E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Non-Squamous Non-Small Cell Lung Cancer |
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E.1.1.1 | Medical condition in easily understood language |
Lung cancer of the non-squamous and non-small cell type that cannot come from the cells that line the inner airways of the lungs or be of the type with very small cancer cells
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029522 |
E.1.2 | Term | Non-small cell lung cancer stage IV |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 compare the efficacy of Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer |
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E.2.2 | Secondary objectives of the trial |
• To compare the safety of Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the rate of immunogenicity of Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To determine population pharmacokinetics of demcizumab when combined with carboplatin and pemetrexed in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Signed Informed Consent Form
2. Histologically or cytologically confirmed Stage IV non-squamous non-small cell lung cancer
3. Availability of FFPE tumor tissue, either fresh core-needle-biopsied or archived
4. Age >21 years
5. ECOG performance status of 0 or 1
6. Disease that is measurable per RECIST v1.1
7. Adequate organ and marrow function
8. For women of childbearing potential, agreement to use two effective forms of contraception |
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E.4 | Principal exclusion criteria |
1. Histologically or cytologically documented, advanced, mixed non-small cell and small cell tumors or mixed adenosquamous carcinomas
2. NSCLC with EGFR mutation or anaplastic lymphoma kinase (ALK) gene translocation (such as EML4-ALK)
3. Prior or ongoing therapy (including chemotherapy, antibody therapy, tyrosine kinase inhibitors, radiotherapy, immunotherapy, hormonal therapy, or investigational therapy) for the treatment of Stage IV non-squamous non-small cell lung cancer
4. Evidence of tumor invading major blood vessels, cavitation of one or more pulmonary tumor mass(es) or tracheo-esophageal fistula
5. Brain metastases, leptomeningeal disease, uncontrolled seizure disorder, or active neurologic disease
6. Metastases involving the lumen of the gastrointestinal tract
7. Malignancies other than non-squamous non-small cell lung cancer successfully treated within 3 years prior to randomization (with the exception of certain early-stage cancers)
8. History of a significant allergic reaction attributed to humanized or human monoclonal antibody therapy
9. Significant intercurrent illness defined as an illness that may result in the subject’s death prior to their death from non-squamous non-small cell lung cancer and/or significantly limit their ability to comply with the requirements of this study
10. Recent hemoptysis >2.5 mL or serious bleeding from another site, known bleeding disorder or coagulopathy or therapeutic anti-coagulation
11. History of cerebral vascular accident (CVA) or transient ischemic attacks (TIAs) within 6 months of randomization
12. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to randomization, or anticipation of need for major surgical procedure during the course of the study
13. Blood pressure (BP) of >140/90 mmH
14. History, signs or symptoms indicative of an increased cardiac risk, including, but not limited to BNP value of >100 pg/mL, left ventricular ejection fraction (LVEF) <50%, peak tricuspid velocity >3.0 m/s on Doppler echocardiogram, history of or current cardiac ischemia or congestive heart failure |
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E.5 End points |
E.5.1 | Primary end point(s) |
To compare the Investigator-assessed median progression-free survival as assessed by RECIST v1.1 in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non squamous non-small cell lung cancer |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• To compare the Investigator-assessed RECIST v1.1 response rate in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the Investigator-assessed RECIST v1.1 clinical benefit rate (i.e., the rate of complete response + partial response + stable disease) in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the Investigator-assessed progression-free survival at 6 months in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the median survival in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the Independent-Review-Facility-assessed RECIST v1.1 response rate and progression-free survival based solely on radiographs in Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To determine the half-life, volume of distribution and clearance of demcizumab when combined with carboplatin and pemetrexed in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the safety profile through adverse events, monitoring, physical examination, vital signs, and clinical laboratory testing as outlined in the Schedule of Assessments between Arm 1 to Arm 2 and Arm 1 to Arm 3 in subjects with 1st-line stage IV non-squamous non-small cell lung cancer
• To compare the incidence of anti-demcizumab antibody development and neutralizing antibody development in subjects with 1st-line stage IV non-squamous non-small cell lung cancer in Arm 1 to Arm 2 and Arm 1 to Arm 3 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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.8.2.4 | Number of treatment arms in the trial | 3 |
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.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
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 | No |
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 |
Australia |
Belgium |
France |
Italy |
Spain |
United States |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |