BIBW2992 (Afatinib) in Advanced (EGFR-FISH +) NSCLC (Non Small Cell Lung Cancer) Patients

Carcinoma, Non-Small-Cell Lung Clinical Trial

Official title:

A Phase II Single-arm Trial of BIBW 2992 in EGFR FISH Positive Non-small Cell Lung Cancer Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00796549
• Other study ID #: 1200.40
• Secondary ID: 2008-001264-37
• Status: Completed
• Phase: Phase 2
• First received: November 21, 2008
• Last updated: July 21, 2014
• Start date: December 2008

Study information

• Verified date: July 2014
• Source: Boehringer Ingelheim
• Contact: n/a
• Is FDA regulated: No
• Health authority: Italy: Ethics Committee
• Study type: Interventional

Clinical Trial Summary

The primary objective of this open-label, single arm Phase II trial is to explore the efficacy of BIBW 2992 defined by the objective response rate (CR, PR) as determined by the RECIST criteria in patients with EGFR FISH positive advanced NSCLC Stage IIIB or IV, selected according to the following scheme:

• Forty (40) 1st line patients

• Thirty (30) 2nd line patients Patients entered into the trial will be treated and followed until death or lost to follow-up. Additional information will be obtained on the safety profile and PK analysis of BIBW 2992.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 70
• Est. primary completion date: May 2012
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion criteria:

1. Male and female patients aged >18 years.

2. Patients with pathologically confirmed diagnosis of NSCLC Stage IIIB (with pleural effusion) or Stage IV and histopathological classification of adeno- or bronchoalveolar carcinoma (BAC).

3. Increased EGFR gene copy number assessed by FISH analysis. After signed informed consent, positive result to EGFR FISH determination is mandatory to proceed to other screening assessments.

4. At least one tumour lesion that can accurately be measured by computed tomography (CT) or magnetic resonance imaging (MRI) in at least one dimension with longest diameter to be recorded as more or same 20 mm using conventional techniques or moro or same 10 mm with spiral CT scan.

5. Patients not previously exposed to chemotherapy for NSCLC (1st line patients, 40 in total; for these subjects adjuvant chemotherapy is allowed if at least 12 months elapsed since last course of treatment), or patients with relapse after one systemic treatment (2nd line patients, 30 in total; if less than 12 months elapsed since adjuvant chemotherapy, patients are 2nd line ones, as adjuvant chemotherapy must be considered a line of treatment).

6. Life expectancy of at least three (3) months.

7. Eastern Cooperative Oncology Group (ECOG, R01-0787) performance score 0, 1 or 2.

8. Written informed consent that is consistent with ICH-GCP guidelines.

Exclusion criteria:

1. More than two (2) prior cytotoxic chemotherapy treatment regimens for relapsed or metastatic NSCLC, included adjuvant chemotherapy if relapse occurred less than 12 months before

2. Previous treatment with erlotinib (Tarceva®), gefitinib (Iressa®) or any other EGFR inhibiting small molecule or antibody.

3. Active brain metastases (stable <4 weeks, symptomatic, requiring treatment with anticonvulsants, or leptomeningeal disease). Dexamethasone therapy will be allowed if administered as a stable dose for at least one month before randomization.

4. Chemo-, hormone- (other than megestrol acetate or steroids required for maintenance non-cancer therapy) or immunotherapy within the past 4 weeks before first drug administration.

5. Significant or recent acute gastrointestinal disorders with diarrhea as a major symptom e.g., Crohn disease, malabsorption, or CTCAE Grade >2 diarrhea of any etiology at baseline

6. Patients who have any other life-threatening illness or organ system dysfunction which, in the opinion of the investigator, would either compromise patient safety or interfere with the evaluation of the safety of the test drug.

7. Other malignancies diagnosed within the past five (5) years (other than non melanomatous skin cancer and in situ cervical cancer).

8. Radiotherapy within the past 2 weeks prior to treatment with the trial drug.

9. Patients with any serious active infection (i.e., requiring an IV antibiotic, antifungal, or antiviral agents).

10. Patients with known HIV, active hepatitis B or active hepatitis C.

11. Known or suspected active drug or alcohol abuse.

12. Women of child-bearing potential or men who are able to father a child unwilling to use a medically acceptable method of contraception during the trial.

