Non Small Cell Lung CancerPhase 2NCT01487265
Trial of Erlotinib and BKM120 in Patients With Advanced Non Small Cell Lung Cancer Previously Sensitive to Erlotinib
A Phase 2 study testing BKM120 and Erlotinib in people with Non Small Cell Lung Cancer, run by SCRI Development Innovations, LLC at 7 sites in United States.
Trial summary
Preclinical data in lung cancer cell lines showed that EGFR mutation can potentially be a positive predictor for sensitivity to BKM120. Furthermore, when the erlotinib-resistant model H1975 (LR858 and T790M mutation) was treated with BKM120, significant tumor control was observed (Novartis internal data). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non Small Cell Lung Cancer
- What is being tested?
- BKM120 and Erlotinib
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 37 participants
- Where
- 7 sitesUnited States
- Study dates
- Mar 2014to 11 Dec 2017
- 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
- Patients must have recovered to Grade 1 or better from any adverse events (except alopecia) related to prior antineoplastic therapy before screening procedures are initiated.
- Patients with progressive NSCLC (any histology)
- Prior sensitivity to erlotinib or gefitinib or other EGFR TKI. Sensitivity is defined as follows:
- Patients treated with erlotinib (or gefitinib or other EGFR TKI) for any duration in the presence of a known EGFR activating mutation that confers sensitivity to TKI treatment. These include, but are not limited to mutations in L858R (Exon 21); Exon 19 deletion; G719S, G719A, G719C mutations (Exon 19);or L861Q (laboratory report required at enrollment).
- Prior treatment with erlotinib (or gefitinib, or other EGFR TKI), regardless of mutation status, where there was ≥6 months of disease control (no disease progression).
- At least one site of measurable disease as defined by RECIST criteria Version 1.1
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- Eastern Cooperative Oncology Group (ECOG) performance status score of 0 to 2
- Archival tumor tissue available for correlative testing (analysis of resistance mechanism to erlotinib).
- Failure of at least 1, and no more than 3, prior systemic treatments for advanced disease (either due to progressive disease or toxicity).
- Male or female ≥18 years of age.
- Patients may have received radiation for palliation prior to starting study drug if they have recovered from the side effects of such therapy. Time from last palliative radiation to beginning of study treatment should be ≥1 week. Patients may have received prior wide-field radiation prior to starting study drug if they have recovered from the side effects of such therapy. Time from last wide-field radiation to beginning of study treatment should be ≥2 weeks.
- Fasting plasma glucose (FPG) ≤120 mg/dL (6.7 mmol/L)
- Adequate hematologic, hepatic and renal function.
- Total calcium (corrected for serum albumin) WNL (bisphosphonate use for malignant hypercalcemia control is allowed)
- Magnesium ≥ the lower limit of normal (LLN)
- Potassium WNL for the institution
- Serum amylase and lipase ≤ ULN
- Ability to swallow oral medication
- Fertile males, defined as all males physiologically capable of conceiving offspring, must use condoms during treatment, and for an additional 24 weeks (6 months in total after study drug discontinuation), and should not father a child in this period.
- Female patients who are not of child-bearing potential, and female patients of child-bearing potential who agree to use adequate contraceptive measures, who are not breastfeeding, and who have a negative serum or urine pregnancy test performed within 48 hours prior to start of treatment.
- Willingness and ability to comply with study and follow-up procedures.
- Ability to understand the investigational nature of this study and give written informed consent.
Who cannot join
- Prior treatment with a phosphatidylinositide 3-kinase (PI3K) inhibitor
- Known hypersensitivity to BKM120, and/or erlotinib/gefitinib
- Failure to recover to Grade 1 or better from any AEs (except alopecia) related to previous antineoplastic therapy before screening procedures are initiated.
- Untreated brain metastases. Patients with treated brain metastases may participate in this study, if the patient is ≥2 weeks from therapy completion (including radiation and/or surgery), has recovered from all effects of treatment, is clinically stable at the time of study entry, and is not receiving high-dose steroid therapy (patients on a low stable dose of steroids may be enrolled).
- Acute or chronic liver or renal disease or pancreatitis
- The following mood disorders, as judged by the Investigator or a Psychiatrist, or as a result of patient's mood assessment questionnaire:
Show all 35Show fewer
- Medically documented history of active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm to others)
- ≥ Grade 3 anxiety
- Meets the cut-off score of ≥10 12 in the Patient Health Questionnaire (PHQ-9) or a cut-off of ≥15 in the Generalized Anxiety Disorder Assessment (GAD-7) mood scale, respectively, or selects a positive response of "1, 2, or 3" to question number 9 regarding potential for suicidal thoughts in the PHQ-9 (independent of the total score of the PHQ-9) will be excluded from the study.
- Active cardiac disease including any of the following:
- Angina pectoris that requires the use of anti-anginal medication
- Ventricular arrhythmias except for benign premature ventricular contractions
- Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication
- Conduction abnormality requiring a pacemaker
- Valvular disease with documented compromise in cardiac function
- Symptomatic pericarditis
- Uncontrolled hypertension
- History of cardiac dysfunction including any of the following:
- Myocardial infarction within the last 6 months
- History of documented congestive heart failure (New York Heart Association functional classification III-IV) within the last 6 months
- Documented cardiomyopathy
- Stroke or transient ischemic attack within the past 6 months
- Poorly controlled diabetes mellitus (HbA1c >8%)
- Currently taking therapeutic doses of warfarin sodium or any other coumadin-derivative anticoagulant. Therapy with low molecular weight heparin (LMWH), rivaroxaban, or fondaparinux is allowed.
- Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g., active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
- Diarrhea ≥ Grade 2.
- Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drugs (e.g., Crohn's disease, ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection).
- Prior treatment with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GM-CSF) ≤1 week prior to starting study drug. Erythropoietin or darbepoetin therapy, if initiated at least 1 week prior to enrollment, may be continued.
- Currently receiving treatment with medication with a known risk to prolong the QT interval or inducing Torsades de Pointes and the treatment cannot either be discontinued or switched to a different medication prior to starting study drug.
- Patients who have taken herbal medications and certain fruits within 7 days prior to starting study drug. Herbal medications include, but are not limited to, St. John's Wort, Kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and ginseng. Fruits include the CYP3A inhibitors: Seville oranges, grapefruit, pummelos, or exotic citrus fruits.
- Currently treated with drugs known to be strong inhibitors or inducers of isoenzyme CYP3A, and the treatment cannot be discontinued or switched to a different medication prior to starting study drug. (Concurrent treatment with moderate or weak inhibitors of CYP3A is allowed).
- Chemotherapy or targeted anticancer therapy ≤4 weeks (6 weeks for nitrosourea, antibodies or mitomycin-C) prior to starting study drug must recover to a Grade 1 before starting the study (with the exception of EGFR targeting TKIs).
- Patients who have received any continuous or intermittent small molecule therapeutics (excluding monoclonal antibodies or EGFR targeting TKIs) ≤21 days or 5 half-lives (whichever is shorter) prior to starting study drug or who have not recovered from side effects of such therapy. A minimum of 10 days between termination of study drug and administration of BKM120/erlotinib is required.
- Oral contraception, injected or implanted hormonal methods are not allowed as BKM120 potentially decreases the effectiveness of hormonal contraceptives.
- Any condition that would prevent patient comprehension of the investigative nature of the study and its associated risks or prevent the ability to comply with study and/or follow-up procedures.
Trial locations and contacts
7 sites in 1 country.
7 sites in 1 country
United States7 sites
Oncology Hematology Care, Inc.
Cincinnati, Ohio, 45242
Florida Cancer Specialists South
Fort Myers, Florida, 33916
Center for Cancer and Blood Disorders
Fort Worth, Texas, 76104
Tennessee Oncology, PLLC
Nashville, Tennessee, 37023
Florida Hospital Cancer Institute
Orlando, Florida, 32804
Florida Cancer Specialists North
St. Petersburg, Florida, 33705
Florida Cancer Specialists East
West Palm Beach, Florida, 33401
About this study
Official title: Phase II Trial of Erlotinib and BKM120 in Patients With Advanced Non Small Cell Lung Cancer Previously Sensitive to Erlotinib
Preclinical data in lung cancer cell lines showed that EGFR mutation can potentially be a positive predictor for sensitivity to BKM120. Furthermore, when the erlotinib-resistant model H1975 (LR858 and T790M mutation) was treated with BKM120, significant tumor control was observed (Novartis internal data). Therefore, combining BKM120 with erlotinib could potentially down-modulate PI3K-Akt activity resulting in a synergistic effect on cell growth inhibition and enhancing the response to erlotinib.
