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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04194944
Registration number
NCT04194944
Ethics application status
Date submitted
9/12/2019
Date registered
11/12/2019
Titles & IDs
Public title
A Study of Selpercatinib (LY3527723) in Participants With Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer
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Scientific title
LIBRETTO-431: A Multicenter, Randomized, Open-Label, Phase 3 Trial Comparing Selpercatinib to Platinum-Based and Pemetrexed Therapy With or Without Pembrolizumab as Initial Treatment of Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer
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Secondary ID [1]
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J2G-MC-JZJC
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Secondary ID [2]
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17479
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Universal Trial Number (UTN)
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Trial acronym
LIBRETTO-431
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non-Small Cell Lung Cancer
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0
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Condition category
Condition code
Cancer
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Lung - Mesothelioma
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Cancer
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0
0
0
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Lung - Non small cell
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Cancer
0
0
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0
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Lung - Small cell
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Selpercatinib
Treatment: Drugs - Carboplatin
Treatment: Drugs - Cisplatin
Treatment: Drugs - Pemetrexed
Treatment: Drugs - Pembrolizumab
Experimental: Selpercatinib - Treatment A (TRT A) - 160 milligram (mg) Selpercatinib administered orally twice daily (BID) continuously in 21-day cycles.
Active comparator: Pemetrexed and Platinum with or without Pembrolizumab - (TRT B) - Pemetrexed 500 milligrams per meter squared (mg/m2) administered intravenously (IV) on Day 1, every 3 weeks (Q3W), plus investigator's choice of carboplatin area under the concentration versus time curve 5 (AUC 5 \[maximum dose of 750 mg\] IV), or cisplatin (75 mg/m2 cisplatin IV) on Day 1 Q3W for 4 cycles, plus investigator's choice with or without 200 mg pembrolizumab IV on Day 1 Q3W up to 35 cycles.
Treatment: Drugs: Selpercatinib
Administered orally
Treatment: Drugs: Carboplatin
Administered IV
Treatment: Drugs: Cisplatin
Administered IV
Treatment: Drugs: Pemetrexed
Administered IV
Treatment: Drugs: Pembrolizumab
Administered IV
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Progression Free Survival (PFS) by Blinded Independent Central Review (BICR) (With Pembrolizumab)
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Assessment method [1]
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PFS is defined as the time from randomization until the occurrence of documented disease progression by the BICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, or death from any cause in the absence of BICR-documented progressive disease.
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Timepoint [1]
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Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
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Primary outcome [2]
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PFS by BICR (With or Without Pembrolizumab)
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Assessment method [2]
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PFS is defined as the time from randomization until the occurrence of documented disease progression by the BICR, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, or death from any cause in the absence of BICR-documented progressive disease.
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Timepoint [2]
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Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
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Secondary outcome [1]
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Percentage of Participant With Disease Control Rate (DCR) by BICR (With Pembrolizumab)
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Assessment method [1]
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DCR by BICR (with Pembrolizumab) is defined as the number of participants who achieve a BOR of complete response (CR), partial response (PR), or stable disease (SD) lasting 16 or more weeks divided by the total number of participants randomized to each treatment arm.
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Timepoint [1]
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Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
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Secondary outcome [2]
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Percentage of Participant With DCR by BICR (With or Without Pembrolizumab)
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Assessment method [2]
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DCR by BICR (with or without Pembrolizumab) is defined as the number of participants who achieve a BOR of CR, PR, or SD lasting 16 or more weeks divided by the total number of participants randomized to each treatment arm.
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Timepoint [2]
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Baseline to Progressive Disease or Death from Any Cause Up to 31 Months
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Secondary outcome [3]
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PFS2 (With Pembrolizumab)
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Assessment method [3]
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PFS2 is defined as the time from randomization to disease progression on the next line of treatment or death from any cause in the absence of observed disease progression.
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Timepoint [3]
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Baseline to Second Disease Progression or Death from Any Cause Up to 38 Months
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Secondary outcome [4]
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PFS2 (With or Without Pembrolizumab)
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Assessment method [4]
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PFS2 is defined as the time from randomization to disease progression on the next line of treatment or death from any cause in the absence of observed disease progression.
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Timepoint [4]
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Baseline to Second Disease Progression or Death from Any Cause Up to 38 Months
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Secondary outcome [5]
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Overall Response Rate (ORR): Percentage of Participants With Complete Response (CR) or Partial Response (PR) by BICR (With Pembrolizumab)
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Assessment method [5]
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ORR is defined as the number of participants who achieve a best overall response (BOR) of complete response (CR) or partial response (PR) divided by the total number of participants randomized to each treatment arm.
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Timepoint [5]
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Baseline through Disease Progression or Death Up to 31 Months
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Secondary outcome [6]
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ORR: Percentage of Participants With CR or PR by BICR (With or Without Pembrolizumab)
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Assessment method [6]
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ORR is defined as the number of participants who achieve a best overall response (BOR) of complete response (CR) or partial response (PR) divided by the total number of participants randomized to each treatment arm.
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Timepoint [6]
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Baseline through Disease Progression or Death Up to 31 Months
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Secondary outcome [7]
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Duration of Response (DoR) by BICR (With Pembrolizumab)
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Assessment method [7]
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DoR was defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) were first met until the first date that disease was recurrent or documented disease progression was observed, or the date of death from any cause in the absence of documented disease progression or recurrence. The DOR according to both BICR and investigator-assessed BOR was evaluated per RECIST 1.1 criteria.
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Timepoint [7]
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Date of CR or PR to Date of Disease Progression or Death Due to Any Cause Up to 31 Months
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Secondary outcome [8]
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DOR by BICR (With or Without Pembrolizumab)
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Assessment method [8]
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DoR was defined as the time from the date that measurement criteria for CR or PR (whichever is first recorded) were first met until the first date that disease was recurrent or documented disease progression was observed, or the date of death from any cause in the absence of documented disease progression or recurrence. The DOR according to both BICR and investigator-assessed BOR was evaluated per RECIST 1.1 criteria.
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Timepoint [8]
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Date of CR or PR to Date of Disease Progression or Death Due to Any Cause Up to 31 Months
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Secondary outcome [9]
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Overall Survival (OS) (With Pembrolizumab)
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Assessment method [9]
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Overall survival was defined as the time from randomization until death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data was censored on the last date the participant is known to be alive.
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Timepoint [9]
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Baseline to Date of Death from Any Cause Up to 38 Months
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Secondary outcome [10]
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OS (With or Without Pembrolizumab)
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Assessment method [10]
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Overall survival was defined as the time from randomization until death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data will be censored on the last date the participant is known to be alive.
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Timepoint [10]
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Baseline to Date of Death from Any Cause Up to 38 Months
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Secondary outcome [11]
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Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 by BICR (With Pembrolizumab)
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Assessment method [11]
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Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with Pembrolizumab)
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Timepoint [11]
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Baseline through Central Nervous System (CNS) Progression or Death up to 31 Months
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Secondary outcome [12]
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Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RECIST 1.1 by BICR (With or Without Pembrolizumab)
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Assessment method [12]
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Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RECIST 1.1 by BICR (with or without Pembrolizumab)
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Timepoint [12]
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Baseline through CNS Progression or Death Up to 31 Months
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Secondary outcome [13]
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Median Intracranial DOR Per RECIST 1.1 by BICR (With Pembrolizumab)
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Assessment method [13]
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Intracranial DOR per RECIST 1.1 by BICR (with Pembrolizumab)
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Timepoint [13]
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Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
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Secondary outcome [14]
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Median Intracranial DOR Per RECIST 1.1 by BICR (With or Without Pembrolizumab)
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Assessment method [14]
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Median Intracranial DOR per RECIST 1.1 by BICR (with or without Pembrolizumab)
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Timepoint [14]
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Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
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Secondary outcome [15]
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Time to Deterioration of Pulmonary Symptoms (With Pembrolizumab)
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Assessment method [15]
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Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-Symptom Assessment Questionnaire (SAQ) (with Pembrolizumab)
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Timepoint [15]
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Baseline to Deterioration of Pulmonary Symptoms Up to 31 Months
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Secondary outcome [16]
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Time to Deterioration of Pulmonary Symptoms (With or Without Pembrolizumab)
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Assessment method [16]
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Time to Deterioration of Pulmonary Symptoms Measured by the NSCLC-SAQ (with or without Pembrolizumab)
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Timepoint [16]
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Baseline to Deterioration of Pulmonary Symptoms Up to 31 Months
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Secondary outcome [17]
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The Concordance of the Local Lab and the Central Lab RET Results: Percentage of Participants With RET-Positive Specimens as Called by the Central Lab, Which is Also RET-Positive as Called by a Local Lab (Positive Percent Agreement)
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Assessment method [17]
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The Concordance of the Local Lab and the Central Lab RET Results: Percentage of Participants with RET-Positive Specimens as Called by the Central Lab, which is also RET-Positive as Called by a Local Lab (Positive Percent Agreement)
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Timepoint [17]
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Baseline
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Secondary outcome [18]
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Median Time to CNS Progression Per RECIST 1.1 by BICR (With Pembrolizumab)
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Assessment method [18]
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Time to CNS Progression per RECIST 1.1 by BICR (with Pembrolizumab)
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Timepoint [18]
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Baseline through CNS Progression or Death Up to 31 Months
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Secondary outcome [19]
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Median Time to CNS Progression Per RECIST 1.1 by BICR (With or Without Pembrolizumab)
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Assessment method [19]
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Time to CNS Progression per RECIST 1.1 by BICR (with or without Pembrolizumab)
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Timepoint [19]
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Baseline through CNS Progression or Death Up to 31 Months
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Secondary outcome [20]
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Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) by BICR (With Pembrolizumab)
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Assessment method [20]
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Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RANO-BM by BICR (with Pembrolizumab)
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Timepoint [20]
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Baseline through CNS Progression or Death Up to 31 Months
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Secondary outcome [21]
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Intracranial ORR: Percentage of Participants With Intracranial CR or PR Per RANO-BM by BICR (With or Without Pembrolizumab)
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Assessment method [21]
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Intracranial ORR: Percentage of Participants with Intracranial CR or PR per RANO-BM by BICR (with or without Pembrolizumab)
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Timepoint [21]
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Baseline through CNS Progression or Death Up to 31 Months
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Secondary outcome [22]
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Intracranial DOR Per RANO-BM by BICR (With Pembrolizumab)
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Assessment method [22]
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Intracranial DOR per RANO-BM by BICR (with Pembrolizumab)
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Timepoint [22]
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Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
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Secondary outcome [23]
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Intracranial DOR Per RANO-BM by BICR (With or Without Pembrolizumab)
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Assessment method [23]
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Intracranial DOR per RANO-BM by BICR (with or without Pembrolizumab)
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Timepoint [23]
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Date of Intracranial CR or PR to Date of CNS Progression or Death Due to Any Cause Up to 31 Months
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Eligibility
Key inclusion criteria
* Histologically or cytologically confirmed, Stage IIIB-IIIC or Stage IV non-squamous NSCLC that is not suitable for radical surgery or radiation therapy.
* A RET gene fusion in tumor and/or blood from a qualified laboratory.
* Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
* Adequate hematologic, hepatic and renal function.
* Willingness of men and women of reproductive potential to observe conventional and highly effective birth control for the duration of treatment and for 6 months after.
* Ability to swallow capsules.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Additional validated oncogenic drivers in NSCLC if known.
* Prior systemic therapy for metastatic disease. Treatment (chemotherapy, immunotherapy, or biological therapy) in the adjuvant/neoadjuvant setting is permitted if it was completed at least 6 months prior to randomization.
* Major surgery within 3 weeks prior to planned start of selpercatinib.
* Radiotherapy for palliation within 1 week of the first dose of study treatment or any radiotherapy within 6 months prior to the first dose of study treatment if more than 30 Gy to the lung.
* Symptomatic central nervous system (CNS) metastases, carcinomatous meningitis, or untreated spinal cord compression.
* Clinically significant active cardiovascular disease or history of myocardial infarction within 6 months prior to planned start of selpercatinib or prolongation of the QT interval corrected for heart rate using Fridericia's formula (QTcF) > 470 milliseconds.
* Active uncontrolled systemic bacterial, viral, or fungal infection or serious ongoing intercurrent illness, such as hypertension or diabetes, despite optimal treatment.
* Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal absorption of the study drug.
* Pregnancy or lactation.
* Other malignancy unless nonmelanoma skin cancer, carcinoma in situ of the cervix or other in situ cancers or a malignancy diagnosed =2 years previously and not currently active.
* Uncontrolled, disease related pericardial effusion or pleural effusion.
* Requiring chronic treatment with steroids.
Exclusion Criteria for Participants Receiving Pembrolizumab:
* History of interstitial lung disease or interstitial pneumonitis.
