Description:
This is a Phase I/II, multi-center, open-label study, composed with a Phase I part
(dose-escalation phase) followed by a Phase II part (expansion phase).
The dose escalation phase was designed to determine as primary objective the maximum
tolerated dose (MTD) or recommended Phase II dose (RP2D) of EGF816 monotherapy in adult
subjects with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC harboring specific
EGFR mutations. Patients may have or not have received prior lines of antineoplastic therapy.
An adaptive Bayesian Logistic Regression Model (BLRM) employing the escalation with overdose
control (EWOC) principle will be used during the dose escalation part for dose level
selection and MTD recommendation. The primary objective of the Phase II part is to estimate
antitumor activity of EGF816 as measured by overall response rate (ORR) determined by Blinded
Independent Review Committee (BIRC) assessment in accordance to RECIST 1.1.
Title
- Brief Title: A Phase I/II, Multicenter, Open-label Study of EGFRmut-TKI EGF816, Administered Orally in Adult Patients With EGFRmut Solid Malignancies
- Official Title: A Phase I/II, Multicenter, Open-label Study of EGFRmut-TKI EGF816, Administered Orally in Adult Patients With EGFRmut Solid Malignancies
Clinical Trial IDs
- ORG STUDY ID:
CEGF816X2101
- SECONDARY ID:
2013-004482-14
- NCT ID:
NCT02108964
Conditions
- Advanced Non-small Cell Lung Cancer
Interventions
Drug | Synonyms | Arms |
---|
EGF816 | Nazartinib | Phase I part |
Purpose
This is a Phase I/II, multi-center, open-label study, composed with a Phase I part
(dose-escalation phase) followed by a Phase II part (expansion phase).
The dose escalation phase was designed to determine as primary objective the maximum
tolerated dose (MTD) or recommended Phase II dose (RP2D) of EGF816 monotherapy in adult
subjects with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC harboring specific
EGFR mutations. Patients may have or not have received prior lines of antineoplastic therapy.
An adaptive Bayesian Logistic Regression Model (BLRM) employing the escalation with overdose
control (EWOC) principle will be used during the dose escalation part for dose level
selection and MTD recommendation. The primary objective of the Phase II part is to estimate
antitumor activity of EGF816 as measured by overall response rate (ORR) determined by Blinded
Independent Review Committee (BIRC) assessment in accordance to RECIST 1.1.
Detailed Description
Following completion of screening procedures and confirmation of patient eligibility, the
participants are enrolled in the study. The study treatment begin on Cycle 1, Day 1 with the
first administration of EGF816. A treatment cycle is defined as 28 days. Oral EGF816 is
administered once daily on a continuous schedule until patient experiences unacceptable
toxicity, progressive disease (PD), and/or treatment is discontinued at the discretion of the
investigator, patient withdrawal of consent, or due to any other reasons. Treatment with
EGF816 may be continued beyond RECIST 1.1 defined PD, if, in the judgment of the
investigator, there is evidence of clinical benefit and the patient wishes to continue with
the study treatment.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase I part | Experimental | Participants with locally advanced or metastatic NSCLC harboring specific EGFR mutations will be administered escalated doses of EGF816 orally once a day as continuous daily dosing in each cycle (of 28 days) during Phase I part of the study. The starting dose for the Phase I part first cohort of patients will be 75 mg once per day capsule. | |
Phase II part | Experimental | Treatment naïve participants with locally advanced or metastatic NSCLC harboring EGFR mutations will be administered with EGF816 at RP2D during Phase II part of the study. | |
Eligibility Criteria
Inclusion Criteria: (For all patients unless otherwise specified)
- Histologically or cytologically confirmed locally advanced (stage IIIB not amenable to
definitive multi-modality therapy including surgery) or metastatic (stage IV) EGFR
mutant NSCLC.
- Patients with controlled brain metastases
- ECOG performance status: Phase I part: 0, 1, or 2; Phase II part: 0 or 1
- Presence of at least one measurable lesion according to RECIST 1.1 per investigator
assessment
- Patients who are either Hepatitis B surface antigen (HBsAg) positive or hepatitis B
virus (HBV)-DNA positive must be willing and able to take antiviral therapy 1-2 weeks
prior to 1st dose of EGF816 treatment and continue on antiviral therapy for at least 4
weeks after the last dose of EGF816
- Patients must have negative hepatitis C antibody (HCV-Ab) or positive HCV-Ab but
undetectable level of HCV-RNA. Note: patients with detectable HCV-RNA are not eligible
for the study.
- For Phase I: patients must have failed no more than 3 lines of any systemic
antineoplastic therapy for advanced NSCLC, including EGFR-TKI
- For Phase II: patients must be naïve from any systemic antineoplastic therapy in the
advanced setting. Patients who have failed no more than 1 cycle of systemic
antineoplastic therapy in the advanced setting are allowed.
Exclusion criteria: (For all patients unless otherwise specified)
- Patients with a history or presence of interstitial lung disease (ILD) or interstitial
pneumonitis, including clinically significant radiation pneumonitis (i.e. affecting
activities of daily living or requiring therapeutic intervention)
- Presence or history of another malignancy
- Undergone a bone marrow or solid organ transplant
- Known history of human immunodeficiency virus (HIV) seropositivity
- Patients receiving concomitant immunosuppressive agents or chronic corticosteroids use
at the time of study entry except for control of brain metastases, topical
applications, inhaled sprays, eye drops or local injections
- Patients with clinically significant, uncontrolled heart disease
- Any prior therapies ≤ 4 weeks prior to the first dose of study treatment
- Patients who are receiving treatment with medications that are known to be strong
inhibitors or inducers of CYP3A4/5 and cannot be discontinued 1 week prior to the
start of EGF816 treatment and for the duration of the study.
