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Tislelizumab in Combination With Sitravatinib in Participants With Locally Advanced or Metastatic Non-Small Cell Lung Cancer

A Randomized Phase 3 Study of Tislelizumab in Combination With Sitravatinib in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer That Progressed on or After Platinum-Based Chemotherapy and Anti-PD-(L)1 Antibody

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04921358
Enrollment
377
Registered
2021-06-10
Start date
2021-07-27
Completion date
2023-12-20
Last updated
2025-06-29

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

Conditions

Non-Small Cell Lung Cancer (NSCLC)

Brief summary

The purpose of this study was to evaluate the efficacy and safety of tislelizumab in combination with sitravatinib compared to docetaxel in participants with locally advanced or metastatic non-small cell lung cancer (NSCLC) who experienced disease progression following platinum-based chemotherapy and anti-programmed cell death protein-1 (PD-1)/programmed cell death ligand-1 (PD-L1) antibody treatment, with the anti-PD-(L)1 antibody administered either in combination with or sequentially before or after the platinum-based chemotherapy.

Interventions

DRUGTislelizumab

200 mg intravenously once every 3 weeks

DRUGDocetaxel

75 mg/m\^2 intravenously once every 3 weeks

DRUGSitravatinib

100 mg orally once daily

Sponsors

BeiGene
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

Key Inclusion Criteria: 1. Metastatic or unresectable locally advanced histologically or cytologically confirmed Non-Small Cell Lung Cancer (NCSLC), not amenable to treatment with curative intent 2. Able to provide archival/fresh tumor tissues for biomarker analysis to assess PD-L1 expression and other biomarkers. 3. No known Epidermal Growth Factor Receptor (EGFR) or B-Raf proto-oncogene (BRAF) sensitizing mutation, or anaplastic lymphoma kinase (ALK) rearrangement or ROS proto oncogene 1 (ROS1) rearrangement 4. Radiographic progression per Response Evaluation Criteria in Solid Tumours (RECIST) v1.1 on or after anti-PD-(L)1 containing therapy for locally advanced and unresectable or metastatic NSCLC. 5. No prior anticancer therapy having the same mechanism of action as sitravatinib (eg, tyrosine kinase inhibitor with a similar target profile or vascular endothelial growth factor (VEGF)- or VEGFR inhibitor) 6. At least 1 measurable lesion as defined based on RECIST v1.1 by investigator Key

Exclusion criteria

1. Has received docetaxel as monotherapy or in combination with other therapies. 2. Squamous NSCLC with central cavitation, or NSCLC with hemoptysis (\> 50 mL/day) 3. Participants with tumor shown by imaging to be located around important vascular structures or if the investigator determines that the tumor is likely to invade important blood vessels and may cause fatal bleeding. 4. Active leptomeningeal disease for metastatic NSCLC, or uncontrolled or untreated brain metastasis. 5. Active autoimmune diseases or history of autoimmune diseases that may relapse. NOTE: Other protocol defined Inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the time from randomization until the date of death due to any cause. Kaplan-Meier methodology was used to estimate the median OS.
Progression Free Survival (PFS) as Assessed by the Independent Review Committee (IRC)Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the time from randomization until first documentation of disease progression as assessed by the IRC based on Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death from any cause, whichever occured first. Kaplan-Meier methodology was used to estimate the median PFS.

Secondary

MeasureTime frameDescription
Duration of Response (DOR)Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the time from the first occurrence of a documented objective response to the time of the first occurrence of disease progression, as determined by the IRC based on RECIST v1.1, or death from any cause, whichever occurs first.
Disease Control Rate (DCR)Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the percentage of participants whose best overall response (BOR) is complete response, partial response, or stable disease per RECIST v1.1.
Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresBaseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)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 into a 0 to 100 scale via linear transformation. Higher scores in GHS and functional scales indicate better quality of life.
Overall Response Rate (ORR)Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR) as assessed by the IRC per RECIST v1.1.
Change From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)Baseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)The EQ-5D-5L comprises a descriptive module that includes five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression and a Visual Analogue Scale. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The VAS records a participant's self-rated health on a vertical scale from 0 to 100, where 0 is 'the worst health you can imagine and 100 is 'the best health you can imagine'. A higher score indicates better health outcomes.
Number of Participants With Adverse EventsFrom the first dose through 30 days after the final dose or until new anticancer therapy, whichever came first, (a median treatment duration of approximately 4 months in Arm 1 and 2 months in Arm 2).Number of participants with treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs), according to National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0
Change From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesBaseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)The EORTC QLQ-LC13 is the lung cancer module of the QLQ-C30 and measures lung cancer-specific disease and treatment symptoms. It includes 13 questions about specific symptoms in which participants respond based on a 4-point scale, where 1 is not at all and 4 is very much. Raw scores are transformed into a 0 to 100 scale via linear transformation. Lower scores indicate an improvement in symptoms.
Progression Free Survival (PFS) as Assessed by the InvestigatorUntil the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).Defined as the time from randomization until first documentation of disease progression as determined by the investigator based on RECIST v1.1, or death from any cause, whichever occured first. Kaplan-Meier methodology was used to estimate the median PFS.

