Status: Finalised
First registered on:
02/12/2014
Last updated on:
18/07/2018
1. Study identification
EU PAS Register NumberEUPAS8097
Official titleA multinational active safety surveillance study of crizotinib in Europe
Study title acronym
Study typeActive surveillance
Brief description of the studyCrizotinib (XALKORI®), an orally administered selective ATP competitive small molecule inhibitor of the anaplastic lymphoma kinase (ALK), has been approved multinational, including in Europe, for the treatment of patients with previously treated locally advanced ALK-positive non small cell lung cancer (NSCLC).
This non interventional Post-Authorization Safety Study (PASS) examines the safety and effectiveness of crizotinib among ALK-positive NSCLC patients using existing healthcare databases in Denmark, Sweden, Finland, the Netherlands and the United States. The primary objective of this study is to estimate the incidence of adverse events that were observed in crizotinib clinical trials including 1) hepatotoxicity, 2) pneumonitis/ interstitial lung disease, 3) QT interval prolongation, 4) bradycardia, and 5) vision disorder. Less frequently observed adverse events, i.e. renal cysts, edema, leukopenia, neuropathy, and photosensitivity as well as patient survival will also be examined. To contextualize the incidence of the adverse event in crizotinib treated patients, the incidence of these adverse events in patients prescribed three other orally administered tyrosine kinase inhibitors, ceritinib, erlotinib and gefitinib, will be estimated.
The international classification of diseases (ICD) diagnostic codes and procedural codes will be used to capture the safety endpoints in the healthcare databases. Additionally, a validation sub study among all crizotinib patients and the same number of ceritinib, erlotinib or gefitinib patients will evaluate the accuracy of the ICD-based endpoint classifications. The validation study will compare ICD-based classification of primary endpoints to endpoints adjudicated by a panel of experts using data abstracted from patient medical records.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 3 (required)
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Department/Research groupDepartment of Clinical Epidemiology
Organisation/affiliationAarhus University / Aarhus University Hospital
Details of (Primary) lead investigator
Title Professor
Last name Sørensen
First name Henrik Toft
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?5
Countries in which this study is being conducted
International study
Denmark
Finland
Netherlands
Sweden
United States
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed19/03/201409/07/2014
Start date of data collection30/12/201430/12/2014
Start date of data analysis
Date of interim report, if expected30/06/201630/06/2016
Date of final study report30/06/201812/06/2018
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesPfizer Inc100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Huang
First name Kui
Address line 1235 East 42nd St
Address line 2
Address line 3
CityNew York
Postcode10017
CountryUnited States
Phone number (incl. country code)01212-7331309
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Huang
First name Kui
Address line 161-21 Saunders St
Address line 2
Address line 3
CityRego Park
Postcode11374
CountryUnited States
Phone number (incl. country code)01-212-7331309
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Single-Constituent (Substance INN)CRIZOTINIB
Multi-Constituent (Substance INN(s))ERLOTINIB
GEFITINIB
CERITINIB
7. Medical conditions to be studied
Medical condition(s)Yes
Non-small cell lung cancer
8. Population under study
Age
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
Other population
Renal impaired
Hepatic impaired
9. Number of subjects
Estimated total number of subjects2683
Additional information
approximately 677 patients for crizotinib and 2006 patients for ceritinib, erlotinib and gefitinib
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Data sources not registered with ENCePP
Finnish healthcare registries, Finland
Sources of data
Administrative database, e.g. claims database
Routine primary care electronic patient registry
Pharmacy dispensing records
11. Scope of the study
What is the scope of the study?
Risk assessment
Effectiveness evaluation
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
The main objective of this study is to evaluate the safety and effectiveness of crizotinib among ALK positive NSCLC patients in the real world setting. Safety and effectiveness will be measured with data from pre-existing European and US databases, and these data will be validated with information extracted from medical records.
Are there primary outcomes?Yes
To estimate the incidence rate and incidence proportion over a 3-year period of observation for hepatotoxicity, pneumonitis/ILD, QTc prolongation related events, bradycardia, and visual disorders among lung cancer patients receiving crizotinib dispensation.
Are there secondary outcomes?Yes
To estimate the incidence of the primary endpoints for lung cancer patients receiving ceritinib/erlotinib/gefitinib dispensation;
To estimate the incidence of renal cysts, edema, leukopenia, neuropathy, and photosensitivity among lung cancer patients receiving crizotinib, ceritinib, erlotinib, or gefitinib dispensation;
To estimate Kaplan-Meier survival probabilities for patients in the study.
13. Study design
What is the design of the study?
Active surveillance of existing databases
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
up to 5 years
15. Data analysis plan
Please provide a brief summary of the analysis method
This study will link existing national or regional databases within Sweden, Denmark, the Netherlands, Finland, and the United States. Demographics, tumor characteristics, pertinent medical history, comorbidities, safety outcomes of interest, and overall patient survival will be examined.
All statistical analyses will be descriptive. Incidence rates and incidence proportions for all study endpoints will be calculated. Subgroup analyses by age, presence or absence of brain metastases, and pre-existing renal or hepatic impairments at baseline will be conducted for all primary study endpoints. Kaplan-Meier survival probability will be estimated for all patients. In addition, sensitivity, specificity and positive predictive value (PPV) of primary study endpoints captured using ICD codes (compared to patient medical records) will be calculated.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Conflict(s) of interest of
investigator(s)Not submitted
Composition of Steering Group and
ObserversNot submitted
Other documents
DescriptionDocumentLatest version
Signed Code of
Conduct Checklist
Not submitted
Signed Code of Conduct Declaration
Not submitted
Signed Checklist for Study
Protocols
Not submitted
