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Brief Title: DuRvalumab With chEmotherapy as First Line treAtment in Advanced Pleural Mesothelioma
Official Title: DREAM3R: DuRvalumab (MEDI4736) With chEmotherapy as First Line treAtment in Advanced Pleural Mesothelioma - A Phase 3 Randomised Trial
Study ID: NCT04334759
Brief Summary: Patients with pleural mesothelioma (PM) that cannot be surgically removed will receive standard chemotherapy (cisplatin or carboplatin and pemetrexed) given with durvalumab, a type of immunotherapy, or a treatment chosen by the study doctor, which is either standard chemotherapy or immunotherapy combination (ipilimumab and nivolumab). Durvalumab is an antibody (a type of human protein) that works by blocking a body substance called Programmed Death-Ligand 1 (PD-L1). Blocking PD-L1 helps the body's immune system attack cancer cells. Research has shown that durvalumab can slow tumor growth and shrink tumors in some people with cancer. Previous studies of combining durvalumab and chemotherapy showed that this combination is active in advanced mesothelioma. The purpose of this study is to see whether adding durvalumab to standard chemotherapy will improve overall survival (OS) in patients with PM.
Detailed Description: Mesothelioma is a malignant tumor of the mesothelial surfaces primarily arising in the thoracic pleura. In the United Kingdom and USA the expected number of cases in the next few decades are 65,000 and 85,000, respectively. Once diagnosed, this disease is rarely cured with a median survival of less than a year. This is an International, Open-Label, Multi-center, Phase III study. Patients will be randomized 1:1 to receive (a) chemotherapy given with durvalumab versus (b) physician's choice of either chemotherapy alone, or ipilimumab and nivolumab. Experimental Arm: - Durvalumab every 3 weeks + standard chemotherapy (cisplatin or carboplatin every 3 weeks + pemetrexed every 3 weeks) for 4 to 6 cycles, followed by durvalumab every 4 weeks until disease progression, unacceptable toxicity or patient withdrawal. Control Arm: Physician Choice * Standard chemotherapy (cisplatin or carboplatin every 3 weeks + pemetrexed every 3 weeks) for 4 to 6 cycles followed by observation * Ipilimumab every 6 weeks and nivolumab every 2 or 3 weeks \[physician discretion\] for up to 2 years until disease progression, unacceptable toxicity or patient withdrawal . Tumor assessments and Quality of Life (QOL) forms will be performed at baseline, then at weeks 6, 12, 18, 26, 34, 42, 50 and then every 12 weeks until disease progression. The QOL forms will also be repeated during the first visit after progression. Mandatory pre-treatment tumor tissue sample (i.e., obtained during a previous procedure or biopsy) for research will also be required. Blood samples for research at 3 time points will be done. The study is being led jointly by PrECOG as the US sponsor and University of Sydney as the international sponsor.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University of California San Diego, La Jolla, California, United States
University of Miami, Miami, Florida, United States
Moffitt Cancer Center, Tampa, Florida, United States
Emory University, Atlanta, Georgia, United States
University of Chicago, Chicago, Illinois, United States
NorthShore University Health System/Kellogg Cancer Center, Evanston, Illinois, United States
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, United States
Massaschusetts General Hospital, Boston, Massachusetts, United States
Dana Farber Cancer Institute, Boston, Massachusetts, United States
University of Michigan, Ann Arbor, Michigan, United States
Metro Minnesota Community Oncology Research Consortium, Saint Louis Park, Minnesota, United States
Morristown Medical/Atlantic Health, Morristown, New Jersey, United States
Jersey Shore University Medical Center, Neptune, New Jersey, United States
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
Memorial Sloan Kettering, New York, New York, United States
University of Cincinnati, Cincinnati, Ohio, United States
Cleveland Clinic Foundation, Cleveland, Ohio, United States
The Ohio State University, Columbus, Ohio, United States
Penn State Cancer Institute, Hershey, Pennsylvania, United States
Abramson Cancer Cener at Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, United States
Allegheny Cancer Center, Pittsburgh, Pennsylvania, United States
University of Texas Southwestern Medical Center, Dallas, Texas, United States
Baylor College of Medicine, Houston, Texas, United States
MD Anderson Cancer Center, Houston, Texas, United States
University of Virginia, Charlottesville, Virginia, United States
Canberra Hospital, Garran, Australian Capital Territory, Australia
Blacktown Hospital, Blacktown, New South Wales, Australia
Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
Gosford Hospital, Gosford, New South Wales, Australia
Wyong Hospital, Hamlyn Terrace, New South Wales, Australia
Nepean Hospital, Kingswood, New South Wales, Australia
Liverpool Hospital, Liverpool, New South Wales, Australia
Orange Health Service, Orange, New South Wales, Australia
Northern Cancer Institute (GenesisCare), Saint Leonards, New South Wales, Australia
Calvary Mater Newcastle, Waratah, New South Wales, Australia
Westmead Hospital, Westmead, New South Wales, Australia
Icon Cancer Care Wesley, Auchenflower, Queensland, Australia
Sunshine Coast University Hospital, Birtinya, Queensland, Australia
Icon Cancer Care Chermside, Chermside, Queensland, Australia
The Prince Charles Hospital, Chermside, Queensland, Australia
Townsville University Hospital, Douglas, Queensland, Australia
Icon Cancer Care South Brisbane, South Brisbane, Queensland, Australia
Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Flinders Medical Centre, Bedford Park, South Australia, Australia
The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
Royal Hobart Hospital, Hobart, Tasmania, Australia
Launceston General Hospital, Launceston, Tasmania, Australia
Monash Health, Clayton, Victoria, Australia
Peninsula & South Eastern Haematology and Oncology Group, Frankston, Victoria, Australia
Austin Hospital, Heidelberg, Victoria, Australia
Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Epworth HealthCare - Richmond, Richmond, Victoria, Australia
Sunshine Hospital (Western Health), Saint Albans, Victoria, Australia
Goulburn Valley Health, Shepparton, Victoria, Australia
Sir Charles Gairdner Hospital (SCGH), Nedlands, Western Australia, Australia
Auckland City Hospital, Grafton, Auckland, New Zealand
Name: Patrick Forde, MD
Affiliation: Johns Hopkins University
Role: STUDY_CHAIR
Name: Anna Nowak, MD
Affiliation: Faculty of Health and Medical Sciences University of Western Australia
Role: STUDY_CHAIR