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Advanced Non-small Cell Lung CancerPhase 1/2NCT02108964

A Phase I/II, Multicenter, Open-label Study of EGFRmut-TKI EGF816, Administered Orally in Adult Patients With EGFRmut Solid Malignancies

A Phase 1/2 study testing EGF816 in people with Advanced Non-small Cell Lung Cancer, run by Novartis Pharmaceuticals at 14 sites in 9 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 is a Phase I/II, multi-center, open-label study, composed with a Phase I part (dose-escalation phase) followed by a Phase II part (expansion phase). The dose escalation phase was designed to determine as primary objective the maximum tolerated dose (MTD) or recommended Phase II dose (RP2D) of EGF816 monotherapy… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Advanced Non-small Cell Lung Cancer
What is being tested?
EGF816
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
225 participants
Where
14 sitesin 9 countries
Study dates
6 Jun 2014to 15 Aug 2023
Phase
Phase 1/2
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

Inclusion Criteria: (For all patients unless otherwise specified)

  • Histologically or cytologically confirmed locally advanced (stage IIIB not amenable to definitive multi-modality therapy including surgery) or metastatic (stage IV) EGFR mutant NSCLC.
  • Patients with controlled brain metastases
  • ECOG performance status: Phase I part: 0, 1, or 2; Phase II part: 0 or 1
  • Presence of at least one measurable lesion according to RECIST 1.1 per investigator assessment
  • Patients who are either Hepatitis B surface antigen (HBsAg) positive or hepatitis B virus (HBV)-DNA positive must be willing and able to take antiviral therapy 1-2 weeks prior to 1st dose of EGF816 treatment and continue on antiviral therapy for at least 4 weeks after the last dose of EGF816
  • Patients must have negative hepatitis C antibody (HCV-Ab) or positive HCV-Ab but undetectable level of HCV-RNA. Note: patients with detectable HCV-RNA are not eligible for the study.
  • For Phase I: patients must have failed no more than 3 lines of any systemic antineoplastic therapy for advanced NSCLC, including EGFR-TKI
  • For Phase II: patients must be naïve from any systemic antineoplastic therapy in the advanced setting. Patients who have failed no more than 1 cycle of systemic antineoplastic therapy in the advanced setting are allowed.

Exclusion criteria: (For all patients unless otherwise specified)

  • Patients with a history or presence of interstitial lung disease (ILD) or interstitial pneumonitis, including clinically significant radiation pneumonitis (i.e. affecting activities of daily living or requiring therapeutic intervention)
  • Presence or history of another malignancy
  • Undergone a bone marrow or solid organ transplant
  • Known history of human immunodeficiency virus (HIV) seropositivity
  • Patients receiving concomitant immunosuppressive agents or chronic corticosteroids use at the time of study entry except for control of brain metastases, topical applications, inhaled sprays, eye drops or local injections
  • Patients with clinically significant, uncontrolled heart disease
  • Any prior therapies ≤ 4 weeks prior to the first dose of study treatment
  • Patients who are receiving treatment with medications that are known to be strong inhibitors or inducers of CYP3A4/5 and cannot be discontinued 1 week prior to the start of EGF816 treatment and for the duration of the study.
  • Patients who have impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of EGF816
  • Patients who are receiving treatment with any enzyme-inducing anticonvulsant that cannot be discontinued at least 1 week before first dose of study treatment, and for the duration of the study
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception
  • Sexually active males unless they use a condom during intercourse while taking drug and for 3 months after stopping treatment

Other protocol-defined inclusion and exclusion criteria may apply.

Trial locations and contacts

14 sites in 9 countries.

14 sites in 9 countries

United States2 sites
  • Massachusetts General Hospital Mass General

    Boston, Massachusetts, 02114

  • Memorial Sloan Kettering Oncology Department

    New York, New York, 10017

Other trials in United States

Germany2 sites
  • Novartis Investigative Site

    Berlin, 13125

  • Novartis Investigative Site

    Cologne, 50937

Other trials in Germany

Japan2 sites
  • Novartis Investigative Site

    Fukuoka, Fukuoka, 811-1395

  • Novartis Investigative Site

    Nagoya, Aichi-ken, 464 8681

Other trials in Japan

South Korea2 sites
  • Novartis Investigative Site

    Seoul, 03080

  • Novartis Investigative Site

    Seoul, 05505

Other trials in South Korea

Spain2 sites
  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    Madrid, 28041

Other trials in Spain

Canada1 site
  • Novartis Investigative Site

    Toronto, Ontario, M5G 2M9

Other trials in Canada

Netherlands1 site
  • Novartis Investigative Site

    Zoetermeer, NL-2722 EP

Other trials in Netherlands

Singapore1 site
  • Novartis Investigative Site

    Singapore, 168583

Other trials in Singapore

Taiwan1 site
  • Novartis Investigative Site

    Taipei, 10002

Other trials in Taiwan

About this study

This is a Phase I/II, multi-center, open-label study, composed with a Phase I part (dose-escalation phase) followed by a Phase II part (expansion phase).

