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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/NCT05153239




Registration number
NCT05153239
Ethics application status
Date submitted
29/11/2021
Date registered
10/12/2021
Date last updated
1/05/2024

Titles & IDs
Public title
Clinical Trial of Lurbinectedin as Single-agent or in Combination With Irinotecan Versus Topotecan or Irinotecan in Patients With Relapsed Small-cell Lung Cancer (LAGOON)
Scientific title
A Randomized, Multicenter, Open-label, Phase III Study of Lurbinectedin Single-Agent or Lurbinectedin in Combination With Irinotecan Versus Investigator's Choice (Topotecan or Irinotecan) in Relapsed Small Cell Lung Cancer Patients (LAGOON Trial)
Secondary ID [1] 0 0
PM1183-C-008-21
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Relapsed Small Cell Lung Cancer 0 0
Condition category
Condition code
Cancer 0 0 0 0
Lung - Mesothelioma
Cancer 0 0 0 0
Lung - Non small cell
Cancer 0 0 0 0
Lung - Small cell

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Irinotecan
Treatment: Drugs - Lurbinectedin
Treatment: Drugs - Irinotecan
Treatment: Drugs - Topotecan
Treatment: Drugs - Lurbinectedin

Experimental: Lurbinectedin - Patients will consecutively receive lurbinectedin on Day 1 q3wk (every three weeks = one treatment cycle)

Experimental: Lurbinectedin plus Irinotecan - Patients will consecutively receive the following q3wk (every three weeks = one treatment cycle):
Irinotecan (Day 1 and Day 8)
Lurbinectedin (Day 1)

Active Comparator: Control arm - Best Investigator's choice prior to randomization between:
Irinotecan on Day 1 q3wk
Topotecan on Days 1-5 q3wk


Treatment: Drugs: Irinotecan
Irinotecan 75 mg/m² intravenously Days 1 & 8 q3wk

Treatment: Drugs: Lurbinectedin
Lurbinectedin 3.2 mg/m² will be administered intravenously on Day 1 q3wk

Treatment: Drugs: Irinotecan
For patients aged <70 years: irinotecan 350 mg/m² intravenously Day 1 q3wk For patients aged =70 years: irinotecan 300 mg/m² intravenously Day 1 q3wk

Treatment: Drugs: Topotecan
Topotecan 2.3 mg/m² oral or 1.5 mg/m² intravenously Days 1-5 q3wk

Treatment: Drugs: Lurbinectedin
Lurbinectedin 2.0 mg/m² will be administered intravenously on Day 1 q3wk
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Overall survival
Timepoint [1] 0 0
From the date of randomization to the date of death or last contact, up to 39 months
Secondary outcome [1] 0 0
Progression-free survival by IRC (Independent Review Committee)
Timepoint [1] 0 0
From the date of randomization to the date of progressive disease, death or last tumor assessment or further anticancer treatment, up to 39 months
Secondary outcome [2] 0 0
Progression-free survival by IA (Investigator Assessment)
Timepoint [2] 0 0
From the date of randomization to the date of progressive disease, death or last tumor assessment or further anticancer treatment, up to 39 months
Secondary outcome [3] 0 0
Overall response rate by IRC
Timepoint [3] 0 0
From the date of randomization to the date of death or last contact, up to 39 months
Secondary outcome [4] 0 0
Overall response rate by IA
Timepoint [4] 0 0
From the date of randomization to the date of death or last contact, up to 39 months
Secondary outcome [5] 0 0
Overall survival rate at 12 months
Timepoint [5] 0 0
At 12 months
Secondary outcome [6] 0 0
Overall survival rate at 24 months
Timepoint [6] 0 0
At 24 months
Secondary outcome [7] 0 0
Progression-free survival rate at 6 months by IRC
Timepoint [7] 0 0
At 6 months
Secondary outcome [8] 0 0
Progression-free survival rate at 6 months by IA
Timepoint [8] 0 0
At 6 months
Secondary outcome [9] 0 0
Progression-free survival rate at 12 months by IRC
Timepoint [9] 0 0
At 12 months
Secondary outcome [10] 0 0
Progression-free survival rate at 12 months by IA
Timepoint [10] 0 0
At 12 months
Secondary outcome [11] 0 0
Duration of response by IRC
Timepoint [11] 0 0
From the date of first documentation of complete or partial response to the date of documented progression disease, death or last contact, up to 39 months
Secondary outcome [12] 0 0
Duration of response by IA
Timepoint [12] 0 0
From the date of first documentation of complete or partial response to the date of documented progression disease, death or last contact, up to 39 months
Secondary outcome [13] 0 0
Patient-reported outcomes
Timepoint [13] 0 0
At baseline and every six weeks (± one week) until end of treatment, up to 39 months

