- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT04028778
Gefitinib in Combination With Anlotinib or Placebo in Previously Untreated EGFR-mutant NSCLC (FL-ALTER)
7. november 2019 oppdatert av: Li Zhang, MD, Sun Yat-sen University
A Multicenter, Randomized, Double-Blind Study of Gefitinib in Combination With Anlotinib or Placebo in Previously Untreated Patients With EGFR Mutation-Positive Advanced Non-Small-Cell Lung Cancer
Gefitinib is currently the standard-of-care for patients with activating-EGFR mutant advanced non-small cell lung cancer (NSCLC).
However, ~30-40% patients are still nonresponsive, and experience significantly varying duration of response and survival rate.
Anlotinib is an efficient multi-target tyrosine kinase inhibitor (TKI) that effectively block the migration and proliferation of endothelial cells and reduce tumor microvascular density by targeting VEGFRs, FGFRs, PDGFRs.
It has been proved to be safe and effective in advanced lung cancer after second-line standard chemotherapy failure, which can significantly extend the survival of patients and approves as a third-line treatment for advanced NSCLC.
Here, we prepared to evaluate whether the combination of gefitinb and anlotinib can preferably improved survival of untreated NSCLC with EGFR activating mutation.
Studieoversikt
Status
Ukjent
Forhold
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Forventet)
310
Fase
- Fase 3
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiekontakt
- Navn: Wenfeng Fang, MD
- Telefonnummer: 020-87343822
- E-post: fangwf@sysucc.org.cn
Studiesteder
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Guangdong
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Guangzhou, Guangdong, Kina
- Rekruttering
- Cancer Center of Sun Yat-Sen University (CCSU)
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Hovedetterforsker:
- Li Zhang, MD
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Ta kontakt med:
- Li Zhang, MD
- Telefonnummer: 86-20-87343458
- E-post: zhangli6@mail.sysu.edu.cn
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år til 75 år (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- 1.≥ 18 and ≤ 75 years of age
- 2.Eastern Cooperative Oncology Group(ECOG)performance scale 0 - 1.
- 3.Life expectancy of more than 3 weeks
- 4.Histologically confirmed,locally advanced and/or metastatic non-squamous NSCLC of stage IIIB (unsuitable for radiotherapy) or IV or recurrent NSCLC with measurable lesion/ according to RECIST 1.1 which has not received radiotherapy or cryotherapy.
- 5.Documented evidence of tumor harboring an activating EGFR mutation (exon19 del and L858R)
- 6.None previous chemotherapy or targeted therapy. NOTE: neoadjuvant and/or adjuvant therapy is allowed which is completed before 6 months
- 7.Prior radiation therapy is allowed if: 25% or less of total bone marrow had been irradiated,pelvis and chest had not been irradiated; at least 4 weeks have elapsed from the completion of radiation treatment, and the acute toxicity from radiation treatment had been recover; irradiated lesion is not including measurable lesions unless documented progress after radiation.
- 8.Adequate hepatic, renal, heart, and hematologic functions (Absolute Neutrophil Count(ANC) ≥ 1.5×109/L, Platelet (PLT) ≥ 100×109/L, Hemoglobin(HB) ≥ 100 g/L, total bilirubin within 1.5×the upper limit of normal(ULN), and serum transaminase≤2.5×the Upper Limit Of Normal(ULN), serum creatine ≤ 1 x Upper Limit Of Normal(ULN), creatinine clearance rate ≥ 50ml/min
- 9.For women of child-bearing age, the pregnancy test results (serum or urine) within 7 days before enrolment must be negative. They will take appropriate methods for contraception during the study until the 8th week post the last administration of study drug. For men (previous surgical sterilization accepted), will take appropriate methods for contraception during the study until the 8th week post the last administration of study drug.
- 10.Signed and dated informed consent. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedure.
