Non Small Cell Lung Carcinoma NSCLCPhase 3NEPTUNENCT02542293
Study of Durvalumab With Tremelimumab Versus SoC as 1st Line Therapy in Metastatic Non Small-Cell Lung Cancer (NSCLC) (NEPTUNE)
A Phase 3 study testing Durvalumab +Tremelimumab, Paclitaxel + carboplatin and Gemcitabine + cisplatin in people with Non Small Cell Lung Carcinoma NSCLC, run by AstraZeneca at 210 sites in 29 countries.
Trial summary
This is a randomized, open-label, multi-center, global, Phase III study to determine the efficacy and safety of durvalumab + tremelimumab combination therapy versus platinum-based SoC chemotherapy in the first-line treatment of patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK)… Read more about this study
- Who is it for?
- Ages 18 to 130 years
- Conditions the study is for
- Non Small Cell Lung Carcinoma NSCLC
- What is being tested?
- Durvalumab +Tremelimumab, Paclitaxel + carboplatin and Gemcitabine + cisplatin
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 953 participants
- Where
- 210 sitesin 29 countries
- Study dates
- 3 Nov 2015to 31 Dec 2026
- Phase
- Phase 3
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 130 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- For inclusion in the study, patients should fulfill the following criteria:
- Aged at least 18 years
- Documented evidence of Stage IV NSCLC
- No activating EGFR mutation or ALK rearrangement
- No prior chemotherapy or any other systemic therapy for recurrent/metastatic NSCLC
- World Health Organization (WHO) Performance Status of 0 or 1
- No Prior exposure to Immune Mediated Therapy (IMT), including, but not limited to, other antiCTLA4, antiPD1, anti PDL1,or antiPDL2 antibodies, excluding therapeutic anticancer vaccines
Who cannot join
- Patients should not enter the study if any of the following exclusion criteria are fulfilled:
- Mixed small cell lung cancer and NSCLC histology, sarcomatoid variant
- Brain metastases or spinal cord compression unless the patient is stable (asymptomatic; no evidence of new or emerging brain metastases) and off steroids for at least 14 days prior to start of study treatment.
- Active or prior documented autoimmune or inflammatory disorders (e.g., Crohn's disease, ulcerative colitis)
Trial locations and contacts
210 sites in 29 countries.
210 sites in 29 countries
Japan27 sites
Research Site
Bunkyō City, 160-0023
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Fukushima, 960-1295
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Habikino-shi, 583-8588
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Hirosaki-shi, 036-8545
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Iizuka-shi, 820-8505
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Iwakuni-shi, 740-8510
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Kanazawa, 920-8641
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Kishiwada-shi, 596-8501
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Kobe, 650-0047
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Kurume-shi, 830-0011
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Kyoto, 607-8062
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Mitaka-shi, 181-8611
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Nagaoka-shi, 940-2085
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Nagoya, 460-0001
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Nagoya, 466-8560
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Niigata, 951-8566
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Okayama, 700-8607
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Osaka, 541-8567
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Saga, 840-8571
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Sagamihara-shi, 252-0375
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Sakaishi, 591-8555
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Sendai, 980-0873
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Tokushima, 770-8503
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Ube-shi, 755-0241
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Wakayama, 641-8510
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Yokohama, 236-0004
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Yokohama, 241-8515
United States15 sites
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Albuquerque, New Mexico, 87102
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Anaheim, California, 92801
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Canton, Ohio, 44710
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Columbus, Ohio, 43219
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East Setauket, New York, 11733
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Florham Park, New Jersey, 07932
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Fresh Meadows, New York, 11366
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Houston, Texas, 77090
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Louisville, Kentucky, 40202
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Pittsburgh, Pennsylvania, 15212
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Poughkeepsie, New York, 12601
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San Diego, California, 92123
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Santa Rosa, California, 95403
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Stony Brook, New York, 11794
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Zanesville, Ohio, 43701
Brazil14 sites
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Barretos, 14784-400
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Belo Horizonte, 30110-022
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Belo Horizonte, 30380-472
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Fortaleza, 60336-045
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Ijuí, 98700-000
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Itajaí, 88301-220
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Porto Alegre, 90035-003
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Porto Alegre, 90160-093
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Porto Alegre, 91350-200
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São José do Rio Preto, 15090-000
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São Paulo, 01221-020
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São Paulo, 01246-000
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São Paulo, 01323 900
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São Paulo, 03102-002
Ukraine14 sites
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Chernivtsі, 58013
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Dnipro, 49102
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Ivano-Frankivsk, 76018
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Kapitanivka Village, 08111
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Kharkiv Region, 61070
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Kirovohrad, 25006
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Kyiv, 03115
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Kyiv, 04107
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Liutizh, 07352
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Lviv, 79031
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Odesa, 65055
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Sumy, 40022
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Uzhhorod, 88000
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Vinnytsia, 21029
China10 sites
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Beijing, 100142
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Changchun, 130000
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Chongqing, 400030
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Guangzhou, 510100
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Hangzhou, 310022
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Shanghai, 200030
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Shanghai, 200032
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Ürümqi, 830000
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Wuhan, 430022
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Wuhan, 430030
Poland10 sites
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Bydgoszcz, 85-796
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Kielce, 25-734
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Krakow, 31-202
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Lodz, 93-513
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Mrozy, 05-320
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Olsztyn, 10-357
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Poznan, 60-569
