A Study In Patients With Non-Small Cell Lung Cancer Testing If Erlotinib Plus SU011248 (Sunitinib) Is Better Than Erlotinib Alone

Carcinoma, Non-Small-Cell Lung Clinical Trial

— SUN1058  

Official title:

Randomized, Double-Blind, Phase 2 Study Of Erlotinib With Or Without SU011248 In The Treatment Of Metastatic Non-Small Cell Lung Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00265317
• Other study ID #: A6181058
• Status: Completed
• Phase: Phase 2
• First received: December 12, 2005
• Last updated: January 31, 2013
• Start date: June 2006
• Est. completion date: January 2012

Study information

• Verified date: January 2013
• Source: Pfizer
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

This study will test whether treatment with erlotinib plus SU011248 is better than erlotinib alone in patients with advanced/metastatic lung cancer who have received previous treatment with a platinum-based regimen

Recruitment information / eligibility

• Status: Completed
• Enrollment: 162
• Est. completion date: January 2012
• Est. primary completion date: January 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with locally advanced/metastatic non-small cell lung cancer

• Prior treatment with no more than 2 chemotherapy regimens including a platinum-based regimen

Exclusion Criteria:

• Prior treatment with any receptor tyrosine kinase inhibitors, Vascular endothelial growth factor (VEGF) inhibitors or other angiogenic inhibitors

• History of or known brain metastases

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung

Intervention

Drug:
• erlotinib
erlotinib 150 mg daily by tablets in a continuous regimen, until progression or unacceptable toxicity
• sunitinib
Sunitinib 37.5 mg daily by oral capsule in a continuous regimen plus erlotinib 150 mg daily by tablets in a continuous regimen, until progression or unacceptable toxicity
• erlotinib
erlotinib 150 mg daily by tablets in a continuous regimen, until progression or unacceptable toxicity
• placebo
Placebo daily by oral capsule in a continuous regimen plus erlotinib 150 mg daily by tablets in a continuous regimen, until progression or unacceptable toxicity

Locations

Country	Name	City	State
Canada	Pfizer Investigational Site	Edmonton	Alberta
Canada	Pfizer Investigational Site	Hamilton	Ontario
Hungary	Pfizer Investigational Site	Budapest
Hungary	Pfizer Investigational Site	Torokbalint
Italy	Pfizer Investigational Site	Genova
Italy	Pfizer Investigational Site	Monteforte Irpino, AV
Netherlands	Pfizer Investigational Site	Amsterdam
Netherlands	Pfizer Investigational Site	Groningen
Poland	Pfizer Investigational Site	Bydgoszcz
Poland	Pfizer Investigational Site	Gdansk
Romania	Pfizer Investigational Site	Bucuresti	Sector 2
Romania	Pfizer Investigational Site	Bucuresti
Romania	Pfizer Investigational Site	Cluj-Napoca	Cluj
Spain	Pfizer Investigational Site	Santander	Cantabria
United States	Pfizer Investigational Site	Antioch	California
United States	Pfizer Investigational Site	Birmingham	Alabama
United States	Pfizer Investigational Site	Birmingham	Alabama
United States	Pfizer Investigational Site	Chapel Hill	North Carolina
United States	Pfizer Investigational Site	Chicago	Illinois
United States	Pfizer Investigational Site	Cleveland	Ohio
United States	Pfizer Investigational Site	Clinton	North Carolina
United States	Pfizer Investigational Site	Creve Coeur	Missouri
United States	Pfizer Investigational Site	Goldsboro	North Carolina
United States	Pfizer Investigational Site	Houston	Texas
United States	Pfizer Investigational Site	Mobile	Alabama
United States	Pfizer Investigational Site	Palm Springs	California
United States	Pfizer Investigational Site	Pleasant Hill	California
United States	Pfizer Investigational Site	San Leandro	California
United States	Pfizer Investigational Site	St. Louis	Missouri
United States	Pfizer Investigational Site	St. Louis	Missouri
United States	Pfizer Investigational Site	St. Peters	Missouri
United States	Pfizer Investigational Site	Wilson	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Pfizer

