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Phase 3 Completed N=376 Randomized Treatment

LDK378 Versus Chemotherapy in Previously Untreated Patients With ALK Rearranged Non-small Cell Lung Cancer

Source: ClinicalTrials.gov NCT01828099 ↗
Enrolled (actual)
376
Serious AEs
44.0%
Results posted
Sep 2017
Primary outcomePrimary: Progression Free Survival (PFS) by Blinded Independent Review Committee (BIRC) — 16.6; 8.1 Months — p=<0.001
◆ Published Evidence
Highly cited
1,152citations · ~128 / year
First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study.
Lancet (London, England) · 2017 · Likely link

Summary

To compare the efficacy and safety of ceritinib with standard first-line chemotherapy (pemetrexed plus cisplatin or carboplatin) in patients with stage IIIB (not candidates for definitive multimodality therapy) or stage IV, non-squamous non-small cell lung cancer (NSCLC) harboring a confirmed anaplastic lymphoma kinase (ALK) rearrangement, using the Ventana immunohistochemistry (IHC) test.

Linked Publications (2)

  • First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study.
    Lancet (London, England) · 2017 · 1,152 citations · Likely link
  • Anaplastic Lymphoma Kinase (ALK) Kinase Domain Mutation Following ALK Inhibitor(s) Failure in Advanced ALK Positive Non-Small-Cell Lung Cancer: Analysis and Literature Review.
    Clinical lung cancer · 2016 · 35 citations · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Progression Free Survival (PFS) by Blinded Independent Review Committee (BIRC)
16.6; 8.1 <0.001 sig
SECONDARY
Overall Survival (OS)
62.9; 40.7
SECONDARY
Overall Response Rate (ORR) by BIRC Assessment
72.5; 26.7
SECONDARY
Overall Response Rate (ORR) by Investigator Assessment
73.5; 33.2
SECONDARY
Duration of Response (DOR) by BIRC Assessment
23.9; 11.1
SECONDARY
Duration of Response (DOR) by Investigator Assessment
22.6; 9.8
SECONDARY
Disease Control Rate (DCR) by BIRC Assessment
84.7; 73.8
SECONDARY
Disease Control Rate (DCR) by Investigator Assessment
89.4; 75.9
SECONDARY
Time to Response (TTR) by BIRC Assessment
6.14; 13.36
SECONDARY
Time to Response (TTR) by Investigator Assessment
6.29; 12.71
SECONDARY
PFS by Investigator Assessment
16.8; 7.2
SECONDARY
Overall Intracranial Response Rate (OIRR)
72.7; 27.3
SECONDARY
Intracranial Disease Control Rate (IDCR)
86.4; 90.9
SECONDARY
Duration of Intracranial Response (DOIR)
16.6; NA
SECONDARY
Time to Definitive 10 Point Deterioration in the Composite Endpoint of Pain, Cough or Dyspnea in the European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ)- Lung Cancer (LC) 13 Questionnaire
76.0; 14.9
SECONDARY
Time to Definitive Deterioration in the Composite Endpoint of Pain, Cough or Dyspnea in the Lung Cancer Symptom Scale (LCSS)
104.0; 36.1
SECONDARY
Least Squares Mean Scores on the EORTC-QLQ C30
69.4; 63.7; 83.5; 77.6; 82.3; 76.6
SECONDARY
Least Squares Mean Scores on the EORTC QLQ- LC13
16.2; 23.3; 9.4; 11.8; 10.6; 12.3
SECONDARY
Least Squares Mean Scores on the Lung Cancer Symptom Scale (LCSS)
20.9; 25.1; 27.4; 33.9; 8.0; 15.1
SECONDARY
Least Squares Mean Scores on the EQ-5D-5L Index
0.80; 0.75
SECONDARY
Least Squares Mean Scores on the EQ-5D-5L Visual Analogue Score (VAS)
77.2; 74.1
SECONDARY
Cmax of LDK378
162; 794
SECONDARY
Tmax of LDK378
6.00; 6.00
SECONDARY
Tlast of LDK378
24.0; 24.0
SECONDARY
AUC0-24 of LDK378
2540; 16600

Eligibility Criteria

Key Inclusion Criteria

  • The patient had a histologically or cytologically confirmed diagnosis of non-squamous Non-small cell lung cancer (NSCLC) that was Anaplastic lymphoma kinase (ALK) positive as assessed by the Ventana Immunohistochemistry (IHC) test. The test was performed at Novartis designated central laboratories.
  • The patient had a newly diagnosed stage IIIB (who was not a candidate for definitive multimodality therapy) or stage IV NSCLC or relapsed locally advanced or metastatic NSCLC not previously treated with any systemic anti-cancer therapy (e.g. cytotoxic drugs, monoclonal antibody therapy, crizotinib or other ALK inhibitors, or other targeted therapies, either experimental or not), with the exception of neo-adjuvant or adjuvant therapy.
  • The patient had at least one measurable lesion as defined by RECIST 1.1.

Key Exclusion Criteria

  • The patient had known hypersensitivity to any of the excipients of LDK378 (microcrystalline cellulose, mannitol, crospovidone, colloidal silicon dioxide, and magnesium stearate).
  • The patient had a history of severe hypersensitivity reaction to platinum-containing drugs, pemetrexed, or any known excipients of these drugs.
  • The patient had symptomatic central nervous system (CNS) metastases and was neurologically unstable or had required increasing doses of steroids within the 2 weeks prior to screening to manage CNS symptoms.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01828099) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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