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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT04644237
Registration number
NCT04644237
Ethics application status
Date submitted
19/11/2020
Date registered
25/11/2020
Date last updated
3/04/2024
Titles & IDs
Public title
Trastuzumab Deruxtecan in Participants With HER2-mutated Metastatic Non-small Cell Lung Cancer (NSCLC)
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Scientific title
A Phase 2, Multicenter, Randomized Study of Trastuzumab Deruxtecan in Subjects With HER2-mutated Metastatic Non-small Cell Lung Cancer (NSCLC) (DESTINY-LUNG02)
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Secondary ID [1]
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2020-003427-42
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Secondary ID [2]
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DS8201-A-U206
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Universal Trial Number (UTN)
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Trial acronym
DESTINY-LUNG02
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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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Condition category
Condition code
Cancer
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Lung - Mesothelioma
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Cancer
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Lung - Non small cell
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Cancer
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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 - Trastuzumab deruxtecan
Experimental: Trastuzumab deruxtecan 6.4 mg/kg - Participants will be randomized to receive trastuzumab deruxtecan 6.4 mg/kg administered by intravenous infusion every 3 weeks (Q3W).
Experimental: Trastuzumab deruxtecan 5.4 mg/kg - Participants will be randomized to receive trastuzumab deruxtecan 5.4 mg/kg administered by intravenous infusion every 3 weeks (Q3W).
Treatment: Drugs: Trastuzumab deruxtecan
Trastuzumab deruxtecan 100 mg will be provided as a sterile lyophilized powder and reconstituted with 5 mL water for injection (final concentration 20 mg/mL [ie, 100 mg/5 mL]). The study drug will be administered as an intravenous (IV) infusion over 30 to 90 min Q3W ± 2 days. The initial dose of study drug will be infused for 90 ± 10 min.
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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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Percentage of Participants With Confirmed Objective Response Rate by Blinded Independent Central Review Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer
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Assessment method [1]
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Confirmed objective response rate (ORR), defined as the proportion of participants with complete response (CR) or partial response (PR), was assessed by blinded independent central review (BICR) based on Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions.
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Timepoint [1]
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9 months after the last participant is randomized to data cut off, up to approximately 21 months
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Secondary outcome [1]
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Percentage of Participants With Confirmed Objective Response Rate by Investigator Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung CancerTumors
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Assessment method [1]
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Confirmed objective response rate (ORR), defined as the percentage of participants with complete response (CR) or partial response (PR), will be assessed by the Investigator based on Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions.
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Timepoint [1]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [2]
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Duration of Response Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer
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Assessment method [2]
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Duration of response (DoR) is defined as the time from the initial response (complete response [CR] or partial response [PR]) until documented tumor progression or death from any cause. DoR is only defined for participants who achieved confirmed CR or PR. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions.
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Timepoint [2]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [3]
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Disease Control Rate Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer
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Assessment method [3]
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Disease control rate (DCR) is the sum of complete response (CR), partial response (PR), and stable disease (SD) rates. CR was defined as a disappearance of all target lesions, PR was defined as at least a 30% decrease in the sum of diameters of target lesions, and stable disease (SD) was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD; at least a 20% increase in the sum of diameters of target lesions.
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Timepoint [3]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [4]
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Progression-free Survival Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer
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Assessment method [4]
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Progression-free survival (PFS) is defined as the time from date of randomization until first objective radiographic tumor progression or death from any cause, based on blinded independent central review (BICR) and investigator assessment.
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Timepoint [4]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [5]
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Overall Survival Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer Tumors
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Assessment method [5]
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Overall survival (OS) is defined as the time from date of randomization until death from any cause.
