Phase 2
N=124
LDK378 in Crizotinib naïve Adult Patients With ALK-activated Non-small Cell Lung Cancer
Non-Small Cell Lung Cancer
Bottom Line
View on ClinicalTrials.gov: NCT01685138 ↗Enrolled (actual)
124
Serious AEs
40.3%
Results posted
Feb 2019
Primary outcome: Primary: Overall Response Rate (ORR) by Investigator Assessment — 67.7 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- LDK378 (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Jan 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate (ORR) by Investigator Assessment |
67.7 | — |
| SECONDARY ORR by Blinded Independent Review Committee (BIRC) |
63.7 | — |
| SECONDARY Duration of Response (DOR) as Per Investigator |
24.0 | — |
| SECONDARY Duration of Response (DOR) as Per BIRC |
27.3 | — |
| SECONDARY Disease Control Rate (DCR) as Per Investigator and BIRC |
90.3; 86.3 | — |
| SECONDARY Time to Response (TTR) as Per Investigator |
2.5 | — |
| SECONDARY Time to Response (TTR) as Per BIRC |
2.2 | — |
| SECONDARY Overall Intracranial Response Rate (OIRR) as Per Investigator |
20.0 | — |
| SECONDARY Overall Intracranial Response Rate (OIRR) as Per BIRC |
61.5 | — |
| SECONDARY Progression-free Survival (PFS) Per Investigator and BIRC |
16.6; 19.4 | — |
| SECONDARY Overall Survival (OS) |
51.3 | — |
Summary
A single-arm, open-label, two-stage multicenter, phase II study. Patients were pre-screened for ALK positive status. Treatment with LDK378 at 750 mg qd was continued until the patient experienced unacceptable toxicity that precluded further treatment, discontinued treatment at the discretion of the investigator or patient, started a new anticancer therapy and/or died. LDK378 was continued beyond RECIST defined progressive disease (PD) as assessed by the investigator, if in the judgment of the investigator, there was evidence of clinical benefit. Patients who discontinued the study medication in the absence of progression continued to be followed for tumor assessment until the time of PD as assessed by the investigator. Male and female patients aged 18 or over with ALK-rearranged non-small cell cancer (NSCLC) were screened for eligibility. Patients had to have received no prior crizotinib, and had to be chemotherapy-naïve or been pretreated with cytotoxic chemotherapy (up to three prior lines).
Eligibility Criteria
Key Inclusion criteria
- Histologically or cytologically confirmed diagnosis of stage IIIB or IV NSCLC that carried an ALK rearrangement, as per the FDA-approved Vysis ALK break-apart FISH assay (Abbott Molecular Inc.)
- Age 18 years or older at the time of informed consent.
- Patients must have NSCLC that had progressed during or after the last chemotherapy regimen received prior to the first dose of LDK378, if chemotherapy was received
- Patients must have been chemotherapy-naive or had received 1-3 lines of cytotoxic chemotherapy to treat their locally advanced or metastatic NSCLC
- Patients must have had a tumor tissue sample available, collected either at the time of diagnosis of NSCLC or any time since.
- Patients must have recovered from all toxicities related to prior anticancer therapies to grade ≤ 2, except for patients with grade 2 nausea/vomiting and/or grade 2 diarrhea despite optimal supportive therapy who were not allowed to participate in the study.
Key Exclusion criteria
- Prior treatment with crizotinib, or any other ALK inhibitor investigational agent, for NSCLC
- Patients with known hypersensitivity to any of the excipients of LDK378.
- Patients with symptomatic central nervous system (CNS) metastases who were neurologically unstable or had required increasing doses of steroids within the 2 weeks prior to study entry to manage CNS symptoms.
- History of carcinomatous meningitis.
- Presence or history of a malignant disease other than NSCLC that has been diagnosed and/or required therapy within the past 3 years.
- Clinically significant, uncontrolled heart disease.
Data sourced from ClinicalTrials.gov (NCT01685138). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.