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Non-Small Cell Lung CancerPhase 2NCT03472560

A Study of Avelumab in Combination With Axitinib In Non-Small Cell Lung Cancer (NSCLC) or Urothelial Cancer (Javelin Medley VEGF)

A Phase 2 study testing Avelumab (MSB0010718C) and Axitinib (AG-013736) in people with Non-Small Cell Lung Cancer and Urothelial Cancer, run by Pfizer at 39 sites in 8 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a Phase 2 study to evaluate the safety and efficacy of avelumab in combination with axitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) who have received at least one prior platinum containing therapy, and in treatment naïve patients with advanced or metastatic urothelial… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-Small Cell Lung Cancer, Urothelial Cancer
What is being tested?
Avelumab (MSB0010718C) and Axitinib (AG-013736)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
61 participants
Where
39 sitesin 8 countries
Study dates
2 May 2018to 9 Feb 2023
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

  • Non-small cell lung cancer (NSCLC) Cohort: Histologically or cytologically confirmed diagnosis of NSCLC that is locally advanced or metastatic; No activating EGFR mutations, ALK or ROS1 translocations/rearrangements where testing is standard of care; received at least 1 prior platinum-based chemotherapy regimen for locally advanced or metastatic NSCLC; No more than 2 prior lines of systemic therapy for locally advanced or metastatic disease (If disease progression occurred during or within 6 months after neoadjuvant/adjuvant chemotherapy or radiotherapy-chemotherapy, the regimen is counted as 1 prior treatment regimen towards the allowed limit of prior treatment regimens); Checkpoint inhibitor naïve.
  • Urothelial Cancer (UC) Cohort: Histologically or cytologically confirmed diagnosis of transitional cell carcinoma (TCC) of the urothelium (if mixed, more than 50% TCC component) including bladder, urethra, ureters, or renal pelvis that is locally advanced or metastatic; No prior systemic treatment for locally advanced or metastatic disease; Prior neoadjuvant or adjuvant therapy is permitted if disease progression occurred >12 months after the completion of therapy; Checkpoint inhibitor naïve; Ineligible for receiving cisplatin-containing front-line chemotherapy based at least one of the following criteria: ECOG performance status (PS) 2; Renal dysfunction (defined as creatinine-clearance <60 ml/min); Grade 2 peripheral neuropathy; Grade 2 hearing loss (hearing loss measured by audiometry of 25 decibels at two contiguous frequencies).
  • At least 1 measurable lesion by RECIST v1.1 not previously irradiated.
  • Availability of an archival FFPE tumor tissue block from primary diagnosis specimen or metastatic specimen or 15 unstained slides (10 minimum). If an archived sample is not available, a fresh tumor biopsy must be performed.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. For UC patients, ECOG performance 2 is permitted (cisplatin ineligibility criterion)

Who cannot join

  • Prior immunotherapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, anti-OX-40, anti-GITR, anti-LAG-3, anti-TIM-3 or anti-CTLA-4 antibody (including ipilimumab).
  • Newly diagnosed brain metastases or known symptomatic brain metastases requiring steroids.
  • Radiologically documented evidence of major blood vessel invasion or encasement by cancer or intratumor cavitation, regardless of tumor histology.
  • Active autoimmune disease (that might deteriorate when receiving an immunostimulatory agent).
  • Current use of immunosuppressive medication (except for those listed in protocol).
  • Known prior severe hypersensitivity to the investigational products /monoclonal antibodies.
  • Known history of immune-mediated colitis, inflammatory bowel disease, immune-mediated pneumonitis, pulmonary fibrosis.
  • NCI CTCAE Grade 3 hemorrhage within 28 days prior to study enrollment.

Trial locations and contacts

39 sites in 8 countries.

39 sites in 8 countries

United States14 sites
  • Arizona Oncology Associates- Saguaro Cancer Center

    Glendale, Arizona, 85308

  • The Oncology Institute of Hope and Innovation

    Glendale, California, 91204

  • Arizona Oncology Associates

    Goodyear, Arizona, 85395

  • Saint Francis Hospital

    Greenville, South Carolina, 29601

  • Saint Francis Hospital Cancer Center

    Greenville, South Carolina, 29607

  • The Oncology Institute of Hope and Innovation

    Long Beach, California, 90805

  • Oncology Hematology West, PC dba Nebraska Cancer Specialists

    Omaha, Nebraska, 68114

  • Oncology Hematology West, PC dba Nebraska Cancer Specialists

    Omaha, Nebraska, 68130

  • Arizona Oncology Associates- Biltmore Cancer Center

    Phoenix, Arizona, 85016

  • Arizona Oncology Associates- Deer Valley Cancer Center

    Phoenix, Arizona, 85027

  • The Oncology Institute of Hope and Innovation

    Santa Ana, California, 92705

  • Oncology Hematology Associates

    Springfield, Missouri, 65807

  • Arizona Oncology Associates- East Valley Cancer Center

    Tempe, Arizona, 85281

  • The Oncology Institute of Hope and Innovation

    Whittier, California, 90602

Other trials in United States

Russia5 sites
  • LLC "University clinic of headache"

    Moscow, 109028

  • Limited Liability Company "VitaMed" (LLC "VitaMed")

    Moscow, 121309

  • LLC "University Clinic of Headache"

    Moscow, 121467

  • Limited Liability Company "VitaMed" (LLC "VitaMed")

    Moscow, 129515

  • GBUZ of Stavropol Territory "Pyatigorsk Inter-regional Oncology Dispanser"

    Pyatigorsk, Stavropol Territory, 357502

Other trials in Russia

South Korea5 sites
  • Samsung Medical Center

    Gangnam-gu, Seoul, 06351

  • National Cancer Center

    Goyang-si, Gyeonggi-do, 10408

  • Seoul National University Bundang Hospital

    Seongnam-si, Gyeonggi-do, 13620

  • Severance Hospital, Yonsei University Health System

    Seoul, 03722

  • Asan Medical Center

    Songpa-gu, Seoul, 05505

Other trials in South Korea

Italy4 sites
  • Azienda Ospedaliero Universitaria Policlinico Umberto I

    Roma, 00161

  • Cardiologia - Azienda Ospedaliero Universitaria Policlinico Umberto I

    Roma, 00161

  • Farmacia Azienda Ospedaliero Universitaria Policlinico Umberto I

    Roma, 00161

  • UOC di Radiologia - Azienda Ospedaliero Universitaria Policlinico Umberto I

    Roma, 00161

Other trials in Italy

Poland4 sites
  • Regionalny Szpital Specjalistyczny Im. Dr. Wladyslawa Bieganskiego w Grudziadzu

    Grudziądz, 86-300

  • Centrum Medyczne Dom Lekarski S.A.

    Szczecin, 70-784

  • Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy w Warszawie

    Warsaw, Masovian Voivodeship, 02-781

  • Centrum Onkologii Instytut im. Marii Sklodowskiej-Curie w Warszawie

    Warsaw, 02-781

Other trials in Poland

Hungary3 sites
  • Bacs-Kiskun Megyei Korhaz Onkoradiologiai Kozpont

    Kecskemét, H-6000

  • Pecsi Tudomanyegyetem Klinikai Kozpont

    Pécs, H-7624

  • Tudogyogyintezet Torokbalint

    Törökbálint, H-2045

Other trials in Hungary

Spain2 sites
  • Consorcio Hospitalario Provincial de Castellon

    Castellon, Castellon, 12002

  • Instituto Catalan de Oncologia

    L'Hospitalet de Llobregat, Barcelona, 08908

Other trials in Spain

Taiwan2 sites
  • Chi Mei Hospital, Liouying

    Tainan, Liouying District, 73657

  • National Cheng Kung University Hospital

    Tainan, 704

Other trials in Taiwan

About this study

Official title: A PHASE 2, OPEN LABEL STUDY TO EVALUATE SAFETY AND CLINICAL ACTIVITY OF AVELUMAB (BAVENCIO (REGISTERED)) IN COMBINATION WITH AXITINIB (INLYTA (REGISTERED)) IN PATIENTS WITH ADVANCED OR METASTATIC PREVIOUSLY TREATED NON-SMALL CELL LUNG CANCER OR TREATMENT NAÏVE CISPLATIN-INELIGIBLE UROTHELIAL CANCER JAVELIN MEDLEY VEGF

This is a Phase 2 study to evaluate the safety and efficacy of avelumab in combination with axitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) who have received at least one prior platinum containing therapy, and in treatment naïve patients with advanced or metastatic urothelial cancer, who are ineligible for cisplatin containing chemotherapy for their advanced disease.

