ 10% | 10.0 months |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Tislelizumab + Chemotherapy | Progression-Free Survival (PFS) | 7.3 months |
| Placebo + Chemotherapy | Progression-Free Survival (PFS) | 5.6 months |