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Lung CancerPhase 2NCT00354549

Bevacizumab and Erlotinib Followed by Cisplatin or Carboplatin and Gemcitabine in Treating Patients With Newly Diagnosed or Recurrent Stage IIIB or Stage IV NSCLC

A Phase 2 study testing bevacizumab + erlotinib hydrochloride and gemcitabine hydrochloride + cisplatin or carboplatin in people with Lung Cancer, run by Swiss Cancer Institute at 2 sites in Switzerland.

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

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Read more about this study

Who is it for?
Ages 18 to 120 years
Conditions the study is for
Lung Cancer
What is being tested?
bevacizumab + erlotinib hydrochloride and gemcitabine hydrochloride + cisplatin or carboplatin
How many people
104 participants
Where
2 sitesSwitzerland
Study dates
Jan 2006to Sep 2010
Phase
Phase 2
Are there results?
None posted in the registry

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 to 120 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-squamous non-small cell lung cancer (NSCLC)
  • Newly diagnosed or recurrent disease
  • Meets 1 of the following staging criteria:
  • Stage IIIB disease, meeting both of the following criteria:
  • Proven malignant effusion or supraclavicular node involvement (i.e., N3 supraclavicular nodes)
  • Not a candidate for curative multimodality treatment or surgery
  • Stage IV disease
  • Measurable disease, defined as ≥ 1 lesion (outside of irradiated areas) that can be measured in ≥ 1 dimension as ≥ 10 mm by spiral or multi-slice CT scan or MRI
  • Immediate chemotherapy not clinically mandatory in the judgement of the investigator
  • No intrathoracic large, centrally located tumors and/or cavitary lesions invading or abutting major blood vessels
  • No evidence of clinically active interstitial lung disease
  • Patients with chronic stable radiographic changes who are asymptomatic are eligible
  • No small cell lung cancer (SCLC), squamous NSCLC, or combined SCLC-NSCLC tumors
  • No brain metastases

PATIENT CHARACTERISTICS:

  • WHO performance status 0-1
  • Hemoglobin ≥ 10 g/dL
  • Absolute neutrophil count ≥ 1,500/mm³
  • Thrombocyte count ≥ 100,000/mm³
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT ≤ 2.5 times ULN (5 times ULN if liver metastases present)
  • Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN if bone metastases present)
  • Quick ≥ 70% OR INR ≤ 1.5
  • Creatinine ≤ 2.0 times ULN
  • Proteinuria ≤ 2+ by urine dipstick
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 12 months after completion of study treatment
  • Able to understand trial information given by the investigator and complete quality of life questionnaire
  • No pre-existing condition that would preclude swallowing and/or absorption of oral medication
  • No prior or concurrent malignancies, except for the following:
  • Malignancy for which the minimum relapse-free interval is ≥ 5 years
  • Nonmelanoma skin cancer or adequately treated carcinoma in situ of the cervix
  • No other medical condition that would preclude study participation, including any of the following:
  • Unstable or uncompensated respiratory, cardiac, hepatic, or renal disease
  • Active infection
  • Uncontrolled diabetes mellitus
  • Hypertension ≥ 150/100 mm Hg despite treatment
  • Myocardial infarction within the past 3 months
  • History of hemorrhagic disorders
  • Non-healing wound, ulcer, or bone fracture
  • No clinical history of coagulopathy or thrombosis
  • No hemoptysis or hematemesis ≥ grade 2 (defined as bright red blood of ≥ 5 mL per episode) within the past 6 months
  • No known hypersensitivity to study drug(s) or to any other component of the study drugs
  • No significant traumatic injury within the past 28 days
  • No serious underlying medical condition that would impair the ability of the patient to participate in the trial or that would preclude use of study drugs
  • No cerebrovascular accident or other CNS bleeding within the past 6 months

PRIOR CONCURRENT THERAPY:

  • At least 4 weeks since prior radiotherapy and recovered
  • No prior radiotherapy to lesion(s) selected for measurement
  • No prior chemotherapy for advanced disease
  • At least 6 months since prior neoadjuvant or adjuvant systemic chemotherapy for NSCLC
  • Prior intrapleural or intrapericardial local chemotherapy allowed
  • No prior endothelial growth factor and/or vascular endothelial growth factor (receptor)-targeted therapy for NSCLC
  • More than 28 days since prior major surgical procedure or open biopsy
  • More than 30 days since prior treatment in another clinical trial
  • No concurrent anticoagulants (e.g., phenprocoumon, acenocoumarol, or full-dose warfarin or heparin)
  • No concurrent full-dose continuous use of non-steroid anti-inflammatory drugs (NSAIDs)
  • No concurrent aspirin or clopidogrel bisulfate
  • Low-dose aspirin (≤ 325 mg daily) may be continued in patients at high risk for arterial thromboembolic disease
  • No other concurrent drugs contraindicated for use with the study drugs, according to the Swissmedic-approved product information
  • No other concurrent experimental drugs or anticancer therapy, including chemotherapy, immunotherapy, or hormone therapy

Trial locations and contacts

2 sites in 1 country.

Switzerland2 sites
  • Universitaetsspital-Basel

    Basel, CH-4031

  • Oncology Institute of Southern Switzerland

    Bellinzona, CH-6500

Other trials in Switzerland

About this study

Official title: Bevacizumab and Erlotinib First-Line Therapy in Advanced Non-Squamous Non-Small-Cell Lung Cancer (Stage IIIB/IV) Followed by Platinum-Based Chemotherapy at Disease Progression. A Multicenter Phase II Trial

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cisplatin, carboplatin, and gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab together with erlotinib followed by cisplatin or carboplatin and gemcitabine at disease progression may be an effective treatment for non-small cell lung cancer.

PURPOSE: This phase II trial is studying how well giving bevacizumab together with erlotinib followed by cisplatin or carboplatin and gemcitabine works in treating patients with newly diagnosed or recurrent stage IIIB or stage IV non-small cell lung cancer.

Read the detailed description

OBJECTIVES:

Primary

  • Assess the efficacy of bevacizumab and erlotinib hydrochloride as initial therapy in patients with newly diagnosed or recurrent stage IIIB or IV non-squamous non-small cell lung cancer (NSCLC).

Secondary

  • Assess the safety of bevacizumab and erlotinib hydrochloride as initial therapy in these patients.
  • Assess the quality of life (QOL) in patients treated with bevacizumab and erlotinib hydrochloride.
  • Assess the efficacy and safety of subsequent cisplatin or carboplatin in combination with gemcitabine hydrochloride in patients who have disease progression.
  • Assess the QOL in patients treated with subsequent cisplatin or carboplatin in combination with gemcitabine hydrochloride at disease progression.

Tertiary

  • Identify novel biomarkers in predicting response to therapy and toxicity in patients treated with bevacizumab and erlotinib hydrochloride as initial therapy.

OUTLINE: This is a multicenter, prospective, open-label study.

Patients receive bevacizumab IV over 90 minutes on day 1 and oral erlotinib hydrochloride once daily on days 1-21. Treatment repeats every 3 weeks in the absence of disease progression or unacceptable toxicity.

Beginning within 3 weeks of documented disease progression, patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. They also receive cisplatin IV over 1 hour or carboplatin IV over 30 minutes on day 1. Treatment with gemcitabine hydrochloride with either cisplatin or carboplatin repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline and periodically during study treatment.

After completion of study treatment, patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 101 patients will be accrued for this study.

Conditions
Lung Cancer
Being tested
bevacizumab + erlotinib hydrochloride, gemcitabine hydrochloride + cisplatin or carboplatin
Keywords
recurrent non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, adenocarcinoma of the lung, bronchoalveolar cell lung cancer, large cell lung cancer
Medical subject headings
Lung Neoplasms, Carcinoma, Non-Small-Cell Lung, Adenocarcinoma of Lung, Adenocarcinoma, Bronchiolo-Alveolar

What participants receive

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

  • bevacizumab + erlotinib hydrochlorideDrug

    Patients receive bevacizumab IV over 90 minutes on day 1 and oral erlotinib hydrochloride once daily on days 1-21. Treatment repeats every 3 weeks in the absence of disease progression or unacceptable toxicity.

  • gemcitabine hydrochloride + cisplatin or carboplatinDrug

    Beginning within 3 weeks of documented disease progression, patients receive gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. They also receive cisplatin IV over 1 hour or carboplatin IV over 30 minutes on day 1. Treatment with gemcitabine hydrochloride with either cisplatin or carboplatin repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

What is being measured

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

  1. Disease stabilization (DS) (complete response [CR], partial response [PR], or stable disease [SD]) as assessed by RECIST criteria after 12 weeks of treatment with bevacizumab and erlotinib hydrochloride

    Measured: 12 weeks

Secondary outcomes (11)
  1. DS as assessed by RECIST criteria after 6 and 18 weeks of treatment with bevacizumab and erlotinib hydrochloride

    Measured: 6 and 18 weeks

  2. Objective response (CR or PR) as assessed by RECIST criteria after 6, 12, and 18 weeks of treatment with bevacizumab and erlotinib hydrochloride

    Measured: 6, 12 and 18 weeks

  3. Best overall response when treated with bevacizumab and erlotinib hydrochloride

    Measured: Until treatment ends

  4. Adverse events (AEs) when treated with bevacizumab and erlotinib hydrochloride

    Measured: Until treatment ends

  5. Time to progression (TTP) when treated with bevacizumab and erlotinib hydrochloride

    Measured: Until treatment ends

  6. Time to treatment failure (TTF) when treated with bevacizumab and erlotinib hydrochloride

    Measured: Until treatment ends

  7. Quality of life (QOL) when treated with bevacizumab and erlotinib hydrochloride

    Measured: Until treatment ends

  8. Objective response (CR or PR) when treated with chemotherapy

    Measured: Until treatment ends

  9. Unexpected adverse drug reaction

    Measured: Until treatment ends

  10. QOL when treated with chemotherapy

    Measured: Periodically

  11. Overall survival (OS) in patients treated with bevacizumab and erlotinib hydrochloride and in patients treated with subsequent chemotherapy at disease progression

    Measured: life-long

Timeline

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

  1. First posted20 Jul 2006 (estimated)
  2. Study startJan 2006
  3. Primary completionApr 2009
  4. Study completionSep 2010

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
104 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00354549
Sponsor's protocol ID
SAKK 19/05
Other IDs
EU-20614
Status last verified
May 2019
First submitted
19 Jul 2006
Last updated
15 May 2019
Results posted
No
Data monitoring committee
Yes

Publications

  • Zappa F, Droege C, Betticher D, von Moos R, Bubendorf L, Ochsenbein A, Gautschi O, Oppliger Leibundgut E, Froesch P, Stahel R, Hess T, Rauch D, Schmid P, Mayer M, Crowe S, Brauchli P, Ribi K, Pless M; Swiss Group for Clinical Cancer Research (SAKK). Bevacizumab and erlotinib (BE) first-line therapy in advanced non-squamous non-small-cell lung cancer (NSCLC) (stage IIIB/IV) followed by platinum-based chemotherapy (CT) at disease progression: a multicenter phase II trial (SAKK 19/05). Lung Cancer. 2012 Dec;78(3):239-44. doi: 10.1016/j.lungcan.2012.08.017. Epub 2012 Sep 23.

    PubMed 23009726
  • Baty F, Joerger M, Fruh M, Klingbiel D, Zappa F, Brutsche M. 24h-gene variation effect of combined bevacizumab/erlotinib in advanced non-squamous non-small cell lung cancer using exon array blood profiling. J Transl Med. 2017 Mar 30;15(1):66. doi: 10.1186/s12967-017-1174-z.

    PubMed 28359318
  • Franzini A, Baty F, Macovei II, Durr O, Droege C, Betticher D, Grigoriu BD, Klingbiel D, Zappa F, Brutsche MH. Gene Expression Signatures Predictive of Bevacizumab/Erlotinib Therapeutic Benefit in Advanced Nonsquamous Non-Small Cell Lung Cancer Patients (SAKK 19/05 trial). Clin Cancer Res. 2015 Dec 1;21(23):5253-63. doi: 10.1158/1078-0432.CCR-14-3135. Epub 2015 Apr 28.

    PubMed 25922429
  • Joerger M, Baty F, Fruh M, Droege C, Stahel RA, Betticher DC, von Moos R, Ochsenbein A, Pless M, Gautschi O, Rothschild S, Brauchli P, Klingbiel D, Zappa F, Brutsche M. Circulating microRNA profiling in patients with advanced non-squamous NSCLC receiving bevacizumab/erlotinib followed by platinum-based chemotherapy at progression (SAKK 19/05). Lung Cancer. 2014 Aug;85(2):306-13. doi: 10.1016/j.lungcan.2014.04.014. Epub 2014 May 29.

    PubMed 24928469

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing bevacizumab + erlotinib hydrochloride and gemcitabine hydrochloride + cisplatin or carboplatin in people with Lung Cancer, run by Swiss Cancer Institute at 2 sites in Switzerland.

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

Who may be eligible to take part?

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 15 May 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Switzerland. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Disease stabilization (DS) (complete response [CR], partial response [PR], or stable disease [SD]) as assessed by RECIST criteria after 12 weeks of treatment with bevacizumab and erlotinib hydrochloride (time frame: 12 weeks). 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 NCT00354549, which also lists 4 linked publications.

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 15 May 2019.

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