Exclusion Criteria:
- 1.small cell lung cancer (including small cell and non-small cell mixed lung cancer)
- 2.Symptomatic brain metastases (Patients who have no symptoms and is not needed to receive therapy before 21 days may participate in this trial, but need to be confirmed by MRI\CT or venography that no hematencephalon symptom)
- 3.Radiologically documented evidence of tumor lesions from large vessels ≤ 5mm or major blood vessel invasion or encasement by cancer; Obvious cavity or necrosis formed in the tumor.
- 4. hypertensive patients are in the combination therapy of two or more antihypertensive drugs.
- 5.patients with positive T790M mutation by Gene detection.
- 6.Patients who suffered from grade II or above myocardial ischemia or myocardial infarction, uncontrolled arrhythmias (including QT interval male ≥ 450 ms, female ≥ 470 ms). Grade III-IV cardiac insufficiency according to New York Heart Association(NYHA) criteria or echocardiography check: left ventricular ejection fraction (LVEF)<50%;
- 7.History of pulmonary interstitial diseases or concurrent pulmonary interstitial diseases.
- 8.Coagulation disfunction(INR>1.5 or PT>Upper Limit Of Normal(ULN)+4s or Activated Partial Thromboplastin Time (APTT) >1.5 Upper Limit Of Normal(ULN)), hemorrhagic tendency or receiving the therapy of thrombolysis or anticoagulation
- 9.Daily hemoptysis up to two teaspoons or more before enrollment
- 10.History of clinically relevant major bleeding event=<3 months (e.g. gastrointestinal hemorrhage, Hemorrhagic acne, bleeding gastric ulcer, occult blood test ≥ (++), and vasculitis ;
- 11.Within 12 months before the first treatment occurs artery / venous thromboembolic events, such as cerebral vascular accident (including transient ischemic attack(TIA), hematencephalon, cerebral infarction), deep vein thrombosis and pulmonary embolism, etc.
- 12.Known inherited and acquired hemorrhagic and thromboplastic possibility (such as hemophilia, coagulopathy, thrombocytopenia, hypersplenism, etc.)
- 13.Long-term untreated wounds or fractures(in addition to tumor-induced pathological fractures)
- 14.Within 4 weeks of major surgery and/or injures, fractures , ulceration
- 15.Significant factors that influence the ingestion and absorption of medicine, (e.g. unable swallow, chronic diarrhea and intestinal obstruction);
- 16.History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess ≤ 6 months.
- 17.Urine protein≥++, and 24h urine protein quantitation≥1.0g;
- 18.Symptomatic serous effusion requiring treatment .(including hydrothorax, ascites, hydropericardium);
- 19.Active infection need antimicrobial treatments(such as antibiotics and antiviral drugs should be used, excluding anti-hepatitis B treatment and antifungal therapy. )
- 20.History of psychiatric drugs abuse and not be abstinent, or dysphrenia
- 21.Less than 4 weeks from the last clinical trial
- 22.History or concomitant other malignancy except cured basal cell skin cancer, or carcinoma in situ of the cervix, or superficial bladder cancer;
- 23.Administration of strong/potent cytochrome P450 (CYP)3A4 inhibitors within 7 days, or inducers within 12 days;
- 24.Pregnant or breastfeeding women;patients who have fertility are unwilling or unable to take effective contraceptive measures;
- 25.Other conditions regimented at investigators' discretion
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Eksperimentell: Gefitinib + Anlotinib
Patients will be treated with Gefitinib 250mg, p.o., qd and anlotinib hydrochloride capsule 12mg, p.o., qd, D1-D14; take on an empty stomach (take at the same time every day as possible), every 3 weeks for a cycle.
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Gefitinib 250mg, p.o., qd, D1-D21; 3 weeks one cycle.
Andre navn:
Anlotinib hydrochloride capsule 12mg, p.o., qd, D1-D14; 3 weeks one cycle.
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Placebo komparator: Gefitinib + Placebo
Patients will be treated with Gefitinib 250mg, p.o., qd and placebo to simulate anlotinib hydrochloride capsule 12mg, p.o., qd, D1-D14; take on an empty stomach (take at the same time every day as possible), every 3 weeks for a cycle
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Gefitinib 250mg, p.o., qd, D1-D21; 3 weeks one cycle.
Andre navn:
Placebo simulating anlotinib hydrochloride capsule 12mg, p.o., qd, D1-D14; 3 weeks one cycle.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Progress-free survival (PFS)
Tidsramme: Approximately 2 Years
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Progression-Free Survival (PFS) as Assessed by Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1)
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Approximately 2 Years
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Overall Survival (OS)
Tidsramme: Approximately 5 Years
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OS was defined as the time from the date of randomization to the date of death due to any cause.
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Approximately 5 Years
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Percentage of Participants With Objective Response (Partial Response [PR] Plus Complete Response [CR]), as Assessed Using RECIST v.1.1
Tidsramme: Approximately 2 Years
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PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
CR was defined as disappearance of all target and non-target lesions and normalization of tumor marker levels (as applicable to non-target lesions).
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Approximately 2 Years
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Percentage of Participants With Clinical Benefit, as Assessed According to RECIST v1.1
Tidsramme: Approximately 2 Years
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Clinical benefit was defined as objective response (PR+CR), or no disease progression lasting for more than or equal to (>/=) 24 weeks since randomization.
PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
CR was defined as disappearance of all target and non-target lesions and normalization of tumor marker levels (as applicable to non-target lesions).
Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, including baseline.
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
For non-target lesions, disease progression was defined as unequivocal progression of existing lesions.
The appearance of one or more new lesions was also considered progression.
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Approximately 2 Years
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Duration of Objective Response, as Assessed by Investigator Using RECIST v1.1
Tidsramme: Approximately 2 Years
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Duration of objective response: the time from the first tumor assessment that supported the participant's objective response (CR or PR, whichever was first recorded) to first documented disease progression or death due to any cause, whichever occurred first.
CR was defined as disappearance of all target and non-target lesions and normalization of tumor marker levels (as applicable to non-target lesions).
PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Disease progression: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, including baseline.
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
For non-target lesions, disease progression was defined as unequivocal progression of existing lesions.
The appearance of one or more new lesions was also considered progression.
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Approximately 2 Years
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Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) Score
Tidsramme: Approximately 2 Years
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The EORTC QLQ-C30 consists of 30 questions that comprise aspects of participant's functioning assessment (physical, emotional, role, cognitive, and social); symptom scales (fatigue; nausea, vomiting, and pain; the global health/quality of life [QoL]); and single items (dyspnoea, insomnia, appetite loss, constipation, diarrhoea, and financial difficulties), within a recall period of "the past week."
Most questions used a 4-point scale (1=Not at all to 4=Very much; two questions used a 7-point scale (1=Very poor to 7=Excellent).
Scores were averaged and transformed to a 0-100 scale; a higher score for Global Qol/functional scales=better level of functioning; a higher score for symptom scale=greater degree of symptoms.
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Approximately 2 Years
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
10. april 2019
Primær fullføring (Forventet)
1. desember 2020
Studiet fullført (Forventet)
1. desember 2022
Datoer for studieregistrering
Først innsendt
11. juli 2019
Først innsendt som oppfylte QC-kriteriene
19. juli 2019
Først lagt ut (Faktiske)
23. juli 2019
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
8. november 2019
Siste oppdatering sendt inn som oppfylte QC-kriteriene
7. november 2019
Sist bekreftet
1. november 2019
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Sykdommer i luftveiene
- Neoplasmer
- Lungesykdommer
- Neoplasmer etter nettsted
- Neoplasmer i luftveiene
- Thoracale neoplasmer
- Karsinom, bronkogent
- Bronkiale neoplasmer
- Lungeneoplasmer
- Karsinom, ikke-småcellet lunge
- Molekylære mekanismer for farmakologisk virkning
- Enzymhemmere
- Antineoplastiske midler
- Proteinkinasehemmere
- Gefitinib
Andre studie-ID-numre
- 2018-FXY-134-内科
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
UBESLUTTE
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
produkt produsert i og eksportert fra USA
Nei
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