Study With Gefitinib in Combination With Olaparib (AZD2281) Versus Gefitinib Alone

Non Small Cell Lung Cancer Clinical Trial

— GOAL  

Official title:

Multicenter, Randomized, Phase Ib/IIb Study to Evaluate the Efficacy and Tolerability of Gefitinib in Combination With Olaparib (AZD2281) Versus Gefitinib Alone, in Patients With EGFR Mutation Positive Advanced Non-small-cell Lung Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01513174
• Other study ID #: GECP10-03
• Secondary ID: 2010-024178-21
• Status: Completed
• Phase: Phase 1/Phase 2
• First received: December 11, 2011
• Last updated: April 25, 2017
• Start date: August 2011
• Est. completion date: July 2016

Study information

• Verified date: October 2016
• Source: Spanish Lung Cancer Group
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a study of gefitinib plus olaparib gefitinib in combination with olaparib (AZD2281) versus gefitinib alone, in patients with Epidermal Growth Factor Receptor (EGFR) mutation positive advanced non-small-cell lung cancer.

Description:

This is a multicenter, randomized, Phase Ib/IIb, open label study to evaluate the efficacy and tolerability of gefitinib in combination with olaparib (AZD2281) versus gefitinib alone, in patients with Epidermal Growth Factor Receptor (EGFR) mutation positive advanced non-small-cell lung cancer The study will be split into 2 parts: an open label Phase I dose escalation part and a randomized controlled, open label Phase II part.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 186
• Est. completion date: July 2016
• Est. primary completion date: July 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Patients age 18 years or more.

2. Histologically confirmed diagnosis of non-small-cell lung carcinoma.

3. Stage IV disease, following the Seventh Edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (27).

4. Tumor tissue available (according to the criterion of the specimen-processing laboratory) for EGFR mutation assessment: to be included in the study patients should present at least one EGFR mutation (exon 19 deletion or L858R with or without T790M).

5. Evidence of measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) criteria version 1.1.

6. ECOG score = 2.

7. Life expectancy of = 3 months.

8. For the Phase II part of the study, patients should not have received previous treatment with chemotherapy or other agents for advanced disease: chemotherapy is allowed if the initial diagnosis of the patient is limited disease and the patient has received adjuvant or neoadjuvant treatment, as long as a minimum of 6 months has passed since the end of the adjuvant and/or neo-adjuvant chemotherapy. This criterion is not mandatory to patients to be included in the Phase I part of the study (these patients are allowed to have received a prior line of treatment for advanced disease).

9. Patients with the following hematologic values:

• Absolute Neutrophil Count (ANC) =1.5 x 109/L

• Hemoglobin (Hb) = 10 g/dl

• Platelets = 100 x 109/L

10. Patients with the following biochemical values:

• Bilirubin = 1.5 mg/dL

• Aspartate aminotransferase (AST) and Alanine transaminase (ALT) < 1.5 upper limit of normality

• Creatinine clearance = 60 ml/min.

11. Patients of childbearing age of either sex must use effective contraceptive methods(barrier methods plus other birth control methods) before entering the study and while participating in the study.

12. Patients should sign an informed consent form before inclusion in the study that specifies that the clinical trial treatment entails consent for the analysis of biological samples of tumor and blood.

13. Patients must be available for clinical follow-up.

Exclusion Criteria:

1. Patients diagnosed of another neoplasm, with the exception of cervical carcinoma insitu, treated squamous cell carcinoma or superficial bladder tumor (Ta and TIS), or other malignant tumors that have received curative treatment within the last 5 years before inclusion in the study.

2. Simultaneous participation in any other study involving an investigational medicinal product, or having participated in a study less than 28 days prior to the start of study treatment.

3. Patients with HIV infection, HCV infection, coronary disease or uncontrolled arrhythmia, uncontrolled cerebrovascular disease and other clinical conditions that, in the judgment of the investigator, contraindicate the patient's participation in the study.

4. Past medical history of interstitial lung disease (ILD), drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease.

5. Pre-existing idiopathic pulmonary fibrosis evidenced by CT scan at baseline.

6. Uncontrolled seizures.

7. Patients considered requiring radiotherapy to the lung at the time of study entry or in the near future.

8. Known or suspected brain metastases or spinal cord compression, unless treated with surgery and/or radiation and stable without steroid treatment for at least 4 weeks prior to the first dose of study medication.

9. Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication.

10. Patients who are pregnant or breastfeeding. Women of childbearing potential must have a negative pregnancy test performed within 7 days before the onset of treatment(Appendix 8).

11. Patients receiving the following classes of inhibitors of CYP3A4 (see Appendix 5 for guidelines and wash out periods):

• Azole antifungals

• Macrolide antibiotics

• Protease inhibitors

12. Concomitant use of known CYP3A4 inducers such as phenytoin, carbamazepine, rifampicin, barbiturates, or St John's Wort.

13. Major surgery within 2 weeks of starting study treatment; patients must have recovered from any effects of any major surgery.

14. Significant weight loss (= 10% of body weight) in the 6 weeks before inclusion in the study.

15. Any condition that is unstable or could endanger the patient's safety and/or the patient's compliance with the study.

16. Substance abuse or clinical, psychological or social conditions that can undermine the validity of the informed consent or protocol compliance.

17. Patients who present any contraindication or suspected allergy to the products under investigation in the study. Tablets of gefitinib contain lactose: patients with rare hereditary problems of galactose intolerance, the Lapp lactose deficiency or glucose and galactose malabsorption, will not be included in this trial.

18. Contraindication for steroid use.

19. Impossibility to comply with treatment due to cultural or geographic circumstances.

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung
• Lung Neoplasms
• Non Small Cell Lung Cancer

Intervention

Drug:
• Gefitinib
Gefitinib 250 mg once a day, continuously, in 28-day cycles, until progression
• Gefitinib plus olaparib
Gefitinib 250 mg once a day, in combination with olaparib (at the recommended dose in the previous Phase Ib study) twice a day, continuously, in 28-day cycles.

Locations

Country	Name	City	State
Spain	H. Gen. Universitario de Alicante	Alicante
Spain	H. Germans Trias i Pujol	Badalona	Barcelona
Spain	H. Vall d'Hebrón	Barcelona
Spain	ICO Hospitalet	Hospitalet	Barcelona
Spain	H. Teresa Herrera	La Coruña

Sponsors (1)

Lead Sponsor	Collaborator
Spanish Lung Cancer Group

Country where clinical trial is conducted

Spain, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	MTD (Maximum Tolerated Dose) defined as the highest dose level at which < 2 out of 6 patients experience a DLT		5 weeks
Secondary	Progression-free survival		An expected average of 2 years
Secondary	Overall response rate		An expected average of 2 years
Secondary	Overall survival		An expected average of 2 years
Secondary	Peak Plasma Concentration		Predose, half an hour, 1, 2, 4, 6 and 12 hours post-dose

External Links

•   Spanish Lung Cancer Group website