HumRes52393
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SNCTP000004660
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BASEC2020-01826
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NCT04543617
A study to investigate the safety and efficacy of Atezolizumab and Tiragolumab compared to a placebo treatment in patients with inoperable esophageal cancer
Summary description of the study
This is a study to assess the efficacy of Tiragolumab and Tecentriq® (Atezolizumab) compared to a placebo treatment in patients with locally advanced esophageal cancer. Approximately 750 patients will participate in this study worldwide. The study will last approximately 4 years. In this study, patients will be assigned to three treatment groups and will receive either Tiragolumab plus Tecentriq®, placebo plus Tecentriq®, or a double placebo. The group assignment will be determined randomly (like flipping a coin). The probability of being assigned to one of the groups is equal. Neither the patient nor the investigator can choose or know the group.
(BASEC)
Intervention under investigation
Patients will receive treatment in 21-day cycles, as described below:
Tecentriq® plus Tiragolumab group
Tecentriq®: i.v. (intravenous) infusion over 30-60 minutes on Day 1 of each cycle
Tiragolumab: i.v. infusion over 30-60 minutes on Day 1 of each cycle
Tecentriq® plus placebo group
Tecentriq®: i.v. infusion over 30-60 minutes on Day 1 of each cycle
Placebo matching Tiragolumab: i.v. infusion over 30-60 minutes on Day 1 of each cycle
Double placebo group
Placebo matching Tecentriq®: i.v. infusion over 30-60 minutes on Day 1 of each cycle
Placebo matching Tiragolumab: i.v. infusion over 30-60 minutes on Day 1 of each cycle
(BASEC)
Disease under investigation
Esophageal cancer
(BASEC)
Criteria for participation in trial
Histologically or cytologically confirmed diagnosis of squamous cell carcinoma of the esophagus ECOG performance status of 0 or 1 Stage II-IVA according to the American Joint Committee on Cancer/Union for International Cancer Control, 8th edition, inoperable locally advanced disease (medical or surgical treatment declined) Patients with stage IVB, where a cervical or upper thoracic squamous cell carcinoma of the esophagus with exclusively supraclavicular lymph node metastases has been diagnosed and who, in the opinion of the treating physician, the multidisciplinary team, or the tumor board, are eligible for definitive chemoradiotherapy, are eligible for participation. Definitive concurrent chemoradiotherapy according to regional oncological guidelines for esophageal cancer with the following criteria: Patients with unresectable tumors must have received at least two cycles of platinum-based chemotherapy and radiotherapy that align with the definitive treatment (50-64 Gy), without evidence of radiological disease progression according to RECIST v1.1, as documented by comparison of scans (pre- and post-definitive chemoradiotherapy) before study initiation. Patients with cervical squamous cell carcinoma of the esophagus may receive a higher radiation dose (50-66 Gy), according to local oncological guidelines. Inclusion in the study must occur within 1-84 days after the last dose of definitive chemoradiotherapy. Archived tumor samples collected prior to the start of definitive chemoradiotherapy in paraffin blocks (preferably) or ≥15 unstained slides with freshly cut, serial sections Patients whose tumor tissue is not evaluable for PD-L1 expression are not eligible for the study. Patients with detectable Hepatitis B surface antigen (HBsAg) or detectable HBV DNA should be treated according to treatment guidelines. Patients receiving antiviral medication must have started treatment at least 2 weeks prior to inclusion in the study and should continue treatment for at least 6 months after the last dose of study treatment. (BASEC)
Exclusion criteria
Previous treatment with antibodies (these are molecules released into the blood). The special feature of antibodies is that each antibody has a specific target. For example, certain antibodies of the CD137 agonist class or immune checkpoint inhibitor therapies, including therapeutic anti-CTLA-4, -PD-1, -PD, target specific proteins on the surface of tumor cells. Any persistent adverse effect (grade >=2) from previous chemoradiotherapy. Patients with irreversible or manageable hearing loss may be eligible. Evidence of complete esophageal obstruction (the hollow tube that runs from the throat to the stomach may be narrowed or completely blocked) that cannot be easily treated. Histology (a microscopic examination of tissue) shows a type of small cell cancer of the esophagus. High risk for the development of an esophageal fistula according to clinical assessment or imaging, such as a history or symptoms of an esophageal fistula or tumor invasion into major vessels or the trachea (the trachea is the tubular organ that connects the larynx to the two main bronchi). Previous surgical removal of the esophagus Positive Epstein-Barr virus (EBV) viral capsid antigen IgM test at screening History of other malignancies (malignant cancers) other than esophageal cancer within 2 years prior to screening. Exceptions are malignancies with negligible risk of metastasis or death (e.g., 5-year survival rate > 90%), such as adequately treated cervical cancer, clear cell skin cancer, localized prostate cancer, ductal carcinoma in situ (a pathological proliferation of cells in the milk ducts of the female breast) or early-stage uterine cancer. (BASEC)