Being tested
Avelumab (MSB0010718C), Axitinib (AG-013736)
Keywords
Cancer, non-small cell lung cancer, non small cell lung cancer, NSCLC, lung cancer, urothelial cancer, bladder cancer, Avelumab, Bavencio, Axitinib, Inlyta
Medical subject headings
Carcinoma, Non-Small-Cell Lung, Neoplasms, Lung Neoplasms, Urinary Bladder Neoplasms

What participants receive

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

  • Avelumab (MSB0010718C)Drug

    Also called Bavencio

    IV treatment: Avelumab administered at 800 mg IV every two weeks

  • Axitinib (AG-013736)Drug

    Also called Inlyta

    Oral treatment: Axitinib given 5 mg PO BID

Study groups in NCT03472560
Study groupRoleWhat they receive
Avelumab in combination with axitinibExperimentalAvelumab administered at 800 mg IV every two weeks in combination with axitinib, 5 mg PO BID.
Receives: Drug: Avelumab (MSB0010718C); Drug: Axitinib (AG-013736)

What is being measured

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

  1. Percentage of Participants With Confirmed Objective Response- Objective Response Rate (ORR)

    ORR: percentage of participants with a confirmed Complete Response (CR) or Partial Response (PR) based on investigator's assessment as per Response Evaluation Criteria in Solid Tumours (RECIST version [v] 1.1). Both CR and PR were confirmed by repeat assessments performed no less than 4 weeks after criteria for response was first met. Per RECIST v1.1: CR was defined as complete disappearance of all target lesions and non-target disease, with exception of nodal disease. All nodes, both target and non-target, must decrease to normal (short axis less than [<]10 millimeter [mm]). No new lesions. PR was defined as greater than or equal to (>=) 30 percent (%) decrease under baseline of sum of diameters of all target lesions. Short axis was used in sum for target nodes, while longest diameter was used in sum for all other target lesions. No unequivocal progression of non-target disease. No new lesions. Stable disease was defined as not qualifying for CR, PR, Progressive Disease.

    Measured: Baseline up to 56 months

Secondary outcomes (17)
  1. Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) During the On-Treatment Period

    An Adverse Event (AE) was any untoward medical occurrence attributed to study drug in a participant who received avelumab or axitinib. Treatment-emergent adverse events (TEAEs) were those events with onset dates occurring during the on-treatment period (the time from the first dose of study treatment through minimum 30 days post last dose of study treatment or start day of new anti-cancer treatment -1 day).

    Measured: From first dose of study treatment (Day 1) up to 30 days post last dose of study treatment or start of new anti-cancer treatment -1 day (maximum up to 56 months)

  2. Percentage of Participants With Hematology Test Results of Maximum National Cancer Institute; Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade During the On-Treatment Period

    The following hematology parameters were assessed: anemia, hemoglobin increased, international normalized ratio (INR) increased, lymphocyte count decreased, lymphocyte count increased, neutrophil count decreased, platelet count decreased and white blood cell decreased. Laboratory abnormality events were graded according to NCI CTCAE v 4.03 (grade 3= severe and grade 4= life-threatening). Categories with non-zero values are presented.

    Measured: From first dose of study treatment (Day 1) up to 30 days post last dose of study treatment or start of new anti-cancer treatment -1 day (maximum up to 56 months)

  3. Percentage of Participants With Chemistry Test Results of Maximum CTCAE Grade During the On-Treatment Period

    The following chemistry parameters were assessed: alanine aminotransferase increased, alkaline phosphatase increased, aspartate aminotransferase increased, blood bilirubin increased, cholesterol high, creatine phosphokinase (CPK) increased, creatinine increased, gamma-glutamyl transferase (GGT) increased, hypercalcemia, hyperglycemia, hyperkalemia, hypermagnesemia, hypernatremia, hypertriglyceridemia, hypoalbuminemia, hypocalcemia, hypoglycemia, hypokalemia, hypomagnesemia, hyponatremia, hypophosphatemia, lipase increased and serum amylase increased. Laboratory abnormalities were graded according CTCAE version 4.03 (grade 3= severe, grade 4= life-threatening and grade 5= death related). Categories with non-zero values are presented.