Countries where clinical trial is conducted

United States,  Canada,  Hungary,  Italy,  Netherlands,  Poland,  Romania,  Spain, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	VEGF-C Ratio to Baseline at Each Timepoint	Plasma VEGF-C concentration at each time point divided by VEGF-C concentration at baseline (ratio to baseline)	Baseline to Cycle 2 (Day 1) and Cycle 3 (Day 1)	No
Other	VEGFR-2 Ratio to Baseline at Each Timepoint	Plasma VEGFR-2 concentration at each time point divided by VEGFR-2 concentration at baseline (ratio to baseline)	Baseline to Cycle 2 (Day 1) and Cycle 3 (Day 1)	No
Other	VEGFR-3 Ratio to Baseline at Each Timepoint	Plasma VEGFR-3 concentration at each time point divided by VEGFR-3 concentration at baseline (ratio to baseline)	Baseline to Cycle 2 (Day 1) and Cycle 3 (Day 1)	No
Other	sKIT Ratio to Baseline at Each Timepoint	Plasma sKIT concentration at each time point divided by sKIT concentration at baseline (ratio to baseline)	Baseline to Cycle 2 (Day 1) and Cycle 3 (Day 1)	No
Primary	Progression-Free Survival (PFS)	PFS=time from randomization date to date of first documentation of progressive disease (PD; defined as greater than or equal to [=]20% increase in sum of longest dimensions of target lesions taking as a reference smallest sum of longest dimensions recorded since first dose or appearance of =1 new lesions) or death on-study due to any cause, whichever occurred first based on third party independent imaging review laboratory assessment. PFS calculated as (first event date minus randomization date plus 1) divided by 7.02. Used 7.02 days as it equals 365 days per year divided by 52 weeks per year.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With Objective Response	Objective Response Rate (ORR)=participants with confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST,Version 1.0) based on third party independent imaging review laboratory assessment. A CR was defined as the disappearance of all target lesions that persisted on repeat imaging study at least 4 weeks after initial documentation of response. A PR was defined as a =30% decrease in sum of longest dimensions of target lesions taking as a reference the baseline sum longest dimensions.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Time to Tumor Progression (TTP)	TTP was defined as the time from date of randomization to first documentation of PD based on third party independent imaging review laboratory assessment. TTP was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Duration of Response (DR)	DR was defined as time from first documentation of objective tumor response (CR or PR) that was subsequently confirmed to the first documentation of PD or death on-study due to any cause, whichever occurred first. DR was calculated as (first date of PD or death minus first date of CR or PR that was subsequently confirmed plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Overall Survival (OS)	OS was defined as time from date of randomization to date of death due to any cause. OS was calculated as (date of death minus date of randomization plus 1) divided by 30.4. For participants still alive at the time of analysis, OS time was censored on last date that participants were known to be alive.	From randomization until death (up to Month 17)	No
Secondary	Percentage of Participants Surviving at 1 Year	Percentage of participants alive at 1 year after date of first administration of study medication.	From randomization until death (up until Month 17)	No
Secondary	Area Under the Curve From Time Zero to 24 Hours [AUC(0-24)] of Erlotinib	AUC0-24=Area under the plasma concentration versus time curve from time zero (pre-dose) to 24 hours (0-24) of erlotinib	Days 1 and 22 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	AUC(0-24) of Sunitinib	AUC0-24=Area under the plasma concentration versus time curve from time zero (pre-dose) to 24 hours (0-24) of sunitinib	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	AUC(0-24) of SU-012662 (Metabolite of Sunitinib)	AUC0-24=Area under the plasma concentration versus time curve from time zero (pre-dose) to 24 hours (0-24) of SU-012662 (metabolite of sunitinib)	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	AUC(0-24) of Total Drug (Sunitinib + SU-012662)	AUC0-24=Area under the plasma concentration versus time curve from time zero (pre-dose) to 24 hours (0-24) of total drug (sunitinib + SU-012662)	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	Maximum Observed Plasma Concentration (Cmax) of Erlotinib		Days 1 and 22 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	Cmax of Sunitinib		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Cmax of SU-012662 (Metabolite of Sunitinib)		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Cmax of Total Drug (Sunitinib + SU-012662)		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Area Under the Curve From Time Zero to Extrapolated Infinite Time (AUC0-inf) for Erlotinib	AUC (0-inf) = Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf) for erlotinib. It is obtained from AUC from time zero (pre-dose) to last quantifiable concentration(AUC[0-t]) plus AUC from time last quantifiable concentration extrapolated infinite time (AUC[t-inf])	Days 1 and 22 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose; predose on Days 22 and 23 (Cycle 1)	No
Secondary	AUC(0-inf) for Sunitinib	AUC (0 - inf) = Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf) for sunitinib. It is obtained from AUC(0-t) plus AUC(t-inf)	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose; predose on Days 15, 16, and 17 (Cycle 1)	No
Secondary	AUC(0-inf) for SU-012662 (Metabolite of Sunitinib)	AUC(0-inf) = Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf) for SU-012662 (metabolite of sunitinib). It is obtained from AUC(0-t) plus AUC(t-inf)	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose; predose on Days 15, 16, and 17 (Cycle 1)	No
Secondary	AUC(0-inf) for Total Drug (Sunitinib + SU-012662)	AUC(0-inf) = Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf) for total drug (sunitinib + SU-012662). It is obtained from AUC(0-t) plus AUC(t-inf)	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose; predose on Days 15, 16, and 17 (Cycle 1)	No
Secondary	Plasma Decay Half-life (t1/2) of Erlotinib	Plasma decay half-life is the time measured for the plasma concentration to decrease by one half.	Days 1 and 22 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	Plasma Decay Half-life (t1/2) of Sunitinib	Plasma decay half-life is the time measured for the plasma concentration to decrease by one half.	Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Erlotinib Clearance at Steady State After Oral Administration (CL/F)		Day 15 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	Sunitinib Clearance at Steady State After Oral Administration (CL/F)		Day 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Time to Reach Maximum Observed Plasma Concentration (Tmax) for Erlotinib		Days 1 and 22 (Cycle 1) at 0, 1, 2, 4, 6, 8, and 24 hours postdose	No
Secondary	Tmax for Sunitinib		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Tmax for SU-012662 (Metabolite of Sunitinib)		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Tmax for Total Drug (Sunitinib + SU-012662)		Days 1 and 15 of Cycle 1 at 0, 1, 2, 4, 6, 8, 24 and 48 hours postdose	No
Secondary	Dose-Corrected Observed Plasma Trough Concentrations (Ctrough) for Erlotinib on Day 1 of Cycles 3-13 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of erlotinib prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original and Amended Lead-In (Arms A and B) Cohorts predose on Day 1 (Cycles 3-13) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 1 (Cycles 3-13); predose Day 1 (Cycles 1-18)	No
Secondary	Dose-Corrected Ctrough for Erlotinib on Day 15 Cycle 1 (Original), Day 1 of Cycle 3 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of erlotinib prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original Cohort predose on Day 15 (Cycle 1, Time Zero) and Day 1 (Cycle 3), in the Amended Lead-In Cohort (Arms A and B) predose on Day 1 (Cycle 3) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 15 (Cycle1); predose Day 1 (Cycle 3); predose Day 1 (Cycles 1-18)	No
Secondary	Dose-Corrected Ctrough for Sunitinib on Day 1 of Cycles 3-13 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of sunitinib prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original and Amended Lead-In (Arms A and B) Cohorts predose on Day 1 (Cycles 3-13) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 1 (Cycles 3-13); predose Day 1 (Cycles 1-18)	No
Secondary	Dose-Corrected Ctrough for Sunitinib on Day 15 Cycle 1 (Original), Day 1 of Cycle 3 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of sunitinib prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original Cohort predose on Day 15 (Cycle 1, Time Zero) and Day 1 (Cycle 3), in the Amended Lead-In Cohort (Arms A and B) predose on Day 1 (Cycle 3) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 15 (Cycle 1) and Day 1 (Cycle 3); predose Day 1 (Cycle 3); predose Day 1 (Cycles 1-18)	No
