E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Subjects with unresectable stage IIIB with pericardial or pleural effusion or stage IV or recurrent Non Small Cell Lung Cancer (NSCLC)
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029521 |
E.1.2 | Term | Non-small cell lung cancer stage IIIB |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029515 |
E.1.2 | Term | Non-small cell lung cancer recurrent |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029522 |
E.1.2 | Term | Non-small cell lung cancer stage IV |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine if treatment with AMG 706 in combination with paclitaxel and carboplatin improves overall survival compared to treatment with placebo in combination with paclitaxel and carboplatin in subjects with advanced non-squamous NSCLC and in subjects with adenocarcinoma histology (adenocarcinoma subpopulation). |
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E.2.2 | Secondary objectives of the trial |
∙ To evaluate progression-free-survival time, objective tumor response rate (only in subjects with measurable disease) and duration of response in subjects with non-squamous NSCLC histology and in subjects with adenocarcinoma
histology
∙ To evaluate the safety and tolerability of AMG 706 in combination with paclitaxel and carboplatin compared to placebo in combination with paclitaxel and carboplatin in subjects with non-squamous NSCLC histology and adenocarcinoma histology
∙ To evaluate OS, PFS, ORR (only in subjects with measurable disease) and duration of response in subjects with non-squamous, non-adenocarcinoma histology
∙ To evaluate the pharmacokinetics (Cmin and Cmax) of AMG 706 when administered with paclitaxel and carboplatin (in approximately 250 subjects at selected centers)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Disease related
∙ Histologically confirmed (cytological specimens obtained by bronchial washing or brushing, or fine-needle aspiration are acceptable), unresectable stage IIIB with pericardial or pleural effusion or stage IV or recurrent non-squamous NSCLC. Evaluation of effusions (ie, with cytology) is not required if diagnosis of non-squamous NSCLC has been otherwise histologically confirmed.
∙ Measurable or non-measurable disease per modified RECIST criteria
∙ ECOG performance status of 0 or 1
∙ Life expectancy of ≥ 3 months as documented by the investigator.
Demographic
∙ Men or women aged ≥ 18 years old.
Laboratory
∙ Hematological function, as follows:
- Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
- Platelet count ≥ 100 x 109/L and ≤ 850 x 109/L
- Hemoglobin ≥ 9 g/dL
∙ Renal function, as follows:
- Creatinine clearance (GFR) > 40 mL/min (calculated by Cockcroft-Gault formula, see Section 6.2.2.2).
- Urinary protein quantitative value of ≤ 30 mg in urinalysis or ≤ 1+ on dipstick unless total quantitative protein is < 500 mg in a 24-hour urine sample.
∙ Hepatic function, as follows:
- Aspartate aminotransferase (AST) ≤ 2.5 x upper limit of normal ULN OR AST < 5 x ULN if liver metastases are present.
- Alanine aminotransferase (ALT) ≤ 2.5 x ULN OR ALT < 5 x ULN if liver metastases are present.
- Alkaline phosphatase ≤ 2.0 x ULN OR alkaline phosphatase < 5 x ULN if liver or bone metastases are present.
- Total bilirubin < 1.5 x ULN OR if total bilirubin < 3 X ULN if subject has UGT1A1 promoter polymorphism (ie, Gilbert syndrome) confirmed by genotyping or Invader® UGT1A1 Molecular Assay prior to randomization.
- Partial thromboplastin (PTT) or activated partial thromboplastin (aPTT)
≤ 1 x ULN and international normalized ratio (INR) ≤ 1.5 x ULN.
Ethical
∙ Competency to give written informed consent.
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E.4 | Principal exclusion criteria |
Disease Related • Subjects with adenosquamous histology or an unclear histology subtype (eg, not otherwise specified) containing greater than 10% squamous cells • Untreated or symptomatic central nervous system metastases. Subjects with a history of brain metastases are eligible if definitive therapy has been administered (surgery and/or radiation therapy), there is no planned treatment for brain metastasis, and the subject is clinically stable and is off corticosteroids for at least 2 weeks prior to randomization. • Prior chemotherapy as follows: - Any prior chemotherapy for advanced non-squamous NSCLC - Any prior adjuvant chemotherapy for non-squamous NSCLC within 52 weeks prior to randomization. Adjuvant chemotherapy completed > 52 weeks prior to randomization is permitted - Any prior chemoradiation for locally advanced stage III disease • Central (chest) radiation therapy within 28 days prior to randomization, radiation therapy within 14 days prior to randomization for peripheral lesions. • History of pulmonary hemorrhage or gross hemoptysis (approximately 3 mL of bright red blood or more) within 6 months prior to randomization. Medications • Prior targeted therapies, including but not limited to: - AMG 706, inhibitors of VEGF (eg, SU5416, SU6668, ZD6474, SU11248, PTK787, AZD2171, AEE-788, sorafenib, bevacizumab), or EGFr (eg, panitumumab, cetuximab, gefitinib, erlotinib) • Any anticoagulation therapy within 7 days prior to randomization. The use of low-dose warfarin [≤ 2 mg daily] or low molecular weight heparin or heparin flushes for prophylaxis against central venous catheter thrombosis is allowed. • Known history of allergy or hypersensitivity reaction to paclitaxel or carboplatin. General • Prior (within 30 days of randomization) yellow fever vaccination • History of arterial or venous thrombosis within 12 months prior to randomization. • History of bleeding diathesis or bleeding within 14 days prior to randomization. • Peripheral neuropathy > grade 1 per Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0. • Clinically significant cardiac disease within 12 months of randomization, including myocardial infarction, unstable angina, grade 2 or greater peripheral vascular disease, cerebrovascular accident, transient ischemic attack, percutaneous transluminal coronary angioplasty/stent, congestive heart failure or ongoing arrhythmias requiring medication. • Any kind of disorder that compromises the ability to comply with the study procedures. • Open wound, ulcer or fracture. • Active infection requiring systemic treatment or any uncontrolled systemic infection ≤ 14 days prior to randomization. • Uncontrolled hypertension as defined by resting blood pressure > 150/90 mm Hg. Anti-hypertensive medications are allowed if the subject is stable on their current dose at the time of randomization. • History of other primary cancer unless: - Curatively resected non-melanomatous skin cancer - Curatively treated cervical carcinoma in situ - Other primary solid tumor curatively treated with no known active disease present and no curative treatment administered for the last 3 years • Surgery: - Major surgical procedures within 28 days prior to randomization. - Minor surgical procedures within 14 days prior to randomization. - Failure to recover from prior surgery. - Placement of a central venous access device (including ports and tunneled or non- tunneled catheters) within 7 days prior to randomization. - Planned elective surgery while on study treatment. - Core needle biopsy within 7 days prior to randomization. • Not recovered from all previous therapies (ie, radiation, surgery and medications). Adverse events related to previous therapies must be CTCAE grade ≤ 1 at screening or returned to the subject’s baseline prior to their most recent previous therapy. • Participation in therapeutic clinical trials or currently receiving other investigational treatment(s) within 30 days prior to randomization. • Pregnant (eg, positive HCG test-urine or serum) or breast feeding woman. • Any subject not consenting to use adequate contraceptive precautions (eg, hormonal, barrier or abstinence) during the course of the study and for 6 months after the last treatment. • Known to be human immunodeficiency virus (HIV), hepatitis B surface antigen or hepatitis C positive. • Known chronic hepatitis. • History of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with the study participation or investigational product(s) administration or may interfere with the interpretation of the results. • Previously randomized to this study. • Not available for follow-up assessments or unable to comply with study requirements. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Overall survival time: Time from randomization to death. Subjects who have not died while on study or are lost to follow-up will be censored at their last contact date. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 52 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 9 |