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A Study of XL184 (Cabozantinib) With or Without Erlotinib in Adults With Non-Small Cell Lung Cancer

Phase 1
Completed
Conditions
Carcinoma, Non-Small-Cell Lung
Interventions
Registration Number
NCT00596648
Lead Sponsor
Exelixis
Brief Summary

In Phase 1 of this study, the purpose is to evaluate the safety, tolerability, and highest safe dose of the multiple receptor tyrosine kinase inhibitor (including VEGFR2, MET, and RET) XL184 in combination with the EGFR inhibitor erlotinib administered to adults with Non-Small-Cell Lung Cancer (NSCLC). In Phase 2 of this study, the purpose is to evaluate the objective response rate of daily oral administration of XL184 with or without erlotinib in subjects with NSCLC who have progressed after responding to treatment with erlotinib.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
92
Inclusion Criteria
  • Histologically confirmed NSCLC and Stage 3b or 4 NSCLC (Phase 1 only), Stage 3b or 4 NSCLC (Phase 2 only)
  • Documented progressive disease following a prior RECIST response to monotherapy with erlotinib OR documented progressive disease following stable disease of at least 6 months on monotherapy with erlotinib (Phase 2 only)
  • Must have tolerated erlotinib at the maximal dose that will be administered in Phase 2 only (or at a higher dose) for a minimum of 6 weeks
  • Measurable disease per RECIST (Phase 2 only)
  • At least 18 years old
  • ECOG performance status of 0 or 1
  • Adequate organ and marrow function
  • Sexually active subjects must agree to use medically accepted methods of contraception during the course of the study and for 3 months following discontinuation of study treatment (excluding women who are not of child bearing potential and men who have been sterilized).
  • Female subjects of childbearing potential must have a negative pregnancy test at enrollment
  • No other diagnosis of malignancy (unless non-melanoma skin cancer, carcinoma in situ of the cervix or malignancy diagnosed ≥ 2 years previously, and currently with no evidence of disease).
  • Capable of understanding and complying with the protocol, and written informed consent
Exclusion Criteria
  • Received anti-cancer treatment within 4 weeks, except erlotinib, prior to first dose (Phase 1 only)

  • In Phase 2 only: the subject has received:

    • Small molecule inhibitors of VEGFR2/KDR OR
    • An investigational anti-cancer agent within 4 weeks of the first dose of study drug OR
    • An investigational agent that targets EGF or EGFR at any time OR
    • An approved agent that targets EGF or EGFR (with the exception of erlotinib and gefitinib) at any time unless approved by Exelixis OR
    • Anti-cancer therapy within 4 weeks (with the exception of gefitinib and erlotinib) of the first dose of study drug OR
    • Prior therapy with a c-Met inhibitor
  • Not recovered to NCI CTCAE v.3 Grade ≤1 from clinically significant adverse events due to antineoplastic agents, investigational drugs, or other medications administered prior to study enrollment

  • Symptomatic or uncontrolled brain metastases requiring current treatment, including steroids and anticonvulsants

  • History of significant hematemesis or recent history of hemoptysis

  • Presence of cavitation, central lesion, or lesion abutting a major blood vessel

  • Intercurrent illness such as hypertension or cardiac arrhythmias or recent history of significant disease such as congestive heart failure

  • Pregnant or breastfeeding

  • Active bacterial or viral infection requiring systemic treatment

  • Allergy or hypersensitivity to components of either the XL184 or erlotinib formulations

  • Incapable of understanding and complying with the protocol or unable to provide informed consent

  • History of idiopathic pulmonary fibrosis or interstitial lung disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Phase 2 Arm 2XL184XL184 administered as a single agent
Phase 2 Arm 1XL184XL184 + erlotinib (dose determined from Phase 1 portion of study)
Phase 1 ArmXL184Escalating doses of XL184 + erlotinib
Phase 1 ArmerlotinibEscalating doses of XL184 + erlotinib
Phase 2 Arm 1erlotinibXL184 + erlotinib (dose determined from Phase 1 portion of study)
Primary Outcome Measures
NameTimeMethod
In Phase 1 of the study: evaluate safety, tolerability, and maximum tolerated dose of daily oral administration of XL184 in combination with erlotinib to subjects with NSCLCAssessed at each visit
In Phase 1 of the study, to evaluate pharmacodynamic effects of XL184 administration in combination with erlotinibAssessed at periodic visits
In Phase 1 of the study, to characterize pharmacokinetic parameters of single agent erlotinib, and of XL184 in combination with erlotinibAssessed at periodic visits (approx. every 8 weeks)
In Phase 2 of the study, to estimate the objective response rate of XL184 with or without erlotinib in adults with NSCLC who have progressed after responding to erlotinibAssessed approx. every 8 weeks
In Phase 2 of the study, to assess pharmacodynamic effects of XL184 administration either alone or with erlotinibAssessed at periodic visits
Secondary Outcome Measures
NameTimeMethod
In Phase 1 and 2 of the study, to evaluate the long-term safety and tolerability of XL184 administered either alone or in combination with erlotinibAssessed at periodic visits
In Phase 2 of the study, to assess progression-free survival, duration of response, and overall survival following treatment with XL184 either alone or in combination with erlotinibAssessed at periodic visits (approx. every 8 weeks)
In Phase 2 of the study, to characterize pharmacokinetic parameters of XL184 as a single agent and XL184 in combination with erlotinib in subjects with NSCLCAssessed at periodic visits (every 8 weeks)

Trial Locations

Locations (13)

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Georgetown University/Lombardi Comprehensive Cancer Center

🇺🇸

Washington, District of Columbia, United States

Park Nicollet Institute

🇺🇸

St. Louis Park, Minnesota, United States

Summit Medical Group

🇺🇸

Berkeley Heights, New Jersey, United States

Katmai Oncology Group

🇺🇸

Anchorage, Alaska, United States

Stanford University Medical Center

🇺🇸

Palo Alto, California, United States

Case Western Reserve University

🇺🇸

Cleveland, Ohio, United States

University of California, Davis

🇺🇸

Sacramento, California, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Yale University School of Medicine

🇺🇸

New Haven, Connecticut, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Washington/ Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

Swedish Cancer Institute

🇺🇸

Seattle, Washington, United States

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