Osimertinib + SRS for Lung Cancer

Not currently recruiting at 2 trial locations
SV
CH
Overseen ByCheryl Ho, MD, FRCPC
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: British Columbia Cancer Agency
Must be taking: Osimertinib
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether osimertinib, a medication, is more effective alone or combined with precise radiation therapy (SRS) for individuals with a specific type of lung cancer that has spread to the brain. Researchers aim to determine which approach better controls cancer cell spread in patients with a certain lung cancer mutation. Individuals who have not received other lung cancer treatments and have brain symptoms manageable with medication might be suitable candidates for this trial. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of participants.

Do I need to stop my current medications to join the trial?

You may need to stop taking certain medications before joining the trial, especially if they are known to affect liver enzymes (CYP3A4) or prolong the QT interval (a heart rhythm measure). It's best to discuss your current medications with the trial team to see if any changes are needed.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Previous studies have shown that osimertinib is both effective and well-tolerated. Patients with certain lung cancer mutations often experience good results with manageable side effects. Research indicates that adding chemotherapy to osimertinib can delay cancer progression compared to using osimertinib alone.

Stereotactic radiotherapy, another treatment in this trial, has also been generally well-received. While most people tolerate it well, about 10% to 30% may experience more serious side effects. These treatments have undergone thorough study, and results suggest they are safe for many people.

Consult a doctor about potential risks and benefits before joining a clinical trial.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments because they offer a potentially more effective approach to tackling lung cancer with brain metastases. Unlike standard treatments such as chemotherapy or whole-brain radiation therapy, the combination of Osimertinib and stereotactic radiotherapy (SRS) targets cancer cells more precisely. Osimertinib is a targeted therapy that specifically inhibits the activity of mutated EGFR, which is often present in lung cancer cells. This allows for more focused treatment, reducing damage to healthy cells. Additionally, starting Osimertinib shortly after SRS might enhance its effectiveness, potentially leading to better outcomes for patients.

What evidence suggests that this trial's treatments could be effective for lung cancer?

Research has shown that osimertinib works well for patients with EGFR-positive lung cancer. In one study, patients taking osimertinib lived for about 20 months without their cancer worsening. Another study found that 84% of patients treated with osimertinib were still alive after three years. In this trial, some participants will receive osimertinib alone, while others will receive a combination of osimertinib and stereotactic radiotherapy (SRS). SRS has also proven effective, with over 90% success in stopping cancer growth in the treated area. Both treatments have shown promising results in managing lung cancer.26789

Who Is on the Research Team?

Dr. Cheryl Ho - Division of Medical ...

Cheryl Ho, MD

Principal Investigator

BC Cancer, Vancouver Centre

SV

Shilo Lefresne, MD

Principal Investigator

BC Cancer, Vancouver Centre

Are You a Good Fit for This Trial?

This trial is for adults with a specific lung cancer (NSCLC) that has spread to the brain, who have not had prior treatment and whose cancer cells show certain mutations (EGFR). Participants must be in stable condition, able to follow study procedures, and willing to use effective contraception. Those with other active cancers, severe brain symptoms, or conditions affecting study participation are excluded.

Inclusion Criteria

I can take care of myself and perform daily activities.
If you have brain metastases, they must meet certain conditions when checked with an MRI.
My cancer has specific EGFR mutations.
See 6 more

Exclusion Criteria

I have brain metastases causing symptoms and affecting my neurological stability.
Pregnant or breastfeeding
You are allergic to the contrast dye used in MRI scans.
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Osimertinib alone or SRS followed by Osimertinib for brain metastases

1 year
Regular visits as per treatment protocol

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 years

Open-label extension (optional)

Participants may opt into continuation of treatment long-term

Long-term

What Are the Treatments Tested in This Trial?

Interventions

  • Osimertinib
  • Stereotactic Radiotherapy
Trial Overview The study compares two approaches: one group receives Osimertinib alone while the other gets Osimertinib plus Stereotactic RadioSurgery (SRS), which is a precise radiation therapy. This phase II trial aims to determine if adding SRS improves outcomes for patients with brain metastases from NSCLC.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Osimertinib aloneExperimental Treatment1 Intervention
Group II: SRS + OsimertinibActive Control2 Interventions

Osimertinib is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Tagrisso for:
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Approved in European Union as Tagrisso for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

British Columbia Cancer Agency

Lead Sponsor

Trials
181
Recruited
95,900+

Princess Margaret Hospital, Canada

Collaborator

Trials
121
Recruited
40,000+

Sunnybrook Health Sciences Centre

Collaborator

Trials
693
Recruited
1,569,000+

AstraZeneca

Industry Sponsor

Trials
4,491
Recruited
290,540,000+

Sir Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Dr. Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Medical Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Citations

Real-world efficacy of low dose osimertinib as second-line ...Treatment with low dose osimertinib demonstrated good efficacy and tolerability in EGFR-mutated advanced NSCLC patients who failed first-line treatment.
Tagrisso plus chemotherapy demonstrated a median ...Over the past decade, Tagrisso has consistently delivered strong survival benefits and tolerable safety across all stages of non-small cell lung ...
Real-world comparative outcomes of EGFR-TKIs for first- ...This study compared real-world clinical outcomes of 1L osimertinib versus 1st or 2nd generation EGFR-TKIs (1/2G-TKIs) in patients with EGFR+ mNSCLC.
Osimertinib after Chemoradiotherapy in Stage III EGFR- ...Interim overall survival data (maturity, 20%) showed 36-month overall survival among 84% of patients with osimertinib (95% CI, 75 to 89) and 74% ...
The Whole Picture of First-Line Osimertinib for EGFR ...Results. A total of 583 patients received osimertinib. The median progression-free and overall survival were 20.0 (95% confidence interval [CI]: ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39703183/
Observational study of the efficacy and safety of first-line ...Conclusions: Osimertinib demonstrated efficacy and tolerability in the clinical setting in patients with uncommon EGFR mutation-positive NSCLC. Keywords: ...
Safety and efficacy of osimertinib plus consolidative ...Osimertinib plus consolidative SABR appears to provide a PFS and OS benefit when considered against historical data with osimertinib alone.
Osimertinib as First-Line Treatment for Patients With ...This study supports the long-term efficacy of OSI, with PFS and OS comparable to those in the FLAURA trial in a Japanese real-world setting.
Osimertinib with or without Chemotherapy in EGFR- ...First-line treatment with osimertinib–chemotherapy led to significantly longer progression-free survival than osimertinib monotherapy among patients with EGFR- ...
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