Secondary	Dose-Corrected Ctrough for SU-012662 (Metabolite of Sunitinib) on Day 1 of Cycles 3-13 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of SU-012662 prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original and Amended Lead-In (Arms A and B) Cohorts predose on Day 1 (Cycles 3-13) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 1 (Cycles 3-13); predose Day 1 (Cycles 1-18)	No
Secondary	Dose-Corrected Ctrough for SU-012662 (Metabolite of Sunitinib) on Day 15 Cycle 1 (Original), Day 1 of Cycle 3 (Original and Amended, Arms A and B), and Day 1 of Cycles 1-18 (Randomized)	Ctrough = plasma concentration of SU-012662 prior to study drug administration. Dose correction was made to the initial intended dose in Cycle 1. Assessed in the Original Cohort predose on Day 15 (Cycle 1, Time Zero) and Day 1 (Cycle 3), in the Amended Lead-In Cohort (Arms A and B) predose on Day 1 (Cycle 3) and in the Randomized Cohort (Sunitinib + Erlotinib treatment group only) predose on Day 1 of Cycles 1-18.	predose Day 15 (Cycle 1) and Day 1 (Cycle 3); predose Day 1 (Cycle 3); predose Day 1 (Cycles 1-18)	No
Secondary	Percentage of Participants With Epidermal Growth Factor Receptor (EGFR) Expression by Immunohistochemistry (IHC) Using 0 Percent [%] Cutoff	Percentage of participants with EGFR expression by IHC using a 0% cutoff; Reported as positive, negative, or unmeasured (where positive was greater than 0% of cells demonstrating membranous staining for EGFR). Correlative analysis of EGFR expression was conducted using tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by EGFR Expression (Using 0% Cutoff)	PFS defined as time in weeks from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in the following subgroups: positive, negative, or unmeasured EGFR expression. EGFR expression was analyzed using a 0% cutoff where positive was greater than 0% of cells demonstrating membranous staining for EGFR. PFS calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With EGFR Expression by IHC (Using 10% Cutoff)	Percentage of participants with EGFR Expression by IHC using a 10% cutoff; Reported as positive (positive values were defined as being greater than 10% of cells demonstrating membranous staining for EGFR), negative, or unmeasured. Correlative analysis of EGFR expression was conducted using tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by EGFR Expression (Using 10% Cutoff)	PFS defined as time in weeks from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in the following subgroups: positive, negative, or unmeasured EGFR expression. EGFR expression was analyzed using a 10% cutoff where positive was greater than 10% of cells demonstrating membranous staining for EGFR. PFS calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With EGFR Gene Copy Number Increase	The number of copies corresponding to exon 19 of the EGFR gene was determined by real-time quantitative polymerase chain reaction (PCR). The percentage of participants with EGFR Gene Copy Number Increase (defined as greater than 4 copies) was determined using deoxyribonucleic acid (DNA) from tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable. Reported as yes, no or unmeasured.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by EGFR Gene Copy Number Increase	PFS, defined as time from date of randomization to the date of the first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by EGFR gene copy number increase (reported as yes, no, or unmeasured). The number of copies corresponding to exon 19 of the EGFR gene was determined and an increase was defined as greater than 4 copies. PFS was calculated as (first event date minus randomization date plus 1)/7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With EGFR Gene Amplification	The percentage of participants with EGFR gene amplification (defined as greater than 15) was determined and reported as yes, no, or unmeasured. Correlative analysis of EGFR gene amplification was conducted using tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by EGFR Gene Amplification	PFS, defined as time from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by EGFR gene amplification (defined as greater than 15) and reported as no or unmeasured. PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With EGFR Gene Mutation	Mutations in exons 18 through 21 of the EGFR gene were analyzed by high-performance liquid chromatography using DNA from tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable. The percentage of participants with EGFR mutations categorized as mutated, wild type or indeterminate was reported.