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Phase II Study for Previously Untreated Subjects With Non Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC)

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ClinicalTrials.gov Identifier: NCT00527735
Recruitment Status : Completed
First Posted : September 11, 2007
Results First Posted : July 16, 2012
Last Update Posted : July 16, 2012
Sponsor:
Information provided by (Responsible Party):
Bristol-Myers Squibb

Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Double (Participant, Investigator);   Primary Purpose: Treatment
Conditions: Lung Cancer
Small Cell Lung Cancer
Carcinoma, Non-Small-Cell Lung
Interventions: Drug: Ipilimumab
Drug: Placebo
Drug: Paclitaxel
Drug: Carboplatin

  Participant Flow

Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
No text entered.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Of 334 participants enrolled in this study, 331 received treatment. One patient with nonsmall-cell lung cancer, randomized to the sequential arm but mistakenly treated with concurrent therapy, is included in the sequential arm for efficacy results and in the concurrent arm for safety results.

Reporting Groups
  Description
Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin on a 3-week schedule. The initial 4 doses consisted of active ipilimumab with paclitaxel/carboplatin, and the last 2 doses consisted of placebo ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered intravenously (IV) as a single dose over 90 minutes. Participants who did not progress and did not experience intolerable toxicity during the treatment phase were allowed to continue in the maintenance phase, receiving additional (blinded) ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until progressive disease (PD), drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Ipilimumab + Paclitaxel/Carboplatin (Sequential) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin on a 3-week schedule. The initial 2 doses consisted placebo ipilimumab with paclitaxel/carboplatin followed by 4 doses of active ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered IV as a single dose over 90 minutes. Participants who did not progress and did not experience intolerable toxicity during the treatment phase were allowed to continue in the maintenance phase, receiving additional (blinded) ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until PD, drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Placebo + Paclitaxel/Carboplatin During induction, participants received up to 6 doses of placebo ipilimumab with paclitaxel/carboplatin every 3 weeks. Matched placebo for ipilimumab was administered as a single dose IV over 90 minutes every 3 weeks (up to 6 doses) as part of induction. Participants who did not progress or experience intolerable toxicity during the treatment phase could continue in the maintenance phase, receiving maintenance placebo administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose.

Participant Flow:   Overall Study
    Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent)   Ipilimumab + Paclitaxel/Carboplatin (Sequential)   Placebo + Paclitaxel/Carboplatin
STARTED   113 [1]   109 [1]   109 [1] 
COMPLETED   5 [2]   2 [2]   2 [2] 
NOT COMPLETED   108   107   107 
Disease progression                47                61                53 
Death                23                13                15 
Completed treatment in treatment phase                14                13                18 
Adverse Event                10                6                7 
Not identified                5                5                5 
Withdrawal by Subject                5                4                3 
No longer met study criteria                2                2                1 
Lost to Follow-up                0                0                3 
Poor compliance or noncompliance                0                1                1 
Completed treatment during maintenance                2                2                1 
[1] Treated
[2] Still on treatment



  Baseline Characteristics

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin (concurrent). The initial 4 doses consisted of active ipilimumab with paclitaxel/carboplatin, and the last 2 doses consisted of placebo ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered intravenously (IV) as a single dose over 90 minutes every 3 weeks. Participants who experienced clinical benefit on treatment phase without intolerable toxicity were allowed to continue in the maintenance phase, receiving additional ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until immune-related progressive disease (irPD), drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Placebo/Ipilimumab + Paclitaxel/Carboplatin (Sequential) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin (sequential). The initial 2 doses consisted placebo ipilimumab with paclitaxel/carboplatin followed by 4 doses of active ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered IV as a single dose over 90 minutes every 3 weeks. Participants who experienced clinical benefit on treatment phase without intolerable toxicity were allowed to continue in the maintenance phase, receiving additional ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until irPD, drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Placebo + Paclitaxel/Carboplatin During induction, participants received up to 6 doses of placebo ipilimumab with paclitaxel/carboplatin. Matched placebo for ipilimumab was administered as a single dose IV over 90 minutes every 3 weeks (up to 6 doses) as part of induction. Participants who experienced clinical benefit on treatment phase without intolerable toxicity could continue in the maintenance phase, receiving maintenance placebo administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose.
Total Total of all reporting groups