13. Pregnancy or breast feeding.

14. Patients unable to comply with the protocol.

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung

Intervention

Drug:
• BiBW 2992
BIBW 2992 in EGFR FISH positive NSCLC patients

Locations

Country	Name	City	State
Italy	1200.40.39011 Boehringer Ingelheim Investigational Site	Arezzo
Italy	1200.40.39007 Boehringer Ingelheim Investigational Site	Aviano (PN)
Italy	1200.40.39013 Boehringer Ingelheim Investigational Site	Faenza (RA)
Italy	1200.40.39003 Boehringer Ingelheim Investigational Site	Genova
Italy	1200.40.39010 Boehringer Ingelheim Investigational Site	Livorno
Italy	1200.40.39012 Boehringer Ingelheim Investigational Site	Lugo (RA)
Italy	1200.40.39008 Boehringer Ingelheim Investigational Site	Modena
Italy	1200.40.39005 Boehringer Ingelheim Investigational Site	Monza (MI)
Italy	1200.40.39006 Boehringer Ingelheim Investigational Site	Padova
Italy	1200.40.39002 Boehringer Ingelheim Investigational Site	Perugia
Italy	1200.40.39004 Boehringer Ingelheim Investigational Site	Prato
Italy	1200.40.39009 Boehringer Ingelheim Investigational Site	Ravenna
Italy	1200.40.39001 Boehringer Ingelheim Investigational Site	Rozzano (MI)

Sponsors (1)

Lead Sponsor	Collaborator
Boehringer Ingelheim

Country where clinical trial is conducted

Italy, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Participants With Best Objective Response	Percentage of participants with best objective response: confirmed complete response (CR) or confirmed partial response (PR) according to RECIST version 1.0.	Tumour assessments were performed at baseline (tumour assessment obtained within 4 weeks prior to beginning of treatment), week 8, and every 8 weeks until last response assessment 28NOV12.	No
Secondary	Number of Participants With Objective Response (OR) Categorized by Time	Cumulative number of participants with objective response by time points with responders.	Tumour assessments were performed at baseline (tumour assessment obtained within 4 weeks prior to beginning of treatment), week 8, and every 8 weeks until last response assessment 28NOV12.	No
Secondary	Duration of Confirmed Objective Response (OR)	Duration of confirmed Objective Response is measured from the time of first Objective Response (OR) to the time of progression or death (or date of censoring for progression free survival).	Tumour assessments were performed at baseline (tumour assessment obtained within 4 weeks prior to beginning of treatment), week 8, and every 8 weeks until last response assessment 28NOV12.	No
Secondary	Percentage of Participants With Disease Control (DC)	Percentage of participants with Objective response (OR) or stable disease (SD) as determined by RECIST version 1.0.	Every 8 weeks until last response assessment 28NOV12	No
Secondary	Duration of Confirmed Disease Control	Duration of Disease Control is measured from the time of first Objective Response to the time of progression or death (or date of censoring for progression free survival) or respectively for SD as the time from date of randomization to date that disease progression.	Every 8 weeks until last response assessment 28NOV12	No
Secondary	Progression Free Survival (PFS) Time	Progression Free Survival time defined as time from the start of treatment to the earliest of progression (RECIST), clinical progression (investigator), start of new anti-cancer treatment or death.	Every 8 weeks until last response assessment 28NOV12	No
Secondary	Overall Survival (OS) Time	Overall survival time is defined as time from the date of start of treatment to the date of death.	Baseline until last vital status assessment 17JUN13	No
Secondary	Pre-dose Concentration of Afatinib in Plasma at Steady State on Day 15 (Cpre,ss,15)	Cpre,ss,15 represents the pre-dose concentration of afatinib in plasma at steady state on day 15.	Day 15	No
Secondary	Number of Participants With Clinical Relevant Finding in Gastrointestinal and Skin Disorder	The safety of patients was overall assessed in terms of adverse events (AEs), graded according to US NCI CTCAE version 3.0 [R04-0474], including skin reactions and gastrointestinal AEs.	First administration of trial medication until 28 days after last administration of trial medication, up until 194 weeks	No
Secondary	Number of Participants With Clinical Relevant Findings in Laboratory Safety Parameters, Vital Signs and Left Ventricular Ejection Fraction	Number of participants with clinical relevant findings in Laboratory safety parameters, vital signs and Left ventricular ejection fraction . Relevant findings or worsenings of baseline conditions were reported as Adverse Events.; There were no clinically relevant finding reported for Vital signs and Left ventricular ejection fraction (LVEF).	First administration of trial medication until 28 days after last administration of trial medication, up until 194 weeks	No
Secondary	Assessment of Eastern Cooperative Oncology Group (ECOG) Performance Status	Performance status assessed according to Eastern Cooperative Oncology Group (ECOG) performance status based on categories defined below : 0 : Fully active, able to carry on all pre-disease performance without restriction.; : Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work.; : Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours.; : Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours.; : Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair.; : Dead.; Note: The ECOG scores presented are assessed at the end of treatment not at baseline, hence the patients having ECOGs>2 are included.	End Of Treatment, up until 190 weeks	No

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