Eligibility
Key inclusion criteria
1. Voluntary written informed consent of the patient obtained before any study-specific
procedure

2. Age=18 years

3. Histologically or cytologically confirmed diagnosis of SCLC.

4. One prior line of platinum-containing chemotherapy with/without anti-PD-1 or
anti-PD-L1 (Note: at least 70% of patients included in the study have to be pretreated
with anti-PD-1 or anti-PD-L1)

5. Chemotherapy-free interval (CTFI, time from the last dose of first-line
platinum-containing chemotherapy to the occurrence of progressive disease) = 30 days
(independent of the immunotherapy maintenance, if applicable)

6. Patients with history of Central Nervous System (CNS) metastases can participate
provided they are pretreated and radiologically stable (i.e., without evidence of
progression) for at least 4 weeks by repeated imaging (note: repeated imaging should
be performed during study screening), asymptomatic, and without requirement of steroid
treatment for at least 7 days before the first dose of study treatment

7. Eastern Cooperative Oncology Group (ECOG) PS = 2

8. Adequate hematological, renal, metabolic and hepatic function:

1. Hemoglobin = 9.0 g/dL [patients may have received prior red blood cell (RBC)
transfusion, if clinically indicated]; absolute neutrophil count (ANC) = 2.0 x
10^9/L, and platelet count = 100 x 10^9/L.

2. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 3.0 x upper
limit of normal (ULN).

3. Total bilirubin = 1.5 x ULN or direct bilirubin = ULN.

4. Albumin = 3.0 g/dL.

5. Calculated creatinine clearance (CrCL) = 30 mL/min (using Cockcroft and Gault's
formula).

9. At least three weeks since last prior antineoplastic treatment and recovery to grade =
1 from any adverse event (AE) related to previous anticancer treatment (excluding
sensory neuropathy, anemia, asthenia and alopecia, all grade = 2) according to the
National Cancer InstituteCommon Terminology Criteria for Adverse Events (NCICTCAE)
v.5.

10. Prior radiotherapy (RT): At least two weeks since completion of prophylactic cranial
irradiation (PCI), and to any other site not previously specified.

11. Evidence of non-childbearing status for women of childbearing potential (WOCBP). WOCBP
must agree to use a highly effective contraceptive measure up to seven months after
treatment discontinuation. Fertile male patients with WOCBP partners should use
condoms during treatment and for four months following the last investigational
medicinal product (IMP) dose.
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Platinum-naïve patients or patients pretreated with more than one prior chemotherapy
regimen (including patients re-challenged with same initial regimen).

2. Prior treatment with lurbinectedin, trabectedin, PM14, or topoisomerase I inhibitors
(irinotecan, topotecan, etc.).

3. Active or untreated CNS metastases and/or carcinomatous meningitis.

4. Patients with limited-stage disease who are candidates for local or regional therapy,
including PCI, thoracic RT or both, must have been offered that option and completed
treatment or refused it prior to randomization.

5. Concomitant diseases/conditions:

1. History or presence of unstable angina, myocardial infarction, congestive heart
failure, or clinically significant valvular heart disease within last year.

