Last reviewed · How we verify

NCT01544179: IMPRESS

A Study of IRESSA Treatment Beyond Progression in Addition to Chemotherapy Versus Chemotherapy Alone

Completed Phase 3 Results posted Last updated 25 September 2020
What this trial tests

Phase 3 trial testing Gefitinib in Non-Small Cell Lung Cancer in 265 participants. Completed in 20 November 2019.

Timeline
15 March 2012
Primary endpoint
5 May 2014
20 November 2019

Quick facts

Lead sponsorAstraZeneca
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment265
Start date15 March 2012
Primary completion5 May 2014
Estimated completion20 November 2019
Sites61 locations across France, Hong Kong, Italy, Japan, Russia, Taiwan, Germany, Hungary

Drugs / interventions tested

Conditions studied

Sponsor

AstraZeneca — full company profile →

Who can join

Adults 18 to 130, any sex, with Non-Small Cell Lung Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-Free Survival (Site Read, Investigator Assessment) Primary · Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks

PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.

GroupValue95% CI
Gefitinib984.5 – 5.7
Placebo1074.6 – 5.5
Median Progression-Free Survival (Site Read, Investigator Assessment) Primary · Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis, assessed up to 50 weeks

PFS is the time from randomisation until the date of objective disease progression as defined by Response Evaluation Criteria In Solid Tumours (RECIST version 1.1) or death (by any cause in the absence of progression). Progression is defined using RECIST (v1.1), as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm.

GroupValue95% CI
Gefitinib5.44.5 – 5.7
Placebo5.44.6 – 5.5
Overall Survival (OS) Secondary · Following progression survival data was collected every 8 weeks until documentation of death, withdrawal of consent, loss to follow-up or the final data cut-off, whichever occurs first.

OS is the time from the date of randomisation until death due to any cause. Any subject not known to have died at the time of analysis will be censored based on the last recorded date on which the subject was known to be alive.

GroupValue95% CI
Gefitinib5010.4 – 19.0
Placebo3715.6 – NA
Median Overall Survival (OS) at Time of PFS Analysis Secondary · Baseline and then every 6 weeks after randomization until objective disease progression. OS is then assessed 8 weekly following PFS progression up to PFS analysis data cut off.
GroupValue95% CI
Gefitinib14.810.4 – 19.0
Placebo17.215.6 – NA
Objective Response Rate (ORR) (Site Read Data) Secondary · Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.

ORR rate is defined as the number (%) of subjects with at least one visit response of Complete Response (CR) or Partial Response (PR) , as defined by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) for target lesions and assessed by CT or MRI. CR, Disappearance of all target lesions; PR, ≥30% decrease in the sum of the longest diameter of target lesions. Data obtained up until progression, or last evaluable assessment in the absence of progression, was included in the assessment of ORR.

GroupValue95% CI
Gefitinib31.60.55 – 1.55
Placebo34.10.55 – 1.55
Disease Control Rate (DCR) Secondary · Radiologic evaluations were carried out every 6 weeks from randomization until documented progression, withdrawal of consent, loss to follow up, death or the primary data cut off (DCO) for the analysis.

DCR is the percentage of patients who achieve disease control at 6 weeks following randomisation. DCR is defined as a Best Objective Response (BOR) of Complete Response, Partial Response or Stable Disease, as defined by Response Evaluation Criteria in Solid Tumours (RECIST v1.1) for target lesions and assessed by CT or MRI. CR, Disappearance of all target lesions; PR, ≥30% decrease in the sum of the longest diameter of target lesions; SD, neither sufficient shrinkage to qualify for PR not sufficient increase to qualify for Progressive Disease (PD); PD, ≥20% increase in the sum of diameters of

GroupValue95% CI
Gefitinib84.20.74 – 2.62
Placebo78.80.74 – 2.62
Improvement in Trial Outcome Index Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

An improvement is defined as a change from baseline of ≥ +6 (0-84 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire.

GroupValue95% CI
Gefitinib360.74 – 2.62
Placebo390.74 – 2.62
Time to Worsening in Trial Outcome Index Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

A worsening is defined as a change from baseline of ≤ -6 (0-84 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

GroupValue95% CI
Gefitinib12.18.7 – 18.1
Placebo9.47.7 – 13.4
Improvement in FACT-L Total Score Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

An improvement is defined as a change from baseline of ≥ +6 (0-136 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

GroupValue95% CI
Gefitinib440.74 – 2.62
Placebo490.74 – 2.62
Time to Worsening in FACT-L Total Score Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

A worsening is defined as a change from baseline of ≤ -6 (0-136 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

GroupValue95% CI
Gefitinib12.06.0 – 15.0
Placebo8.96.0 – 9.9
Improvement in Lung Cancer Subscale Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

An improvement is defined as a change from baseline of ≥ +2 (0-28 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

GroupValue95% CI
Gefitinib54
Placebo55
Time to Worsening in Lung Cancer Subscale Secondary · At visits 2-8, then every 6 weeks until progression, at progression or treatment discontinuation, and every 8 weeks after progression until PFS analysis data cut off.

