Phase 2
Completed N=222
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
| Outcome | Result | p-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
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.