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Warsaw, 01-138
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Warsaw, 02-781
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Wodzisław Śląski, 44-300
Russia9 sites
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Moscow, 105229
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Moscow, 115280
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Moscow, 125367
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Omsk, 644013
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Saint Petersburg, 194291
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Saint Petersburg, 197022
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Saint Petersburg, 197183
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Saint Petersburg, 197342
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Saint Petersburg, 197758
Turkey (Türkiye)9 sites
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Adana, 01120
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Ankara, 06200
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Ankara, 06230
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Ankara, 06280
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Ankara, 6500
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Istanbul, 31755
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Istanbul, 34030
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Istanbul, 34349
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Izmir, 35100
United Kingdom9 sites
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Guildford
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London, EC1M 6BQ
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London, NW1 2PG
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London, W6 8RF
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Manchester, M20 4BX
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Metropolitan Borough of Wirral, CH63 4JY
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Nottingham, NG5 1PB
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Taunton, TA1 5DA
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Wolverhampton, WV10 0QP
Argentina8 sites
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Berazategui, B1884BBF
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CABA, C1426ANZ
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Ciudad de Buenos Aires, C1025ABI
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Córdoba, 5000
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La Rioja, 5300
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Rosario, S2000KZE
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San Salvador de Jujuy, 4600
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Santa Rosa, 6300
Bulgaria8 sites
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Plovdiv, 4004
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Shumen, 9700
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Sofia, 1303
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Sofia, 1330
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Sofia, 1431
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Sofia, 1784
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Varna, 9010
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Vratsa, 3000
Chile7 sites
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Santiago, 7500713
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Santiago, 7500921
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Santiago, 7520349
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Santiago, 8380456
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Santiago, 8420383
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Temuco, 4810297
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Viña del Mar, 2520612
India7 sites
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Ahmedabad, 380016
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Bangalore, 560068
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Bangalore, 560076
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Chennai, 600035
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Gūrgaon, 122001
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Karamsad, 388325
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New Delhi, 110 085
Peru7 sites
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Arequipa, AREQUIPA01
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Bellavista, CALLAO 2
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Lima, 15033
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Lima, 41
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Lima, L27
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Lima, LIMA 34
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Lima, LIMA 41
Greece6 sites
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Athens, 115 22
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Athens, 11527
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Athens, 14564
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Heraklion, 71110
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Holargos, Athens, 155 62
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Ioannina, 45000
Israel6 sites
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Beersheba, 8410101
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Jerusalem, 91031
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Kfar Saba, 95847
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Nahariya, 22100
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Petah Tikva, 49100
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Ramat Gan, 5265601
Mexico6 sites
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Acapulco, 39670
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Aguascalientes, 20020
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Mérida, 97134
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México, 06100
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México, 14080
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Monterrey, 64710
Philippines6 sites
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Baguio City, 2600
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Cebu, 6000
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Las Piñas, PH-1704
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Manila, 1000
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Manila, 1003
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Quezon City, 1112
Portugal5 sites
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Amadora, 2720-276
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Lisbon, 1500-650
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Porto, 4099-001
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Porto, 4100-180
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Porto, 4200-319
South Korea5 sites
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Daegu, 41404
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Hwasun-gun, 58128
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Seoul, 05030
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Seoul, 06273
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Seoul, 08308
Singapore4 sites
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Singapore, 119228
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Singapore, 217562
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Singapore, 258499
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Singapore, 308433
Sweden4 sites
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Eskilstuna, 63188
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Linköping, 581 85
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Stockholm, 171 64
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Uppsala, 751 85
Hong Kong3 sites
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Hong Kong
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King's Park, 150001
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Shatin, 00000
Malaysia3 sites
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Kuala Lumpur, 59100
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Kuantan, 25100
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Kuching, 93586
Saudi Arabia3 sites
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Dammam, 31444
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Riyadh, 11426
Research Site
Riyadh, 12372
About this study
Official title: A Phase III Randomized, Open-Label, Multi-Center, Global Study of MEDI4736 in Combination With Tremelimumab Therapy Versus Standard of Care Platinum-Based Chemotherapy in First-Line Treatment of Patients With Advanced or Metastatic Non Small-Cell Lung Cancer (NSCLC).