Read the detailed description
This is a multicentered, open-label, non-randomized Phase II study of BKM120 and erlotinib in patients with advanced NSCLC previously sensitive to erlotinib. After six patients are enrolled and complete one treatment cycle a safety analysis of adverse events (AEs) will be conducted to assure there are no unexpected or prohibitive toxicities of the combination. The planned study enrollment will continue to up to 37 patients. Duration of a patient's participation in the study will vary. Treatment will continue as long as the patient is benefitting from the treatment, has no evidence of disease progression, and does not meet any criteria for discontinuation or withdrawal.
- Conditions
- Non Small Cell Lung Cancer
- Being tested
- BKM120 and Erlotinib
- Keywords
- Erlotinib, BKM120, NSCLC
- Medical subject headings
- Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BKM120 and ErlotinibDrug
Also called Buparlisib (BKM 120) and Tarceva (erlotinib)
BKM120 and Erlotinib will be given once daily. Erlotinib 100 mg PO will be administered. During Cycle 1-Week 1 all patients will receive 80 mg PO daily BKM120. After the first week of Cycle 1, the dose of BKM120 will escalate to 100 mg PO daily and treatment will continue as long as there are no unexpected or prohibitive toxicities, or disease progression.
| Study group | Role | What they receive |
|---|---|---|
| BKM120 and Erlotinib | Experimental | Cycle 1: BKM120 80 mg PO daily; Erlotinib 100mg PO daily
Cycles 2 and beyond: BKM120 100 mg PO daily; Erlotinib 100mg PO daily Receives: Drug: BKM120 and Erlotinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression Free Survival at 3 Months
Percentage of patients who are alive and progression-free at 3 months (APF3) from first treatment.
Measured: 3 months
Secondary outcomes (4)
Overall Survival
Defined as the time from first treatment until death from any cause.
Measured: every 3 months after study treatment, projected 24 months
Duration of Response
Defined as the time from complete or partial response (CR or PR) until objective tumor progression. Tumor measurements will be obtained using CT scans of chest, abdomen and pelvis and assessed per RECIST v 1.1. Complete response (CR) is defined as a disappearance of all lesions; partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking the baseline sum LD as reference. Stable Disease (SD) is defined as neither sufficient shrinkage to qualify for PR, nor sufficient increase to qualify for progressive disease, taking as reference the smallest (nadir) sum LD since start of treatment.
Measured: every 8 weeks for 12 months, then every 12 weeks thereafter, estimated 18 months
Objective Response Rate
Defined as the percentage of complete and partial responses (CR + PR) among all patients. Complete response (CR) is defined as a disappearance of all lesions; partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking the baseline sum LD as reference. Stable Disease (SD) is defined as neither sufficient shrinkage to qualify for PR, nor sufficient increase to qualify for progressive disease, taking as reference the smallest (nadir) sum LD since start of treatment.
Measured: every 8 weeks for 12 months, then every 12 weeks thereafter, estimated 18 months
Number of Participants With Serious and Non-serious Adverse Events as a Measure of Safety.
Adverse events will be graded using CTCAE v4.3. and will be collected until 30 days after the discontinuation of study treatment for each participant. A non-serious adverse event is any untoward medical occurrence. A serious adverse event (SAE) is an event that meets one or more of the following: results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; requires intervention to prevent permanent impairment or damage. Specific AE and SAE terms are provided in the Adverse event module.
Measured: Every 2 weeks for 8 weeks, then every 8 weeks thereafter, estimated 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Dec 2011 (estimated)
- Study startMar 2014
- Primary completion31 May 2016
- Study completion11 Dec 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Non Small Cell Lung CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 37 participants (actual)
Sponsor and investigators
- Lead sponsor
- SCRI Development Innovations, LLC
- Sponsor type
- University, hospital or other
- Collaborators
- Novartis
- Responsible party
- Sponsor
- Investigators
- David R Spigel, MD, Study chair, SCRI Development Innovations, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01487265
- Sponsor's protocol ID
- SCRI LUN 214
- Status last verified
- Feb 2019
- First submitted
- 1 Dec 2011
- Last updated
- 6 Mar 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Mar 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Trial of Erlotinib and BKM120 in Patients With Advanced Non Small Cell Lung Cancer Previously Sensitive to Erlotinib
- ClinicalTrials.gov ID
- NCT01487265
- Acronym / sponsor ID
- SCRI LUN 214
- Conditions
- Non Small Cell Lung Cancer
- Keywords
- Erlotinib, BKM120, NSCLC
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 37 participants (actual)
- Lead sponsor
- SCRI Development Innovations, LLCUniversity, hospital or other
- Collaborators
- Novartis
- Study start
- Mar 2014
- Primary completion
- 31 May 2016 (actual)
- Study completion
- 11 Dec 2017 (actual)
- First posted
- 7 Dec 2011 (estimated)
- Results
- Posted 13 Dec 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Preclinical data in lung cancer cell lines showed that EGFR mutation can potentially be a positive predictor for sensitivity to BKM120. Furthermore, when the erlotinib-resistant model H1975 (LR858 and T790M mutation) was treated with BKM120, significant tumor control was observed (Novartis internal data). Therefore, combining BKM120 with erlotinib could potentially down-modulate PI3K-Akt activity resulting in a synergistic effect on cell growth inhibition and enhancing the response to erlotinib.