Histologically or cytologically confirmed diagnosis of squamous cell carcinoma of the esophagus ECOG performance status of 0 or 1 Stage II-IVA according to the American Joint Committee on Cancer/Union for International Cancer Control, 8th edition, inoperable locally advanced disease (medical or surgical treatment declined) Patients with stage IVB, where a cervical or upper thoracic squamous cell carcinoma of the esophagus with exclusively supraclavicular lymph node metastases has been diagnosed and who, in the opinion of the treating physician, the multidisciplinary team, or the tumor board, are eligible for definitive chemoradiotherapy, are eligible for participation. Definitive concurrent chemoradiotherapy according to regional oncological guidelines for esophageal cancer with the following criteria: Patients with unresectable tumors must have received at least two cycles of platinum-based chemotherapy and radiotherapy that align with the definitive treatment (50-64 Gy), without evidence of radiological disease progression according to RECIST v1.1, as documented by comparison of scans (pre- and post-definitive chemoradiotherapy) before study initiation. Patients with cervical squamous cell carcinoma of the esophagus may receive a higher radiation dose (50-66 Gy), according to local oncological guidelines. Inclusion in the study must occur within 1-84 days after the last dose of definitive chemoradiotherapy. Archived tumor samples collected prior to the start of definitive chemoradiotherapy in paraffin blocks (preferably) or ≥15 unstained slides with freshly cut, serial sections Patients whose tumor tissue is not evaluable for PD-L1 expression are not eligible for the study. Patients with detectable Hepatitis B surface antigen (HBsAg) or detectable HBV DNA should be treated according to treatment guidelines. Patients receiving antiviral medication must have started treatment at least 2 weeks prior to inclusion in the study and should continue treatment for at least 6 months after the last dose of study treatment. (BASEC)
Exclusion criteria
Previous treatment with antibodies (these are molecules released into the blood). The special feature of antibodies is that each antibody has a specific target. For example, certain antibodies of the CD137 agonist class or immune checkpoint inhibitor therapies, including therapeutic anti-CTLA-4, -PD-1, -PD, target specific proteins on the surface of tumor cells. Any persistent adverse effect (grade >=2) from previous chemoradiotherapy. Patients with irreversible or manageable hearing loss may be eligible. Evidence of complete esophageal obstruction (the hollow tube that runs from the throat to the stomach may be narrowed or completely blocked) that cannot be easily treated. Histology (a microscopic examination of tissue) shows a type of small cell cancer of the esophagus. High risk for the development of an esophageal fistula according to clinical assessment or imaging, such as a history or symptoms of an esophageal fistula or tumor invasion into major vessels or the trachea (the trachea is the tubular organ that connects the larynx to the two main bronchi). Previous surgical removal of the esophagus Positive Epstein-Barr virus (EBV) viral capsid antigen IgM test at screening History of other malignancies (malignant cancers) other than esophageal cancer within 2 years prior to screening. Exceptions are malignancies with negligible risk of metastasis or death (e.g., 5-year survival rate > 90%), such as adequately treated cervical cancer, clear cell skin cancer, localized prostate cancer, ductal carcinoma in situ (a pathological proliferation of cells in the milk ducts of the female breast) or early-stage uterine cancer. (BASEC)
Trial sites
Bern, Zurich
(BASEC)
Argentina, Australia, Austria, Belgium, Brazil, China, Czechia, France, Germany, Greece, Hungary, Israel, Italy, Japan, Kenya, Korea, Republic of, Morocco, New Zealand, Poland, Portugal, Russian Federation, South Africa, Spain, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Kingdom, United States (ICTRP)
Sponsor
NA
(BASEC)
Contact
Contact Person Switzerland
Annina Williner
+41 61 715 43 55
switzerland.clinical-research@clutterroche.comRoche Pharma (Schweiz) AG
(BASEC)
General Information
Hoffmann-La Roche
(ICTRP)
Scientific Information
Hoffmann-La Roche
(ICTRP)
Name of the authorising ethics committee (for multicentre studies, only the lead committee)
Ethics Committee Bern