This is a randomized, open-label, multi-center, global, Phase III study to determine the efficacy and safety of durvalumab + tremelimumab combination therapy versus platinum-based SoC chemotherapy in the first-line treatment of patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) wild-type advanced or metastatic NSCLC.
Read the detailed description
Patients will be randomized in a 1:1 to receive treatment with durvalumab + tremelimumab combination therapy or SoC therapy. The primary objective of this study is to assess the efficacy of combination treatment compared with SoC in terms of Overall Survival (OS) in patients.
- Conditions
- Non Small Cell Lung Carcinoma NSCLC
- Being tested
- Durvalumab +Tremelimumab, Paclitaxel + carboplatin, Gemcitabine + cisplatin, Gemcitabine + carboplatin, Pemetrexed + cisplatin
- Keywords
- NSCLC, PDL1, TMB, MEDI4736, Durvalumab, Tremelimumab, OS
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Durvalumab +TremelimumabBiological
Paclitaxel + carboplatinDrug
Also called Platinum based Standard of Care Chemotherapy
Chemotherapy Agents
Gemcitabine + cisplatinDrug
Also called Platinum based Standard of Care Chemotherapy
Chemotherapy Agents
Gemcitabine + carboplatinDrug
Also called Platinum based Standard of Care Chemotherapy
Chemotherapy Agents
Pemetrexed + cisplatinDrug
Also called Platinum based Standard of Care Chemotherapy
Chemotherapy Agent
Pemetrexed + carboplatinDrug
Also called Platinum based Standard of Care Chemotherapy
Chemotherapy Agent
| Study group | Role | What they receive |
|---|---|---|
| Combination Therapy | Experimental | Durvalumab (PD-L1 monoclonal antibody) + Tremelimumab (monoclonal antibody directed against CTLA-4) Receives: Biological: Durvalumab +Tremelimumab |
| Standard of Care | Active comparator | Standard of Care chemotherapy treatment Receives: Drug: Paclitaxel + carboplatin; Drug: Gemcitabine + cisplatin; Drug: Gemcitabine + carboplatin; Drug: Pemetrexed + cisplatin; Drug: Pemetrexed + carboplatin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS); Global Cohort: Blood Tumor Mutational Burden (bTMB) ≥20 Mutations Per Megabase (Mut/Mb) Analysis Set
The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on the last recorded date on which the participant was known to be alive. Median OS was calculated using the Kaplan-Meier technique.
Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global cohort DCO date (a maximum of approximately 44 months).
OS; China Cohort: China Programmed Cell Death Ligand 1 (PD-L1) Negative NSCLC Analysis Set
The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on the last recorded date on which the participant was known to be alive. Median OS was calculated using the Kaplan-Meier technique.
Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the China cohort DCO date (a maximum of approximately 44 months).
Secondary outcomes (18)
OS; Global Cohort: bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, PD-L1-Negative NSCLC, bTMB <20 Mut/Mb, bTMB Non-Evaluable Population, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets
OS was defined as time from date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at time of analysis was censored based on last recorded date on which participant was known to be alive.
bTMB ≥16 mut/Mb, bTMB ≥12 mut/Mb and bTMB <20 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥16 mut/Mb, ≥12 mut/Mb and <20 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
bTMB non-evaluable analysis set included the subset of participants in FAS whose bTMB status at baseline could not be determined by the GuardantOMNI CDx assay or whose sample was not available.
tTMB analysis sets are defined same as the bTMB analysis sets.
Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global cohort DCO date (a maximum of approximately 44 months).
OS; Global and China Cohorts: FAS, PD-L1 Tumor Cell (TC) ≥25%, and PD-L1 TC ≥50% Analysis Sets
The OS was defined as time from date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1). Any participant not known to have died at the time of analysis was censored based on last recorded date on which participant was known to be alive.
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment. Any participants recruited in China, after global recruitment had ended, were not included in the FAS.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included the subset of participants in the FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.
Measured: From baseline (Day 1, Week 0) until death due to any cause, assessed up to the Global or China cohort DCO dates, as applicable (a maximum of approximately 44 months) for each cohort.