Baseline Measures
   Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent)   Placebo/Ipilimumab + Paclitaxel/Carboplatin (Sequential)   Placebo + Paclitaxel/Carboplatin   Total 
Overall Participants Analyzed 
[Units: Participants]
 		 113   110   111   334 
Age, Customized [1] 
[Units: Participants]
 		       
Younger than 65 years   79   73   76   228 
65 years and older   34   37   35   106 
[1] Age of participants who received treatment.
Gender 
[Units: Participants]
 		       
Female   27   29   29   85 
Male   86   81   82   249 
Age Customized, by Disease Type [1] 
[Units: Participants]
 		       
Younger than 65 years (NSCLC patients)   44   44   40   128 
65 years and older (NSCLC patients)   26   24   26   76 
Younger than 65 years (SCLC patients)   35   29   36   100 
65 years and older (SCLC patients)   8   13   9   30 
[1] NSCLC=nonsmall-cell lung cancer; SCLC=small-cell lung cancer
Gender, by Disease Type [1] 
[Units: Participants]
 		       
Female (NSCLC patients)   17   19   17   53 
Male (NSCLC patients)   53   49   49   151 
Female (SCLC patients)   10   10   12   32 
Male (SCLC patients)   33   32   33   98 
[1] NSCLC=nonsmall-cell lung cancer; SCLC=small-cell lung cancer
Disease Stage at Study Entry [1] 
[Units: Participants]
 		       
Stage IIIB (NSCLC patients)   11   7   17   35 
Stage IV (NSCLC patients)   59   61   49   169 
Extensive (SCLC patients)   43   42   44   129 
Recurrent disease (SCLC patients)   0   0   1   1 
[1] NSCLC=nonsmall-cell lung cancer; SCLC=small-cell lung cancer. Staging of NSCLC is based on the findings of several clinical tests, including magnetic resonance imaging scans and fine needle biopsy. Stages range from 1 (best prognosis) to IV (worst prognosis). Stage I cancer is confined to the lung. Stages II and III cancers are locally advanced. Stage IV cancer has spread outside the lung to other organs. SCLC is staged using a 2-tiered system: Limited stage SCLC is confined to its area of origin in the lung and lumph nodes. Extensive-stage SCLC has spread beyond the lung to other organs.
Cell Type [1] 
[Units: Participants]
 		       
Adenocarcinoma (NSCLC patients)   35   30   38   103 
Bronchoalveolar carcinoma (NSCLC patients)   1   1   0   2 
Large-cell carcinoma (NSCLC patients)   6   11   7   24 
Other (NSCLC patients)   6   4   3   13 
Squamous-cell carcinoma (NSCLC patients)   21   21   15   57 
Unknown (NSCLC patients)   1   1   3   5 
Other (SCLC patients)   2   2   0   4 
Small-cell carcinoma (SCLC patients)   41   38   45   124 
Unknown (SCLC patients)   0   1   0   1 
Not reported (SCLC patients)   0   1   0   1 
[1] NSCLC=nonsmall-cell lung cancer; SCLC=small-cell lung cancer


  Outcome Measures

1.  Primary:   Immune-related Progression-free Survival (irPFS) in Participants With Nonsmall-cell Lung Cancer (NSCLC) Per Immune-related Response Criteria (irRC)   [ Time Frame: Tumor assessed at screening, every 6 weeks on treatment to Week 24, and every 12 weeks on maintenance until immune-related Progressive Disease (irPD) or death (of censored, maximum reached: 16.5 months) ]
  Show Outcome Measure 1

2.  Secondary:   Progression-free Survival (PFS) in Participants With NSCLC Per Modified World Health Organization (mWHO) Criteria   [ Time Frame: Randomization date to date of progression or death (of censored, maximum reached: 13.6 months) ]
  Show Outcome Measure 2

3.  Secondary:   Overall Survival in Participants With NSCLC   [ Time Frame: Randomization date to date of death (of censored, maximum reached: 26.5 months) ]
  Show Outcome Measure 3

4.  Secondary:   Best Overall Response Rate (BORR) Per mWHO Criteria in Participants With NSCLC and SCLC   [ Time Frame: Tumor assessment at screening, every 6 weeks on treatment to Week 24, and every 12 weeks on maintenance ]
  Show Outcome Measure 4

5.  Secondary:   Immune-related Best Overall Response Rate (irBORR) Per irRC in Participants With NSCLC and Small-cell Lung Cancer (SCLC)   [ Time Frame: Tumor assessment at screening, every 6 weeks on treatment to Week 24, and every 12 weeks on maintenance ]
  Show Outcome Measure 5

6.  Secondary:   Immune-related Disease Control Rate (irDCR) Per irRC and Disease Control Rate (DCR) Per mWHO Criteria in Participants With NSCLC and SCLC   [ Time Frame: Tumor assessment at screening, every 6 weeks on treatment to Week 24, and every 12 weeks on maintenance until irPD, progressive disease, or death (maximum reached: 22 months) ]
  Show Outcome Measure 6

7.  Secondary:   Immune-related Duration of Response (irDoR) Per irRC and DoR Per mWHO Criteria in Participants With NSCLC and SCLC   [ Time Frame: Date of irCR or irPR to date of irPD or death (maximum reached: 14.2 months) ]
  Show Outcome Measure 7

8.  Secondary:   Number of Participants With NSCLC Who Have Death as Outcome, Serious Adverse Events (SAEs), Drug-related SAEs, Adverse Events (AEs), AEs Leading to Discontinuation, and Drug-related AEs by Worst Common Terminology Criteria (CTC) Grade   [ Time Frame: Weeks 4, 7, 10, 16, 19, and 24; at end of treatment; and at follow-up (70 days from last dose) ]
  Show Outcome Measure 8

9.  Secondary:   Percentage of Participants With NSCLC Who Have Abnormalities in On-study Hematology Laboratory Test Results by Worst CTC Grade   [ Time Frame: At screening; predose Day 1; and Weeks 4, 7, 10, 13, 16, 19, and 24; and every 12 weeks on maintenance until disease progression, study closure, or withdrawal of consent ]
  Show Outcome Measure 9

10.  Secondary:   irPFS in Participants With SCLC Per irRC   [ Time Frame: Randomization date to date of irPD or death (maximum reached: 22 months) ]
  Show Outcome Measure 10

11.  Secondary:   Number of Participants With NSCLC Who Have Abnormalities in On-Study Liver Function Test Results By Worst CTC Grade   [ Time Frame: At screening; predose Day 1; Weeks 4, 7, 10, 13, 16, 19, and 24; and every 12 weeks on maintenance until disease progression, study closure, or withdrawal of consent ]
  Show Outcome Measure 11

12.  Secondary:   Number of Participants With NSCLC Who Had Abnormalities in Vital Sign Measurements and Physical Examination Findings   [ Time Frame: At screening; Day 1; Weeks 4, 7, 10, 13, 16, and 24; and every 12 weeks on maintenance until disease progression, study closure, or withdrawal of consent ]
  Show Outcome Measure 12

13.  Secondary:   Percentage of Participants With NSCLC Who Have Abnormalities in Pancreatic Enzyme Clinical Laboratory Test Results by Worst CTC Grade   [ Time Frame: At screening; predose Day 1; Weeks 4, 7, 10, 13, 16, 19, and 24; and at end of treatment ]
  Show Outcome Measure 13

