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Pulmonary DiseasesPhase 2NCT00284141

Study of AVE0005 (VEGF Trap) in Locally Advanced or Metastatic Platinum- and Erlotinib- Resistant Non-small-cell-lung Adenocarcinoma

A Phase 2 study testing Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®) in people with Pulmonary Diseases and Neoplasms, Lung, run by Sanofi at 3 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study evaluated the efficacy and safety of aflibercept in the treatment of participants with advanced chemoresistant non-small cell lung adenocarcinoma (NSCLA). Primary objective: To determine the overall objective response rate (ORR) of AVE0005 (ziv-aflibercept, aflibercept, VEGF trap, ZALTRAP®) 4.0 mg/kg… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pulmonary Diseases, Neoplasms, Lung
What is being tested?
Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
98 participants
Where
3 sitesin 3 countries
Study dates
Jan 2006to Jul 2008
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed non-small-cell lung adenocarcinoma that is locally advanced or metastatic
  • Prior treatment with at least 2 cancer drug regimens in the advanced disease setting
  • Platinum- and erlotinib-resistant disease defined by relapse or progression during or after treatment
  • Measurable disease by RECIST criteria
  • ECOG Performance status less than or equal to 2
  • Resolution of any toxic effects of prior therapy
Show all 9Show fewer
  • Adequate organ and bone marrow function
  • Female patients must be post-menopausal, surgically sterile or using effective contraception
  • Willing and able to comply with study procedures and sign informed consent

Who cannot join

  • Diagnosis of squamous-cell lung cancer or any second malignancy within the last 5 years (except for adequately treated basal cell or squamous cell skin cancer or in situ carcinoma of the cervix uteri)
  • Prior treatment with a VEGF or VEGF receptor inhibitor with the exception of bevacizumab (Avastin-TM)
  • Anticipation of a need for major surgical procedure
  • Treatment with chemotherapy, radiotherapy, surgery, blood products, or an investigational agent within 3 weeks (6 weeks for nitrosoureas, mitomycin C, immunotherapy, or cytokine therapy) of study enrollment
  • Uncontrolled hypertension
  • Any severe or acute medical or psychiatric problem within the past 6 months requiring further investigation or that may cause undue risk for the patient's safety
Show all 10Show fewer
  • History of brain metastases, spinal cord compression, or carcinomatous meningitis, or new evidence of brain or leptomeningeal disease
  • Active infection or on antiretroviral therapy for HIV disease
  • Pregnant or breast-feeding
  • The above information is not intended to contain all considerations relevant to potential participation in a clinical trial.

Trial locations and contacts

3 sites in 3 countries.

3 sites in 3 countries

United States1 site
  • Sanofi-Aventis Administrative Office

    Bridgewater, New Jersey, 08807

Other trials in United States

Canada1 site
  • Sanofi-Aventis Administrative Office

    Laval

Other trials in Canada

France1 site
  • Sanofi-Aventis Administrative Office

    Paris

Other trials in France

About this study

Official title: A Multicenter, Open-label, Single-arm, Two-stage Study of the Efficacy and Safety of AVE0005 (VEGF Trap) Administered Intravenously Every 2 Weeks in Patients With Platinum- and Erlotinib-resistant Locally Advanced or Metastatic Non-small-cell Lung Adenocarcinoma

This study evaluated the efficacy and safety of aflibercept in the treatment of participants with advanced chemoresistant non-small cell lung adenocarcinoma (NSCLA).

Primary objective:

Read more
  • To determine the overall objective response rate (ORR) of AVE0005 (ziv-aflibercept, aflibercept, VEGF trap, ZALTRAP®) 4.0 mg/kg intravenously (IV) every 2 weeks in participants with platinum- and erlotinib-resistant, locally advanced or metastatic NSCLA.

Secondary objective:

  • To assess duration of response (DR), progression-free survival (PFS), and overall survival (OS) in this participant population
  • To evaluate the safety profile of IV AVE0005 (ziv-aflibercept, aflibercept, VEGF trap, ZALTRAP®).

This study employed an Independent Review Committee (IRC) for radiological tumor assessments. For all tumor assessment-related efficacy variables, two analyses were performed: the primary analysis was based on Independent Review Committee (IRC) reviewed data and the secondary analysis was based on Investigator evaluation.

In addition, both Response Evaluation Criteria In Solid Tumors (RECIST) and Modified Response Evaluation Criteria In Solid Tumors (mRECIST) were used to assess tumors. Where as RECIST criteria only consider the longest diameter of the tumors for calculations pertaining to changes in tumor size, mRECIST assessments also account for the differences in the cavities of lesions observed in non-small-cell lung cancer (NSCLC). Responses based on RECIST and mRECIST are reported.

