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A Phase 1b/2 Study of Safety and Efficacy of Rociletinib in Combination With MPDL3280A in Patients With Advanced or Metastatic EGFR-mutant NSCLC

NCT02630186

Description:

This clinical research study is being carried out in two parts, Phase 1 and Phase 2. The primary purpose of the Phase 1 portion of the study is to observe the safety of the combination of rociletinib and MPDL3280A in EGFR-mutant NSCLC patients. The primary purpose of the Phase 2 portion of the study is to evaluate the safety and anti-tumor effects of the combination of rociletinib and MPDL3280A, at the best doses for the combination determined in Phase 1, in patients with EGFR-mutant NSCLC.

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

Terminated

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Phase 1b/2 Study of Safety and Efficacy of Rociletinib in Combination With MPDL3280A in Patients With Advanced or Metastatic EGFR-mutant NSCLC
  • Official Title: A Phase 1b/2 Study of the Safety and Efficacy of Rociletinib (CO-1686) Administered in Combination With MPDL3280A in Patients With Activating EGFR Mutation-positive (EGFRm) Advanced or Metastatic Non-small Cell Lung Cancer (NSCLC)

Clinical Trial IDs

  • ORG STUDY ID: CO-1686-032
  • NCT ID: NCT02630186

Conditions

  • Non-small Cell Lung Cancer

Interventions

DrugSynonymsArms
RociletinibCO-1686Single Arm Rociletinib and MPDL3280A
MPDL3280AatezolizumabSingle Arm Rociletinib and MPDL3280A

Purpose

This clinical research study is being carried out in two parts, Phase 1 and Phase 2. The primary purpose of the Phase 1 portion of the study is to observe the safety of the combination of rociletinib and MPDL3280A in EGFR-mutant NSCLC patients. The primary purpose of the Phase 2 portion of the study is to evaluate the safety and anti-tumor effects of the combination of rociletinib and MPDL3280A, at the best doses for the combination determined in Phase 1, in patients with EGFR-mutant NSCLC.

Detailed Description

      This is a Phase 1b/2, open-label, non-randomized, multicenter study evaluating the safety and
      efficacy of rociletinib administered in combination with MPDL3280A.

      Phase 1: This will be the dose finding phase of the study. Patients will be enrolled to
      available Dosing Cohort. Patients who have progressed after prior first- or second-generation
      EGFR TKI, regardless of T790M mutation status, will be enrolled.

      Phase 2: Patients will be enrolled into 2 groups. Group A will enroll eligible first-line
      patients who are EGFR TKI treatment-naïve and chemotherapy-naïve. Group B will enroll
      eligible patients who have progressed after prior first- or second-generation EGFR TKI,
      regardless of T790M mutation status.
    

Trial Arms

NameTypeDescriptionInterventions
Single Arm Rociletinib and MPDL3280AExperimentalSpecific doses of rociletinib, taken continuously BID, will be administered in combination with a fixed dose of MPDL3280A, given intravenously on Day 1 of each 21-day cycle.
  • Rociletinib
  • MPDL3280A

Eligibility Criteria

        Inclusion Criteria:

          -  ECOG performance status of 0 or 1

          -  Adequate hematological and biological function, confirmed by defined laboratory values

          -  Histologically or cytologically documented metastatic or unresectable, locally
             advanced or metastatic NSCLC, with one or more activating EGFR mutation (eg, G719X,
             exon 19 deletion, L858R, L861Q) and absence of exon 20 insertion

          -  Measurable disease as defined by RECIST v1.1

          -  Biopsy of tumor tissue for central evaluation, within 60 days prior to the first day
             of study treatment

          -  For Phase 1 and Phase 2 Group B, progression after prior 1st or 2nd generation EGFR
             TKI (eg, erlotinib, gefitinib, afatinib). Previous chemotherapy for NSCLC is allowed.

          -  For Phase 2 Group A, EGFR TKI treatment-naïve and chemotherapy-naïve

        Exclusion Criteria:

          -  Unresolved toxicities from prior therapy

          -  Symptomatic, untreated or unstable central nervous system or leptomeningeal metastases

          -  Previous treatment with rociletinib or MPDL3280A, or other 3rd generation EGFR TKI
             (eg, AZD-9291, HM61713), or PD 1 axis targeted therapy (eg, anti PD 1 or anti-PD L1)

          -  Prior treatment with CD137 agonists or other immune checkpoint blockade therapies,
             including anti-CTLA-4 therapeutic antibodies

          -  Uncontrolled pleural effusion, pericardial effusion or ascites requiring recurrent
             drainage procedures

          -  Uncontrolled hypercalcemia or symptomatic hypercalcemia requiring continued use of
             bisphosphonate therapy or denosumab (bisphosphonate use for prevention of skeletal
             events allowed)

          -  Known hypersensitivity to any component of the MPDL3280A or rociletinib formulations
             or history or hypersensitivity to chimeric humanized antibodies or fusion proteins

          -  History of autoimmune disease

          -  History of prior allogeneic hematopoietic stem cell transplantation or prior solid
             organ transplantation

          -  Treatment with systemic immunosuppressive medications within 2 weeks prior to first
             day of study treatment (inhaled corticosteroids and mineralocorticoids allowed)

          -  Live attenuated vaccine within 4 weeks prior to first day of study treatment

          -  Active tuberculosis, active hepatitis, or positive HIV status

          -  Class II to IV heart failure as defined by the New York Heart Association functional
             classification system

          -  Untreated or uncontrolled cardiovascular disease or other symptomatic cardiac
             dysfunction

          -  QTCF > 450 ms, inability to measure QT interval on ECG, personal or family history of
             long QT syndrome, requirement for medications that have the potential to prolong the
             QT interval

          -  History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced
             pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening
             chest computerized tomography (CT) scan (history of radiation pneumonitis in radiation
             field may be allowed)

          -  Other malignancies within 5 years prior to enrollment, with the exception of carcinoma
             in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer,
             or ductal carcinoma in situ
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of Treatment-emergent Adverse Events, as Assessed by NCI CTCAE v4.03
Time Frame:Continuously, up to approximately 18.5 months
Safety Issue:
Description:The safety analyses will be performed using the safety population. Safety data analysis will be conducted on all patients receiving at least one dose of rociletinib or MPDL3280A.

Secondary Outcome Measures

Measure:Objective Response Rate Per Modified RECIST v1.1, Incorporating Immune-related Criteria, in Phase 2
Time Frame:Approximately every 6-9 weeks, up to 24 months
Safety Issue:
Description:Conventional response criteria may not be adequate to characterize the antitumor activity of immunotherapeutic agents like MPDL3280A, which can produce delayed responses that may be preceded by initial apparent radiological progression, including the appearance of new lesions. Therefore, modified response criteria have been developed that account for the possible appearance of new lesions and allow radiological progression to be confirmed at a subsequent assessment. In this protocol, patients will be permitted to continue study treatment even after modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria for progressive disease are met if the benefit-risk ratio is judged to be favorable. These modified criteria are derived from RECIST version 1.1 (v1.1) conventions and immune related response criteria (irRC).
Measure:Duration of Response Per RECIST v1.1 and Modified RECIST v1.1, Incorporating Immune-related Criteria, in Phase 2
Time Frame:Approximately every 6-9 weeks, up to 24 months
Safety Issue:
Description:Conventional response criteria may not be adequate to characterize the antitumor activity of immunotherapeutic agents like MPDL3280A, which can produce delayed responses that may be preceded by initial apparent radiological progression, including the appearance of new lesions. Therefore, modified response criteria have been developed that account for the possible appearance of new lesions and allow radiological progression to be confirmed at a subsequent assessment. In this protocol, patients will be permitted to continue study treatment even after modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria for progressive disease are met if the benefit-risk ratio is judged to be favorable. These modified criteria are derived from RECIST version 1.1 (v1.1) conventions and immune related response criteria (irRC).
Measure:Progression-free Survival Per RECIST v1.1 and Modified RECIST v1.1, Incorporating Immune-related Criteria, in Phase 2
Time Frame:Approximately every 6-9 weeks, up to 24 months
Safety Issue:
Description:Conventional response criteria may not be adequate to characterize the antitumor activity of immunotherapeutic agents like MPDL3280A, which can produce delayed responses that may be preceded by initial apparent radiological progression, including the appearance of new lesions. Therefore, modified response criteria have been developed that account for the possible appearance of new lesions and allow radiological progression to be confirmed at a subsequent assessment. In this protocol, patients will be permitted to continue study treatment even after modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria for progressive disease are met if the benefit-risk ratio is judged to be favorable. These modified criteria are derived from RECIST version 1.1 (v1.1) conventions and immune related response criteria (irRC).
Measure:Number of Patients Alive at Study Termination
Time Frame:Up to approximately 18.5 months
Safety Issue:
Description:Patients who received the combination of rociletinib and MPDL3280A alive at the termination of this study.
Measure:Longitudinal Changes in Blood Based Biomarkers (eg, Mutations in EGFR) in ctDNA
Time Frame:Blood samples will be collected from each patient approximately every 3 weeks, up to 24 months
Safety Issue:
Description:Tumor tissue, plasma, and blood specimens will be used for pharmacodynamic assessment of rociletinib and/or MPDL3280A activity, to evaluate the concordance of mutant EGFR detection between tissue and plasma, and to explore biomarkers that may be predictive of response or resistance to rociletinib and/or MPDL3280A. Biomarkers and changes in biomarker status will be investigated for associations with rociletinib and/or MPDL3280A exposure, safety, and clinical activity. Given the limited sample size, no formal statistical analysis is planned.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Clovis Oncology, Inc.

Last Updated

July 5, 2019