Clinical Trials /

Osimertinib and Bevacizumab as Treatment for EGFR-mutant Lung Cancers

NCT02803203

Description:

The purpose of this study is to test the safety of combining the drugs osimertinib and bevacizumab at different dose levels. The investigators want to find out what effects, good and/or bad, taking osimertinib and bevacizumab has on the patient and lung cancer. This study will try to find the best dose of osimertinib and bevacizumab given together that does not cause significant side effects. Once the investigators determine that combining osimertinib and bevacizumab is safe, they want to see if the combination is effective in treating lung cancers with the EGFR mutation.

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

Active, not recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Osimertinib and Bevacizumab as Treatment for EGFR-mutant Lung Cancers
  • Official Title: A Phase 1/2 Study of Combination Osimertinib and Bevacizumab as Treatment for Patients With EGFR-mutant Lung Cancers

Clinical Trial IDs

  • ORG STUDY ID: 16-033
  • NCT ID: NCT02803203

Conditions

  • Non-small Cell Lung Cancer
  • EGFR-mutant Lung Cancers

Interventions

DrugSynonymsArms
osimertinibAZD9291osimertinib and bevacizumab
Bevacizumabosimertinib and bevacizumab

Purpose

The purpose of this study is to test the safety of combining the drugs osimertinib and bevacizumab at different dose levels. The investigators want to find out what effects, good and/or bad, taking osimertinib and bevacizumab has on the patient and lung cancer. This study will try to find the best dose of osimertinib and bevacizumab given together that does not cause significant side effects. Once the investigators determine that combining osimertinib and bevacizumab is safe, they want to see if the combination is effective in treating lung cancers with the EGFR mutation.

Trial Arms

NameTypeDescriptionInterventions
osimertinib and bevacizumabExperimentalPhase 1: 3+3 dose escalation design 2 dose levels Dose level -1: Osimertinib 40mg daily Maximum accrual = 12 Bevacizumab 15mg/kg q3 weeks Dose level 1: Osimertinib 80mg daily Bevacizumab 15mg/kg q3 Weeks Phase 2: Use MTD determined during phase 1
  • osimertinib
  • Bevacizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Written informed consent

          -  Advanced biopsy-proven metastatic non-small cell lung cancer

          -  Somatic activating mutation in EGFR

          -  No prior treatment with an EGFR TKI

          -  No prior treatment with a VEGF inhibitor

          -  Measurable (RECIST 1.1) indicator lesion not previously irradiated

          -  Karnofsky performance status (KPS) ≥ 70%

          -  Age >18 years old

          -  Adequate organ function

               -  AST, ALT ≤ 3 x ULN

               -  Total bilirubin ≤ 1.5x ULN

               -  Creatinine ≤ 1.5x ULN OR calculated creatinine clearance > 60ml/min

               -  Absolute neutrophil count (ANC) ≥ 1000 cells/mm3

               -  Hemoglobin≥8.0 g/dL

               -  Platelets ≥100,000/mm3

        Exclusion Criteria:

          -  Any contra-indications to bevacizumab which include but are not limited to recent

               1. Any previous venous thromboembolism > NCI CTCAE Grade 3

               2. Severe uncontrolled hypertension (systolic blood pressure ≥150 mmHg and/or
                  diastolic blood pressure ≥ 100mmHg)

               3. Cardiovascular disease including stroke of myocardial infarction <6 months prior
                  to study enrollment, New York Heart Association Grade 2 or greater congestive
                  heart failure, serious cardiac arrythmia uncontrolled by medication

               4. Hemorrhagic brain metastases. Asymptomatic (not requiring escalating doses of
                  steroids) brain metastases are acceptable.

               5. History of severe proteinuria (urine dipstick ≥ 2+ or 24 hr urine > 2gm/24hr)

               6. Prior history of hypertensive crisis or hypertensive encephalopathy

               7. History of a central nervous system disease (e.g. seizures) unrelated to cancer
                  unless adequately treated with standard medical therapy

               8. Significant vascular disease (e.g. aortic aneurysm requiring surgical repair)≥ 6
                  months prior to study enrollment

               9. History of hemoptysis (≥1/2 teaspoon of bright red blood per episode) within the
                  last 3 months

              10. Evidence of a bleeding diathesis or significant coagulopathy (in the absence of
                  therapeutic anticoagulation)

              11. Current or recent (within 10 days of study drug start) use of aspirin (>325mg
                  daily), clopidogrel (>75mg daily).

              12. Recent initiation of full dose oral or parental anticoagulants that have not been
                  in place for at least 2 weeks.

              13. Tumor invading or abutting major blood vessels

              14. Tumor histology classified by squamous cell histology.

              15. Any history of abdominal fistula or GI perforation within 6 months of study
                  enrollment

          -  Pregnant or lactating women

          -  Any type of systemic anticancer therapy (chemotherapy or experimental drugs) within 2
             weeks of starting treatment on protocol

          -  Any radiotherapy within 1 week of starting treatment on protocol

          -  Any major surgery within 4 weeks of starting treatment on protocol

          -  Any evidence of clinically significant interstitial lung disease

          -  Known hypersensitivity to any component of bevacizumab and osimertinib
      
Maximum Eligible Age:N/A
Minimum Eligible Age:19 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:maximum tolerated dose (MTD) (Phase I)
Time Frame:1 year
Safety Issue:
Description:The MTD (maximum tolerated dose)/recommended phase 2 dose will be the highest dose level at which <1 DLT is detected in the first cycle for 6 treated patients. If only 3 patients are treated at a dose level being considered for the MTD, an additional 3 patients will be enrolled.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Memorial Sloan Kettering Cancer Center

Trial Keywords

  • Osimertinib
  • bevacizumab
  • metastatic
  • 16-033

Last Updated

December 19, 2020