    Measured: From first dose of study treatment (Day 1) up to 30 days post last dose of study treatment or start of new anti-cancer treatment -1 day (maximum up to 56 months)

  4. Time to Tumor Response (TTR) in Participants With Confirmed CR or PR

    TTR was defined as the time from the first dose of study treatment to the first documentation of objective tumor response documented in participants with confirmed objective response (CR or PR). CR was defined as complete disappearance of all target lesions and non-target disease, with the exception of nodal disease. All nodes, both target and non-target, must decrease to normal (short axis <10 mm). No new lesions. PR was defined as >=30% decrease under baseline of the sum of diameters of all target lesions. The short axis was used in the sum for target nodes, while the longest diameter was used in the sum for all other target lesions. No unequivocal progression of non-target disease. No new lesions. Analysis was performed using Kaplan-Meier method.

    Measured: From date of start of treatment until date of first documentation of objective tumor response (maximum up to 56 months)

  5. Duration of Response in Participants With Confirmed CR or PR

    Duration of response was defined as the time from the first documentation of objective tumor response to the first documentation of objective tumor progression or to death due to any cause, whichever occurred first in participants with confirmed objective response (CR or PR). CR was defined as complete disappearance of all target lesions and non-target disease, with the exception of nodal disease. All nodes, both target and non-target, must decrease to normal (short axis <10 mm). No new lesions. PR was defined as >=30% decrease under baseline of the sum of diameters of all target lesions. The short axis was used in the sum for target nodes, while the longest diameter was used in the sum for all other target lesions. No unequivocal progression of non-target disease. No new lesions. Analysis was performed using Kaplan-Meier method.

    Measured: From date of first documentation of objective tumor response to the first documentation of objective tumor progression or to death due to any cause, whichever occurred first (maximum up to 56 months)

  6. Progression Free Survival (PFS)

    PFS was defined as the time from first dose of study treatment (ie, start date) to the date of progression of disease (PD) by RECIST v 1.1 or death due to any cause, whichever occurred first. PFS data was censored on the date of the last adequate tumor assessment for participants without an event (PD or death), for participants who started new anti-cancer treatment prior to an event, or for participants with an event after two or more missing tumor assessments. PD as per RECIST v1.1 for target lesions was defined as 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy), with a minimum absolute increase of 5 mm. For non-target lesions PD was defined as unequivocal progression of pre-existing lesions. Analysis was performed using Kaplan-Meier method.

    Measured: From start of study treatment until first documentation of PD or death due to any cause or censoring date (maximum of 24 months)

  7. Overall Survival

    Overall survival was defined as the time from the date of first study treatment to the date of death due to any cause. Participants last known to be alive were censored at date of last contact. Analysis was performed using Kaplan-Meier method.

    Measured: From date of start of study treatment until date of death or censoring date (maximum up to 56 months)

  8. Maximum Observed Serum Concentration (Cmax) of Avelumab

    Measured: Pre-dose, 1 hour post-dose on Cycle 1 Day 1, Day 15 and Cycle 2 Day 1

  9. Cmax of Axitinib

    Measured: Pre-dose, 2 hour post-dose on Cycle 1 Day 15, Cycle 2 Day 1 and 15

  10. Pre-dose Observed Serum Concentration (Ctrough) of Avelumab

    Measured: Pre-dose on Cycle 1 Day 1, 15, Cycle 2 Day 1, Cycle 3 Day 15, Cycle 6 Day 15, Cycle 9 Day 15, and Cycle 12 Day 15

  11. Ctrough of Axitinib

    Measured: Pre-dose on Cycle 1 Day 15, Cycle 2 Day 1 and 15

  12. Number of Participants With Programmed Death-Ligand 1 (PD-L1) Status

    PD-L1 status was defined as positive when PD-L1 staining of any intensity was observed in >= 1% of the tumor cells. PD-L1 status was defined as negative when PD-L1 staining of any intensity was observed in < 1% of the tumor cells.