- Patients who have impairment of gastrointestinal (GI) function or GI disease that may
significantly alter the absorption of EGF816
- Patients who are receiving treatment with any enzyme-inducing anticonvulsant that
cannot be discontinued at least 1 week before first dose of study treatment, and for
the duration of the study
- Women of child-bearing potential, defined as all women physiologically capable of
becoming pregnant, unless they are using highly effective methods of contraception
- Sexually active males unless they use a condom during intercourse while taking drug
and for 3 months after stopping treatment
Other protocol-defined inclusion and exclusion criteria may apply.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Number of Participants With Dose Limiting Toxicities (DLTs) (Phase I Part) |
Time Frame: | First 28 days of dosing |
Safety Issue: | |
Description: | Number of participants with DLTs during the first 28 days of therapy. A DLT is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first cycle of treatment with EGF816 and meets any of the criteria described in the protocol. A participant with multiple occurrences of DLTs under one treatment is counted only once. |
Secondary Outcome Measures
Measure: | Progression-free Survival (PFS) by Investigator Assessment (Phase I & Phase II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | PFS is defined as time from date of first dose of study treatment to date of first documented disease progression or death due to any cause determined by Investigator assessment in accordance to RECIST 1.1 |
Measure: | Duration of Response (DOR) by Investigator Assessment (Phase I & II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause determined by Investigator assessment in accordance to RECIST 1.1 |
Measure: | Observed Maximum Plasma Concentration (Cmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part) |
Time Frame: | Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose). |
Safety Issue: | |
Description: | To characterize the PK properties of EGF816 and metabolite LMI258, Cmax will be calculated (Phase I & II parts) |
Measure: | Time to Maximum Plasma Concentration (Tmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part) |
Time Frame: | Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose). |
Safety Issue: | |
Description: | To characterize the PK properties of EGF816 and metabolite LMI258, Tmax will be calculated (Phase I & II parts) |
Measure: | Area Under the Serum Concentration-time Curve From Time Zero to the End of the Dosing Interval Tau (AUCtau) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part) |
Time Frame: | Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose). |
Safety Issue: | |
Description: | To characterize the PK properties of EGF816 and metabolite LMI258, AUCtau will be calculated (Phase I & II parts) |
Measure: | Change From Baseline in H-score for Immunohistochemistry (IHC) Biomarkers From Tumor Tissue Samples (Phase I Part) |
Time Frame: | Baseline and Cycle 1 Day 15 |
Safety Issue: | |
Description: | Changes in EGFR signaling pathway of newly obtained tumor samples following EGF816 treatment will be evaluated by IHC of three pharmacodynamics (PD) biomarkers: p-EGFR, p-AKT and p-ERK. The assigned H-score semi-quantitatively assesses the expression level of these protein markers and their phosphorylated forms. |
Measure: | Overall Response Rate (ORR) by Investigator Assessment (Phase I & II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | ORR is defined as proportion of patients with best overall response of PR+CR determined by Investigator assessment in accordance to RECIST 1.1 |
Measure: | Disease Control Rate (DCR) by Investigator Assessment (Phase I & II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | DCR is defined as the proportion of patients with best overall response of CR, PR, or SD determined by Investigator assessment in accordance to RECIST 1.1 |
Measure: | Time to Response (TTR) by Investigator Assessment (Phase I & II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | TTR is defined as the time from the date of the first dose to the date of first documented response (CR or PR) determined by Investigator assessment in accordance to RECIST 1.1 |
Measure: | Number of Participants With Dose Interruptions and Dose Reductions (Phase I & II Parts) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | Assessment of the tolerability of EGF816 will be performed continuously during the treatment phase |
Measure: | Duration of Response (DOR) by BIRC (Phase II Part) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause determined by BIRC in accordance to RECIST 1.1 |
Measure: | Disease Control Rate (DCR) by BIRC (Phase II Part) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | DCR is defined as the proportion of patients with best overall response of CR, PR, or SD determined by BIRC in accordance to RECIST 1.1 |
Measure: | Progression-Free Survival (PFS) by BIRC (Phase II Part) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | PFS is defined as time from date of first dose of study treatment to date of first documented disease progression or death due to any cause determined by BIRC in accordance to RECIST 1.1 |
Measure: | Time to Response (TTR) by BIRC (Phase II Part) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | TTR is defined as as the time from the date of first dose of study treatment to the date of first documented response (CR or PR) determined by by BIRC in accordance to RECIST 1.1 |
Measure: | Overall Survival (OS) (Phase II Part) |
Time Frame: | At least 24 weeks |
Safety Issue: | |
Description: | OS is defined as the time from first dose of the study treatment to the date of death due to any cause. |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Novartis Pharmaceuticals |
Trial Keywords
- NSCLC
- Non-small Cell Lung Cancer EGFRmut
- EGFR TKIs (EGF816)
- acquired T790M mutation
- de novo T790M mutation
- EGFR TKI activating mutation (i.e. L858R or ex19del)
- Treatment naive advanced NSCLC with EGFR activating mutations
- Locally advanced NSCLC (Stage IIIB NSCLC not amenable to definitive multi-modality therapy including surgery)
- Metastatic NSCLC refers to Stage IV NSCLC
- 1st line
Last Updated
August 13, 2021