A trial of osimertinib for non small cell lung cancer (ADAURA2)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
Cancer type:
Status:
Phase:
This trial is looking at osimertinib after surgery for non small cell lung cancer (NSCLC).
It is for people who have:
- a small early cancer (stage 1A NSCLC)
- had surgery or have surgery planned to remove the cancer
- changes to genes affecting a protein called
EGFR
More about this trial
Surgery is a common treatment for non small cell lung cancer. Some cancer cells have changes in particular genes and proteins. For example, a change in the epidermal growth factor receptor (EGFR) gene. If your lung cancer cells have these receptors it is called EGFR positive.
Doctors are looking for ways to improve treatment for early NSCLC that is EGFR positive. In this trial they are looking at a drug called at osimertinib.
Osimertinib is a type of
Osimertinib is already a treatment for cancer that has spread elsewhere in the body. Researchers now want to see how well it works for smaller non small cell lung cancers to stop them coming back after surgery.
In this trial some people have osimertinib and some have a dummy drug (
The main aims of the trial are to find out:
- if having osimertinib after surgery stops the cancer coming back (recurring)
- more about the side effects
- how treatment affects quality of life
Who can enter
The following bullet points are a summary of the entry conditions for this trial. Talk to your doctor or trial team if you are unsure about any of these. They will be able to advise you.
Who can take part
You may be able to join this trial if all of the following apply. You:
- have early stage non small cell lung cancer that is up to 3cm across or smaller (stage 1A)
- have had or are having surgery to remove all the lung cancer. This includes having surgery to remove a lobe or segment of the lung or surgery called a sleeve resection.
- had surgery within 3 months of being put into a treatment group
- are completely better after surgery
- have a sample of tissue available for the trial team to do some tests on
- have certain gene changes in the EGFR gene to have treatment in the trial. Your doctor will check this.
- are fit and active but might not be able to do heavy physical work (performance status of 0 or 1)
- have satisfactory blood test results
- are willing to use reliable contraception during the trial and for a period after if there is any chance you or your partner could become pregnant
- are at least 18 years old
Who can’t take part
Cancer related
You cannot join this trial if any of these apply. You:
- have a mix of small cell and non small cell lung cancer. Your doctor will know this.
- are having surgery to remove either the whole lung, a wedge section of the lung or 2 lobes of the lung. Or your doctor couldn’t remove all the cancer. Your doctor will know this.
- have already had chemotherapy, a
targeted drug ,immunotherapy or an experimental drug in the past - took part in a trial of osimertinib, even if you didn’t have it as part of your treatment
- are having another treatment for cancer
- have had another cancer that has got worse or needed treatment in the past 5 years unless it has a low chance of coming back. You can join if it was successfully treated
non melanoma skin cancer orcarcinoma in situ - have side effects from past treatments that aren’t getting better. This doesn’t include hair loss.
- are taking part in another study unless it doesn’t involve a treatment
Medical conditions
You cannot join this trial if any of these apply. You:
- have a severe bleeding problem
- have an abnormal heart rhythm or you have a family history of a condition that causes a fast heartbeat
- have high blood pressure that isn’t well controlled with medication
- have HIV, an active hepatitis B or hepatitis C infection or any other severe infection that needs treatment
- can’t swallow tablets for any reason
- have a problem with your
digestive system that means you can’t absorb tablets, you feel very sick or are being sick a lot - have or have had a lung condition called interstitial lung disease or inflammation of the lungs or you had this in the past and needed to have
steroids to treat it - have had recent major surgery or a very bad injury
- are taking medication or herbal supplements that affect the CYP enzymes
- have another medical condition that your doctor or the trial team think could affect you taking part
Other
You can’t join this trial if any of these apply. You:
- have had a live
vaccination within 30 days of being put into a treatment group. Please note the current approved COVID-19 vaccines are not live. - are allergic to any of the drugs in the trial or anything they contain
- are pregnant or breastfeeding
Trial design
This phase 3 trial is taking place worldwide. The team need to find 380 people to take part including 10 from the UK.
Surgery
Everyone has surgery as planned. This is part of your routine care. Your doctor can tell you more about the type of surgery you will have. They can also tell you how long you’ll be in hospital for and how long it will take to get better.
Trial treatment
The treatment part is randomised. There are 2 treatment groups. A computer puts you into a group. Neither you nor your doctor will be able to decide which group you are in. Nor will you know which group you are in.
You have 1 of the following:
- osimertinib (group 1)
- a dummy drug (group 2)
Samples for research
The trial team ask you to give some extra blood samples. Where possible you have these at the same time as your routine blood tests.
They will also ask to look at samples of the cancer from your surgery. They might ask you to give a new sample if your cancer comes back.
The researchers plan to use the samples to:
- look at substances called
biomarkers to help work out why treatment might work for some people and not for others - look at
genes in your cancer cells to learn more about NSCLC - measure small amounts of cancer cells that may be in the bloodstream after surgery
- see what happens to osimertinib in the body
Quality of life
The trial team ask you to fill out a questionnaire:
- before you start treatment
- at set times during treatment
You complete these on an electronic device like an I-pad or on your phone. The questionnaire asks about side effects and how you’ve been feeling. This is called a quality of life study.
Hospital visits
You see the doctor and have tests before you can take part. These include:
- blood tests
- a
physical examination - heart trace (
ECG ) - heart scan (
echocardiogram ) orMUGA scan - eye test
- CT scan or MRI scan
During treatment you see the trial doctor for a check up and blood tests at:
- 3 months
- 6 months and then
- every 6 months until you stop treatment
Each visit takes between 1 and 3 hours. You have a CT scan every 6 months for up to 5 years.
Follow up
If your cancer hasn’t come back you have a check up every:
- 6 months for 5 years
- 9 months for 2 years and then
- every year until the end of the trial
The trial visits and scans stop if your cancer comes back (recurs). Your doctor will talk to you about other treatment options. The trial team then call you every 6 months to see how you are.
Side effects
The trial team monitor you during treatment and afterwards. Contact your advice line or tell your doctor or nurse if any side effects are bad or not getting better.
The most common side effects of osimertinib include:
- diarrhoea
- skin problems such as rash, dry skin, acne or itching
- nail problems
- sore mouth
- a drop in the number of blood cells causing an increased risk of bruising or bleeding or an increased risk of infection
The trial doctor will talk to you about all the possible side effects of treatment.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Dr Laura Cove-Smith
Supported by
AstraZeneca
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040