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Durvalumab or Placebo in Combination With Gemcitabine/Cisplatin in Patients With 1st Line Advanced Biliary Tract Cancer (TOPAZ-1)

A Phase III Randomized, Double-Blind Placebo Controlled, Multi-Regional, International Study of Durvalumab in Combination With Gemcitabine Plus Cisplatin Versus Placebo in Combination With Gemcitabine Plus Cisplatin for Patients With First-Line Advanced Biliary Tract Cancers

Status
Active, not recruiting
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03875235
Acronym
TOPAZ-1
Enrollment
810
Registered
2019-03-14
Start date
2019-04-16
Completion date
2027-05-16
Last updated
2026-08-26

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

Conditions

Biliary Tract Neoplasms

Keywords

First-Line Advanced Biliary Tract Cancers (BTC), Durvalumab, Gemcitabine/Cisplatin, Placebo

Brief summary

Durvalumab or Placebo in Combination With Gemcitabine/Cisplatin in Patients With 1st Line Advanced Biliary Tract Cancer (TOPAZ-1).

Detailed description

A Phase III Randomized, Double-Blind Placebo Controlled, Multi-Regional, International Study of Durvalumab in Combination with Gemcitabine Plus Cisplatin Versus Placebo in Combination with Gemcitabine Plus Cisplatin for Patients With First-Line Advanced Biliary Tract Cancers.

Interventions

DRUGDurvalumab

IV infusion every 3 weeks with gemcitabine plus cisplatin up to 8 cycles followed by monotherapy every 4 weeks until disease progression or other discontinuation criteria.

DRUGPlacebo

IV infusion every 3 weeks with gemcitabine plus cisplatin up to 8 cycles followed by monotherapy every 4 weeks until disease progression or other discontinuation criteria.

Sponsors

AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Intervention model description

Durvalumab in Combination with Gemcitabine plus Cisplatin Placebo in Combination with Gemcitabine plus Cisplatin

Eligibility

Sex/Gender
ALL
Age
18 Years to 130 Years
Healthy volunteers
No

Inclusion criteria

Inclusion 1. Histologically confirmed, unresectable advanced or metastatic biliary tract, including cholangiocarcinoma (intrahepatic or extrahepatic) and gallbladder carcinoma. 2. Patients with previously untreated disease if unresectable or metastatic at initial diagnosis will be eligible. 3. Patient with recurrent disease \>6 months after curative surgery or \>6 months after the completion of adjuvant therapy (chemotherapy and/or radiation) will be eligible. 4. WHO/ECOG PS of 0 or 1 Exclusion 1. History of another primary malignancy 2. Brain metastases or spinal cord compression 3. Uncontrolled intercurrent illness 4. Major surgical procedure within 28 days prior to the first dose of IP. 5. Prior locoregional therapy such as radioembolization

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)From date of randomization until death due to any cause. Assessed up to maximum of approximately 27 months (from date of randomization to primary analysis data cut-off)Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).
Overall Survival (OS) Rate at 18 MonthsFrom date of randomization until death due to any cause. Calculated at 18 months using the Kaplan-Meier technique.Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).
Overall Survival (OS) Rate at 24 MonthsFrom date of randomization until death due to any cause. Calculated at 24 months using the Kaplan-Meier technique.Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).