2. Symptomatic arrhythmia or any uncontrolled arrhythmia requiring ongoing
treatment.

3. Ongoing chronic alcohol consumption or cirrhosis with Child-Pugh score B or C.

4. Known Gilbert's disease.

5. Active uncontrolled infection. Serious non-healing wound, ulcer or bone fracture.
Presence of external drainages.

6. Ongoing, treatment-requiring, non-neoplastic chronic liver disease of any origin.
For Hepatitis B, this includes positive tests for both Hepatitis B surface
antigen (HBsAg) and quantitative Hepatitis B polymerase chain reaction (PCR). For
Hepatitis C, this includes positive tests for both Hepatitis C antibody and
quantitative Hepatitis C PCR. Subjects taking hepatitis related antiviral therapy
within six months prior to the first dose of study drugs will also be excluded.

7. Intermittent or continuous oxygen requirement within two weeks prior to
randomization. Patients with confirmed or suspected diagnosis of diffuse
interstitial lung disease or pulmonary fibrosis.

8. Patients with a second invasive malignancy treated with chemotherapy and/or RT.
Patients with a previous malignancy that was completely resected with curative
intention three or more years prior to randomization, except treated in situ
carcinoma of the cervix, basal or squamous cell skin carcinoma, and in situ
transitional cell bladder carcinoma and who has been continuously in remission
since then will be permitted.

9. Limitation of the patient's ability to comply with the treatment or to follow the
protocol.

10. Documented or suspected invasive fungal infections requiring systemic treatment
within 12 weeks of randomization.

11. Known human immunodeficiency virus (HIV) infection.

12. Any past or present chronic inflammatory colon and/or liver disease, past
intestinal obstruction, pseudo or subocclusion or paralysis.

13. Evident symptomatic pleural or cardiac effusion rapidly increasing and/or
necessitating prompt local treatment within seven days.

14. Any other major illness that, in the Investigator's judgment, will substantially
increase the risk associated with the patient's participation in this study
(e.g.; COVID-19 disease).

6. RT in more than 35% of the bone marrow.

7. History of previous bone marrow and/or stem cell transplantation and allogenic
transplant.

8. Patient has received a live or live-attenuated vaccine within 30 days before the first
dose of study intervention. Administration of inactivated vaccines is allowed.

9. Impending need for RT (e.g., painful bone metastasis and/or risk of spinal cord
compression).

10. History of allergy or hypersensitivity to any of the study drugs or any of their
excipients.

11. Women who are pregnant or breast feeding and fertile patients (men and women) who are
not able to use a highly effective method of contraception

