Phase 2
N=225
A Phase I/II, Multicenter, Open-label Study of EGFRmut-TKI EGF816, Administered Orally in Adult Patients With EGFRmut Solid Malignancies
Advanced Non-small Cell Lung Cancer
Bottom Line
View on ClinicalTrials.gov: NCT02108964 ↗Enrolled (actual)
225
Serious AEs
47.6%
Results posted
Oct 2020
Primary outcome: Primary: Number of Participants With Dose Limiting Toxicities (DLTs) (Phase I Part) — 0; 0; 2; 0 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- EGF816 (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Mar 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Dose Limiting Toxicities (DLTs) (Phase I Part) |
0; 0; 2; 0; 1; 0 | — |
| PRIMARY Overall Response Rate (ORR) by Blinded Independent Review Committee (BIRC) (Phase II Part) |
64.4 | — |
| SECONDARY Progression-free Survival (PFS) by Investigator Assessment (Phase I & Phase II Parts) |
6.3; 12.1; 7.4; 13.7; 11.1; 11.8 | — |
| SECONDARY Duration of Response (DOR) by Investigator Assessment (Phase I & II Parts) |
46.2; 11.3; 7.9; 14.9; 16.5; 10.2 | — |
| SECONDARY Observed Maximum Plasma Concentration (Cmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part) |
333; 301; 541; 641; 935; 1070 | — |
| SECONDARY Time to Maximum Plasma Concentration (Tmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part). Tmax is the Time to Reach Maximum (Peak) Plasma Drug Concentration (Time). |
2.83; 3.24; 2.74; 3.66; 2.64; 3.37 | — |
| SECONDARY Area Under the Serum Concentration-time Curve From Time Zero to the End of the Dosing Interval Tau (AUCtau) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part) |
4340; 4000; 6880; 8310; 12100; 15000 | — |
| SECONDARY Percentage Change From Baseline in H-score for Immunohistochemistry (IHC) Biomarkers From Tumor Tissue Samples (Phase I Part) |
-10.0; -39.0; -31.8; 3.5; 16.1; -2.5 | — |
| SECONDARY Overall Response Rate (ORR) by Investigator Assessment (Phase I & II Parts) |
41.7; 50.0; 50.0; 62.5; 62.5; 60.0 | — |
| SECONDARY Disease Control Rate (DCR) by Investigator Assessment (Phase I & II Parts) |
83.3; 97.1; 83.3; 100.0; 95.8; 100.0 | — |
| SECONDARY Time to Response (TTR) by Investigator Assessment (Phase I & II Parts) |
NA; 5.5; 11.6; 4.5; 1.9; 1.7 | — |
| SECONDARY Number of Participants With Dose Interruptions and Dose Reductions (Phase I & II Parts) |
3; 17; 35; 5; 20; 5 | — |
| SECONDARY Duration of Response (DOR) by BIRC (Phase II Part) |
18.6 | — |
| SECONDARY Disease Control Rate (DCR) by BIRC (Phase II Part) |
93.3 | — |
| SECONDARY Progression-Free Survival (PFS) by BIRC (Phase II Part) |
18.9 | — |
| SECONDARY Time to Response (TTR) by BIRC (Phase II Part) |
48.3 | — |
| SECONDARY Overall Survival (OS) (Phase II Part) |
48.3 | — |
Summary
This is a Phase I/II, multi-center, open-label study, composed with a Phase I part (dose-escalation phase) followed by a Phase II part (expansion phase).
The dose escalation phase was designed to determine as primary objective the maximum tolerated dose (MTD) or recommended Phase II dose (RP2D) of EGF816 monotherapy in adult subjects with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC harboring specific EGFR mutations. Patients may have or not have received prior lines of antineoplastic therapy. An adaptive Bayesian Logistic Regression Model (BLRM) employing the escalation with overdose control (EWOC) principle will be used during the dose escalation part for dose level selection and MTD recommendation. The primary objective of the Phase II part is to estimate antitumor activity of EGF816 as measured by overall response rate (ORR) determined by Blinded Independent Review Committee (BIRC) assessment in accordance to RECIST 1.1.
Eligibility Criteria
Inclusion Criteria: (For all patients unless otherwise specified)
- Histologically or cytologically confirmed locally advanced (stage IIIB not amenable to definitive multi-modality therapy including surgery) or metastatic (stage IV) EGFR mutant NSCLC.
- Patients with controlled brain metastases
- ECOG performance status: Phase I part: 0, 1, or 2; Phase II part: 0 or 1
- Presence of at least one measurable lesion according to RECIST 1.1 per investigator assessment
- Patients who are either Hepatitis B surface antigen (HBsAg) positive or hepatitis B virus (HBV)-DNA positive must be willing and able to take antiviral therapy 1-2 weeks prior to 1st dose of EGF816 treatment and continue on antiviral therapy for at least 4 weeks after the last dose of EGF816
- Patients must have negative hepatitis C antibody (HCV-Ab) or positive HCV-Ab but undetectable level of HCV-RNA. Note: patients with detectable HCV-RNA are not eligible for the study.
- For Phase I: patients must have failed no more than 3 lines of any systemic antineoplastic therapy for advanced NSCLC, including EGFR-TKI
- For Phase II: patients must be naïve from any systemic antineoplastic therapy in the advanced setting. Patients who have failed no more than 1 cycle of systemic antineoplastic therapy in the advanced setting are allowed.
Exclusion criteria: (For all patients unless otherwise specified)
- Patients with a history or presence of interstitial lung disease (ILD) or interstitial pneumonitis, including clinically significant radiation pneumonitis (i.e. affecting activities of daily living or requiring therapeutic intervention)
- Presence or history of another malignancy
- Undergone a bone marrow or solid organ transplant
- Known history of human immunodeficiency virus (HIV) seropositivity
- Patients receiving concomitant immunosuppressive agents or chronic corticosteroids use at the time of study entry except for control of brain metastases, topical applications, inhaled sprays, eye drops or local injections
- Patients with clinically significant, uncontrolled heart disease
- Any prior therapies ≤ 4 weeks prior to the first dose of study treatment
- Patients who are receiving treatment with medications that are known to be strong inhibitors or inducers of CYP3A4/5 and cannot be discontinued 1 week prior to the start of EGF816 treatment and for the duration of the study.
- Patients who have impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of EGF816
- Patients who are receiving treatment with any enzyme-inducing anticonvulsant that cannot be discontinued at least 1 week before first dose of study treatment, and for the duration of the study
- Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception
- Sexually active males unless they use a condom during intercourse while taking drug and for 3 months after stopping treatment
Other protocol-defined inclusion and exclusion criteria may apply.
Data sourced from ClinicalTrials.gov (NCT02108964). 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.