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A Study Comparing AC0010 and Chemotherapy in Patients With Advanced NSCLC Who Have Progressed Following Prior EGFR TKI

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ClinicalTrials.gov Identifier: NCT03058094
Recruitment Status : Withdrawn (Considiering to change the Chemotherapy into Gefitinib)
First Posted : February 20, 2017
Last Update Posted : February 4, 2019
Sponsor:
Collaborator:
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Information provided by (Responsible Party):
Hangzhou ACEA Pharmaceutical Research Co., Ltd.

Brief Summary:
A Phase III, Open-Label, Randomized Multicenter Study to Compare AC0010 and Pemetrexed/Cisplatin in Patients With Advanced NSCLC Who Have Progressed Following Prior EGFR TKI.

Condition or disease Intervention/treatment Phase
NSCLC Drug: Pemetrexed Drug: Cisplatin 75mg/m2 Drug: AC0010 Phase 3

Detailed Description:

This is a phase III, open label, randomized study assessing AC0010 (300 mg, BID) versus pemetrexed/cisplatin (4-6 cycles) in patients with advanced NSCLC, who have progressed following prior therapy with EGFR-TKI.

Patients must provide a biopsy for central confirmation of T790M mutation positive. Eligible patients will be randomized (2:1) into AC0010 group or pemetrexed/cisplatin group. Patients in chemotherapy group can cross-over to AC0010 treatment when patients experience disease progression or intolerability of chemotherapy. The primary objective of the study is to compare the PFS of AC0010 and pemetrexed/cisplatin.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase III, Open-Label, Randomized Multicenter Study to Compare AC0010 and Pemetrexed/Cisplatin in Patients With Advanced NSCLC Who Have Progressed Following Prior EGFR TKI
Estimated Study Start Date : December 2018
Estimated Primary Completion Date : December 2019
Estimated Study Completion Date : January 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: AC0010
AC0010, 300mg, orally, BID with a 21-day cycle
Drug: AC0010
300mg, orally, BID
Other Name: AC0010MA

Active Comparator: Chemotherapy
pemetrexed 500 mg/m2 + cisplatin 75 mg/m2 on day one of 21-day cycle, with total of 4-6 cycles.
Drug: Pemetrexed
Pemetrexed will be administered as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle. Folic acid will be administered 1-2 weeks prior to the 1st dose, then daily during the treatment period until 21days post the last dose. Vitamin B12 will be administered on the same day of pemetrexed infusion during the treatment period. Corticosteroid will be adminstered on the day prior to, on the day, and on the day after infusion.
Other Name: Alimta

Drug: Cisplatin 75mg/m2
Cisplatin will be administered as an intravenous infusion.
Other Name: cis-platinum




Primary Outcome Measures :
  1. Progression-Free Survival (PFS) [ Time Frame: From the date of randomization until the date of first documented progression or the date of death from any cause, whichever came first, assessed up to 24 months. ]
    To assess the Progression-Free Survival (PFS) of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).


Secondary Outcome Measures :
  1. Objective Response Rate (ORR) [ Time Frame: Baseline up to 28 days after completion of study drug, assessed up to 24 months. ]
    To assess the overall objective response rate (ORR) of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).

  2. Duration of Response (DoR) [ Time Frame: From occurring of CR or PR until progression or the date of death from any cause, whichever came first, assessed up to 24 months. ]
    To assess the overall objective response rate (ORR) of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).

  3. Disease Control Rate (DCR) [ Time Frame: From the date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 24 months. ]
    To assess the Disease Control Rate (DCR) of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).

  4. Overall Survival (OS) [ Time Frame: From the date of randomization to death or end of study, which is assessed up to 36 months. ]
    To assess the Overall Survival (OS) of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).

  5. Patient Reported Outcomes by EORTC QLQ-C30 Questionnaire [ Time Frame: Baseline up to 28 days after completion of study drug, assessed up to 24 months. ]
    To assess the safety of AC0010 in EGFR T790M mutation-positive patients with advanced non-small cell lung cancer (NSCLC).


Other Outcome Measures:
  1. Incidence of toxicity, grading with CTCAE 4.03 [ Time Frame: From the date of randomization until end of treatment,which is assessed up to 24 months ]
    Clinical chemistry, hematology, urinalysis, vital signs, physical examination, weight, ECG and ECOG Performance status and adverse event will be used to assess safety endpoints.



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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male or female, aged between 18-75 years old.
  2. Histological or cytological confirmed diagnosis of locally or metastatic NSCLC (stage IIIB/IV).
  3. Locally advanced or metastatic NSCLC, not amenable to curative surgery or radiotherapy.
  4. Radiological proven disease progression while on first generation EGFR TKIs.
  5. At least one measurable disease according to RECIST 1.1.
  6. Confirmation of tumor EGFR sensitive mutation positive in previous tumor samples, including G719X, exon 19 deletion, L858R, L861Q.
  7. Confirmation of tumor harboring of T790M mutation by central lab with a biopsy sample taken after failure of first generation EGFR TKIs.
  8. Adequate organ function:

    • Bone marrow reserve: Absolute neutrophil count ≥1.5 ´ 109/L,. Platelet count ≥100´ 109/L , Hemoglobin≥9 g/dL
    • Liver function: Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) ≤2.5 × the upper limit of normal (ULN) or <5 times ULN in the presence of liver metastases; Total bilirubin ≤1.5 × ULN
    • Kidney function: Creatinine ≤1.5 × ULN
  9. Anti-cancer treatment prior to EGFR TKIs including chemotherapy, radiotherapy and other anti-cancer drugs for advanced stage is not allowed.
  10. Resolved toxicities from prior therapy less than CTCAE grade 1 (except alopecia) and minimum 7 days of washout period from previous erlotinib, gefitinib or icotinib.
  11. ECOG performance status 0 to1.
  12. Life expectancy more than 3 months.
  13. Patients without CNS metastases or asymptomatic patients with brain metastases. End of local therapy for brain metastases, including radiotherapy and surgery is required ≥28 days prior to beginning of screening.
  14. Provision of signed informed consent.

Exclusion Criteria:

  1. Undiagnosed by pathology.
  2. HCV antibody positive, active hepatitis B (hepatitis B virus carrier can be recruited)
  3. HIV antibody positive, other acquired immunodeficiency disease and congenital immunodeficiency disease. Patients with organ transplantation.
  4. Patients received new aided/aided system therapy with palindromia in 12 months, the new aided/aieded system therapy is considered to be previous first-line treatment.
  5. Condition of organ system:

    • Large field radiation or radiation field covered more than 30% bone marrow within 4 weeks of enrollment.
    • A past history of interstitial lung disease, drug-induced interstitial lung disease or other active interstitial lung disease with clinical proof
    • Idiopathic pulmonary fibrosis (IPF).
    • In the investigator opinion, any severe or uncontrolled disease, such as unstable or uncontrolled respiratory, cardiovascular, liver or kidney diseases.
    • Any unstable system disease including refractory hypertension, unstable angina pectoris, congestive heart-failure, liver and renal disease, metabolic disease.
    • Patients with other malignant tumor in 5 years (except cured cervical carcinoma in situ, Basal cell carcinomas, squamous cell carcinoma)
    • A past history of neurological disorder or mental disorder including epilepsy and dementia.
    • Patients with chronic gastrointestinal diseases, inability to swallow medication, malabsorption syndrome or previous significant bowel resection that would preclude adequate absorption of AC0010.
  6. Uncontrolled pleural and pericardial effusion.
  7. Patients who have used high-dose glucocorticoids or other immunosuppressive agents within 1 month prior to screening.
  8. Patient with symptomatic CNS metastases.
  9. Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction within 6 months, heart block with second degree or greater, QTcB > 430ms(male)or > 450ms(female).
  10. Patients receiving medication known to prolong QT interval and potent inducers and inhibitors of CYP3A4 within 4 weeks of fist dose of AC0010.
  11. Patients prove 1ml plasma to site's central lab after signing informed consent and the test results show the medication of AZD9291.
  12. Patients who have been registered and received the study treatment or withdrawn from the study cannot be enrolled.
  13. Patients receive unrelated surgery more than 14 days prior to the screening.
  14. Pregnant and lactating women.
  15. Women with childbearing potential are defined as all women who are physiologically able to have a pregnancy, unless they are using an efficient contraceptive method during treatment and within 7 days after discontinuation of treatment.
  16. Men who have sexual intercourse unless they use a condom during sexual intercourse during treatment and 7 days after discontinuation of treatment and do not impregnate their sexual partners during the period. Vasectomized males are also required to use condoms to prevent the transmission of drugs through semen.
  17. Patients who are considered by the investigator as inappropriate to participate in the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03058094


Locations
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China, Beijing
Beijing Cancer Hospital
Beijing, Beijing, China, 100000
Chinese General PLA Hospital
Beijing, Beijing, China, 100000
Peking Union Medical College Hospital
Beijing, Beijing, China, 100000
China, Chongqing
Xinqiao Hospital Army Medical University
Chongqing, Chongqing, China, 400000
China, Fujian
Fujian Cancer Hospital
Fuzhou, Fujian, China, 350000
Fuzhou General Hospital of Nanjing Military Command
Fuzhou, Fujian, China, 350000
China, Hebei
Tumor Hospital of Hebei Province
Shijiazhuang, Hebei, China, 050000
China, Heilongjiang
Harbin Medical University Cancer Hospital
Harbin, Heilongjiang, China, 150000
China, Henan
Henan Cancer Hospital
Zhengzhou, Henan, China, 450000
China, Jiangsu
Jiangsu Province Hospital
Nanjing, Jiangsu, China, 210000
Nanjing General Hospital
Nanjing, Jiangsu, China, 210000
China, Liaoning
The First Affiliated Hospital of Dalian Medical University
Dalian, Liaoning, China, 116000
The second Hospital of Dalian Medical University
Dalian, Liaoning, China, 116000
The First Affiliated Hospital of China Medical University
Shenyang, Liaoning, China, 110000
China, Shanghai
Fudan University Shanghai Cancer Center
Shanghai, Shanghai, China, 200000
China, Sichuan
Sichuan Cancer Hospital & Institute
Chengdu, Sichuan, China, 610000
West China Hospital,Sichuan University
Chengdu, Sichuan, China, 610000
China, Tianjin
Tianjin Medical University Cancer Institute & Hospital
Tianjin, Tianjin, China, 300000
China, Zhejiang
The First Affiliated Hospital,Zhejiang University
Hangzhou, Zhejiang, China, 310000
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, China, 310000
China
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Beijing, China, 100021
Sponsors and Collaborators
Hangzhou ACEA Pharmaceutical Research Co., Ltd.
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Investigators
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Principal Investigator: Yuankai Shi, MD. Cancer Institute and Hospital, Chinese Academy of Medical Sciences

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Responsible Party: Hangzhou ACEA Pharmaceutical Research Co., Ltd.
ClinicalTrials.gov Identifier: NCT03058094     History of Changes
Other Study ID Numbers: AEGIS2:AC201602AVTN04
First Posted: February 20, 2017    Key Record Dates
Last Update Posted: February 4, 2019
Last Verified: January 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No

Additional relevant MeSH terms:
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Cisplatin
Pemetrexed
Antineoplastic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors