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Phase 2 Completed N=222 Randomized Treatment

A Study to Evaluate the Efficacy of Brigatinib (AP26113) in Participants With Anaplastic Lymphoma Kinase (ALK)-Positive, Non-small Cell Lung Cancer (NSCLC) Previously Treated With Crizotinib

Source: ClinicalTrials.gov NCT02094573 ↗
Enrolled (actual)
222
Serious AEs
58.0%
Results posted
Jun 2017
Primary outcomePrimary: Confirmed Objective Response Rate (ORR) as Assessed by Investigator — 45.5; 57.3 percentage of participants

Summary

The purpose of this study is to evaluate the efficacy and safety of two different dosing regimens of brigatinib (AP26113) in participants with ALK-positive locally advanced or metastatic non-small cell lung cancer (NSCLC) whose disease has progressed on therapy with crizotinib.

Outcome Measures

OutcomeResultp-value
PRIMARY
Confirmed Objective Response Rate (ORR) as Assessed by Investigator
45.5; 57.3
SECONDARY
Confirmed Objective Response Rate (ORR) as Assessed by Independent Review Committee (IRC)
51.8; 56.4
SECONDARY
Confirmed Intracranial Central Nervous System Objective Response Rate (CNS ORR) in Participants With Measurable Active Brain Metastases
47.4; 73.3
SECONDARY
Confirmed Intracranial Central Nervous System Objective Response Rate (CNS ORR) in Participants With Only Non-measurable Active Brain Metastases
12.1; 16.7
SECONDARY
Intracranial CNS Progression Free Survival (PFS) in Participants With Active Brain Metastases
12.8; 12.8
SECONDARY
Time to Response
1.8; 1.9
SECONDARY
Duration of Response
12.0; 13.8
SECONDARY
Time on Treatment
402.0; 522.0
SECONDARY
Disease Control Rate (DCR)
81.3; 86.4
SECONDARY
Progression Free Survival (PFS)
9.2; 15.6
SECONDARY
Overall Survival (OS)
25.9; 40.6
SECONDARY
Number of Participants Who Had at Least One Treatment-Emergent Adverse Event (TEAE)
109; 110
SECONDARY
Pre-dose Brigatinib Plasma Concentration
295.2; 520.0; 263.9; 537.0; 236.1; 564.7
SECONDARY
Patient-reported Symptoms Global Health Status/Quality of Life (QoL) Scores
52.39; 58.49; 64.19; 65.72; 65.57; 68.50

Eligibility Criteria

Inclusion Criteria

  • Have histologically or cytologically confirmed locally advanced or metastatic Non-small Cell Lung Cancer (NSCLC) that is anaplastic lymphoma kinase (ALK+).
  • Must meet one of the following two criteria:
  • Have documented ALK rearrangement by a positive result from the Vysis® ALK Break-Apart fluorescence in situ hybridization (FISH) Probe Kit; or
  • Have documented ALK positivity by a different test and tissue available for the Vysis® FISH test. Tissue should be derived preferably from a biopsy taken after progression with crizotinib. If such a sample is not available, testing may be performed with archived tumor tissue.
  • Had progressive disease while on crizotinib, as assessed by the investigator or treating physician.
  • Have at least 1 measurable lesion per RECIST v1.1. Note: Previously irradiated lesions may not be used for target lesions, unless there is unambiguous radiological progression after radiotherapy. Brain lesions may not be used as target lesions if they were: 1) previously treated with whole brain radiation therapy (WBRT) within 3 months, or 2) previously treated by stereotactic radiosurgery (SRS) or surgical resection.
  • Recovered from toxicities related to prior anticancer therapy to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, v4.0) grade ≤2.
  • Are a male or female participants ≥18 years old.
  • Have a life expectancy ≥3 months.
  • Have adequate organ and hematologic function, as determined by:
  • Alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ≤2.5 x upper limit of normal (ULN; ≤5 x ULN is acceptable if liver metastases are present)
  • Total serum bilirubin ≤1.5 x ULN (<3.0 x ULN for participants with Gilbert syndrome)
  • Serum creatinine ≤1.5 x ULN
  • Serum lipase/amylase ≤1.5 x ULN
  • Absolute neutrophil count (ANC) ≥1500/µL
  • Platelets ≥75000/µL
  • Hemoglobin ≥10 g/dL
  • Have Eastern Cooperative Oncology Group (ECOG) performance status ≤2.
  • Have normal QT interval on screening electrocardiogram (ECG) evaluation, defined as QT interval corrected (Fridericia) (QTcF) of ≤450 ms in males or ≤470 ms in females.
  • For female participants of childbearing potential, a negative pregnancy test must be documented prior to enrollment.
  • Female and male participants who are fertile must agree to use a highly effective form of contraception with their sexual partners throughout study participation.
  • Must provide a signed and dated informed consent indicating that the participants has been informed of all pertinent aspects of the study, including the potential risks, and is willingly participating.
  • Have the willingness and ability to comply with scheduled visits and study procedures.

Exclusion Criteria

  • Received any prior ALK-targeted TKI other than crizotinib.
  • Received crizotinib within 3 days of the first dose of brigatinib (Day 1, Cycle 1).
  • Received cytotoxic chemotherapy, investigational agents, or radiation within 14 days, except SRS or stereotactic body radiosurgery.
  • Received monoclonal antibodies or had major surgery within 30 days of the first dose of brigatinib (Day 1, Cycle 1).
  • Have been diagnosed with another primary malignancy within the past 3 years (except for adequately treated non-melanoma skin cancer, cervical cancer in situ, or prostate cancer, which are allowed within 3 years).
  • Have symptomatic CNS metastases that are neurologically unstable or require an increasing dose of corticosteroids.
  • Have current spinal cord compression.
  • Have significant, uncontrolled, or active cardiovascular disease, specifically including, but not restricted to:
  • Myocardial infarction (MI) within 6 months prior to the first dose of brigatinib
  • Unstable angina within 6 months prior to first dose
  • Congestive heart failure (CHF) within 6 months prior to first dose
  • History of clinically significant (as determined by the treating physician) atrial arrhythmia
  • Any history of ventricular ar
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02094573). 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. Informational only — not medical advice.

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