    Measured: Screening, up to 28 days prior to Day 1

  13. Tumour Mutational Burden (TMB) in Tumor Tissue

    Mutational load within tumor tissue was defined as number per megabase of the genome, coding, base substitution, and indel mutations present in the sample. Mutational load was determined in whole blood samples using next generation deoxyribonucleic acid (DNA) sequencing followed by computational analysis.

    Measured: Screening, up to 28 days prior to Day 1

  14. T-cell Receptor (TCR) Sequencing to Identify Fraction Productive of Cells

    The immune response was measured by total T cell receptor (TCR) sequencing in peripheral blood and determined the characterization of immune repertoires. Fraction productive of cells is defined as the number of T cells within the total nucleated cell count (T cells and non-T cells).

    Measured: Screening, up to 28 days prior to Day 1

  15. T-cell Receptor (TCR) Sequencing to Identify Simpson Clonality

    The immune response was measured by TCR sequencing in peripheral blood and determined the characterization of immune repertoires. Simpson clonality is calculated for a sample as the square root of Simpson's diversity index for all productive rearrangements. Values for clonality ranged from 0 to 1. Values near 1 represented samples with one or a few predominant rearrangements (monoclonal or oligoclonal samples) dominating the observed repertoire. Clonality values near 0 represented more polyclonal samples.

    Measured: Pre-dose on Day 1 of Cycle 1

  16. T-cell Receptor (TCR) Sequencing to Identify Total T Cells

    The immune response was measured by total TCR sequencing in peripheral blood and determined the characterization of immune repertoires.

    Measured: Pre-dose on Day 1 of Cycle 1

  17. Number of Participants With Positive Anti-drug Antibody (ADA) and Neutralizing Antibodies (nAb) Against Avelumab

    ADA and nAb positive was defined as presence of at least one positive ADA and nAb sample, respectively. NAb analysis was planned to be conducted for ADA positive samples.

    Measured: Within 2 hours pre-dose on Cycle 1 Day 1,15, Cycle 2 Day 1; Day 15 of Cycle 3, 6, 9, 12, end of treatment and 30 days after last dose of study treatment (maximum up to 56 months)

Timeline

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

  1. First posted21 Mar 2018
  2. Study start2 May 2018
  3. Primary completion9 Feb 2023
  4. Study completion9 Feb 2023

Why it stopped: The study was terminated since there was no need for further safety or efficacy data to be collected. The participants having benefit from the Investigational treatments have been moved to a continuation study (NCT05059522)

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
61 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03472560
Sponsor's protocol ID
B9991027
Other IDs
2017-004345-24, AVE/ AXI COMBO UC, AVE/AXI COMBO UC/NSCLC, 2017
Status last verified
Mar 2024
First submitted
28 Feb 2018
Last updated
9 Apr 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.

Publications

  • Galffy G, Lugowska I, Poddubskaya EV, Cho BC, Ahn MJ, Han JY, Su WC, Hauke RJ, Dyar SH, Lee DH, Serwatowski P, Estelles DL, Holden VR, Kim YJ, Vladimirov V, Horvath Z, Ghose A, Goldman A, di Pietro A, Wang J, Murphy DA, Alhadab A, Laskov M. A phase II open-label trial of avelumab plus axitinib in previously treated non-small-cell lung cancer or treatment-naive, cisplatin-ineligible urothelial cancer. ESMO Open. 2023 Jun;8(3):101173. doi: 10.1016/j.esmoop.2023.101173. Epub 2023 May 2.

    PubMed 37141847

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Avelumab (MSB0010718C) and Axitinib (AG-013736) in people with Non-Small Cell Lung Cancer and Urothelial Cancer, run by Pfizer at 39 sites in 8 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 5 inclusion and 8 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: stopped early, as of the sponsor's last update on 9 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in United States, Russia, South Korea, Italy, Poland and 3 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 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 9 Apr 2024). 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?

Percentage of Participants With Confirmed Objective Response- Objective Response Rate (ORR) (time frame: Baseline up to 56 months). 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 NCT03472560, 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 9 Apr 2024.

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