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TIGER-1: Safety and Efficacy Study of Rociletinib (CO-1686) or Erlotinib in Patients With EGFR-mutant/Metastatic NSCLC Who Have Not Had Any Previous EGFR Directed Therapy

NCT02186301

Description:

The purpose of this study is to compare the safety and anti-tumor effect of rociletinib with erlotinib in patients whose tumors have specific EGFR mutations and who have not previously received any treatment for advanced/metastatic EGFR mutated NSCLC. This study is a 'Randomized' Study. This means that upon entering the study, patients will be randomly assigned to be dosed with either rociletinib twice a day or erlotinib once a day. Patients will continue to take either rociletinib or erlotinib until it is no longer beneficial.

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Terminated

Phase:

Phase 2/Phase 3

Trial Eligibility

Document

Title

  • Brief Title: TIGER-1: Safety and Efficacy Study of Rociletinib (CO-1686) or Erlotinib in Patients With EGFR-mutant/Metastatic NSCLC Who Have Not Had Any Previous EGFR Directed Therapy
  • Official Title: TIGER 1: A Randomized, Open-Label, Phase 2/3 Study of CO-1686 or Erlotinib as First-Line Treatment of Patients With EGFR-Mutant Advanced/Metastatic NSCLC

Clinical Trial IDs

  • ORG STUDY ID: CO-1686-022 (TIGER-1)
  • NCT ID: NCT02186301

Conditions

  • Non-Small Cell Lung Cancer

Interventions

DrugSynonymsArms
Rociletinib Mono-TherapyRociletinib Mono-Therapy
Erlotinib Mono-TherapyErlotinib Mono-Therapy

Purpose

The purpose of this study is to compare the safety and anti-tumor effect of rociletinib with erlotinib in patients whose tumors have specific EGFR mutations and who have not previously received any treatment for advanced/metastatic EGFR mutated NSCLC. This study is a 'Randomized' Study. This means that upon entering the study, patients will be randomly assigned to be dosed with either rociletinib twice a day or erlotinib once a day. Patients will continue to take either rociletinib or erlotinib until it is no longer beneficial.

Detailed Description

      This is a randomized, Phase 2/3 study of rociletinib versus erlotinib as a first-line
      treatment for patients with EGFR-mutant advanced/metastatic NSCLC whose tumors have
      EGFR-activating mutations. The study will consist of Phase 2 and Phase 3 parts which will use
      the same enrollment criteria and treatment assignment principles. Patients will be randomized
      1:1 to erlotinib or rociletinib. The Phase 2 part is an open-label study. In the Phase 3
      part, the sponsor will be blinded to the efficacy and safety results. The study will consist
      of a screening phase to establish study eligibility (including tumor genotype) and document
      baseline measurements, a treatment phase, in which patients will receive either rociletinib
      BID (twice a day) or erlotinib QD (once daily) to ascertain safety and efficacy until
      protocol-defined disease progression, and a follow-up phase, to monitor survival status and
      subsequent NSCLC cancer therapy. In the Phase 2 part only, patients initially randomized to
      erlotinib may be eligible to participate in an optional crossover phase to receive
      rociletinib if they demonstrate the T790M resistance mutation after radiographic progression
      on erlotinib treatment among other eligibility requirements. Patients eligible for this study
      must have EGFR-mutated NSCLC who have not been treated with an EGFR-directed
      therapy.Treatment with rociletinib or erlotinib is continuous. Each 28 day period of
      treatment will represent one cycle, with dosing initiated on Cycle 1 Day 1 (C1 D1).
    

Trial Arms

NameTypeDescriptionInterventions
Erlotinib Mono-TherapyActive Comparator
  • Erlotinib Mono-Therapy
Rociletinib Mono-TherapyExperimental
  • Rociletinib Mono-Therapy

Eligibility Criteria

        Inclusion Criteria:

          1. Histologically or cytologically confirmed metastatic or unresectable locally
             advanced/metastatic NSCLC

          2. Documented evidence of a tumor with activating EGFR mutations by local testing.
             Patients with exon 20 insertions are not eligible with the exception of patients with
             documented evidence of the exon 20 insertion A763_Y764insFQEA in the EGFR gene

          3. Have undergone a biopsy or surgical resection of either primary or metastatic tumor
             tissue within 60 days of the first day of study treatment, C1D1, and have tissue
             available to send to sponsor laboratories or are able to undergo a biopsy during
             screening and provide tissue to sponsor laboratories

          4. Measureable disease according to RECIST Version 1.1

          5. Life expectancy of at least 3 months

          6. ECOG (Eastern Cooperative Oncology Group) performance status of 0 to 1

          7. Minimum age 18 years (in certain territories, the minimum age requirement may be
             higher (e.g. 20 years in Japan and Taiwan)

          8. Adequate hematological and biological function, confirmed by defined laboratory values

          9. Written consent on an IRB/IEC-approved Informed Consent Form (ICF) prior to any
             study-specific evaluation

        Exclusion Criteria:

          1. Documented evidence of an exon 20 insertion activating mutation other than
             A763_Y764insFQEA in the EGFR gene

          2. Prior treatment with cytotoxic chemotherapy for advanced NSCLC; neoadjuvant/adjuvant
             chemotherapy is permitted if at least 6 months has elapsed between the end of
             chemotherapy and randomization

          3. Active second malignancy; i.e., patient known to have potentially fatal cancer present
             for which he/she may be (but not necessarily) currently receiving treatment

          4. Patients with a history of malignancy that has been completely treated, and currently
             with no evidence of that cancer, are permitted to enroll in the trial provided all
             chemotherapy was completed > 6 months prior and/or bone marrow transplant > 2 years
             prior to first day of study treatment

          5. Known pre-existing interstitial lung disease

          6. Brain metastases

          7. Treatment with prohibited medications less than or equal to 14 days prior to first day
             of study treatment

          8. Patients who are currently receiving treatment with any medications that have the
             potential to prolong the QT interval if that treatment cannot be either discontinued
             or switched to a different medication prior to administration of study drug

          9. Prior treatment with EGFR TKIs (e.g. erlotinib, gefitinib, neratinib, afatinib,
             AZD9291, or dacomitinib), rociletinib or other drugs that target mutant EGFR

         10. Clinically significant abnormal 12-lead ECG, QT interval corrected using Fridericia's
             method (QTCF) > 450 ms

         11. Inability to measure QT interval on ECG

         12. Personal or family history of long QT syndrome

         13. Implantable pacemaker or implantable cardioverter defibrillator

         14. Resting bradycardia < 55 beats/min

         15. Non-study related surgical procedures less than or equal to 7 days prior to
             administration of study drug. In all cases, the patient must be sufficiently recovered
             and stable before treatment administration.

         16. Females who are pregnant or breastfeeding

         17. Refusal to use adequate contraception for fertile patients (females and males) for 12
             weeks after the last dose of rociletinib and 2 weeks after the last dose of erlotinib

         18. Presence of any serious or unstable concomitant systemic disorder incompatible with
             the clinical study

         19. Any other reason the investigator considers the patient should not participate in the
             study
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression Free Survival (PFS) According to RECIST Version 1.1 as Determined by Investigator Review (invPFS)
Time Frame:Cycle 1 Day 1 to End of Treatment, up to approximately 35 months
Safety Issue:
Description:To compare the antitumor efficacy of oral single-agent rociletinib with that of erlotinib as measured by progression-free survival (PFS), when administered as a first-line targeted treatment to patients with EGFR-mutated, advanced NSCLC.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.The appearance of one or more new lesions is also considered progression.

Secondary Outcome Measures

Measure:Confirmed Response Rate
Time Frame:Cycle 1 Day 1 to End of Treatment, up to approximately 35 months.
Safety Issue:
Description:Proportion of patients with a best overall confirmed response of partial response (PR) or complete response (CR) recorded from the start of the treatment until disease progression or recurrence. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions, defined by and assessed as: Complete Response (CR), is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm. Partial Response (PR),at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum of longest diameter. Overall Response (OR),is the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). The patient's best response assignment was dependent on the achievement of both measurement and confirmation criteria.
Measure:Duration of Response
Time Frame:Cycle 1 Day 1 to End of Treatment, up to approximately 35 months
Safety Issue:
Description:Duration of Response in Patients with Confirmed Response per Investigator

Details

Phase:Phase 2/Phase 3
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Clovis Oncology, Inc.

Trial Keywords

  • cancer
  • metastatic
  • locally advanced
  • lung
  • non-small cell lung cancer
  • NSCLC
  • epidermal growth factor receptor
  • EGFR
  • T790M
  • CO-1686
  • unresectable
  • recurrent
  • EGFR-directed therapy
  • irreversible EGFR inhibitor
  • TIGER
  • rociletinib

Last Updated

May 7, 2019