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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04686305
Registration number
NCT04686305
Ethics application status
Date submitted
8/12/2020
Date registered
28/12/2020
Titles & IDs
Public title
Phase Ib Study of the Safety of T-DXd and Immunotherapy Agents With and Without Chemotherapy in Advanced or Metastatic HER2+, Non-squamous NSCLC
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Scientific title
A Phase Ib Multicenter, Open-label Study to Evaluate the Safety and Tolerability of Trastuzumab Deruxtecan (T-DXd) and Immunotherapy Agents With and Without Chemotherapy Agents in First-line Treatment of Patients With Advanced or Metastatic Non-squamous Non-small Cell Lung Cancer (NSCLC) and Human Epidermal Growth Factor Receptor 2 (HER2) Overexpression (OE) (DESTINY-Lung03)
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Secondary ID [1]
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2020-003260-31
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Secondary ID [2]
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D967YC00001
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Universal Trial Number (UTN)
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Trial acronym
DL03
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Locally Advanced or Metastatic Non-Small Cell Lung Cancer
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Condition category
Condition code
Cancer
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Lung - Mesothelioma
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Cancer
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Lung - Non small cell
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Cancer
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Lung - Small cell
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - T-DXd
Treatment: Other - Durvalumab
Treatment: Drugs - Cisplatin
Treatment: Drugs - Carboplatin
Treatment: Drugs - Pemetrexed
Treatment: Drugs - Volrustomig
Treatment: Drugs - Rilvegostomig
Experimental: Arm 1A: T-DXd, Durvalumab and Cisplatin - T-DXd, Durvalumab and Cisplatin
Experimental: Arm 1B: T-DXd, Durvalumab and Carboplatin - T-DXd, Durvalumab and Carboplatin
Experimental: Arm 1C: T-DXd, Durvalumab and Pemetrexed - T-DXd, Durvalumab and Pemetrexed (Arm not initiated)
Experimental: Arm 1D: T-DXd - T-DXd
Experimental: Arm 3A: T-DXd and Volrustomig - Drug: T-DXd and Volrustomig T-DXd: administered as an IV infusion Other Name: DS-8201a, Trastuzumab deruxtecan Biological/Vaccine: Volrustomig Volrustomig: administered as an IV infusion Other Name: Volrustomig
Experimental: Arm 3B: T-DXd, Volrustomig and Carboplatin - Drug: T-DXd, Volrustomig and Carboplatin T-DXd: administered as an IV infusion Other Name: DS-8201a, Trastuzumab deruxtecan Biological/Vaccine: Volrustomig Volrustomig: administered as an IV infusion Other Name: Volrustomig Drug: Carboplatin Carboplatin: administered as an IV infusion
Experimental: Arm 4A: T-DXd and Rilvegostomig - T-DXd and Rilvegostomig Drug: T-DXd, Rilvegostomig T-DXd: administered as an IV infusion Other Name: DS-8201a, Trastuzumab deruxtecan Biological/Vaccine: Rilvegostomig Rilvegostomig: administered as an IV infusion Other Name: Rilvegostomig, AZD2936
Experimental: Arm 4B T-DXd and Rilvegostomig with Carboplatin - Drug: T-DXd, Rilvegostomig and Carboplatin T-DXd: administered as an IV infusion Other Name: DS-8201a, Trastuzumab deruxtecan Biological/Vaccine: Rilvegostomig Rilvegostomig: administered as an IV infusion Other Name: Rilvegostomig, AZD2936 Drug: Carboplatin Carboplatin: administered as an IV infusion
Treatment: Drugs: T-DXd
T-DXd: administered as an IV infusion
Treatment: Other: Durvalumab
Durvalumab: administered as an IV infusion
Treatment: Drugs: Cisplatin
Cisplatin: administered as an IV infusion
Treatment: Drugs: Carboplatin
Carboplatin: administered as an IV infusion
Treatment: Drugs: Pemetrexed
Pemetrexed: administered as an IV infusion (drug not used)
Treatment: Drugs: Volrustomig
Volrustomig: administered as an IV infusion
Treatment: Drugs: Rilvegostomig
Rilvegostomig: administered as an IV infusion
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Frequency of AEs and SAEs
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Assessment method [1]
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Occurrence of AEs and SAEs graded according to NCI CTCAE v5.0
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Timepoint [1]
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Safety and tolerability (and to determine RP2D) will be assessed for approximately 20 months from informed consent
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Secondary outcome [1]
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Confirmed Objective Response Rate (ORR)
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Assessment method [1]
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Confirmed ORR per RECIST 1.1 is the percentage of patients with Complete Response or Partial Response that is subsequently confirmed, based on investigator assessment
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Timepoint [1]
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An average of approximately 12 months
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Secondary outcome [2]
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Duration of Response (DoR)
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Assessment method [2]
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DOR is defined as the time from the date of first documented response until the date of documented progression or death, based on RECIST 1.1 assessment
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Timepoint [2]