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
22/07/2022
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/04/2026
Actual
Sample size
Target
705
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,VIC
Recruitment hospital [1] 0 0
The Chris Obrien Lifehouse - Camperdown
Recruitment hospital [2] 0 0
BRICC - Ballarat Health Services - Ballarat Central
Recruitment hospital [3] 0 0
Box Hill Hospital Eastern Health Clinical School - Box Hill
Recruitment hospital [4] 0 0
Northern Beaches Hospital - Frenchs Forest
Recruitment hospital [5] 0 0
Gosford Hospital GH - Central Coast Cancer Centre - Gosford
Recruitment hospital [6] 0 0
Austin Hospital- Medical Oncology Unit - Heidelberg
Recruitment hospital [7] 0 0
St John of God Murdoch Hospital - Murdoch
Recruitment hospital [8] 0 0
Cancer Care Wollongong - Wollongong
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
3350 - Ballarat Central
Recruitment postcode(s) [3] 0 0
3128 - Box Hill
Recruitment postcode(s) [4] 0 0
NSW 2086 - Frenchs Forest
Recruitment postcode(s) [5] 0 0
2250 - Gosford
Recruitment postcode(s) [6] 0 0
VIC 3084 - Heidelberg
Recruitment postcode(s) [7] 0 0
WA 6150 - Murdoch
Recruitment postcode(s) [8] 0 0
NSW 2500 - Wollongong
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Arizona
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United States of America
State/province [2] 0 0
Arkansas
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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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Illinois
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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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Nebraska
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United States of America
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North Carolina
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United States of America
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Utah
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United States of America
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Washington
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United States of America
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Wisconsin
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Austria
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Salzburg
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Vienna
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Antwerp
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Brasschaat
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Charleroi
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Liège
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Mechelen
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Mons
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Parana
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Salvador
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Barretos
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Ijuí
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Sofia
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Aalborg
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Næstved
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Sønderborg
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Vejle
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Besancon
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Caen
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Suresnes
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Villejuif
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Batumi
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Bremen
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Duisburg
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Esslingen
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Freiburg
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Germany
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Gauting
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Halle (saale)
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Germany
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Halle
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Heidelberg
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Germany
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Karlsruhe
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Germany
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Kassel
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Germany
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Löwenstein
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Germany
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Mannheim
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Germany
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München
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Offenbach
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Hungary
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Debrecen
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Hungary
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Farkasgyepu
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Kecskemét
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Szolnok
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Törökbálint
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Haifa
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Jerusalem
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Petah tikva
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Israel
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Ramat Gan
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Israel
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Tel Aviv
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Alessandria
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Ancona
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Aviano
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Italy
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Bologna
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Italy
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Catania
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Italy
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Cuneo
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Italy
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Florence
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Italy
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Genova
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Milan
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Napoli
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Novara
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Orbassano
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Italy
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Padova
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Italy
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Piacenza
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Italy
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Rionero In Vulture
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Italy
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Roma
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Italy
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Siena
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Sondrio
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Varese
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Aomori
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Fukuoka
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Hyogo
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Ishikawa
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Miyagi
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Okayama
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Osaka-Fu
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Osaka
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Tokyo
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Gyeonggi-do
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Korea, Republic of
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Incheon
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Korea, Republic of
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Seoul
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Poland
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Bialystok
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Gdynia
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Lublin
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Prabuty
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Rzeszów
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Tomaszów Mazowiecki
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Lódz
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Romania
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Baia Mare
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Romania
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Cluj-Napoca
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Romania
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Craiova
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Romania
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Ovidiu
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Romania
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Timisoara
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Barcelona
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Spain
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Cantabria
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Spain
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Gran Canaria
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Spain
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Navarra
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Spain
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Pontevedra
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Spain
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A Coruña
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Spain
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Córdoba
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Spain
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Lugo
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Madrid
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Málaga
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Sevilla
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Valencia
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Valladolid
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Zaragoza
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Switzerland
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Basel
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Bellinzona
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Switzerland
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Frauenfeld
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Switzerland
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Lausanne
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Switzerland
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Liestal
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Switzerland
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Münsterlingen
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Switzerland
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Villars-sur-Glâne
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Taiwan
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Chiayi
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Taiwan
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Chang Hua
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Taiwan
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Kaohsiung
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Taiwan
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Taipei
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Taiwan
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Taoyuan
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Turkey
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Adana
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Turkey
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Ankara
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Turkey
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Istambul
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Turkey
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Kocaeli
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United Kingdom
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Belfast
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Harlow
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United Kingdom
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London
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United Kingdom
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Manchester
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Nottingham
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United Kingdom
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Wirral
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United Kingdom
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Wolverhampton

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
PharmaMar
Address
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Ethics approval
Ethics application status

Summary
Brief summary
Multicenter, open-label, randomized, controlled phase III clinical trial to evaluate and
compare the activity and safety of two experimental arms consisting of lurbinectedin as
single agent (Group A) or the combination of lurbinectedin with irinotecan (Group B) versus
Investigator's Choice (topotecan or irinotecan) as control arm (Group C), in Small-cell Lung
Cancer (SCLC) patients who failed one prior platinum-containing line.
Trial website
https://clinicaltrials.gov/ct2/show/NCT05153239
Trial related presentations / publications
Public notes

Contacts
Principal investigator
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Contact person for public queries
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José Antonio Lopez-Vilariño, MD
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0034 91 823 4564
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jalopez-vilarino@pharmamar.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05153239