Secondary

MeasureTime frameDescription
Progression-free Survival (PFS)Tumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Assessed up to maximum of approximately 27 months.PFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.
Progression-free Survival (PFS) Rate at 9 MonthsTumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Calculated at 9 months using the Kaplan-Meier technique.PFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.
Progression-free Survival (PFS) Rate at 12 MonthsTumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Calculated at 12 months using the Kaplan-Meier techniquePFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.
Objective Response Rate (ORR)Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.Disease assessments based on investigator assessments were determined by using RECIST version 1.1 guidelines. The ORR was defined as the percentage of patients with confirmed complete response (CR) or confirmed partial response (PR). The CR was defined as disappearance of all target and non-target lesions and no new lesions. The PR was defined as \>= 30% decrease in the sum of diameters of target lesions (compared to baseline) and no new non-target lesion. A confirmed CR or PR was defined as 2 CRs or 2 PRs with no evidence of progression in-between. Patients who discontinued randomized treatment without progression, received a subsequent anti-cancer therapy and then responded were not included as responders for ORR.
Duration of Response (DoR)Tumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.The DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.
Duration of Response (DoR): Percentage Remaining in Response at 9 MonthsTumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Calculated at 9 months using the Kaplan-Meier techniqueThe DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.
Duration of Response (DoR): Percentage Remaining in Response at 12 MonthsTumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Calculated at 12 months using the Kaplan-Meier techniqueThe DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.
Disease Control Rate (DCR) - OverallTumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR), partial response (PR) or stable disease (SD).
Disease Control Rate (DCR) - 24 WeeksTumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization.Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 24 or who have stable disease (SD) at least 24 weeks following start of treatment.
Disease Control Rate (DCR) - 32 WeeksTumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter.Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 32 or who have stable disease (SD) at least 32 weeks following start of treatment.
Disease Control Rate (DCR) - 48 WeeksTumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter.Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 48 or who have stable disease (SD) at least 48 weeks following start of treatment.

Countries

Argentina, Bulgaria, Chile, China, France, Hong Kong, India, Italy, Japan, Poland, Russia, South Korea, Taiwan, Thailand, Turkey (Türkiye), United Kingdom, United States

Contacts

STUDY_DIRECTORGordon Cohen

AstraZeneca

Participant flow

Recruitment details

The study is active, not recruiting and conducted in 17 countries with 685 patients who were randomized prior to or on 18 December 2020. Results are reported for the study at data cut-off (DCO) 28 February 2025.

Pre-assignment details

Eligible patients previously untreated for unresectable locally advanced or metastatic Biliary Tract Cancer (BTC) were randomized in a 1:1 ratio with either Durvalumab in combination with Gemcitabine/Cisplatin or Placebo in combination with Gemcitabine/Cisplatin. Randomization was stratified by disease status (initially unresectable versus recurrent) and primary tumor site (IHCC versus EHCC versus GBC).

Participants by arm

ArmCount
Durvalumab + Gemcitabine + Cisplatin
Drug: Durvalumab IV infusion every 3 weeks with gemcitabine plus cisplatin up to 8 cycles followed by monotherapy every 4 weeks until disease progression or other discontinuation criteria.
341
Placebo + Gemcitabine + Cisplatin
Drug: Placebo IV infusion every 3 weeks with gemcitabine plus cisplatin up to 8 cycles followed by monotherapy every 4 weeks until disease progression or other discontinuation criteria.
344
Total685

Baseline characteristics

CharacteristicDurvalumab + Gemcitabine + CisplatinPlacebo + Gemcitabine + CisplatinTotal
Age, Continuous62.2 Years
STANDARD_DEVIATION 10.49
62.6 Years
STANDARD_DEVIATION 10.66
62.4 Years
STANDARD_DEVIATION 10.57
Age, Customized
Age group (years)
>=65 - < 75 years
122 Participants114 Participants236 Participants
Age, Customized
Age group (years)
< 65 years
181 Participants184 Participants365 Participants
Age, Customized
Age group (years)
>= 75 years
38 Participants46 Participants84 Participants
Race/Ethnicity, Customized
Race
American Indian of Alaska Native
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Race
Asian
185 Participants201 Participants386 Participants
Race/Ethnicity, Customized
Race
Black or African American
8 Participants6 Participants14 Participants
Race/Ethnicity, Customized
Race
Other
17 Participants12 Participants29 Participants
Race/Ethnicity, Customized
Race
White
131 Participants124 Participants255 Participants
Sex: Female, Male
Female
172 Participants168 Participants340 Participants
Sex: Female, Male
Male
169 Participants176 Participants345 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
308 / 341326 / 344
other
Total, other adverse events
326 / 338330 / 342
serious
Total, serious adverse events
168 / 338152 / 342

Outcome results

Primary

Overall Survival (OS)

Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).