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by EGFR Gene Mutation	PFS, defined as time from date of randomization to date of first documentation of PD or to death on-study due to any cause, whichever occurred first, in subgroups that were defined by EGFR gene mutation (reported as mutated, wild type, or indeterminate). PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With KRAS (V-Ki-ras2 Kirsten Rat Sarcoma Viral Oncogene Homolog) Gene Mutations	Mutations in exons 2-3 of the KRAS gene (including codons 12, 13, and 61) were analyzed by high-performance liquid chromatography using DNA from tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable. The percentage of participants with KRAS mutations categorized as mutated, wild type or indeterminate was reported.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by KRAS Gene Mutation	PFS, defined as time from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by KRAS gene mutation (reported as mutated, wild type, or indeterminate). PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants With Germline Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) Polymorphisms	Blood samples were collected at baseline for multiplex reverse transcription (RT) analysis of genes expressing proteins that are targets of sunitinib or involved in angiogenesis or tumor growth to determine expression levels. Percentage of participants with germline VEGFR2 single nucleotide polymorphisms (SNPs) was reported for the following genotype frequencies: homozygous C alleles (C/C), T alleles (T/T), G alleles (G/G), or A alleles (A/A), and the following heterozygous genotypes C/T, G/T, T/A, and G/A.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by Germline VEGFR2 Polymorphisms	PFS, defined as time from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by VEGFR2 polymorphisms. PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Overall Survival (OS) in Subgroups That Were Defined by Germline VEGFR2 Polymorphisms	OS, defined as time from date of randomization to date of death due to any cause, in subgroups that were defined by VEGFR2 polymorphisms. OS was calculated as (date of death minus date of randomization plus 1) divided by 30.4.	From randomization until death (up to Month 17)	No
Secondary	Percentage of Participants With Germline Platelet-derived Growth Factor Receptor Beta (PDGFRB) Polymorphisms	Blood samples were collected at baseline for multiplex RT analysis of genes expressing proteins that are targets of sunitinib or involved in angiogenesis or tumor growth to determine expression levels. Percentage of participants with germline PDGFRB SNPs was reported for the following genotype frequencies: homozygous C alleles (C/C), T alleles (T/T), G alleles (G/G), or A alleles (A/A), and the following heterozygous genotypes C/T, A/T, A/G, T/C, T/G, G/C, C/A and G/A.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by Germline PDGFRB Polymorphisms	PFS, defined as time from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by PDGFRB polymorphisms. PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	OS in Subgroups That Were Defined by Germline PDGFRB Polymorphisms	OS, defined as time from date of randomization to date of death due to any cause, in subgroups that were defined by PDGFRB polymorphisms. OS was calculated as (date of death minus date of randomization plus 1) divided by 30.4.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Percentage of Participants by Tumor VEGFR Mutation	Percentage of participants with VEGFR mutations in DNA from tumor samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable.	Baseline	No
Secondary	Correlation of Polymorphisms in Stem Cell Factor Receptor (c-Kit), FMS-like Tyrosine Kinase 3 Receptor (FLT-3), and c-FMS With Blood Counts	A blood sample (6 mL) was collected before on-study treatment and was used to isolate DNA. These samples were not anonymized. Correlation was investigated by the percentage of participants with anemia (based on hemoglobin count), neutropenia (based on neutrophil count) and thrombocytopenia (based on platelet count) endpoints and genetic variation as measured by c-KIT, FLT-3, and c-FMS was to be analyzed.	Baseline (Day 1, Cycle 1)	No
Secondary	Percentage of Participants by Ribonucleic Acid (RNA) Expression Profile	Includes colony-stimulating factor 1 receptor (CSF-1R), PDGFRalpha, PDGFRbeta, vascular endothelial growth factor (VEGF), VEGF C (VEGF-C), VEGF receptor 1 (VEGFR1), VEGF receptor 2 (VEGFR2), VEGF receptor 3 (VEGFR3), fibroblast growth factor (FGF), FLT-3, KIT (stem cell factor receptor), and RET (rearranged during transfection). Correlative analysis was conducted using tumor biopsy samples collected at the time of initial diagnosis (preferred) or at the time of most recent recurrence/progression, although any time was acceptable.	Baseline	No
Secondary	PFS in Subgroups That Were Defined by RNA Expression Profile	PFS, defined as time from date of randomization to date of first documentation of PD or death on-study due to any cause, whichever occurred first, in subgroups that were defined by RNA Gene expression (CSF-1R, PDGFRalpha, PDGFRbeta, VEGF, VEGF-C, VEGFR1, VEGFR2, VEGFR3, FGF, FLT-3, KIT, and RET). PFS was calculated as (first event date minus randomization date plus 1) divided by 7.02.	From randomization to Weeks 8 and 12, then every 8 weeks until disease progression or death (up to Month 17)	No
Secondary	Health Related Quality of Life (HRQoL) and Lung Cancer Related Symptoms as Assessed With European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) Score	EORTC QLQ-C30: self-administered questionnaire assessing global health status/quality of life (QoL), functional domains (physical, role, cognitive, emotional, and social), symptom scales/items (fatigue, pain, nausea and vomiting, dyspnea, insomnia, loss of appetite, constipation, and diarrhea), and financial difficulties. Recall period: past week; response range: not at all (1) to very much (4); global/QoL range: very poor (1) to excellent (7). Scale score range: 0 to 100. Higher functional/global QoL score = better functioning and higher symptom score = greater degree of symptoms.	Baseline (Cycle [C] 1, Day [D] 1) to Cycle 18, Day 1	No
Secondary	EORTC-QLQ-C30 Lung Cancer Module (LC13) Score	The EORTC-QLQ-C30 LC13 is a self-administered questionnaire assessing specific lung cancer disease related symptoms (dyspnea, coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, pain in the chest, arm/shoulder or other parts of the body). Recall period: past week; response range: not at all (1) to very much (4). Scale score range: 0 to 100. Higher symptom score = greater degree of symptoms.	Baseline (Cycle 1 [Day 1]) to Cycle 18 (Day 1)	No
Secondary	Number of Participants With Blood Pressure (BP) Greater Than 150/100 Millimeters of Mercury (mmHg)	Systolic/diastolic BP measured in triplicate (separated by approximately 2 minutes [min]) using validated electronic device (same device for all measurements), recorded to nearest mmHg. Dominant arm used (same one each time) with appropriate cuff size encircling at least 80% of arm. BP measured after 5 min rest and before invasive procedures, while seated in a chair with back supported, arms bared, supported at heart level. No smoking or caffeine use allowed during 30 min before measurement. Number of participants with systolic BP >150 mmHg/diastolic BP >100 mmHg at any timepoint postbaseline.	Randomization up until Month 17	No
Secondary	Number of Participants With BP Greater Than 200/110 mmHg	Systolic/diastolic BP measured in triplicate (separated by approximately 2 minutes [min]) using validated electronic device (same device for all measurements), recorded to nearest mmHg. Dominant arm used (same one each time) with appropriate cuff size encircling at least 80% of arm. BP measured after 5 min rest and before invasive procedures, while seated in a chair with back supported, arms bared, supported at heart level. No smoking or caffeine use allowed during 30 min before measurement. Number of participants with systolic BP >150 mmHg/diastolic BP >100 mmHg at any timepoint postbaseline.	Randomization up until Month 17	No
Secondary	Number of Participants on Anti-hypertensive Medications	Number of participants with BP greater than 150/100 mmHg or 200/110 mmHg who were treated with anti-hypertensive medications.	Randomization to Day 28 of Cycle 18	No
Secondary	Plasma Concentration of VEGF-C at Baseline		Baseline (Cycle 1, Day 1)	No
Secondary	Plasma Concentration of Soluble VEGFR-2 at Baseline		Baseline (Cycle 1, Day 1)	No
Secondary	Plasma Concentration of Soluble VEGFR-3 at Baseline		Baseline (Cycle 1, Day 1)	No
Secondary	Plasma Concentration of Soluble KIT (sKIT) at Baseline		Baseline (Cycle 1, Day 1)	No

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