The dose escalation phase was designed to determine as primary objective the maximum tolerated dose (MTD) or recommended Phase II dose (RP2D) of EGF816 monotherapy in adult subjects with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC harboring specific EGFR mutations. Patients may have or not have received prior lines of antineoplastic therapy. An adaptive Bayesian Logistic Regression Model (BLRM) employing the escalation with overdose control (EWOC) principle will be used during the dose escalation part for dose level selection and MTD recommendation. The primary objective of the Phase II part is to estimate antitumor activity of EGF816 as measured by overall response rate (ORR) determined by Blinded Independent Review Committee (BIRC) assessment in accordance to RECIST 1.1.

Read the detailed description

Following completion of screening procedures and confirmation of patient eligibility, the participants are enrolled in the study. The study treatment begin on Cycle 1, Day 1 with the first administration of EGF816. A treatment cycle is defined as 28 days. Oral EGF816 is administered once daily on a continuous schedule until patient experiences unacceptable toxicity, progressive disease (PD), and/or treatment is discontinued at the discretion of the investigator, patient withdrawal of consent, or due to any other reasons. Treatment with EGF816 may be continued beyond RECIST 1.1 defined PD, if, in the judgment of the investigator, there is evidence of clinical benefit and the patient wishes to continue with the study treatment.

Being tested
EGF816
Keywords
NSCLC, Non-small Cell Lung Cancer EGFRmut, EGFR TKIs (EGF816), acquired T790M mutation, de novo T790M mutation, EGFR TKI activating mutation (i.e. L858R or ex19del), Treatment naive advanced NSCLC with EGFR activating mutations, Locally advanced NSCLC (Stage IIIB NSCLC not amenable to definitive multi-modality therapy including surgery), Metastatic NSCLC refers to Stage IV NSCLC, 1st line

What participants receive

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

  • EGF816Drug

    Also called Nazartinib

    EGF816 will be dosed once daily. On the first day of each treatment cycle, the patient receives an adequate drug supply for self-administration at home. The investigator will instruct the patient to take EGF816 exactly as prescribed.

Study groups in NCT02108964
Study groupRoleWhat they receive
Phase I partExperimentalParticipants with locally advanced or metastatic NSCLC harboring specific EGFR mutations will be administered escalated doses of EGF816 orally once a day as continuous daily dosing in each cycle (of 28 days) during Phase I part of the study. The starting dose for the Phase I part first cohort of patients will be 75 mg once per day capsule.
Receives: Drug: EGF816
Phase II partExperimentalTreatment naïve participants with locally advanced or metastatic NSCLC harboring EGFR mutations will be administered with EGF816 at RP2D during Phase II part of the study.
Receives: Drug: EGF816

What is being measured

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

  1. Number of Participants With Dose Limiting Toxicities (DLTs) (Phase I Part)

    Number of participants with DLTs during the first 28 days of therapy. A DLT is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first cycle of treatment with EGF816 and meets any of the criteria described in the protocol. A participant with multiple occurrences of DLTs under one treatment is counted only once.

    Measured: First 28 days of dosing

  2. Overall Response Rate (ORR) by Blinded Independent Review Committee (BIRC) (Phase II Part)

    ORR is defined as the percentage of patients with a best overall response of complete response (CR) or partial response (PR) determined by BIRC assessment in accordance to Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    Measured: From baseline up to 64 weeks

Secondary outcomes (15)
  1. Progression-free Survival (PFS) by Investigator Assessment (Phase I & Phase II Parts)

    PFS is defined as time from date of first dose of study treatment to date of first documented disease progression or death due to any cause determined by Investigator assessment in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  2. Duration of Response (DOR) by Investigator Assessment (Phase I & II Parts)

    DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause determined by Investigator assessment in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  3. Observed Maximum Plasma Concentration (Cmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part)

    To characterize the PK properties of EGF816 and metabolite LMI258, Cmax will be calculated (Phase I \& II parts).

    Cmax is maximum (peak) observed plasma drug concentration (mass x volume-1).

    Measured: Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose).

  4. Time to Maximum Plasma Concentration (Tmax) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part). Tmax is the Time to Reach Maximum (Peak) Plasma Drug Concentration (Time).

    To characterize the PK properties of EGF816 and metabolite LMI258, Tmax will be calculated (Phase I \& II parts). Tmax is the time to reach maximum (peak) plasma drug concentration (time).

    Measured: Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose).

  5. Area Under the Serum Concentration-time Curve From Time Zero to the End of the Dosing Interval Tau (AUCtau) of EGF816 and Metabolite LMI258 (Phase I & Phase II Part)

    To characterize the PK properties of EGF816 and metabolite LMI258, AUCtau will be calculated (Phase I \& II parts). AUCtau is the AUC calculated to the end of a dosing interval (tau) (amount x time x volume-1).