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An average of approximately 20 months
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Secondary outcome [3]
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Disease Control Rate (DCR)
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Assessment method [3]
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DCR is the percentage of patients who have a best overall response of complete response (CR) or partial response (PR) or stable disease (SD), based on RECIST 1.1 assessment. DCR is assessed at 6 and 12 weeks
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Timepoint [3]
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An average of approximately 12 months
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Secondary outcome [4]
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Progression-free survival (PFS)
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Assessment method [4]
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PFS is the time from first dose of study treatment until the date of objective disease progression or death, based on RECIST 1.1 assessment
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Timepoint [4]
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An average of approximately 20 months
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Secondary outcome [5]
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Overall survival (OS)
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Assessment method [5]
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OS is the time form the date of first dose of study treatment until death due to any cause
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Timepoint [5]
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An average of approximately 20 months
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Secondary outcome [6]
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Pharmacokinetics (PK) assessed by the serum concentration of T-DXd, total anti-HER2 antibody, and MAAA-1181 in all arms
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Assessment method [6]
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Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for T-DXd, total anti-HER2 antibody and MAAA-1181a
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Timepoint [6]
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An average of approximately 20 months
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Secondary outcome [7]
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Pharmacokinetics (PK) assessed by the serum concentration of durvalumab in study arms including T-DXd in combination with durvalumab
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Assessment method [7]
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Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for durvalumab, including T-DXd in combination with durvalumab
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Timepoint [7]
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An average of approximately 20 months
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Secondary outcome [8]
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Pharmacokinetics (PK) assessed by the serum concentration of volrustomig in study arms including T-DXd in combination with volrustomig
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Assessment method [8]
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Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for volrustomig, including T-DXd in combination with volrustomig
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Timepoint [8]
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An average of approximately 20 months
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Secondary outcome [9]
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Pharmacokinetics (PK) assessed by the serum concentration of rilvegostomig in study arms including T-DXd in combination with rilvegostomig
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Assessment method [9]
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Individual patient data and descriptive statistics will be provided for serum concentration data at each time point for rilvegostomig, including T- DXd in combination with rilvegostomig
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Timepoint [9]
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An average of approximately 20 months
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Secondary outcome [10]
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The immunogenicity of T-DXd, durvalumab, volrustomig and rilvegostomig assessed by the presence of ADAs for T-DXd, durvalumab, volrustomig, or rilvegostomig
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Assessment method [10]
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Individual participant data and descriptive statistics will be provided for data at each time point for each dose level for T-DXd, durvalumab or volrustomig, or rilvegostomig
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Timepoint [10]
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An average of approximately 20 months
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Eligibility
Key inclusion criteria
Inclusion criteria:
* Histologically documented unresectable locally advanced/metastatic non-squamous NSCLC
* Part 1: Progression after 1 or 2 lines of systemic therapy for recurrent or metastatic setting.
* Part 3 and 4: Patients must have tumors that do not harbor known genomic alterations or actionable driver kinases, for which approved therapies are available are allowed.