Time frame: From date of randomization until death due to any cause. Assessed up to maximum of approximately 27 months (from date of randomization to primary analysis data cut-off)

Population: Full analysis set

ArmMeasureValue (MEDIAN)
Durvalumab + Gemcitabine + CisplatinOverall Survival (OS)12.8 Months
Placebo + Gemcitabine + CisplatinOverall Survival (OS)11.5 Months
Comparison: The 2-sided significance level for OS at the second interim analysis was 3%.p-value: 0.02197% CI: [0.64, 0.99]Log Rank
Primary

Overall Survival (OS) Rate at 18 Months

Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).

Time frame: From date of randomization until death due to any cause. Calculated at 18 months using the Kaplan-Meier technique.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinOverall Survival (OS) Rate at 18 Months35.1 Percentage of Participants
Placebo + Gemcitabine + CisplatinOverall Survival (OS) Rate at 18 Months25.6 Percentage of Participants
Primary

Overall Survival (OS) Rate at 24 Months

Overall Survival (OS) was defined as the time from the date of randomization until death due to any cause. Any patient not known to have died at the time of analysis was censored based on the last recorded date on which the patient was known to be alive. Median OS was calculated using the Kaplan-Meier technique. The second interim analysis was pre-specified after approximately 397 OS events occurred in both arms (59% maturity).

Time frame: From date of randomization until death due to any cause. Calculated at 24 months using the Kaplan-Meier technique.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinOverall Survival (OS) Rate at 24 Months24.9 Percentage of Participants
Placebo + Gemcitabine + CisplatinOverall Survival (OS) Rate at 24 Months10.4 Percentage of Participants
Secondary

Disease Control Rate (DCR) - 24 Weeks

Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 24 or who have stable disease (SD) at least 24 weeks following start of treatment.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDisease Control Rate (DCR) - 24 Weeks57.5 Percentage of Participants
Placebo + Gemcitabine + CisplatinDisease Control Rate (DCR) - 24 Weeks48.3 Percentage of Participants
Secondary

Disease Control Rate (DCR) - 32 Weeks

Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 32 or who have stable disease (SD) at least 32 weeks following start of treatment.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDisease Control Rate (DCR) - 32 Weeks41.9 Percentage of Participants
Placebo + Gemcitabine + CisplatinDisease Control Rate (DCR) - 32 Weeks36.3 Percentage of Participants
Secondary

Disease Control Rate (DCR) - 48 Weeks

Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR) or partial response (PR) by week 48 or who have stable disease (SD) at least 48 weeks following start of treatment.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDisease Control Rate (DCR) - 48 Weeks35.2 Percentage of Participants
Placebo + Gemcitabine + CisplatinDisease Control Rate (DCR) - 48 Weeks27.0 Percentage of Participants
Secondary

Disease Control Rate (DCR) - Overall

Disease control rate based on investigator assessments according to RECIST version 1.1 was defined as the rate of best objective response of complete response (CR), partial response (PR) or stable disease (SD).

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDisease Control Rate (DCR) - Overall85.3 Percentage of Participants
Placebo + Gemcitabine + CisplatinDisease Control Rate (DCR) - Overall82.6 Percentage of Participants
Secondary

Duration of Response (DoR)

The DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.

Population: Full analysis set - subjects with objective response and measurable disease at baseline

ArmMeasureValue (MEDIAN)
Durvalumab + Gemcitabine + CisplatinDuration of Response (DoR)6.4 Months
Placebo + Gemcitabine + CisplatinDuration of Response (DoR)6.2 Months
Secondary

Duration of Response (DoR): Percentage Remaining in Response at 12 Months

The DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Calculated at 12 months using the Kaplan-Meier technique

Population: Full analysis set - subjects with objective response and measurable disease at baseline

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDuration of Response (DoR): Percentage Remaining in Response at 12 Months26.1 Percentage of Participants
Placebo + Gemcitabine + CisplatinDuration of Response (DoR): Percentage Remaining in Response at 12 Months15.0 Percentage of Participants
Secondary

Duration of Response (DoR): Percentage Remaining in Response at 9 Months

The DoR was defined as the time from the date of first documented OR (confirmed CR or confirmed PR) until date of documented progression (PD) based on investigator assessments by using RECIST version 1.1 or death in absence of disease progression (i.e. date of PFS event or censoring - date of first response + 1) . A confirmed CR was defined in above outcome measures. The PD was defined at least 20% increase in sum of diameters of target lesions (compared with nadir at 2 consecutive visits with an absolute increase of 5 mm), unequivocal progression of existing non-target lesions or new lesion. For participants who were alive and no documented PD at the time of data cutoff for analysis, DoR was censored at the last evaluable disease assessment date. Median DoR was calculated using Kaplan-Meier method.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Calculated at 9 months using the Kaplan-Meier technique