    Measured: Cycle (C) 1 Day (D) 1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hours (hrs) post-dose), C1D15 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose) (for Phase I part only) and C2D1 (pre-dose and 0.5,1,2,3,4,6,8,12 and 24 hrs post-dose).

  6. Percentage Change From Baseline in H-score for Immunohistochemistry (IHC) Biomarkers From Tumor Tissue Samples (Phase I Part)

    Changes in EGFR signaling pathway of newly obtained tumor samples following EGF816 treatment were evaluated by IHC of three pharmacodynamics (PD) biomarkers: p-EGFR, p-AKT and p-ERK. The assigned H-score semi-quantitatively assessed the expression level of these protein markers and their phosphorylated forms.

    Measured: Baseline and Cycle 1 Day 15

  7. Overall Response Rate (ORR) by Investigator Assessment (Phase I & II Parts)

    ORR is defined as percentage of patients with best overall response of partial response (PR)+ complete response (CR) determined by Investigator assessment in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 4 years

  8. Disease Control Rate (DCR) by Investigator Assessment (Phase I & II Parts)

    DCR is defined as the proportion of patients with best overall response of CR, PR, or SD determined by Investigator assessment in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 4 years

  9. Time to Response (TTR) by Investigator Assessment (Phase I & II Parts)

    TTR is defined as the time from the date of the first dose to the date of first documented response (CR or PR) determined by Investigator assessment in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  10. Number of Participants With Dose Interruptions and Dose Reductions (Phase I & II Parts)

    Assessment of the tolerability of EGF816 will be performed continuously during the treatment phase

    Measured: At least 24 weeks up to approx. 9 years

  11. Duration of Response (DOR) by BIRC (Phase II Part)

    DOR is defined as the time from first documented response (PR or CR) to the date of first documented disease progression or death due to any cause determined by BIRC in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  12. Disease Control Rate (DCR) by BIRC (Phase II Part)

    DCR is defined as the percentage of patients with best overall response of CR, PR, or SD determined by BIRC in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  13. Progression-Free Survival (PFS) by BIRC (Phase II Part)

    PFS is defined as time from date of first dose of study treatment to date of first documented disease progression or death due to any cause determined by BIRC in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  14. Time to Response (TTR) by BIRC (Phase II Part)

    TTR is defined as as the time from the date of first dose of study treatment to the date of first documented response (CR or PR) determined by by BIRC in accordance to RECIST 1.1

    Measured: At least 24 weeks up to approx. 9 years

  15. Overall Survival (OS) (Phase II Part)

    OS is defined as the time from first dose of the study treatment to the date of death due to any cause.

    Measured: At least 24 weeks up to approx. 9 years

Timeline

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

  1. First posted9 Apr 2014 (estimated)
  2. Study start6 Jun 2014
  3. Primary completion22 Mar 2018
  4. Study completion15 Aug 2023

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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
225 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02108964
Sponsor's protocol ID
CEGF816X2101
Other IDs
2013-004482-14
Status last verified
Dec 2024
First submitted
7 Apr 2014
Last updated
11 Dec 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Tan DSW, Kim SW, Ponce Aix S, Sequist LV, Smit EF, Yang JCH, Hida T, Toyozawa R, Felip E, Wolf J, Grohe C, Leighl NB, Riely G, Cui X, Zou M, Ghebremariam S, O'Sullivan-Djentuh L, Belli R, Giovannini M, Kim DW. Nazartinib for treatment-naive EGFR-mutant non-small cell lung cancer: Results of a phase 2, single-arm, open-label study. Eur J Cancer. 2022 Sep;172:276-286. doi: 10.1016/j.ejca.2022.05.023. Epub 2022 Jul 7.

    PubMed 35810553
  • Tan DS, Leighl NB, Riely GJ, Yang JC, Sequist LV, Wolf J, Seto T, Felip E, Aix SP, Jonnaert M, Pan C, Tan EY, Ko J, Moody SE, Kim DW. Safety and efficacy of nazartinib (EGF816) in adults with EGFR-mutant non-small-cell lung carcinoma: a multicentre, open-label, phase 1 study. Lancet Respir Med. 2020 Jun;8(6):561-572. doi: 10.1016/S2213-2600(19)30267-X. Epub 2020 Jan 15.

    PubMed 31954624

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing EGF816 in people with Advanced Non-small Cell Lung Cancer, run by Novartis Pharmaceuticals at 14 sites in 9 countries.

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 11 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States, Germany, Japan, South Korea, Spain and 4 more countries. 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 26 Oct 2020). 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?

Number of Participants With Dose Limiting Toxicities (DLTs) (Phase I Part) (time frame: First 28 days of dosing). 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 NCT02108964, which also lists 2 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 11 Dec 2024.

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