Countries

Australia, China

Participant flow

Recruitment details

Participants were enrolled across multiple study centers in China and Australia. The first participant was dosed on July 27th, 2021, and the last participant completed the study on December 20th, 2023. A decision to terminate the study was made on September 25th, 2023.

Pre-assignment details

Patients were randomized in a 1:1 ratio to one of two treatment groups.

Participants by arm

ArmCount
Tislelizumab + Sitravatinib
Participants received 200 mg of intravenous tislelizumab every 3 weeks, combined with 100 mg of oral sitravatinib daily.
187
Docetaxel
Participants received 75 mg/m² of intravenous docetaxel every 3 weeks.
190
Total377

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath9282
Overall StudyLost to Follow-up36
Overall StudyStudy Terminated by Sponsor8689
Overall StudyWithdrawal by Subject613

Baseline characteristics

CharacteristicDocetaxelTotalTislelizumab + Sitravatinib
Age, Continuous61.3 Years
STANDARD_DEVIATION 8.77
61.3 Years
STANDARD_DEVIATION 8.6
61.2 Years
STANDARD_DEVIATION 8.43
Histology
Non-squamous
93 Participants184 Participants91 Participants
Histology
Squamous
97 Participants193 Participants96 Participants
PD-L1 Expression Status
< 1% Tumor Cells
119 Participants235 Participants116 Participants
PD-L1 Expression Status
>= 1% Tumor Cells
71 Participants142 Participants71 Participants
Race/Ethnicity, Customized
Asian
177 Participants352 Participants175 Participants
Race/Ethnicity, Customized
White
13 Participants25 Participants12 Participants
Region of Enrollment
Australia
15 participants28 participants13 participants
Region of Enrollment
China
175 participants349 participants174 participants
Sex: Female, Male
Female
39 Participants73 Participants34 Participants
Sex: Female, Male
Male
151 Participants304 Participants153 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
92 / 18782 / 190
other
Total, other adverse events
181 / 186150 / 177
serious
Total, serious adverse events
83 / 18666 / 177

Outcome results

Primary

Overall Survival (OS)

Defined as the time from randomization until the date of death due to any cause. Kaplan-Meier methodology was used to estimate the median OS.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: The Intent-to-Treat (ITT) analysis set consists of all participants who were randomized to a treatment arm.

ArmMeasureValue (MEDIAN)
Tislelizumab + SitravatinibOverall Survival (OS)11.5 Months
DocetaxelOverall Survival (OS)11.4 Months
95% CI: [0.75, 1.39]
Primary

Progression Free Survival (PFS) as Assessed by the Independent Review Committee (IRC)

Defined as the time from randomization until first documentation of disease progression as assessed by the IRC based on Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death from any cause, whichever occured first. Kaplan-Meier methodology was used to estimate the median PFS.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Tislelizumab + SitravatinibProgression Free Survival (PFS) as Assessed by the Independent Review Committee (IRC)4.4 Months
DocetaxelProgression Free Survival (PFS) as Assessed by the Independent Review Committee (IRC)2.9 Months
95% CI: [0.62, 1.07]
Secondary

Change From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain Scales

The EORTC QLQ-LC13 is the lung cancer module of the QLQ-C30 and measures lung cancer-specific disease and treatment symptoms. It includes 13 questions about specific symptoms in which participants respond based on a 4-point scale, where 1 is not at all and 4 is very much. Raw scores are transformed into a 0 to 100 scale via linear transformation. Lower scores indicate an improvement in symptoms.

Time frame: Baseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)

Population: Participants in the ITT Analysis Set with available data at Baseline and each postbaseline visit

ArmMeasureGroupValue (MEAN)Dispersion
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesCoughing at Cycle 7-5.2 score on a scaleStandard Deviation 25.08
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesCoughing at Cycle 51.6 score on a scaleStandard Deviation 30.09
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesDyspnoea at Cycle 52.6 score on a scaleStandard Deviation 19.09
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesDyspnoea at Cycle 7-0.9 score on a scaleStandard Deviation 14.66
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesChest Pain at Cycle 5-0.6 score on a scaleStandard Deviation 24.45
Tislelizumab + SitravatinibChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesChest Pain at Cycle 7-2.4 score on a scaleStandard Deviation 22.43
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesChest Pain at Cycle 5-0.5 score on a scaleStandard Deviation 20.21
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesDyspnoea at Cycle 72.1 score on a scaleStandard Deviation 14.43
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesCoughing at Cycle 5-2.4 score on a scaleStandard Deviation 27.61
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesCoughing at Cycle 7-1.3 score on a scaleStandard Deviation 29.49
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesChest Pain at Cycle 7-1.3 score on a scaleStandard Deviation 16.12
DocetaxelChange From Baseline in EORTC Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) Coughing, Dyspnoea, and Chest Pain ScalesDyspnoea at Cycle 54.5 score on a scaleStandard Deviation 16.76
Secondary

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

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 into a 0 to 100 scale via linear transformation. Higher scores in GHS and functional scales indicate better quality of life.

