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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT02228369




Registration number
NCT02228369
Ethics application status
Date submitted
20/08/2014
Date registered
29/08/2014
Date last updated
19/05/2020

Titles & IDs
Public title
Oral Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors, AZD3759 or AZD9291, in Patients Who Have Advanced Non-Small Cell Lung Cancer
Scientific title
A Phase I, Open-label, Multicentre Study to Assess the Safety, Tolerability, Pharmacokinetics and Preliminary Anti-Tumour Activity of AZD3759 or AZD9291 in Patients With EGFR Mutation Positive Advanced Stage Non Small Cell Lung Cancer (NSCLC)
Secondary ID [1] 0 0
D6030C00001
Universal Trial Number (UTN)
Trial acronym
BLOOM
Linked study record

Health condition
Health condition(s) or problem(s) studied:
EGFR Mutation Positive Advanced Non 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 - AZD3759
Treatment: Drugs - AZD9291

Experimental: Daily dose of AZD3759 - Daily oral dose of AZD3759

Experimental: Daily Dose of AZD9291 - Daily oral dose of AZD9291


Treatment: Drugs: AZD3759
Starting dose 50 mg, administered twice daily. If tolerated subsequent cohorts will test increasing doses of AZD3759, until a maximum tolerated dose or an effective dose is defined