(BASEC)
Date of authorisation
11.01.2021
(BASEC)
ICTRP Trial ID
NCT04543617 (ICTRP)
Official title (approved by ethics committee)
A PHASE III, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF ATEZOLIZUMAB WITH OR WITHOUT TIRAGOLUMAB (ANTI-TIGIT ANTIBODY) IN PATIENTS WITH UNRESECTABLE ESOPHAGEAL SQUAMOUS CELL CARCINOMA WHOSE CANCERS HAVE NOT PROGRESSED FOLLOWING DEFINITIVE CONCURRENT CHEMORADIOTHERAPY (BASEC)
Academic title
A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Atezolizumab With or Without Tiragolumab (Anti-TIGIT Antibody) in Patients With Unresectable Esophageal Squamous Cell Carcinoma Whose Cancers Have Not Progressed Following Definitive Concurrent Chemoradiotherapy (ICTRP)
Public title
A Study of Atezolizumab With or Without Tiragolumab in Participants With Unresectable Esophageal Squamous Cell Carcinoma Whose Cancers Have Not Progressed Following Definitive Concurrent Chemoradiotherapy (ICTRP)
Disease under investigation
Esophageal Squamous Cell Carcinoma (ICTRP)
Intervention under investigation
Drug: TiragolumabDrug: AtezolizumabDrug: Tiragolumab Matching PlaceboDrug: Atezolizumab Matching Placebo (ICTRP)
Type of trial
Interventional (ICTRP)
Trial design
Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor). (ICTRP)
Inclusion/Exclusion criteria
Key Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
- Histologically or cytologically confirmed diagnosis of squamous cell carcinoma of
the esophagus
- Unresectable disease ineligible for curative surgery based on the documented opinion
of the qualified medical, surgical or radiation oncologist prior to dCRT and is not
expected to undergo tumor resection during the course of the study
- dCRT treatment according to regional oncology guidelines for esophageal cancer
- Representative archival formalin-fixed, paraffin-embedded (FFPE) tumor specimens
collected prior to initiation of dCRT
- Adequate hematologic and end-organ function prior to randomization
- Women of childbearing potential must remain abstinent or use contraceptive methods
with a failure rate of < 1% per year during the treatment period, for 5 months after
the final dose of atezolizumab/placebo, and for 90 days after the final dose of
tiragolumab/placebo, whichever is later
- Men must agree to remain abstinent (refrain from heterosexual intercourse) or use a
condom, and agree to refrain from donating sperm during the treatment period and for
90 days after the final dose of tiragolumab/placebo.
Key Exclusion Criteria:
- Prior treatment with CD137 agonists or immune checkpoint blockade therapies,
including anti-CTLA-4, anti-PD-1, anti-PD-L1 and anti-TIGIT therapeutic antibodies
- Any unresolved toxicity of National Cancer Institute's (NCI) Common Terminology
Criteria for Adverse Events (CTCAE) Grade = 2 from the prior chemoradiation therapy
with the exception of irreversible and manageable hearing loss
- Prior allogeneic stem cell or solid organ transplantation
- Active or history of autoimmune disease or immune deficiency
- History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis
obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of
active pneumonitis
- Malignancies other than esophageal cancer within 2 years prior to screening, with
the exception of malignancies with a negligible risk of metastasis or death
- Treatment with any other investigational agent, including epidermal growth factor
receptor (EGFR) inhibitors, with therapeutic intent for esophageal cancer prior to
randomization. (ICTRP)
not available
Primary and secondary end points
Arm A vs Arm C: Investigator-Assessed Progression-Free Survival (PFS);Arm A vs Arm C: Overall Survival (OS);Arm B vs Arm C: OS (ICTRP)
Arm B vs Arm C: Investigator-Assessed PFS;Arm A vs Arm B: Investigator-Assessed PFS;Arm A vs Arm B: OS;Independent Review Facility (IRF)-Assessed PFS;Investigator-Assessed Confirmed Objective Response Rate (ORR);IRF-Assessed Confirmed ORR;Investigator-Assessed Duration of Objective Response (DOR);IRF-Assessed DOR;Percentage of Participants With Clinically Meaningful Changes in Physical Functioning, Role Functioning, Quality of Life (QoL) as Measured by EORTC QLQ-C30;Percentage of Participants With Clinically Meaningful Changes in Dysphagia as Measured by EORTC QLQ-OES18;Percentage of Participants With Adverse Events (AEs);Serum Concentration of Tiragolumab;Serum Concentration of Atezolizumab;Percentage of Participants With Anti-drug Antibodies (ADAs) to Tiragolumab;Percentage of Participants With ADAs to Atezolizumab (ICTRP)
Registration date
not available
Incorporation of the first participant
not available
Secondary sponsors
not available
Additional contacts
Clinical Trial, Hoffmann-La Roche (ICTRP)
Secondary trial IDs
2020-001178-31, YO42137 (ICTRP)
Results-Individual Participant Data (IPD)
not available
Further information on the trial
https://clinicaltrials.gov/ct2/show/NCT04543617 (ICTRP)
Results of the trial
Results summary
not available
Link to the results in the primary register
not available