NOV120101 Phase 2 Study in NSCLC Patients With Aquired Resistance to 1st Generation EGFR Tyrosine Kinase Inhibitors

Increased Drug Resistance Clinical Trial

— NSCLC  

Official title:

Phase II Exploratory Trial to Evaluate the Efficacy and Safety of NOV120101 (Poziotinib) in Lung Adenocarcinoma Patients With Acquired Resistance to 1st Generation EGFR Tyrosine Kinase Inhibitors

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01718847
• Other study ID #: NOV120101-202
• Status: Completed
• Phase: Phase 2
• First received: October 22, 2012
• Last updated: August 13, 2015
• Start date: January 2013
• Est. completion date: September 2014

Study information

• Verified date: August 2015
• Source: National OncoVenture
• Contact: n/a
• Is FDA regulated: No
• Health authority: Korea: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

The purpose of this open-label, single-arm, multi-center phase II trial is to evaluate the efficacy and safety of novel pan-HER inhibitor, NOV120101 (Poziotinib), as a 2nd line monotherapy agent in lung adenocarcinoma patients with acquired resistance to prior EGFR tyrosine kinase inhibitors (TKIs).

Description:

Acquired resistance to prior EGFR TKIs is considered as "unmet medical need" in clinical practice. To evaluate the efficacy of NOV120101 (Poziotinib) as a second-line monotherapeutic agent, patients with acquired resistance to gefitinib or erlotinib will be enrolled in this study. Subjects will receive NOV120101 (Poziotinib) 16 mg PO once daily until disease progression or unacceptable toxicity development. Progression free survival (PFS) will be analyzed as the primary endpoint in this trial. Secondary endpoints including PFS rate at 16 weeks, ORR and DCR will also be analyzed.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: September 2014
• Est. primary completion date: September 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 20 Years and older

Eligibility

Inclusion Criteria:

1. Male or female patients aged 20 years or older

2. Pathologically confirmed stage IIIB (unresectable) or IV lung adenocarinoma

3. Patients who have 1 or more than 1 measurable or evaluable but unmeasurable lesions according to RECIST ver1.1

4. Patients who received prior 1st generation EGFR TKIs (gefitinib or erlotinib) monotherapy and meet the following criteria:

1. Patients with EGFR mutation (e.g., G719X, exon 19 deletion, L858R, L861Q, etc) known to be associated with sensitivity to TKIs

2. Patients who showed objective clinical benefit from treatment with an EGFR TKI as defined by either:

• Patients who showed complete (CR) or partial response (PR), or

• Patients who maintained stable disease (SD) status = 6 months

3. Patients who showed progressive disease (PD, RECIST ver1.1) while on continuous treatment with gefitinib or erlotinib within the last 30 days (However, patients whose progressive disease is limited in the brain cannot participate in this trial.)

4. No intervening systemic chemotherapy between cessation of the EGFR TKI and participation of this study

5. Patients who agree to the collection of tumor tissue specimen

6. ECOG performance status = 2

7. Life expectancy of = 12 weeks

8. Adequate hematological, hepatic and renal functions:

WBC = 4,000/mm3, Platelet = 100,000/mm3, Serum creatinine = 1.5 X ULN, AST and ALT = 2.5 X ULN, Total bilirubin = 1.5 X ULN

9. Patients who give written informed consent voluntarily

Exclusion Criteria:

1. Patients who receive IP within 3 days from prior treatment with gefitinib or erlotinib

2. NCI-CTCAE grade > 1 adverse events due to treatment with gefitinib or erlotinib

3. Prior systemic chemo, immuno, hormonal and/or biological therapy except gefitinib or erlotinib within 4 weeks before IP administration

4. Acquired resistance to EGFR TKI due to conversion of adenocarcinoma into small cell lung cancer

5. Patients who received major surgery within 4 weeks before IP administration

6. Symptomatic CNS metastases (patients with radiologically and neurologically stable metastases and being off corticosteroids for at least 4 weeks are able to participate in this trial.)