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Timepoint [5]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [6]
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The Percentage of Participants Reporting Treatment-emergent Adverse Events Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer Tumors
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Assessment method [6]
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Timepoint [6]
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9 months after the last participant is randomized or later to data cut off, up to approximately 35 months
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Secondary outcome [7]
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Pharmacokinetic Parameter Maximum Serum Concentration (Cmax) for Trastuzumab Deruxtecan, Total Anti-HER2 Antibody, and Active Metabolite MAAA-1181a
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Assessment method [7]
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Timepoint [7]
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Cycle 1 Day 1; Cycle 2 Day 1, and Cycle 3 Day 1: pre- and post-dose; Cycle 1 Day 8: 7 days post-dose; Cycle 1 Day 15: 14 days post-dose; Cycle 4 Day 1 and Cycle 6 Day 1: pre-dose (each cycle is 21 days)
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Secondary outcome [8]
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Pharmacokinetic Parameter Minimum Observed Concentration (Ctrough) for Trastuzumab Deruxtecan, Total Anti-HER2 Antibody, and Active Metabolite MAAA-1181a
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Assessment method [8]
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Timepoint [8]
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Cycle 1 Day 1; Cycle 2 Day 1, and Cycle 3 Day 1: pre- and post-dose; Cycle 1 Day 8: 7 days post-dose; Cycle 1 Day 15: 14 days post-dose; Cycle 4 Day 1 and Cycle 6 Day 1: pre-dose (each cycle is 21 days)
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Secondary outcome [9]
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Pharmacokinetic Parameter Area Under the Serum Concentration-Time Curve (AUC) for Trastuzumab Deruxtecan, Total Anti-HER2 Antibody, and Active Metabolite MAAA-1181a
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Assessment method [9]
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Timepoint [9]
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Cycle 1 Day 1; Cycle 2 Day 1, and Cycle 3 Day 1: pre- and post-dose; Cycle 1 Day 8: 7 days post-dose; Cycle 1 Day 15: 14 days post-dose; Cycle 4 Day 1 and Cycle 6 Day 1: pre-dose (each cycle is 21 days)
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Secondary outcome [10]
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Incidence of Anti-Drug Antibodies (ADA) Following Intravenous Administration of Trastuzumab Deruxtecan in Participants With Metastatic Non-small Cell Lung Cancer Tumors
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Assessment method [10]
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Timepoint [10]
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Pre-dose on Day 1 of Cycles 1, 2 and 4, and then every 4 cycles (each cycle is 21 days)
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Secondary outcome [11]
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Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and EORTC Quality of Life Questionnaire for Lung Cancer Trials (QLQ-LC13) Scores
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Assessment method [11]
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The EORTC QLQ-C30 consists of 30 questions assessing global health-related quality of life, five aspects of subject functioning (physical, emotional, role, cognitive, and social), three symptom scales (fatigue, nausea and vomiting, and pain), and six single-items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Higher scores for functioning scales and global health status indicate a better level of functioning while higher scores on the symptom and single-item scales indicate a higher level of symptoms. The QLQ-LC13 is a 13-item questionnaire designed to assess lung cancer-related symptoms and treatment side effects. The scales ranges from 1=not at all to 4=very much. The summation of scores range from 0 to 100, where higher scores represent increasing symptoms levels.
scales.
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Timepoint [11]
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On Day 1 of every cycle (each cycle is 21 days), and at end of treatment visit 40-day follow-up visit
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Secondary outcome [12]
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Time to Deterioration in European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) Scores
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Assessment method [12]
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The EORTC QLQ-C30 consists of 30 questions assessing global health-related quality of life, five aspects of subject functioning (physical, emotional, role, cognitive, and social), three symptom scales (fatigue, nausea and vomiting, and pain), and six single-items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Higher scores for functioning scales and global health status indicate a better level of functioning while higher scores on the symptom and single-item scales indicate a higher level of symptoms.
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Timepoint [12]
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On Day 1 of every cycle (each cycle is 21 days), and at end of treatment visit 40-day follow-up visit
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Eligibility
Key inclusion criteria
- Written informed consent
- Men or women =18 years, follow local regulatory requirements if the legal age of the
consent for study participation is >18 years
- Pathologically documented metastatic NSCLC with a known activating HER2 mutation.
Note: A HER2 mutation documented only from a liquid biopsy samples cannot be used for
enrollment.
- Had previous treatment including platinum therapy in the metastatic/locally advanced
setting and not amenable to curative surgery or radiation. Participant must have
progressed during or after the last treatment regimen or discontinued because of
unacceptable toxicity.
- Presence of at least 1 measurable lesion confirmed by the blinded Independent Central
Review based on RECIST version 1.1
- Willing and able to provide an archival tumor tissue sample. A fresh biopsy is
required if an archival tumor tissue sample cannot be supplied. Resection and core
needle biopsy are acceptable. Fine needle aspirates or cell block are not acceptable.