Progression-Free Survival (PFS); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets
The PFS (per Response Evaluation Criteria in Solid Tumors, version 1.1 [RECIST 1.1] using Investigator assessments) was defined as the time from the date of randomization until the date of objective PD or death (by any cause in the absence of progression) regardless of whether the participant withdrew from randomized therapy or received another anticancer therapy prior to progression (ie, date of PFS event or censoring - date of randomization + 1).
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
tTMB ≥14 mut/Mb, tTMB ≥12 mut/Mb, tTMB ≥10 mut/Mb and tTMB ≥8 mut/Mb analysis sets included the subset of participants in FAS whose tTMB status was ≥14 mut/Mb, ≥12 mut/Mb, ≥10 mut/Mb and ≥8 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).
PFS; Global and China Cohorts: PD-L1-Negative NSCLC, FAS, PD-L1 TC ≥25%, and PD-L1 TC ≥50% Analysis Sets
PFS (per RECIST 1.1 using Investigator assessments) was defined as time from date of randomization until date of objective PD or death regardless of whether participant withdrew from randomized therapy or received another anticancer therapy prior to progression (ie, date of PFS event or censoring - date of randomization + 1).
PD-L1-negative analysis set included subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: FAS included all randomized participants prior to end of global recruitment.
China Cohort: China FAS included all randomized participants in China cohort and were used for all China only efficacy analyses.
PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included subset of participants in FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.
Objective Response Rate (ORR); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, bTMB ≥12 Mut/Mb, tTMB ≥14 Mut/Mb, tTMB ≥12 Mut/Mb, tTMB ≥10 Mut/Mb, and tTMB ≥8 Mut/Mb Analysis Sets
The ORR (per RECIST 1.1 using Investigator assessments) was defined as the percentage of participants with at least 1 visit response of complete response (CR) or partial response (PR) prior to PD.
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
tTMB ≥14 mut/Mb, tTMB ≥12 mut/Mb, tTMB ≥10 mut/Mb and tTMB ≥8 mut/Mb analysis sets included the subset of participants in FAS whose tTMB status was ≥14 mut/Mb, ≥12 mut/Mb, ≥10 mut/Mb and ≥8 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).
ORR; Global and China Cohorts: PD-L1-Negative NSCLC, FAS, PD-L1 TC ≥25%, and PD-L1 TC ≥50% Analysis Sets
The ORR (per RECIST 1.1 using Investigator assessments) was defined as the percentage of participants with at least 1 visit response of CR or PR prior to PD.
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
PD-L1 TC ≥25% and PD-L1 TC ≥50% analysis sets included the subset of participants in the FAS whose PD-L1 status was TC ≥25% and TC ≥50% membrane expression in tumoral tissue, respectively at baseline as defined by the Ventana SP263 PD-L1 Assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.
Duration of Response (DoR); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets
DoR (per RECIST 1.1 using Investigator assessments) was defined as the time from the date of first documented response (CR or PR) until the first date of documented progression or death in the absence of PD (ie, date of PFS event or censoring - date of first response + 1).
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).
DoR; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets
DoR (per RECIST 1.1 using Investigator assessments) was defined as the time from the date of first documented response (CR or PR) until the first date of documented progression or death in the absence of PD (ie, date of PFS event or censoring - date of first response + 1).
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.
Alive and Progression-Free at 12 Months (APF12); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets
The APF12 was defined as the percentage of participants who were alive and progression free at 12 months from randomization (ie, PFS rate at 12 months).
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Tumour scans performed at baseline then every 6 weeks up to 12 months.
APF12; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets
The APF12 was defined as the percentage of patients who were alive and progression free at 12 months from randomization (ie, PFS rate at 12 months).
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
Measured: Tumour scans performed at baseline then every 6 weeks up to 12 months.
Time From Randomization to Second Progression or Death (PFS2); Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets
The PFS2 was defined as the time from the date of randomization to the earliest of the progression events subsequent to that used for the primary variable PFS, or death (ie, date of PFS2 event or censoring - date of randomization + 1).
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global cohort DCO date (approximately 44 months).
PFS2; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets
The PFS2 was defined as the time from the date of randomization to the earliest of the progression events subsequent to that used for the primary variable PFS, or death (ie, date of PFS2 event or censoring - date of randomization + 1).
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
Measured: Tumour scans performed at baseline and every 6 weeks up to 48 weeks relative to date of randomization, then every 8 weeks thereafter until confirmed PD/death. Up to Global or China cohort DCO dates, as applicable (approximately 44 months) for each cohort.