14.  Secondary:   Number of Participants With NSCLC Who Have Positive Human Antihuman Antibody (HAHA) Status Postbaseline   [ Time Frame: Day 1; Weeks 4, 7, 10, 13, 16, 19, and 24; and at end of treatment ]
  Show Outcome Measure 14

15.  Secondary:   Number of Participants With SCLC With Death as Outcome, Serious Adverse Events (SAEs), Drug-related SAEs, Adverse Events (AEs), AEs Leading to Discontinuation, Drug-related AEs by Worst CTC Grade   [ Time Frame: Weeks 4, 7, 10, 16, 19, and 24; at end of treatment; and at follow-up (70 days from last dose) ]
  Show Outcome Measure 15

16.  Secondary:   Number of Participants With SCLC Who Have Abnormalities in On-study Hematology Laboratory Test Results by Worst CTC Grade   [ Time Frame: At screening, predose Day 1, and Weeks 4, 7, 10, 13, 16, 19, 24, and at end of treatment ]
  Hide Outcome Measure 16

Measure Type Secondary
Measure Title Number of Participants With SCLC Who Have Abnormalities in On-study Hematology Laboratory Test Results by Worst CTC Grade
Measure Description CTC, Version 3 used to assess parameters. LLN=lower limit of normal. CTC criteria: ANC=absolute neutrophil count. White blood cells Gr 1:<LLN to 3.0*10^9/L, Gr 2:<3.0 to 2.0*10^9/L, Gr 3:<2.0 to 1.0*10^9/L, Gr 4:<1.0*10^9/L. ANC Gr 1:<LLN to 1.5*10^9/L, Gr 2:<1.5 to 1.0*10^9/L, Gr 3:<1.0 to 0.5*10^9/L, Gr 4:<0.5*10^9/L. Platelet count Gr 1:LLN to 75.0*10^9/L, Gr 2:<75.0 to 50.0*10^9/L, Gr 3:<50.0 to 25.0*10^9/L, Gr 4:<25.0 to 10^9/L. Hemoglobin Gr 1:<LLN to 10.0 g/dL, Gr 2:<10.0 to 8.0 g/dL, Gr 3:<8.0 to 6.5 g/dL, Gr 4:<6.5 g/dL.
Time Frame At screening, predose Day 1, and Weeks 4, 7, 10, 13, 16, 19, 24, and at end of treatment  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
All participants with SCLC who received at least 1 dose of ipilimumab and/or chemotherapy and had at least 1 on-study hematology test result available.

Reporting Groups
  Description
Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin on a 3-week schedule. The initial 4 doses consisted of active ipilimumab with paclitaxel/carboplatin, and the last 2 doses consisted of placebo ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered IV as a single dose over 90 minutes. Participants who did not progress or experience intolerable toxicity during the treatment phase were allowed to continue in the maintenance phase, receiving additional (blinded) ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until irPD, drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Placebo/Ipilimumab + Paclitaxel/Carboplatin (Sequential) During induction, participants received up to 6 doses of blinded ipilimumab with paclitaxel/carboplatin on a 3-week schedule. The initial 2 doses consisted placebo ipilimumab with paclitaxel/carboplatin followed by 4 doses of active ipilimumab with paclitaxel/carboplatin. Ipilimumab, 10 mg/kg, was administered IV as a single dose over 90 minutes. Participants who did not progress or experience intolerable toxicity during the treatment phase were allowed to continue in the maintenance phase, receiving additional (blinded) ipilimumab at a dose of 10 mg/kg administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose until PD, drug intolerance, withdrawal of consent, pregnancy, death, loss to follow up, or study closure.
Placebo + Paclitaxel/Carboplatin During induction, participants received up to 6 doses of placebo ipilimumab with paclitaxel/carboplatin every 3 weeks. Matched placebo for ipilimumab was administered as a single dose IV over 90 minutes every 3 weeks (up to 6 doses) as part of induction. Participants who did not progress or experience intolerable toxicity during the treatment phase could continue in the maintenance phase, receiving maintenance placebo administered IV over 90 minutes every 12 weeks starting 24 weeks after the first dose.

Measured Values
   Ipilimumab/Placebo + Paclitaxil/Carboplatin (Concurrent)   Placebo/Ipilimumab + Paclitaxel/Carboplatin (Sequential)   Placebo + Paclitaxel/Carboplatin 
Participants Analyzed 
[Units: Participants]
 		 42   42   44 
Number of Participants With SCLC Who Have Abnormalities in On-study Hematology Laboratory Test Results by Worst CTC Grade 
[Units: Participants]
 		     
White blood cells, Grade 1 (n=39, 42, 43)   7   11   13 
White blood cells, Grade 2 (n= 39, 42, 43)   10   9   7 
White blood cells, Grades 3 (n= 39, 42, 43)   0   2   0 
White blood cells, Grade 4 (n= 39, 42, 43)   0   0   0 
Absolute neutrophil count, Grade 1 (n= 39, 42, 43)   8   8   8 
Absolute neutrophil count, Grade 2 (n= 39, 42, 43)   8   9   91 
Absolute neutrophil count, Grade 3 (n= 39, 42, 43)   2   2   1 
Absolute neutrophil count, Grade 4 (n= 39, 42, 43)   1   2   0 
Platelet count, Grade 1 (n= 39, 42, 43)   15   18   23 
Platelet count, Grade 2 (n= 39, 42, 43)   2   3   3 
Platelet count, Grade 3 (n= 39, 42, 43)   1   2   1 
Platelet count, Grade 4 (n= 39, 42, 43)   0   1   0 
Hemoglobin, Grade 1 (n= 39, 42, 43)   26   24   25 
Hemoglobin, Grade 2 (n= 39, 42, 43)   8   10   11 
Hemoglobin, Grade 3 (n= 39, 42, 43)   2   2   3 
Hemoglobin, Grade 4 (n= 39, 42, 43)   0   2   0 

No statistical analysis provided for Number of Participants With SCLC Who Have Abnormalities in On-study Hematology Laboratory Test Results by Worst CTC Grade



17.  Secondary:   Number of Participants With SCLC Who Have Abnormalities in Liver Function Test Results by Worst CTC Grade   [ Time Frame: At screening; predose Day 1; Weeks 4, 7, 10, 13, 16, 19, and 24; and at end of treatment ]
  Show Outcome Measure 17

18.  Secondary:   Percentage of Participants With SCLC Who Have Abnormalities in Pancreatic Enzyme and Other Clinical Laboratory Test Results by Worst CTC Grade   [ Time Frame: At screening, predose Day 1, and Weeks 4, 7, 10, 13, 16, 19, 24, and at end of treatment ]
  Show Outcome Measure 18

19.  Secondary:   Progression-free Survival (PFS) in Participants With SCLC Per mWHO Criteria   [ Time Frame: Randomization date to date of progression or death (of censored, maximum reached: 22 months) ]
  Show Outcome Measure 19

20.  Secondary:   Number of Participants With SCLC Who Had Abnormalities in Vital Sign Measurements and Physical Examination Findings   [ Time Frame: Predose Day 1; Weeks 4, 7, 10, 13, 16, and 24; and every 12 weeks on maintenance until end of treatment ]
  Show Outcome Measure 20

21.  Secondary:   Number of Participants With SCLC Who Have Positive HAHA Status Postbaseline   [ Time Frame: Day 1; Weeks 4, 7, 10, 13, 16, 19, and 24; and at end of treatment ]
  Show Outcome Measure 21

22.  Secondary:   Overall Survival in Participants With SCLC   [ Time Frame: Randomization date to date of death (of censored, maximum reached: 22 months) ]
  Show Outcome Measure 22


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.


  More Information