* Part 3 and 4: Patient must be treatment-naïve for advanced or metastatic NSCLC. Patients who have received prior adjuvant, or neoadjuvant chemotherapy, or definitive chemoradiation for advanced disease are eligible, provided that progression has occurred > 6 months from end of last therapy
* HER2overexpression status as determined by central review of tumor tissue
* WHO / ECOG performance status of 0 or 1
* Measurable target disease assessed by the investigator using RECIST 1.1
* Has protocol defined adequate organ and bone marrow function
* Part 3 and part 4: Minimum body weight of 35 kg.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
* HER2 mutation if previously known
* Has a history of (non-infectious) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening
* Lung-specific intercurrent clinically significant illnesses including, but not limited to, any underlying pulmonary disorder and prior pneumonectomy
* Active primary immunodeficiency known HIV infection, or active chronic and resolved hepatitis B (positive hepatitis B virus surface antigen [HBsAg+ve] or hepatitis B virus core antibody (anti-HBc +ve) regardless of HBV DNA level)) or hepatitis C infection. Patients positive for HCV antibody are eligible only if polymerase chain reaction is negative for HCV RNA. Patients should be tested for HIV prior to treatment assignment if required by local regulations or IRB/EC
* Active infection including tuberculosis and uncontrolled infection requiring IV antibiotics, antivirals, or antifungals
* Spinal cord compression or clinically active central nervous system metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms
* Medical history of myocardial infarction within 6 months before treatment assignment, symptomatic CHF (New York Heart Association Class II to IV), clinically important cardiac arrhythmias, or a recent (< 6 months) cardiovascular event including stroke
* For Part 3 and Part 4: Cardiomyopathy of any etiology, symptomatic CHF (as defined by New York Heart Association Class > II), unstable angina pectoris, history of MI within the past 12 months, or cardiac arrhythmia are to be excluded. Patients with troponin levels above ULN at screening (as defined by the manufacturer), and without any myocardial related symptoms, should have a cardiologic consultation before treatment assignment to rule out acute cardiopulmonary events.
* Ascites or pericardial effusion that requires drainage, peritoneal shunt, Pleuroperitoneal shunt or CART (Concentrated Ascites Reinfusion Therapy)
* For Part 3 and Part 4: Active non-infectious skin disease (including any grade rash, urticarial, dermatitis, ulceration, or psoriasis) requiring systemic treatment, active or prior documented autoimmune or inflammatory disorders requiring chronic treatment with steroids or other immunosuppressive treatment.
* Unresolved toxicities not yet resolved to Grade = 1 or baseline from previous anticancer therapy OR prior discontinuation of any planned study therapy due to toxicity.
* must not have any medical contraindication to platinum-based chemotherapy.
* Part 3 and 4 patients must not have had prior exposure to anti-PD-1, anti-PD-L1, anti-CTLA-4, anti-TIGIT or any other experimental immunotherapy in any setting.
* For Part 3 and Part 4: History of substance abuse or any other medical or psychological conditions that may, in the opinion of the Investigator, interfere with the subject's participation in the clinical study or evaluation of the clinical study results
* For Part 3 and Part 4: History of thromboembolic events within 3 months before the first dose of IP (limited to pulmonary embolism, deep vein thrombosis, or cerebral venous sinus thrombosis).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
9/03/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
23/12/2025
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Actual
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Sample size
Target
244
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Research Site - Adelaide
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Recruitment hospital [2]
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Research Site - Heidelberg
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Recruitment hospital [3]
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Research Site - Nedlands
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Recruitment postcode(s) [1]
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5000 - Adelaide
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Recruitment postcode(s) [2]
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3084 - Heidelberg
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Recruitment postcode(s) [3]
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6009 - Nedlands
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Recruitment outside Australia
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United States of America
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California
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United States of America
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Kansas
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United States of America
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Maryland
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United States of America
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Michigan
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New York
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Texas
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United States of America
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Virginia
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United States of America
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Washington
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Belgium
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Edegem
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Bordeaux Cedex
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France
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Dijon
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France
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Pierre Benite Cedex
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France
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Saint Herblain
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France
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Kfar-Saba
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Monza
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Italy
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Padova
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Bacolod
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Valencia
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Taoyuan
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Bangkok
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Hat Yai
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Khon Kaen
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Muang
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Turkey
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Ankara
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Turkey
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Bornova-Izmir
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
AstraZeneca
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Daiichi Sankyo
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Ethics approval
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Summary
Brief summary
DESTINY-Lung03 will investigate the safety and tolerability of trastuzumab deruxtecan in combination with Immunotherapy Agents with and without chemotherapy in patients with HER2 over-expressing non-small cell lung cancer. The efficacy will be also analyzed as a secondary endpoint.
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Trial website
https://clinicaltrials.gov/study/NCT04686305
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Contact person for public queries
Name
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AstraZeneca Clinical Study Information Center
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Address
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Phone
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1-877-240-9479
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
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When will data be available (start and end dates)?
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
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Available to whom?
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://astrazenecagroup-dt.pharmacm.com/DT/Home
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04686305