Population: Full analysis set - subjects with objective response and measurable disease at baseline

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinDuration of Response (DoR): Percentage Remaining in Response at 9 Months32.6 Percentage of Participants
Placebo + Gemcitabine + CisplatinDuration of Response (DoR): Percentage Remaining in Response at 9 Months25.3 Percentage of Participants
Secondary

Objective Response Rate (ORR)

Disease assessments based on investigator assessments were determined by using RECIST version 1.1 guidelines. The ORR was defined as the percentage of patients with confirmed complete response (CR) or confirmed partial response (PR). The CR was defined as disappearance of all target and non-target lesions and no new lesions. The PR was defined as \>= 30% decrease in the sum of diameters of target lesions (compared to baseline) and no new non-target lesion. A confirmed CR or PR was defined as 2 CRs or 2 PRs with no evidence of progression in-between. Patients who discontinued randomized treatment without progression, received a subsequent anti-cancer therapy and then responded were not included as responders for ORR.

Time frame: Tumor assessments (per RECIST 1.1) every 6 weeks for the first 24 weeks relative to the date of randomization and then every 8 weeks thereafter. Assessed up to maximum of approximately 27 months.

Population: Full analysis set - subjects with measurable disease at baseline

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinObjective Response Rate (ORR)26.7 Percentage of Participants
Placebo + Gemcitabine + CisplatinObjective Response Rate (ORR)18.7 Percentage of Participants
p-value: 0.01195% CI: [1.11, 2.31]Cochran-Mantel-Haenszel
Secondary

Progression-free Survival (PFS)

PFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.

Time frame: Tumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Assessed up to maximum of approximately 27 months.

Population: Full analysis set

ArmMeasureValue (MEDIAN)
Durvalumab + Gemcitabine + CisplatinProgression-free Survival (PFS)7.2 Months
Placebo + Gemcitabine + CisplatinProgression-free Survival (PFS)5.7 Months
Comparison: The 2-sided significance level for PFS at the second interim analysis was 4.81%.p-value: 0.00195.19% CI: [0.63, 0.89]Log Rank
Secondary

Progression-free Survival (PFS) Rate at 12 Months

PFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.

Time frame: Tumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Calculated at 12 months using the Kaplan-Meier technique

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinProgression-free Survival (PFS) Rate at 12 Months16.0 Percentage of Participants
Placebo + Gemcitabine + CisplatinProgression-free Survival (PFS) Rate at 12 Months6.6 Percentage of Participants
Secondary

Progression-free Survival (PFS) Rate at 9 Months

PFS based on investigator assessments according to RECIST version 1.1 was defined as time from date of randomization until date of objective disease progression or death (by any cause in the absence of progression), regardless of whether the patient withdrew from randomized therapy or received another anticancer therapy prior to progression. Progression (i.e., PD) was defined as at least a 20% increase in the sum of diameters of target lesions (TLs) and an absolute increase of ≥5mm, taking as reference the smallest sum of diameters since treatment started including the baseline sum of diameters, or a measurable increase in a non-target lesion, or the appearance of new lesions. Median PFS was calculated using the Kaplan-Meier technique.

Time frame: Tumor assessments every 6 weeks after randomization for the first 24 weeks and then every 8 weeks thereafter until date of RECIST 1.1 defined radiological progressive disease or death. Calculated at 9 months using the Kaplan-Meier technique.

Population: Full analysis set

ArmMeasureValue (NUMBER)
Durvalumab + Gemcitabine + CisplatinProgression-free Survival (PFS) Rate at 9 Months34.8 Percentage of Participants
Placebo + Gemcitabine + CisplatinProgression-free Survival (PFS) Rate at 9 Months24.6 Percentage of Participants

Source: ClinicalTrials.gov · Data processed: Aug 27, 2026