A worsening is defined as a change from baseline of ≤ -2 (0-28 score range). Measured by the Functional Assessment of Cancer Therapy for Lung Cancer (FACT-L) questionnaire

GroupValue95% CI
Gefitinib14.69.1 – 24.3
Placebo9.16.1 – 23.9

Adverse events — posted to ClinicalTrials.gov

Time frame: AEs were collected from signature of informed consent, throughout the treatment period until 30 days after discontinuation of the investigational product. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Gefitinib 250 mg
Serious: 38/132 (29%)
Deaths:
Placebo
Serious: 28/132 (21%)
Deaths:

Serious adverse events (65 terms)

ReactionSystemGefitinib 250 mgPlacebo
PneumoniaInfections and infestations
DyspnoeaRespiratory, thoracic and mediastinal disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
PyrexiaGeneral disorders
CellulitisInfections and infestations
Urinary tract infectionInfections and infestations
HypokalaemiaMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders
Cognitive disorderNervous system disorders
Pleural effusionRespiratory, thoracic and mediastinal disorders
Bone marrow failureBlood and lymphatic system disorders
Febrile bone marrow aplasiaBlood and lymphatic system disorders
Cardiac failureCardiac disorders
Myocardial infarctionCardiac disorders
Pericardial effusionCardiac disorders
Wolff-Parkinson-White syndromeCardiac disorders
Inappropriate antidiuretic hormone secretionEndocrine disorders
Abdominal discomfortGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
DysphagiaGastrointestinal disorders
EnteritisGastrointestinal disorders
Gastric perforationGastrointestinal disorders
Other adverse events (327 terms — click to expand)

ReactionSystemGefitinib 250 mgPlacebo
NauseaGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
VomitingGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
AnaemiaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
AstheniaGeneral disorders
NeutropeniaBlood and lymphatic system disorders
FatigueGeneral disorders
LeukopeniaBlood and lymphatic system disorders
Neutrophil count decreasedInvestigations
PyrexiaGeneral disorders
CoughRespiratory, thoracic and mediastinal disorders
HeadacheNervous system disorders
White blood cell count decreasedInvestigations
RashSkin and subcutaneous tissue disorders
StomatitisGastrointestinal disorders
Back painMusculoskeletal and connective tissue disorders
Abdominal pain upperGastrointestinal disorders
HypokalaemiaMetabolism and nutrition disorders
Blood creatinine increasedInvestigations
DyspnoeaRespiratory, thoracic and mediastinal disorders
Dry skinSkin and subcutaneous tissue disorders
Alanine aminotransferase increasedInvestigations
HyponatraemiaMetabolism and nutrition disorders
MalaiseGeneral disorders
Aspartate aminotransferase increasedInvestigations
Peripheral sensory neuropathyNervous system disorders
InsomniaPsychiatric disorders
Productive coughRespiratory, thoracic and mediastinal disorders
ThrombocytopeniaBlood and lymphatic system disorders
Platelet count decreasedInvestigations
MyalgiaMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
AlopeciaSkin and subcutaneous tissue disorders
Bone marrow failureBlood and lymphatic system disorders
ConjunctivitisInfections and infestations
NasopharyngitisInfections and infestations
Haemoglobin decreasedInvestigations
HypocalcaemiaMetabolism and nutrition disorders

Most-reported serious reactions: Pneumonia, Dyspnoea, Respiratory failure, Anaemia, Diarrhoea, Nausea, Pyrexia, Cellulitis.

Data from ClinicalTrials.gov NCT01544179 adverse events section.

Sponsor's own description

The purpose of this study is to assess the efficacy and safety of gefitinib in patients who have progressed on first line gefitinib, comparing continuing gefitinib in addition to cisplatin plus pemetrexed combination chemotherapy versus cisplatin plus pemetrexed combination chemotherapy alone.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update.
    Masters GA, Temin S, Azzoli CG, Giaccone G, et al · · 2015 · cited 344× · PMID 26324367 · DOI 10.1200/jco.2015.62.1342
  2. Gefitinib plus chemotherapy versus placebo plus chemotherapy in EGFR-mutation-positive non-small-cell lung cancer after progression on first-line gefitinib (IMPRESS): a phase 3 randomised trial.
    Soria JC, Wu YL, Nakagawa K, Kim SW, et al · · 2015 · cited 327× · PMID 26159065 · DOI 10.1016/s1470-2045(15)00121-7
  3. Emerging paradigms in the development of resistance to tyrosine kinase inhibitors in lung cancer.
    Gainor JF, Shaw AT. · · 2013 · cited 263× · PMID 24101047 · DOI 10.1200/jco.2012.45.2029
  4. Chemotherapy with Erlotinib or chemotherapy alone in advanced non-small cell lung cancer with acquired resistance to EGFR tyrosine kinase inhibitors.
    Goldberg SB, Oxnard GR, Digumarthy S, Muzikansky A, et al · · 2013 · cited 103× · PMID 24072220 · DOI 10.1634/theoncologist.2013-0168
  5. Therapeutic strategies utilized in the setting of acquired resistance to EGFR tyrosine kinase inhibitors.
    Yu HA, Riely GJ, Lovly CM. · · 2014 · cited 66× · PMID 25303979 · DOI 10.1158/1078-0432.ccr-13-2437
  6. Mechanisms of resistance to irreversible epidermal growth factor receptor tyrosine kinase inhibitors and therapeutic strategies in non-small cell lung cancer.
    Xu J, Wang J, Zhang S. · · 2017 · cited 38× · PMID 29163853 · DOI 10.18632/oncotarget.21164
  7. Medical management of lung cancer: Experience in China.
    Shi Y, Sun Y. · · 2015 · cited 35× · PMID 26273329 · DOI 10.1111/1759-7714.12168
  8. Management of acquired resistance to epidermal growth factor receptor kinase inhibitors in patients with advanced non-small cell lung cancer.
    Sacher AG, Jänne PA, Oxnard GR. · · 2014 · cited 27× · PMID 24752335 · DOI 10.1002/cncr.28723

Verify or expand the search:

Other trials of Gefitinib

Trials testing the same drug.

Other recruiting trials for Non-Small Cell Lung Cancer

Currently open trials in the same condition.

Other AstraZeneca trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT01544179.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing