A trial to assess whether nivolumab improves survival in relapsed mesothelioma more than placebo

ISRCTN ISRCTN79814141
DOI https://doi.org/10.1186/ISRCTN79814141
EudraCT/CTIS number 2016-003111-35
ClinicalTrials.gov number NCT03063450
Secondary identifying numbers 32290
Submission date
27/02/2017
Registration date
02/03/2017
Last edited
29/11/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-looking-at-nivolumab-for-mesothelioma-confirm#undefined

Contact information

Mrs Kelly Cozens
Public

Southampton Clinical Trials Unit
MP131
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
United Kingdom

Dr Kayleigh Hill
Scientific

Southampton Clinical Trials Unit
MP131
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
United Kingdom

Study information

Study designRandomised; Interventional; Design type: Treatment, Drug, Immunotherapy
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet No participant information sheet available
Scientific titleCheckpOiNt blockade For Inhibition of Relapsed Mesothelioma (CONFIRM): A Phase III Trial to Evaluate the Efficacy of Nivolumab in Relapsed Mesothelioma
Study acronymCONFIRM
Study objectivesThe aim of this study is to compare overall survival of nivolumab with placebo in patients with relapsed mesothelioma.
Ethics approval(s)West Midlands - Edgbaston Research Ethics Committee, 06/12/2016, ref: 16/WM/0472
Health condition(s) or problem(s) studiedMesothelioma
InterventionPatients will be randomised 2:1 to nivolumab or placebo, with twice as many people getting nivolumab as placebo. Randomisation will be stratified by site and epithelioid vs. non-epithelioid.

Active treatment arm: Patients will be treated with nivolumab at a dose of 240mg, every two weeks, infused over 30 minutes until disease progression, to a maximum of 12 months.

Placebo control arm: Patients will receive a placebo consisting of sterile 0.9% sodium chloride, every two weeks, infused over 30 minutes until disease progression, to a maximum of 12 months.

All patients will be followed up for a minimum 6 months and maximum of 5 years.
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase III
Drug / device / biological / vaccine name(s)Nivolumab
Primary outcome measureOverall survival will be calculated as time from randomisation until date of death
Secondary outcome measures1. Progression free survival is calculated as time from randomisation to disease progression by RECIST 1.1 or modified RECIST using CT scans at baseline compared to further CT scans after cycles 3 and 6 (each cycle is 14 days)
2. Overall response rate is measured by RECIST 1.1 or modified RECIST using CT scans at baseline compared to further CT scans after cycles 3 and 6 (each cycle is 14 days)
3. Quality of life is measured using EQ-5D-5L at baseline, after cycles 3 and 6 (each cycle is 14 days) and 1, 6 and 12 months post progression/treatment discontinuation
4. Toxicity is measured using CTCAE V4.03 at baseline, after each treatment cycle (each cycle is 14 days) and each follow up visit
5. Cost effectiveness is measured using a health resource use questionnaire at baseline, after cycles 3 and 6 (each cycle is 14 days) and 1, 6 and 12 months post progression/treatment discontinuation
Overall study start date01/10/2016
Completion date30/09/2022

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 336; UK Sample Size: 336
Total final enrolment332
Key inclusion criteria1. Histological confirmation of mesothelioma
2. Prior treatment with at least two lines of platinum based chemotherapy
3. ECOG Performance Status 0-1
4. Evidence of disease progression (which is radiologically assessable through RECIST) on CT scan within 28 days of trial treatment
5. Age 18 and above
6. Screening laboratory values within protocol specified ranges
7. Willing to use adequate contraception methods where applicable
8. Willing to provide blood and tissue samples relating to mesothelioma
9. Expected survival of at least 12 weeks
Key exclusion criteria1. Untreated, symptomatic CNS metastases
2. Carcinomatous meningitis
3. Active, known or suspected auto-immune disease
4. Those requiring systemic treatment with corticosteroids or immunosuppressive medications within 14 days of planned first dose
5. Other active malignancy requiring treatment
6. Serious or uncontrolled medical disorder or active infection which would impact on the trial or affect their involvement
7. Prior treatment with anti-PD-L1, anti-PD-L2, anti-CD137 or anti-CTLA-4 antibody
8. History of testing positive for HIV or AIDS or a positive test for Hepatitis indicating acute or chronic infection
9. History of allergy or sensitivity to monoclonal antibodies
10. Women who are pregnant or breastfeeding
Date of first enrolment27/03/2017
Date of final enrolment27/03/2020

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Southampton Clinical Trials Unit
MP131
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
United Kingdom

Sponsor information

University of Southampton
University/education

Research & Innovation Services
University Road
Southampton
SO17 1BJ
England
United Kingdom

Phone +44 23 8059 8673
Email rgoinfo@soton.ac.uk
ROR logo "ROR" https://ror.org/01ryk1543

Funders

Funder type

Charity

Cancer Research UK
Private sector organisation / Other non-profit organizations
Alternative name(s)
CR_UK, Cancer Research UK - London, CRUK
Location
United Kingdom

Results and Publications

Intention to publish date30/09/2023
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe results of the trial will be published in a high-impact peer reviewed scientific journal around six months after overall trial end date.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available for sharing via controlled access by authorised Southampton CTU (SCTU) staff (as delegated to SCTU by the trial sponsor) and anonymised IPD within the clinical trial dataset will be available for sharing via open access after the trial is published.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article 18/04/2018 05/10/2022 Yes No
HRA research summary 28/06/2023 No No
Statistical Analysis Plan version 3 01/08/2022 11/10/2023 No No
Results article 14/10/2021 22/10/2024 Yes No

Additional files

ISRCTN79814141 CONFIRM SAP v3 1Aug2022.pdf

Editorial Notes

29/11/2024: A scientific contact was added.
22/10/2024: Publication reference added.
11/10/2023: The statistical analysis plan was uploaded as an additional file.
05/10/2022: Publication reference added.
14/09/2022: The following changes have been made:
1. The overall trial end date was changed from 30/09/2021 to 30/09/2022.
2. The intention to publish date was changed from 30/09/2022 to 30/09/2023.
04/05/2020: The following changes have been made:
1. The recruitment end date has been changed from 23/03/2021 to 27/03/2020.
2. The final enrolment number has been added.
16/01/2020: The ClinicalTrials.gov number has been added.
28/03/2019: The condition has been changed from "Specialty: Cancer, Primary sub-specialty: Lung Cancer; UKCRC code/ Disease: Cancer/ Malignant neoplasms of respiratory and intrathoracic organs" to "Mesothelioma" following a request from the NIHR.
05/04/2017: Cancer Help UK lay summary link added to plain English summary field