Detailed description
This is a multicentered, open-label, non-randomized Phase II study of BKM120 and erlotinib in patients with advanced NSCLC previously sensitive to erlotinib. After six patients are enrolled and complete one treatment cycle a safety analysis of adverse events (AEs) will be conducted to assure there are no unexpected or prohibitive toxicities of the combination. The planned study enrollment will continue to up to 37 patients. Duration of a patient's participation in the study will vary. Treatment will continue as long as the patient is benefitting from the treatment, has no evidence of disease progression, and does not meet any criteria for discontinuation or withdrawal.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| BKM120 and Erlotinib | Experimental | Drug: BKM120 and ErlotinibCycle 1: BKM120 80 mg PO daily; Erlotinib 100mg PO daily Cycles 2 and beyond: BKM120 100 mg PO daily; Erlotinib 100mg PO daily |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (22 listed)
- Patients must have recovered to Grade 1 or better from any adverse events (except alopecia) related to prior antineoplastic therapy before screening procedures are initiated.
- Patients with progressive NSCLC (any histology)
- Prior sensitivity to erlotinib or gefitinib or other EGFR TKI. Sensitivity is defined as follows:
- At least one site of measurable disease as defined by RECIST criteria Version 1.1
- Eastern Cooperative Oncology Group (ECOG) performance status score of 0 to 2
Key exclusion criteria (35 listed)
- Prior treatment with a phosphatidylinositide 3-kinase (PI3K) inhibitor
- Known hypersensitivity to BKM120, and/or erlotinib/gefitinib
- Failure to recover to Grade 1 or better from any AEs (except alopecia) related to previous antineoplastic therapy before screening procedures are initiated.
- Untreated brain metastases. Patients with treated brain metastases may participate in this study, if the patient is ≥2 weeks from therapy completion (including radiation and/or surgery), has recovered from all effects of treatment, is clinically stable at the time of study entry, and is not receiving high-dose steroid therapy (patients on a low stable dose of steroids may be enrolled).
- Acute or chronic liver or renal disease or pancreatitis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BKM120 and ErlotinibAlso: Buparlisib (BKM 120) and Tarceva (erlotinib)BKM120 and Erlotinib will be given once daily. Erlotinib 100 mg PO will be administered. During Cycle 1-Week 1 all patients will receive 80 mg PO daily BKM120. After the first week of Cycle 1, the dose of BKM120 will escalate to 100 mg PO daily and treatment will continue as long as there are no unexpected or prohibitive toxicities, or disease progression. | Drug | BKM120 and Erlotinib |
Primary outcome
Progression Free Survival at 3 Months
Time frame: 3 months
Percentage of patients who are alive and progression-free at 3 months (APF3) from first treatment.
4 secondary outcomes
Overall Survival
Time frame: every 3 months after study treatment, projected 24 months
Duration of Response
Time frame: every 8 weeks for 12 months, then every 12 weeks thereafter, estimated 18 months
Objective Response Rate
Time frame: every 8 weeks for 12 months, then every 12 weeks thereafter, estimated 18 months
Number of Participants With Serious and Non-serious Adverse Events as a Measure of Safety.
Time frame: Every 2 weeks for 8 weeks, then every 8 weeks thereafter, estimated 24 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Mar 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David R Spigel, MD study chair
SCRI Development Innovations, LLC
7 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing BKM120 and Erlotinib in people with Non Small Cell Lung Cancer, run by SCRI Development Innovations, LLC at 7 sites in United States.
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 22 inclusion and 35 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 6 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 7 sites in United States. 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 13 Dec 2017). 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?
Progression Free Survival at 3 Months (time frame: 3 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 6 Mar 2019.