7. History of other malignancies except effectively treated non-melanoma skin cancers, carcinoma in situ of the cervix, ductal carcinoma in situ or effectively treated malignancy that has been in remission for = 3 years and considered to be cured by investigator's judgment

8. Known pre-existing interstitial lung disease (ILD)

9. NYHA class III or IV heart failure, uncontrolled hypertension, unstable angina or myocardial infarction within 6 months, poorly controlled arrhythmia or other clinically significant cardiovascular abnormalities at investigator's discretion

10. Patients whose left ventricle ejection fraction (LVEF) is below the institutional lower limit of normal (if no lower limit of normal is defined in the site, the lower limit is 50%.)

11. Patients with known active hepatitis B, HIV infection, or other uncontrolled infectious disease

12. Clinically significant or recent acute gastrointestinal disorders with diarrhea as a major symptom (e.g., Crohn's disease, malabsorption disorders, CTCAE grade = 2 diarrhea due to any etiology)

13. Patients who cannot receive IP by mouth and be diagnosed with clinically significant gastrointestinal disorders which can prevent administration, transit or absorption of the IP

14. Pregnancy or breast-feeding

15. Women of childbearing potential (WOCBP) or men who are unwilling to use adequate contraception or be abstinent during the trial and for at least 2 months after the end of treatment

16. Patients who received other investigational products except gefitinib and erlotinib within 4 weeks before participation

17. Patients who cannot participate in this trial by investigator's judgment

Study Design

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

Related Conditions & MeSH terms

• Increased Drug Resistance

Intervention

Drug:
• NOV120101 (Poziotinib)
16 mg PO once daily until disease progression or unacceptable toxicity development

Locations

Country	Name	City	State
Korea, Republic of	Chungbuk National University Hospital	Cheongju-si,	Chungcheongbuk-do
Korea, Republic of	Ulsan University Hospital	Dong-gu	Ulsan
Korea, Republic of	National Cancer Center	Goyang-si	Gyeonggi-do
Korea, Republic of	Gachon University Gil Medical Center	Incheon
Korea, Republic of	Asan Medical Center	Songpa-gu	Seoul

Sponsors (2)

Lead Sponsor	Collaborator
National OncoVenture	Hanmi Pharmaceutical Company Limited

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Population pharmacokinetics (PK) of NOV120101 (Poziotinib)	The study of the sources and correlates of variability in drug concentrations among individuals who are the target patient population receiving clinically relevant doses of a study drug. Certain patient demographic, pathophysiological, and therapeutical features, such as body weight, excretory and metabolic functions, and the presence of other therapies, can regularly alter dose-concentration relationships.	By 3 months after enrollment of the last subject	No
Other	Subgroup analyses with the genetic information	Subgroup analysis, in the context of design and analysis of study drug, refers to looking for pattern in a subset of the subjects according to genotype	by 1 year after enrollment of the last patient	No
Primary	Progression free survival (PFS)	The length of time during and after medication or treatment during which the disease being treated (usually cancer) does not get worse.	By 1 year after enrollment of the last subject	No
Secondary	PFS rate at 16 weeks	The proportion of Patients maintaining progress-free status at 16 weeks	16 weeks	No
Secondary	Objective response rate (ORR)	The proportion of patients with partial response or complete response at their best tumor treatment evaluation	By 1 year after enrollment of the last subject	No
Secondary	Disease control rate (DCR)	The proportion of patients with CR, PR and/or stable disease (SD)	By 1 year after enrollment of the last subject	No
Secondary	Overall survival (OS)		By 1 year after enrollment of the last subject	No
Secondary	Time to progression (TTP)		By 1 year after enrollment of the last subject	No
Secondary	Time to objective response		By 1 year after enrollment of the last subject	No
Secondary	Duration of objective response		By 1 year after enrollment of the last subject	No
Secondary	Duration of disease control		By 1 year after enrollment of the last subject	No
Secondary	Change of quality of life (QoL) measured by EQ-5D questionnaire		baseline and the end of treatment, by 1 year after enrollment of the last subject	No