Time frame: Baseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)

Population: Participants in the ITT Analysis Set with available at Baseline and each postbaseline visit

ArmMeasureGroupValue (MEAN)Dispersion
Tislelizumab + SitravatinibChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresGlobal Health Status at Cycle 5-5.5 score on a scaleStandard Deviation 16.05
Tislelizumab + SitravatinibChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresGlobal Health Status at Cycle 7-6.1 score on a scaleStandard Deviation 15.86
Tislelizumab + SitravatinibChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresPhysical Functioning at Cycle 5-4.1 score on a scaleStandard Deviation 12.76
Tislelizumab + SitravatinibChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresPhysical Functioning at Cycle 7-2.8 score on a scaleStandard Deviation 12.3
DocetaxelChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresPhysical Functioning at Cycle 7-3.1 score on a scaleStandard Deviation 16.98
DocetaxelChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresGlobal Health Status at Cycle 5-3.0 score on a scaleStandard Deviation 18.69
DocetaxelChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresPhysical Functioning at Cycle 5-5.1 score on a scaleStandard Deviation 15.89
DocetaxelChange From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status (GHS) and Physical Functioning ScoresGlobal Health Status at Cycle 7-3.4 score on a scaleStandard Deviation 17.25
Secondary

Change From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)

The EQ-5D-5L comprises a descriptive module that includes five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression and a Visual Analogue Scale. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The VAS records a participant's self-rated health on a vertical scale from 0 to 100, where 0 is 'the worst health you can imagine and 100 is 'the best health you can imagine'. A higher score indicates better health outcomes.

Time frame: Baseline and Cycle 5 Day 1 (Week 12) and Cycle 7 Day 1 (Week 18)

Population: Participants in the ITT Analysis Set with available at Baseline and each postbaseline visit

ArmMeasureGroupValue (MEAN)Dispersion
Tislelizumab + SitravatinibChange From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)Cycle 5-6.1 score on a scaleStandard Deviation 14.27
Tislelizumab + SitravatinibChange From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)Cycle 7-5.9 score on a scaleStandard Deviation 12.31
DocetaxelChange From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)Cycle 5-3.5 score on a scaleStandard Deviation 13.76
DocetaxelChange From Baseline in European Quality of Life-5 Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS)Cycle 7-3.2 score on a scaleStandard Deviation 12.6
Secondary

Disease Control Rate (DCR)

Defined as the percentage of participants whose best overall response (BOR) is complete response, partial response, or stable disease per RECIST v1.1.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: ITT Analysis Set.

ArmMeasureValue (NUMBER)
Tislelizumab + SitravatinibDisease Control Rate (DCR)69.5 percentage of participants
DocetaxelDisease Control Rate (DCR)53.7 percentage of participants
Secondary

Duration of Response (DOR)

Defined as the time from the first occurrence of a documented objective response to the time of the first occurrence of disease progression, as determined by the IRC based on RECIST v1.1, or death from any cause, whichever occurs first.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: ITT Analysis Set. Only participants with best overall response of complete response or partial response confirmed per RECIST v1.1 were included in the analysis, and percentages were based on the number of responders.

ArmMeasureValue (MEDIAN)
Tislelizumab + SitravatinibDuration of Response (DOR)6.0 months
DocetaxelDuration of Response (DOR)NA months
Secondary

Number of Participants With Adverse Events

Number of participants with treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs), according to National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0

Time frame: From the first dose through 30 days after the final dose or until new anticancer therapy, whichever came first, (a median treatment duration of approximately 4 months in Arm 1 and 2 months in Arm 2).

Population: The Safety analysis set includes all participants who were randomized and received any dose of any study drug

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Tislelizumab + SitravatinibNumber of Participants With Adverse EventsTEAEs183 Participants
Tislelizumab + SitravatinibNumber of Participants With Adverse EventsSAEs83 Participants
DocetaxelNumber of Participants With Adverse EventsSAEs66 Participants
DocetaxelNumber of Participants With Adverse EventsTEAEs162 Participants
Secondary

Overall Response Rate (ORR)

Defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR) as assessed by the IRC per RECIST v1.1.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Tislelizumab + SitravatinibOverall Response Rate (ORR)12.3 percentage of participants
DocetaxelOverall Response Rate (ORR)12.6 percentage of participants
Secondary

Progression Free Survival (PFS) as Assessed by the Investigator

Defined as the time from randomization until first documentation of disease progression as determined by the investigator based on RECIST v1.1, or death from any cause, whichever occured first. Kaplan-Meier methodology was used to estimate the median PFS.

Time frame: Until the study completion data cut-off date of December 20, 2023, or the last available date confirming participants were alive (a median follow-up of approximately 8 months).

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Tislelizumab + SitravatinibProgression Free Survival (PFS) as Assessed by the Investigator4.4 Months
DocetaxelProgression Free Survival (PFS) as Assessed by the Investigator2.9 Months
95% CI: [0.5, 0.83]

Source: ClinicalTrials.gov · Data processed: Feb 17, 2026