* Active autoimmune disease or any illness or treatment that could compromise the immune system.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
17/02/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
18/06/2026
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Actual
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Sample size
Target
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Accrual to date
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Final
261
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Chris O'Brien Lifehouse - Camperdown
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Recruitment hospital [2]
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [3]
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Westmead Hospital - Westmead
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Recruitment hospital [4]
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Monash Health - Clayton
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Recruitment hospital [5]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment hospital [6]
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St Vincent's Hospital - Melbourne
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Recruitment hospital [7]
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Peninsula Oncology Centre - Frankston
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2298 - Waratah
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Recruitment postcode(s) [3]
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2145 - Westmead
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Recruitment postcode(s) [4]
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3168 - Clayton
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Recruitment postcode(s) [5]
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3000 - Melbourne
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Recruitment postcode(s) [6]
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3065 - Melbourne
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Recruitment postcode(s) [7]
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3199 - Frankston
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Recruitment outside Australia
Country [1]
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Argentina
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State/province [1]
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Buenos Aires
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Argentina
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Río Negro
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Argentina
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Ciudad de Buenos Aires
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Argentina
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San Juan
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Belgium
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Bruxelles-Capitale, Région De
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Belgium
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Oost-Vlaanderen
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Belgium
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Vlaams-Brabant
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Belgium
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West Flanders
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Belgium
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Gent
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Belgium
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Mechelen
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Belgium
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Namur
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Brazil
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Bahia
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Brazil
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Paraná
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Brazil
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Rio Grande Do Sul
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Brazil
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RJ
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Brazil
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Sao Paulo
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Brazil
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SP
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Brazil
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Rio de Janeiro
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Brazil
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Sao Paolo
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São Paulo
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Canada
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Alberta
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Canada
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Ontario
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China
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Beijing
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China
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Guangdong
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China
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Guangzhou
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China
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Heilongjiang
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China
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China
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Jilin
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China
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China
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China
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Zhejiang
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China
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Hangzhou
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Czechia
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Olomouc
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Czechia
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Ostrava - Vitkovice
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Czechia
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Praha 8
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Hérault
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France
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France
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France
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Paris
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Germany
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Baden-Württemberg
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Germany
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Bayern
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Germany
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Niedersachsen
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Germany
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Germany
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Schleswig-Holstein
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Germany
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Berlin
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Attikí
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Greece
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Israel
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Ramat Gan
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Israel
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?eifa
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Italy
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Campania
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Lazio
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Italy
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Italy
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Italy
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Italy
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Italy
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Japan
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Tottori
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Seoul, Korea
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Daejon
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Seoul
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Amsterdam
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Bucure?ti
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Romania
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Constan?a
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Romania
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Timi?
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Romania
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Suceava
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Russian Federation
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Russian Federation
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Russian Federation
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Russian Federation
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Kazan
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Russian Federation
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Moscow
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Singapore
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Baleares
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Spain
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Las Palmas
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Madrid
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Alicante
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Barcelona
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Spain
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Valencia
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Taiwan
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Kaohsiung
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Taiwan
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Tainan
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Taiwan
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Taipei City
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Taipei
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Turkey
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Izmir
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Turkey
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Adana
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Edirne
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Istanbul
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Malatya
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Sariyer
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Ukraine
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Dnipropetrovska Oblast
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Ukraine
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Kharkivska Oblast
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Ukraine
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Odeska Oblast
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Ukraine
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Ukraine
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Ukraine
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Chernivtsi
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Ukraine
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Kryvyi Rig
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Ukraine
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Kyiv
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Ukraine
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Odesa
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United Kingdom
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Nottinghamshire
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Loxo Oncology, Inc.
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Address
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Country
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Other collaborator category [1]
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0
Commercial sector/industry
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Name [1]
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Eli Lilly and Company
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Address [1]
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0
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The reason for this study is to see if the study drug selpercatinib compared to a standard treatment is effective and safe in participants with rearranged during transfection (RET) fusion-positive non-squamous non-small cell lung cancer (NSCLC) that has spread to other parts of the body. Participants who are assigned to the standard treatment and discontinue due to progressive disease have the option to potentially crossover to selpercatinib.
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Trial website
https://clinicaltrials.gov/study/NCT04194944
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Trial related presentations / publications
Claerhout S, Lehnert S, Vander Borght S, Spans L, Dooms C, Wauters E, Vansteenkiste J, Weynand B, Deraedt K, Bourgain C, Vanden Bempt I. Targeted RNA sequencing for upfront analysis of actionable driver alterations in non-small cell lung cancer. Lung Cancer. 2022 Apr;166:242-249. doi: 10.1016/j.lungcan.2022.02.013. Epub 2022 Mar 1. Solomon BJ, Zhou CC, Drilon A, Park K, Wolf J, Elamin Y, Davis HM, Soldatenkova V, Sashegyi A, Lin AB, Lin BK, F Loong HH, Novello S, Arriola E, Perol M, Goto K, Santini FC. Phase III study of selpercatinib versus chemotherapy +/- pembrolizumab in untreated RET positive non-small-cell lung cancer. Future Oncol. 2021 Mar;17(7):763-773. doi: 10.2217/fon-2020-0935. Epub 2020 Nov 5.
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Public notes
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Contacts
Principal investigator
Name
0
0
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
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Address
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0
Eli Lilly and Company
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0
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Clinical study report (CSR)
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When will data be available (start and end dates)?
Data are available 6 months after the primary publication and approval of the indication studied in the US and EU, whichever is later. Data will be indefinitely available for requesting.
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Available to whom?
A research proposal must be approved by an independent review panel and researchers must sign a data sharing agreement.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: http://vivli.org/
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/44/NCT04194944/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/44/NCT04194944/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT04194944