OS at Months 12, 18 and 24; Global Cohort: bTMB ≥20 Mut/Mb, bTMB ≥16 Mut/Mb, and bTMB ≥12 Mut/Mb Analysis Sets
The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1).
bTMB ≥20 mut/Mb, bTMB ≥16 mut/Mb and bTMB ≥12 mut/Mb analysis sets included the subset of participants in FAS whose bTMB status was ≥20 mut/Mb, ≥16 mut/Mb and ≥12 mut/Mb, respectively at baseline as defined by the GuardantOMNI CDx assay.
Measured: Months 12, 18 and 24
OS at Months 12, 18 and 24; Global and China Cohorts: PD-L1-Negative NSCLC and FAS Analysis Sets
The OS was defined as the time from the date of randomization until death due to any cause (ie, date of death or censoring - date of randomization + 1).
PD-L1-negative analysis set included the subset of participants in FAS whose PD-L1 status was PD-L1-negative at baseline as defined by the Ventana SP263 PD-L1 Assay (ie, <1% PD-L1-membrane expression in tumoral tissue).
Global Cohort: The FAS included all randomized participants prior to the end of global recruitment.
China Cohort: The China FAS included all randomized participants in the China cohort and were used for all China only efficacy analyses.
Measured: Months 12, 18 and 24
Serum Concentrations of Durvalumab
Blood samples were collected to determine the serum concentration of durvalumab.
Measured: Pre-dose and within 1 hour after end of infusion at Week 0 and 12; pre-dose on Week 24 and at follow-up Month 3
Serum Concentrations of Tremelimumab
Blood samples were collected to determine the serum concentration of tremelimumab.
Measured: Pre-dose and within 1 hour after end of infusion at Week 0 and 12, and at follow-up Month 3
Number of Participants With Anti-Drug Antibody (ADA) Response to Durvalumab
Blood samples were measured for the presence of ADAs and ADA-neutralizing antibodies (nAb) for durvalumab using validated assays. ADA prevalence is defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Treatment-emergent ADA is defined as the sum of treatment-induced ADA and treatment-boosted ADA. ADA incidence is the percentage of participants who were treatment-emergent ADA-positive. Treatment-boosted ADA is defined as baseline positive ADA titer that was boosted to >=4 fold during the study period. Persistently positive is defined as having at least 2 post baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. Transiently positive is defined as having at least 1 post baseline ADA positive measurement and not fulfilling the conditions for persistently positive.
Measured: At Weeks 0, 12, and 24; 3 and 6 months after last dose of study treatment.
Number of Participants With ADA Response to Tremelimumab
Blood samples were measured for the presence of ADAs and ADA-nAb for tremelimumab using validated assays. ADA prevalence is defined as the percentage of participants with positive ADA result at any time, baseline or post-baseline. Treatment-emergent ADA is defined as the sum of treatment-induced ADA and treatment-boosted ADA. ADA incidence is the percentage of participants who were treatment-emergent ADA-positive. Treatment-boosted ADA is defined as baseline positive ADA titer that was boosted to >=4 fold during the study period. Persistently positive is defined as having at least 2 post baseline ADA positive measurements with at least 16 weeks (112 days) between the first and last positive measurements, or an ADA positive result at the last available assessment. Transiently positive is defined as having at least 1 post baseline ADA positive measurement and not fulfilling the conditions for persistently positive.
Measured: At Weeks 0 and 12; 3 and 6 months after last dose of study treatment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Sep 2015 (estimated)
- Study start3 Nov 2015
- Primary completion21 Sep 2020
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Non Small Cell Lung Carcinoma NSCLCStudies of the same condition, open and under way.
- More trials run by AstraZenecaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 953 participants (actual)
Sponsor and investigators
- Lead sponsor
- AstraZeneca
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Gilberto de Castro, Principal investigator, Faculdade de Medicina da Universidade de São Paulo
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02542293
- Sponsor's protocol ID
- D419AC00003
- Other IDs
- 2015-002197-21, 2015
- Acronym
- NEPTUNE
- Status last verified
- Aug 2026
- First submitted
- 26 Aug 2015
- Last updated
- 6 Aug 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Publications
Cheng Y, Zhou Q, Han B, Fan Y, Shan L, Chang J, Sun S, Fang J, Chen Y, Sun J, Wu G, Mann H, Naicker K, Shire N, Mok T, de Castro G Jr. NEPTUNE China cohort: First-line durvalumab plus tremelimumab in Chinese patients with metastatic non-small-cell lung cancer. Lung Cancer. 2023 Apr;178:87-95. doi: 10.1016/j.lungcan.2023.01.013. Epub 2023 Feb 1.
PubMed 36806898