Treatment: Drugs: AZD9291
AZD9291 160mg once daily

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Safety and Tolerability (The number of patients with each AE by system organ class, preferred term and CTCAE grade) - Adverse events will be collected from Informed consent until the end of the follow-up period which is defined as 28 days (+7 days) after study treatment is discontinued.Physical exam (screening, single dosing day, Day 1 of every 3-week cycle of multiple dosing and treatment discontinuation). ECG and vital signs (screening, Day 1 and 2 of Cycle 0 for AZD3759 cohorts, Day 8 of Cycle 1 for AZD3759 cohorts, Day 1 of every 3-week cycle, treatment discontinuation, and if occurrence of any cardiac adverse event). Lab variables (screening, first dosing day, Day 1, 8 and 15 of multiple dosing, Day 1 of every 3-week cycle and treatment discontinuation). Eye exam (at screening and study drug discontinuation and upon occurrence of any visual AE). Echocardiogram or multigated radionuclide angiography (at screening,whenever necessary as clinically indicated throughout the study for AZD3759 cohorts.
Timepoint [1] 0 0
From Informed consent until the end of the follow-up period which is defined as 28 days (+7 days) after study treatment is discontinued.
Secondary outcome [1] 0 0
Plasma concentration of AZD3759 and metabolite and pharmacokinetics parameters after single dose of AZD3759(Cmax, tmax, terminal rate constant, half life, AUC, clearance, volume of distribution, mean residence time) - The parent drug and N-demethylated metabolite in plasma samples will be analyzed: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48, hour in Day 1; 24hour in Day 2 and 48hour in Day 3.
AUC: Area Under Curve
Timepoint [1] 0 0
Cycle 0 Day 1 to 3 in Part A patients.
Secondary outcome [2] 0 0
Plasma,urine,cerebrospinal fluid concentration of AZD3759 and metabolite and pharmacokinetics parameters after multiple dosing(Cmax,ss, tmax,ss, Cmin,ss, AUCss, CLss/F). - The parent drug and N-demethylated metabolite in plasma samples from all patients will be analyzed: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12hour on Cycle 1 Day 8 and Cycle 3 Day 1 . The parent drug and N-demethylated metabolite in urine samples from Part A patients will be analyzed: 0-12h at Cycle 1 Day 8. The parent drug and N-demethylated metabolite in cerebrospinal fluid samples will be analyzed: pre-dose of Cycle 1 Day 8 in brain metastasis patients; pre-dose of Cycle 1 Day 8 and Cycle 3 Day 1 in leptomeningeal metastasis patients. AUCss: Area Under Curve Steady State CLss: Clearance Steady State
Timepoint [2] 0 0
Blood samples: Cycle 1 Day 8 and Cycle 3 Day 1 in all patients. Urine samples: 0-12h at Cycle 1 Day 8 in Part A. CSF samples: pre-dose of Cycle 1 Day 8 in BM; Pre-dose of Cycle 1 Day 8 and Cycle 3 Day 1 in LM
Secondary outcome [3] 0 0
Plasma,urine, cerebrospinal fluid concentration of AZD3759 and metabolite and pharmacokinetics parameters after multiple dosing (extent of accumulation, renal clearance, time dependency of pharmacokinetics and amount of drug excreted) - The parent drug and N-demethylated metabolite in plasma samples from all patients will be analyzed: pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12hour on Cycle 1 Day 8 and Cycle 3 Day 1. The parent drug and N-demethylated metabolite in urine samples from Part A patients will be analyzed: 0-12h at Cycle 1 Day 8. The parent drug and N-demethylated metabolite in cerebrospinal fluid samples will be analyzed: pre-dose of Cycle 1 Day 8 in brain metastasis patients; pre-dose of Cycle 1 Day 8 and Cycle 3 Day 1 in leptomeningeal metastasis patients.
Timepoint [3] 0 0
Blood samples: Cycle 1 Day 8 and Cycle 3 Day 1 in all patients. Urine samples: 0-12h at Cycle 1 Day 8 in Part A patients. CSF samples: pre-dose of Cycle 1 Day 8 and Cycle 3 Day 1 in Part B patients .
Secondary outcome [4] 0 0
Plasma, cerebrospinal fluid concentration of AZD9291 and metabolite and pharmacokinetics parameters after multiple dose of AZD9291(Cmax,ss, tmax,ss, Cmin,ss, AUCss, CLss/F). - The parent drug and metabolites in plasma samples from all patients treated with AZD9291 will be analyzed: pre-dose of Cycle 1 Day 1, 8, 15; pre-dose, 1, 1.5, 2, 4, 6, 8, 10, 12, 24hour on Cycle 2 Day 1. The parent drug and metabolites in cerebrospinal fluid samples will be analyzed: pre-dose of Cycle 2 Day 1 in brain metastasis patients; pre-dose of Cycle 2 Day 1 and Cycle 3 Day 1 in leptomeningeal metastasis patients . AUCss: Area Under Curve Steady State CLss: Clearance Steady State
Timepoint [4] 0 0
Blood samples: Cycle 1 Day 1, 8, 15 and Cycle 2 Day 1. Cerebrospinal fluid samples: pre-dose of Cycle 2 Day 1 and pre-dose of Cycle 3 Day 1.
Secondary outcome [5] 0 0
Plasma, cerebrospinal fluid concentration of AZD9291 and metabolites and pharmacokinetics parameters after multiple dosing (extent of accumulation, renal clearance, time dependency of pharmacokinetics and amount of drug excreted) - The parent drug and metabolites in plasma samples from all patients treated with AZD9291 will be analyzed: pre-dose of Cycle 1 Day 1, 8, 15; pre-dose, 1, 1.5, 2, 4, 6, 8, 10, 12, 24hour on Cycle 2 Day 1. The parent drug and metabolites in cerebrospinal fluid samples will be analyzed: pre-dose of Cycle 2 Day 1 in brain metastasis patients; pre-dose of Cycle 2 Day 1 and Cycle 3 Day 1 in leptomeningeal metastasis patients . AUCss: Area Under Curve Steady State CLss: Clearance Steady State