- Eastern Cooperative Oncology Group performance status 0 to 1
- Left ventricular ejection fraction = 50% within 28 days before randomization Resection
and core needle biopsy are acceptable - Adequate organ function as specified in
protocol within 14 days before randomization
- Adequate treatment washout period before randomization
- Participants of reproductive/childbearing potential agree to use a highly effective
form of contraception (or avoid intercourse) during study period and up to 7 months
(females) and 4 months (males) after last study dose
- Males should not freeze or donate sperm throughout the study period up to at least 4
months after last study dose; females should not donate or retrieve ova for their own
use throughout the study period and up to at least 7 months after last study dose
- Life expectancy 3 months or more
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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
- Known driver mutation in the epidermal growth factor receptor (EGFR), BRAF, or MET
exon 14 gene or a known anaplastic lymphoma kinase (ALK), ROS1, RET, or NTRK fusion
- Medical history of myocardial infarction within 6 months before randomization,
symptomatic congestive heart failure (CHF) (New York Heart Association Class II to
IV). Participants with troponin levels above upper limit of normal at screening (as
defined by the manufacturer) and without any myocardial infarction (MI)-related
symptoms should have a cardiologic consultation before randomization to rule out MI
- Corrected QT interval (QTcF) prolongation > 470 msec (females) or >450 msec (males)
based on average of the triplicate12-lead electrocardiogram at screening
- History of non-infectious interstitial lung disease (ILD)/pneumonitis that required
steroids, current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled
out by imaging at screening
- Spinal cord compression or clinically active central nervous system metastases,
defined as untreated and symptomatic, or requiring therapy with corticosteroids or
anticonvulsants to control associated symptoms
- Multiple primary malignancies within 3 years, except adequately resected non-melanoma
skin cancer, curatively treated in-situ disease, or other solid tumors curatively
treated
- History of severe hypersensitivity reactions to either the drug substances or inactive
ingredients in the drug product
- History of severe hypersensitivity reactions to other monoclonal antibodies
- Uncontrolled infection requiring IV antibiotics, antivirals, or antifungals
- Substance abuse or any other medical conditions such as clinically significant cardiac
or psychological conditions, that may, in the opinion of the investigator, interfere
with the participant's participation in the clinical study or evaluation of the
clinical study results
- Known human immunodeficiency virus (HIV) infection
- Known active, clinically relevant liver disease (eg, active hepatitis B, or active
hepatitis C) such as those with serologic evidence of viral infection within 28 days
of Cycle 1, Day 1
- Unresolved toxicities from previous anticancer therapy, defined as toxicities (other
than alopecia) not yet resolved to Grade = 1 or baseline
- Pregnant, breastfeeding, or planning to become pregnant
- Otherwise considered inappropriate for the study by the Investigator
- Lung-specific intercurrent clinically significant illnesses including, but not limited
to, any underlying pulmonary disorder (eg. pulmonary emboli within three months of the
study randomization, severe asthma, severe COPD, restrictive lung disease, pleural
effusion, etc.)
- Any autoimmune, connective tissue or inflammatory disorders (e.g., Rheumatoid
arthritis, Sjogren's, sarcoidosis etc.) where there is documented, or a suspicion of
pulmonary involvement at the time of screening
- Prior complete pneumonectomy
- Had prior treatment with any agent, including an antibody drug conjugate (ADC),
containing a chemotherapeutic agent targeting topoisomerase I
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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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
19/03/2021
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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
31/08/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
152
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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St John of God Subiaco Hospital - Subiaco
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Recruitment hospital [2]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
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6008 - Subiaco
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Recruitment postcode(s) [2]
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4102 - Woolloongabba
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Colorado
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United States of America
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Florida
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United States of America
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Kentucky
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United States of America
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Massachusetts
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United States of America
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Michigan
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United States of America
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Missouri
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United States of America
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Tennessee
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United States of America
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Virginia
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Canada
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Toronto
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France
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Lyon
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France
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Marseille
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France
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Rennes
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France
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Saint-Herblain
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France
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Toulouse
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France
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Villejuif
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Italy
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Lucca
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Italy
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Milano
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Italy
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Modena
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Italy
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Napoli
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Italy
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Orbassano
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Italy
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Rozzano
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Japan
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Chikusa
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Japan
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Chuo Ku
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Japan
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Fukuoka
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Japan
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Kashiwa
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Japan
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Okayama
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Japan
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Osaka-sayama
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Korea, Republic of
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Chungbuk
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Korea, Republic of
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Seongnam
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Korea, Republic of
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Seoul
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Netherlands
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Amsterdam
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Netherlands
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Rotterdam
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Valencia
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Taiwan
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Taichung
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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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Taiwan
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State/province [39]
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Taoyuan
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Daiichi Sankyo
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Address
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Other collaborator category [1]
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Commercial sector/Industry
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Name [1]
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AstraZeneca
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Ethics approval
Ethics application status
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Summary
Brief summary
This study was designed to evaluate the safety and efficacy of trastuzumab deruxtecan in
HER2-mutated metastatic non-small cell lung cancer (NSCLC) participants who had disease
recurrence or progression during/after at least one regimen of prior anticancer therapy
(second line or later) that must have contained a platinum-based chemotherapy drug.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT04644237
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Global Clinical Leader
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Address
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Daiichi Sankyo
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Contact person for public queries
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT04644237
Download to PDF