Read the detailed description

The study included :

  • A screening phase up to 21 days followed by registration
  • Treatment initiation within 5 working days of registration
  • A treatment phase with 14-day study treatment cycles until a study withdrawal criterion was met or up to the clinical database cut-off date (18 July 2008)
  • A follow-up phase - up to 60 days after end of treatment

Withdrawal criteria that led to treatment discontinuation were:

  • The participant or their legally authorized representative requested to withdraw
  • In the investigator's opinion, continuation of the study would be detrimental to the participant's well being, due to reasons such as disease progression, unacceptable toxicity, noncompliance, or logistical considerations.
  • A specific request by the Sponsor
  • Participant had intercurrent illness that prevented further administration of study treatment
  • Participant had more than 2 aflibercept dose reductions
  • Participant had arterial thromboembolic events, including cerebrovascular accidents, myocardial infarctions, transient ischemic attacks, new onset or worsening of pre-existing angina
  • Participant had radiographic evidence of intestinal obstruction (e.g., dilated loops of bowel accompanied by air-fluid levels) or gastrointestinal perforation (e.g., presence of extraluminal gas) requiring surgical intervention
  • Participant was lost to follow-up

After discontinuing treatment, participants remained on the study until the last post-treatment visit or until recovery of drug related toxicities, whichever was later.

Being tested
Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®)
Keywords
lung, cancer, non-small-cell lung cancer, metastatic, carcinoma, lung neoplasm, lung diseases, angiogenesis, anti-angiogenesis, anti-angiogenesis inhibitors, cancer and other neoplasms, respiratory tract, (lung and bronchial) diseases
Medical subject headings
Lung Diseases, Lung Neoplasms, Neoplasms, Carcinoma, Non-Small-Cell Lung, Neoplasm Metastasis, Carcinoma, Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®)Drug

    Aflibercept 4.0 mg/kg administered intravenously (IV) over a period of at least 1 hour once every 2 weeks.

    Aflibercept could be reduced by 1 dose level (to 3.0 mg/kg) or 2 dose levels (to 2.0 mg/kg) in case of uncontrolled hypertension or urinary protein >3.5 g/24 hours. Intrapatient dose escalation was not to be permitted. Participants requiring more than 2 dose level reductions would be withdrawn from study treatment.

Study groups in NCT00284141
Study groupRoleWhat they receive
aflibercept 4.0 mg/kgExperimentalParticipants with metastatic non-small-cell lung adenocarcinoma administered 4.0 mg/kg Aflibercept every 2 weeks until a study withdrawal criterion was met.
Receives: Drug: Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Confirmed Objective Response (OR) Based Upon Modified Response Evaluation Criteria in Solid Tumors (RECIST) Assessed by the Independent Review Committee (IRC).

    OR was either complete response (CR) or partial response (PR) based on RECIST or modified RECIST. CR was the disappearance of all target/nor-target lesions; and PR was at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, with reference to the baseline sum LD (According to modified RECIST, to calculate LD for cavitated lesions, the longest cavitation diameters were subtracted from the LD of cavitated target lesions).

    Assessments were made by the IRC, and confirmed by repeat tumor imaging 4-6 weeks after documentation of the initial response.

    Measured: up to 2.5 years from initial treatment

  2. Confirmed Objective Response Based Upon Modified Response Evaluation Criteria in Solid Tumors (RECIST) Assessed by the Investigator.

    OR was either complete response (CR) or partial response (PR) based on RECIST or modified RECIST. CR was the disappearance of all target/nor-target lesions; and PR was at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, with reference to the baseline sum LD (According to modified RECIST, to calculate LD for cavitated lesions, the longest cavitation diameters were subtracted from the LD of cavitated target lesions).

    Assessments were made by the Investigator, and confirmed by repeat tumor imaging 4-6 weeks after documentation of the initial response.

    Measured: up to 2.5 years from initial treatment

Secondary outcomes (10)
  1. Duration of Response (DR)

    DR was the time interval from the first complete response (CR) or partial response (PR) to the date of tumor progression or death from any cause, whichever was earlier. The duration of response was calculated only for those participants who achieved CR or PR.

    Measured: up to 2.5 years from initial treatment

  2. Progression-free Survival (PFS) Time Assessed by the Independent Review Committee (IRC)

    PFS time was interval from the date of registration to the date of tumor progression (by RECIST or modified RECIST), or death from any cause, whichever was earlier. Median PFS time was estimated from Kaplan-Meier Plots.

    Progression was at least a 20% increase in the sum of the longest diameter (LD) of tumors, compared to smallest sum LD recorded since treatment started, or the appearance of one or more new tumors.

    If a participant did not progress or die, the date was censored to the date of last valid tumor assessment or the date of data cut-off, whichever was earlier.

    Measured: up to 2.5 years from initial treatment

  3. Progression-free Survival (PFS) Time Assessed by the Investigator

    PFS time was interval from the date of registration to the date of tumor progression (by RECIST or modified RECIST), or death from any cause, whichever was earlier. If a participant did not progress or die, the date was censored to the date of last valid tumor assessment or the date of data cut-off, whichever was earlier. Median PFS time was estimated from Kaplan-Meier Plots.

    Progression was at least a 20% increase in the sum of the longest diameter (LD) of tumors, compared to smallest sum LD recorded since treatment started, or the appearance of one or more new tumors.

    Measured: up to 2.5 years from initial treatment

  4. Overall Survival (OS)

    OS was the time interval between registration to the date of death from any cause. The median time for OS was estimated from Kaplan-Meier Plots.

    A participant was to be censored for the OS analysis if the participant was alive by the study cut-off date. The censoring date was either the date that the participant was last known to be alive or the date of study cut-off, whichever came earlier.

    Measured: up to 2.5 years from initial treatment

  5. Heath-related Quality of Life (QOL) Measured Via the Lung Cancer Subscale

    HRQL was assessed with the Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) questionnaire, which was completed by the participants on Day 1 of Cycle 1 only (for baseline value), then on Day 14 of each even-numbered cycle to evaluate the participants symptoms.

    The questionnaire scored 7 symptoms: shortness of breath, weight loss, clarity in thinking, coughing, appetite, chest tightness, ease of breathing, on a 0-4 scale. The total FACT-LCS score ranged from 0-28 (where 28 was related to the worst outcome). To calculate a change, the baseline score was subtracted from the score obtained after treatment. A negative value implied an improvement in HRQL.

    Measured: Baseline to 2.5 years

  6. Overall Safety - Number of Participants With Adverse Events

    All AEs regardless of seriousness or relationship to study treatment, spanning from the first administration of study treatment until 60 days after the last administration of study treatment, were recorded, and followed until resolution or stabilization. The number of participants with all treatment emergent adverse events (TEAE), serious adverse events (SAE), TEAE leading to death, and TEAE leading to permanent treatment discontinuation are reported.

    Measured: up to 60+/-5 days after treatment discontinuation, or or until TEAE was resolved or stabilized (Collected till 18 July 2008)

  7. Number of Participants With Laboratory Abnormalities

    Participants with abnormal laboratory results for

    • Liver and renal function (Alkaline phosphatase, Alanine aminotransferase [ALT], aspartate aminotransferase [AST], Creatinine, Hyperbilirubinemia),
    • Electrolytes (Hypercalcemia, Hypocalcemia, Hypokalemia, Hypernatremia, Hyponatremia, Hypophosphatemia)
    • Metabolism (Hypoalbuminemia, Hyperglycemia, Hypoglycemia)
    • Hematology (Partial thromboplastin time, Anemia, Lymphopenia, Neutropenia, Thrombocytopenia, Leukopenia)

    Measured: Up to 2.5 years

  8. Peak of Free Aflibercept (VEGF Trap)

    Plasma free aflibercept levels after the first aflibercept infusion were estimated by a validated direct measured by enzyme-linked immunosorbent assay (ELISA), with a limit of quantification (LOQ) of 15.6 ng/mL.

    Measured: Day 1 of the first infusion of Aflibercept (cycle 1)

  9. Free and VEGF-bound Trough Aflibercept Concentrations (VEGF Trap)

    Median free and VEGF-bound trough concentrations were determined at the end of each cycle beyond Cycle 2 (Steady-state) for each participant.

    Plasma free aflibercept levels were estimated by a validated direct ELISA, with an LOQ of 15.6 ng/mL. Plasma VEGF-bound aflibercept levels were also estimated by a separate validated direct ELISA with an LOQ of 43.9 ng/mL.

    Mean ± SD (coefficient of variation [CV%]) values were estimated from the median values calculated for each participant.

    Measured: At the end of each treatment cycle (up to 2.5 years)

  10. Number of Participants With Anti-drug Antibodies

    Anti-drug antibodies in a participant's serum sample were assayed with an anti-drug ELISA assay, with a lower limit of quantitation of 238.4 ng/mL for an undiluted human serum sample.

    Serum for anti-drug antibody analysis was collected pre-dose on every fourth cycle after Cycle 1 Day 1 (at 8 week intervals), at end of treatment (EOT), and during post-treatment follow-up 60 days after the last dose.

    Measured: up to 2.5 years after initial treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jan 2006 (estimated)
  2. Study startJan 2006
  3. Primary completionJul 2008
  4. Study completionJul 2008

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
98 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00284141
Sponsor's protocol ID
ARD6123
Other IDs
AVE0005B/2001
Status last verified
Jul 2011
First submitted
30 Jan 2006
Last updated
10 Dec 2012
Data monitoring committee
Yes

Publications

  • Leighl NB, Raez LE, Besse B, Rosen PJ, Barlesi F, Massarelli E, Gabrail N, Hart LL, Albain KS, Berkowitz L, Melnyk O, Shepherd FA, Sternas L, Ackerman J, Shun Z, Miller VA, Herbst RS. A multicenter, phase 2 study of vascular endothelial growth factor trap (Aflibercept) in platinum- and erlotinib-resistant adenocarcinoma of the lung. J Thorac Oncol. 2010 Jul;5(7):1054-9. doi: 10.1097/jto.0b013e3181e2f7fb.

    PubMed 20593550

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Aflibercept (ziv-aflibercept, AVE0005, VEGF trap, ZALTRAP®) in people with Pulmonary Diseases and Neoplasms, Lung, run by Sanofi at 3 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Dec 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States, Canada, France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Dec 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Confirmed Objective Response (OR) Based Upon Modified Response Evaluation Criteria in Solid Tumors (RECIST) Assessed by the Independent Review Committee (IRC). (time frame: up to 2.5 years from initial treatment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00284141, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Dec 2012.

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