Timepoint [5] 0 0
Blood samples: Cycle 1 Day 1, 8, 15 and Cycle 2 Day 1. Cerebrospinal fluid samples: pre-dose of Cycle 2 Day 1 and pre-dose of Cycle 3 Day 1.
Secondary outcome [6] 0 0
Overall survival follow up for all expansion patients - After 28-day follow-up visit, patients will be followed for overall survival via telephone every 6 weeks until death, lost to follow-up or consent withdrawal
Timepoint [6] 0 0
Every 6 weeks after the 28- day safety follow-up visit
Secondary outcome [7] 0 0
4b-hydroxy cholesterol in Part B patients with BM - Blood collection at pre-dose of Cycle 0 Day 1 and Cycle 1 Day 15 to evaluate if AZD3759 affects 4b-hydroxy cholesterol which is an endogenous marker of CYP enzyme induction
Timepoint [7] 0 0
pre-dose of Cycle 0 Day 1 and Cycle 1 Day 15
Secondary outcome [8] 0 0
The effect of food on the pharmacokinetics of a single dose of AZD3759 in plasma - Pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12 hour of Cycle 0 Day 1and Day 4; 24 hour of Cycle 0 Day 2 and Day 4.A Mixed Effects model with treatment (fed/fasted) and period as fixed effects and patient as a random effect will be used to compare AUC/Cmax in the fed state with AUC/Cmax in the fasted state.
Timepoint [8] 0 0
Cycle 0 Day 1 to Day 4 in Part B patients with BM
Secondary outcome [9] 0 0
Cerebrospinal fluid response rate for patients with LM and/or BM - Cerebrospinal fluid collection at screening and every 6 weeks until progression to evaluate the cerebrospinal fluid response rate which is defined as the percentage of leptomeningeal metastasis patients who have at least one cerebrospinal fluid response (100% clearance of tumour cells from cerebrospinal
Timepoint [9] 0 0
Screening and every 6 weeks (relative to first dose of multiple dosing) until progression, expected average 6 months
Secondary outcome [10] 0 0
Changes from baseline in central nervous system symptoms (analyzed from QLQ-BN20) in patients with LM treated with AZD3759 /AZD9291 - Quality of life questionnaire-Brain Cancer 20 questionnaire completed by patients at screening, Day 1 of every 3-week cycle and treatment discontinuation. Use relevant symptom questions to evaluate improvement of central nervous system symptoms.
Timepoint [10] 0 0
Screening, Day 1 of every 3-week cycle and treatment discontinuation, expected average 6 months.
Secondary outcome [11] 0 0
Changes from baseline in neurological exam in patients with LM treated with AZD3759 /AZD9291 - Neurological exam will be performed: screening, single dosing day, Day 1 of every 3-week cycle of multiple dosing and treatment discontinuation
Timepoint [11] 0 0
Screening, Day 1 of every 3-week cycle and treatment discontinuation, expected average 6 months.
Secondary outcome [12] 0 0
Measurement of Objective Response Rate (ORR) - ORR assessed through the number of patients who achieve a disease response (i.e. complete response or partial response) assessed according to modified RECIST 1.1 criteria for central nervous system disease, extracranial disease and overall disease
Timepoint [12] 0 0
Screening within 28days of treatments start and then every 6 weeks ± 1week(relative to first dose of multiple dosing) until objective disease progression or withdrawal from study,expected average 6 months.
Secondary outcome [13] 0 0
Measurement of Disease Control Rate (DCR) - DCR assessed through the number of patients who achieve a best response of confirmed CR, confirmed PR or responding, or stable disease according to modified RECIST 1.1 criteria for central nervous system disease, extracranial disease, leptomeningeal disease and overall disease
Timepoint [13] 0 0
Screening within 28days of treatments start and then every 6 weeks ± 1week(relative to first dose of multiple dosing) until objective disease progression or withdrawal from study,expected average 6 months.
Secondary outcome [14] 0 0
Measurement of Response Rate (RR) - RR assessed through the number of patients who have at least one confirmed response of Complete Response or Responding prior to any evidence of progression according to modified RECIST 1.1 criteria for leptomeningeal disease
Timepoint [14] 0 0
Screening within 28days of treatments start and then every 6 weeks ± 1week(relative to first dose of multiple dosing) until objective disease progression or withdrawal from study,expected average 6 months.
Secondary outcome [15] 0 0
Measurement of Progression Free Survival (PFS) - PFS assessed through change in tumour size (as well as assessment of non-target lesions and appearance of any new lesions) according to modified RECIST 1.1 criteria for Part B patients with brain metastasis and patients with leptomeningeal metastasis
Timepoint [15] 0 0
Screening within 28days of treatments start and then every 6 weeks ± 1week(relative to first dose of multiple dosing) until objective disease progression or withdrawal from study,expected average 6 months.
Secondary outcome [16] 0 0
Best Leptomeningeal Metastasis (LM) assessment for AZD9291 LM patients - Best LM assessment via LANO criteria through the number of patients with LM present at baseline, without a requirement for confirmation. LANO assessments will be mapped to RECIST-like scores and performed via central imaging reading.
Timepoint [16] 0 0
Screening within 28days

Eligibility
Key inclusion criteria
1. Obtained written informed consent

2. Male or female aged at least 18 years. Aged at least 20 if Japanese.

3. Histologically or cytologically confirmed diagnosis of NSCLC with single activating
EGFR mutations (L858R or Exon19Del).

4. Eastern Cooperative Oncology Group performance status of 0 to1. For LM patients, 0 to
2 is acceptable.

5. In Part A, prior treatment with at least one line of a single agent EGFR TKI and at
least 1 line of chemotherapy.

6. In Part B-BM expansion, patients must have not received any EGFR TKI and have
asymptomatic brain metastasis, either found during screening process which does not
require local treatment in the opinion of the investigator or local treatment has been
given (surgery or radiation), patient must be stable without corticosteroid and/or
anti-convulsants treatment for at least 2 weeks before study enrollment. For Part B-LM
expansion, patients who received previous EGFR TKI treatment must have stable
extracranial disease;EGFR TKI treatment naïve patients can also be enrolled into
AZD9291 cohorts, or AZD3759 cohorts if efficacy signal seen in Part A and agreed by
Safety Review Committee.

7. For patients with neither LM nor measurable BM: At least one measurable extracranial
lesion. For patients with measurable BM but without LM: at least one measurable
intracranial lesion

8. For patients with LM: Confirmed diagnosis of LM by positive CSF cytology.

9. Male patients should be willing to use barrier contraception, i.e., condoms, until 3
months after last study drug is taken.

10. Females should agree to use adequate contraceptive measures, should not be breast
feeding and must have a negative pregnancy test prior to start of dosing if of
child-bearing potential or must have evidence of non-child-bearing potential

11. In Part B-AZD9291 LM expansion (sub-cohort of T790M+ LM patients), patients must have
central confirmation of T790M+ mutation status from a sample taken after documented
progression on the last treatment administered prior to enrolling in the study.
Patients must have received prior therapy with an EGFR TKI and may also have received
additional lines of treatment. Stable extracranial disease is not required.
Minimum age
18 Years
Maximum age
130 Years
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. For patients with LM and/or BM, CNS complications that require urgent neurosurgical
intervention

2. For patient with LM, inability to undergo collection of CSF

3. Treatment with an EGFR TKI (e.g., erlotinib or gefitinib) within 8 days or
approximately 5 x half-life, whichever is the longer, of the first dose of study
treatment.

4. Any cytotoxic chemotherapy,or other anticancer drugs for the treatment of advanced
NSCLC from a previous treatment regimen within 14 days of the first dose of study
treatment

5. Radiotherapy with a wide field of radiation within 4 weeks or radiotherapy with a
limited field of radiation for palliation within 1 week of the first dose of study
treatment with the exception of patients receiving radiation to more than 30% of the
bone marrow which must be completed within 4 weeks of the first dose of study
treatment.

6. Patients currently receiving (or unable to stop use at least 1 week prior to receiving
the first dose of AZD3759/AZD9291) medications or herbal supplements known to be
potent inhibitors or inducers of cytochrome P450 3A4/5 and potential inhibitors of
cytochrome P450 2C8 (for patients to be enrolled into AZD9291 cohorts only).

7. Past medical history of interstitial lung disease, drug-induced interstitial lung
disease, radiation pneumonitis which required steroid treatment, or any evidence of
clinically active interstitial lung disease.

8. Known intracranial haemorrhage which is unrelated to tumour

9. Refractory nausea and vomiting if not controlled by supportive therapy, chronic
gastrointestinal diseases, inability to swallow the formulated product or previous
significant bowel resection that would preclude adequate absorption of AZD3759/AZD9291

10. Any evidence of severe or uncontrolled systemic diseases, including uncontrolled
hypertension and active bleeding diatheses

11. Inadequate bone marrow reserve or organ function

12. Clinically significant ECG abnormalities or any factors that increase the risk of
corrected QT interval prolongation or risk of arrhythmic events

13. Prior history of whole brain radiotherapy (only applicable for AZD3759 BM expansion)

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised 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 1
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Active, not recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Research Site - Camperdown
Recruitment hospital [2] 0 0
Research Site - Heidelberg
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
3084 - Heidelberg
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
Korea, Republic of
State/province [2] 0 0
Seongnam-si
Country [3] 0 0
Korea, Republic of
State/province [3] 0 0
Seoul
Country [4] 0 0
Taiwan
State/province [4] 0 0
Taipei

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
AstraZeneca
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This is the first time in patient study to assess the safety, tolerability and preliminary
efficacy of AZD3759 in patients with advanced Non Small Cell Lung Cancer (NSCLC) In this
study, patients with Leptomeningeal Metastasis and Brain Metastasis may also be enrolled to
assess the anti-tumour efficacy, safety, pharmacokinetics and potential biological activity
of AZD9291
Trial website
https://clinicaltrials.gov/show/NCT02228369
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Pamela Yang, M.D. PhD
Address 0 0
Building 2, 199 Liangjing Road, Zhangjiang Hi-tech Park, Shanghai 201203, China
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications