Study to Evaluate Safety, Efficacy, Pharmacokinetics And Pharmacodynamics Of Avelumab In Combination With Either Crizotinib Or PF-06463922 In Patients With NSCLC. (Javelin Lung 101)
- Conditions
- Non-Small Cell Lung Cancer
- Interventions
- Registration Number
- NCT02584634
- Lead Sponsor
- Pfizer
- Brief Summary
The purpose of this study is to evaluate the safety and efficacy of avelumab when combined with either crizotinib or PF-06463922.
- Detailed Description
This is a Phase 1b/2, open label, multi center, multiple dose, safety, pharmacokinetic and pharmacodynamic study of Group A and Group B in cohorts of adult patients with locally advanced or metastatic NSCLC.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 43
Not provided
- No prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody.
- No Severe or Chronic medical conditions including gastrointestinal abnormalities or significant cardiac history
- No active infection requiring systemic therapy
- Prior organ transplantation including allogenic stem cell transplantation.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group A Crizotinib ALK negative Non-Small Cell Lung Cancer Group A Avelumab ALK negative Non-Small Cell Lung Cancer Group B Avelumab ALK positive Non-Small Cell Lung Cancer Group B PF-06463922 ALK positive Non-Small Cell Lung Cancer
- Primary Outcome Measures
Name Time Method Number of Participants With Dose-limiting Toxicities (DLTs): Phase 1b First 2 cycles (1 cycle = 14 days) Any of the following adverse events (AEs) occurring during the primary DLT observation period that are attributable to one, the other, or both study drugs were classified as DLTs: Grade 4 (life-threatening) neutropenia if \>7 days in duration; febrile neutropenia; Grade \>=3 (severe or life threatening) neutropenic infection; Grade \>=3 thrombocytopenia with bleeding; Grade 4 thrombocytopenia \>7 days; Grade 4 anemia; any Grade \>=3 toxicity, except for any of the following: transient (\<=6 hours) Grade 3 (severe) flu like symptoms or fever; transient (\<=24 hours) Grade 3 fatigue, local reactions, or headache that resolved to Grade \<=1 (no AE or mild AE); Grade 3 nausea and/or vomiting, diarrhea or skin toxicity that resolved to Grade \<=1 within 7 days; any Grade \>=3 amylase or lipase abnormality; tumor flare phenomenon; single laboratory values out of normal range that were not related to treatment, did not have any clinical correlate, and resolve to Grade \<=1 within 7 days.
Percentage of Participants With Objective Response (OR): Phase 2 Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) OR is defined as complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 from start date (the date of first dose of study treatment) until disease progression or death due to any cause. Both CR and PR must be confirmed by repeat assessments performed no less than 4 weeks after the criteria for response are first met. Per RECIST v1.1: CR is defined as the disappearance of all target or non-target lesions; any pathological lymph nodes (whether target or non target) must have reduction in short axis to \<10 mm and all lymph nodes must be non-pathological in size (\<10 mm short axis). PR is defined as a \>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions.
Percentage of Participants With CR for Group B: Phase 2 Baseline up to 60 months Per RECIST v1.1: CR is defined as the disappearance of all target or non-target lesions; any pathological lymph nodes (whether target or non target) must have reduction in short axis to \<10 mm and all lymph nodes must be non-pathological in size (\<10 mm short axis).
- Secondary Outcome Measures
Name Time Method Number of Participants With Baseline Laboratory Abnormalities Grade <=2 and Post-Baseline Laboratory Abnormalities of Grades 3 or 4 Per NCI CTCAE v4.03 Screening up to end of treatment/withdrawal (maximum of 5 years) The laboratory results were graded according to the NCI CTCAE v4.03 severity grade. Grade 1=mild AE. Grade 2=moderate AE. Grade 3=severe AE. Grade 4=life-threatening consequences; urgent intervention indicated. Shift tables were provided to examine the distribution of laboratory toxicities. The following parameters had met the criteria of CTCAE grade shift change from Grade \<=2 at baseline to Grade 3 or 4 post baseline: anemia, lymphocyte count decreased, lymphocyte count decreased, neutrophil count decreased, white blood cell decreased, alanine aminotransferase increased, aspartate aminotransferase increased, blood bilirubin increased, cholesterol high, Creatine phosphokinase (CPK) increased, Gamma glutamyl transferase (GGT) increased, hypercalcemia, hyperglycemia, hypermagnesemia, hypertriglyceridemia, hypoalbuminemia, hyponatremia, lipase increased, serum amylase increased. Baseline is defined as the last assessment prior to the date/time of the first dose of study treatment.
Disease Control Rate (DCR) Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) DC is defined as objective response (CR or PR) or stable disease (SD) per RECIST v.1.1 from the date of first dose of study treatment until disease progression or death due to any cause. The DCR is the proportion of patients with DC. Per RECIST v1.1: CR is defined as the disappearance of all target or non-target lesions; any pathological lymph nodes (whether target or non target) must have reduction in short axis to \<10 mm. PR is defined as a \>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions. SD is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD). PD is defined as a \>=20% increase in the sum of the longest dimensions of the target lesions taking as a reference the smallest sum of the longest dimensions recorded since the treatment started, or the appearance of one or more new lesions.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) Baseline up to 30 days after last dose of study treatment or the day before start day of new anti-cancer therapy (maximum of 5 years) TEAEs are those events with onset dates occurring during the on-treatment period for the first time, or if the worsening of an event is during the on-treatment period. Treatment-related AEs was any untoward medical occurrence attributed to study drug in a participant who received study drug. Per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.03: Grade 3 (Severe) events=unacceptable or intolerable events, significantly interrupting usual daily activity, require systemic drug therapy/other treatment; Grade 4 (Life-threatening) events caused participant to be in imminent danger of death; Grade 5 (Death) events=death related to an AE. A serious AE (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged in participant hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.
Number of Participants With Vital Signs Meeting Pre-defined Criteria Screening up to end of treatment/withdrawal (maximum of 5 years) Pre-defined criteria in vital signs: pulse rate \<50 beats per minute, pulse rate \>120 bpm, sitting diastolic blood pressure (DBP) increase and decrease in change from baseline of \>= 20 millimeter of mercury (mmHg), sitting systolic blood pressure(SBP) \< 90 mmHg, increase and decrease in change from baseline of \>= 30mmHg. Baseline is defined as the last assessment prior to the date/time of the first dose of study treatment.
Progression-free Survival (PFS) Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) PFS is defined as the time from start date (the date of first dose of treatment) to the date of the first documentation of PD per RECIST v1.1 or death due to any cause, whichever occurs first. Per RECIST v1.1: PD: a \>=20% increase in the sum of the longest dimensions of the target lesions taking as a reference the smallest sum of the longest dimensions recorded since the treatment started, or the appearance of one or more new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
Apparent Plasma Clearance (CL/F) of Crizotinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Clearance was estimated from population pharmacokinetic (PK) modeling. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.
Tmax of Crizotinib Metabolite PF-06260182 in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 Tmax of crizotinib metabolite PF-06260182 in the presence of avelumab was observed directly from data as time of first occurrence.
Duration of Response (DR) Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) DR: time from first documented occurrence of response (PR or CR) until date of first documented PD or death due to underlying cancer. Per RECIST 1.1: CR: disappearance of all non-nodal target lesions and of all non-target lesions; any pathological lymph nodes assigned as target lesions/non-target lesions have a reduction in short axis to \<10 mm. PR: at least a \>=30% decrease in sum of diameter of all target lesions, taking as reference baseline sum of diameters. PD: at least a \>=20% increase in sum of diameter of all measured target lesions, taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline. In addition to the relative increase of 20%, sum must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of existing non-target lesions. Appearance of new lesions. Participants with no PD and were still alive by 02 Feb 2020, were censored at last adequate tumor assessment. Kaplan-Meier method was used for DR analysis.
Time to Tumor Response (TTR) Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) TTR is defined, for participants with an objective response (CR or PR), as the time from the start date (the date of first dose of treatment) to the first documentation of objective response (CR or PR) which is subsequently confirmed. Per RECIST v1.1: CR: disappearance of all non-nodal target lesions and of all non-target lesions. In addition, any pathological lymph nodes assigned as target lesions/ non-target lesions must have a reduction in short axis to \<10 mm. PR: at least a 30% decrease in sum of diameter of all target lesions, taking as reference baseline sum of diameters.
Kaplan-Meier Estimates of Overall Survival (OS) Screening, Day 1 of each cycle starting Cycle 3, up to end of treatment/withdrawal (maximum of 5 years) OS is defined as the time from start date (the date of first dose of treatment) to the date of death due to any cause.
Maximum Plasma Concentration (Cmax) of Crizotinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 Cmax of crizotinib in the presence of avelumab was observed directly from data.
Time to Cmax (Tmax) of Crizotinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 Tmax of crizotinib in the presence of avelumab was observed directly from data as time of first occurrence.
Area Under The Plasma Concentration-Time Curve During The Dosing Interval Time Course (AUCtau) of Crizotinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 AUCtau of crizotinib in the presence of avelumab was calculated by Linear/Log trapezoidal method. Dose interval is defined as after single dose from time zero to the next dose (after single dose and at steady state).
Cmax of Crizotinib Metabolite PF-06260182 in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 Cmax of crizotinib metabolite PF-06260182 in the presence of avelumab was observed directly from data.
AUCtau of Crizotinib Metabolite PF-06260182 in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 AUCtau of crizotinib metabolite PF-06260182 in the presence of avelumab was calculated by Linear/Log trapezoidal method. Dose interval: single dose from time zero to the next dose (after single dose and at steady state).
Metabolite to Parent Ratio for AUCtau (MRAUCtau) of PF-06260182 in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 MRAUCtau of metabolite PF-06260182 in the presence of avelumab was calculated (MRAUCtau=Metabolite AUCtau/parent AUCtau). Parent=crizotinib, metabolite=PF-06260182
Metabolite to Parent Ratio for Cmax (MRCmax) of PF-06260182 in The Presence of Avelumab Pre-dose, 1, 2, 4, 6 and 8 hours post dose on Day 1 of Cycle 2 MRCmax of metabolite PF-06260182 in the presence of avelumab was calculated (MRCmax=Metabolite Cmax/parent Cmax). Parent=crizotinib, metabolite=PF-06260182
Cmax of Lorlatinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6, 8, and 24 hours (prior to Day 2 lorlatinib dose) post dose on Day 1 of Cycle 2 Cmax of lorlatinib in the presence of avelumab was observed directly from data.
Tmax of Lorlatinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6, 8, and 24 hours (prior to Day 2 lorlatinib dose) post dose on Day 1 of Cycle 2 Tmax of lorlatinib in the presence of avelumab was observed directly from data.
AUCtau of Lorlatinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6, 8, and 24 hours (prior to Day 2 lorlatinib dose) post dose on Day 1 of Cycle 2 AUCtau of lorlatinib in the presence of avelumab was calculated by Linear/Log trapezoidal method. Dose interval: single dose from time zero to the next dose (after single dose and at steady state).
Area Under The Plasma Concentration Time Curve From Time of Dosing to The Last Collection Time Point (AUClast) of Lorlatinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6, 8, and 24 hours (prior to Day 2 lorlatinib dose) post dose on Day 1 of Cycle 2 AUClast of lorlatinib in the presence of avelumab.
CL/F of Lorlatinib in The Presence of Avelumab Pre-dose, 1, 2, 4, 6, 8, and 24 hours (prior to Day 2 lorlatinib dose) post dose on Day 1 of Cycle 2 Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Clearance was estimated from population PK modeling. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.
Cmax of Avelumab in The Presence of Crizotinib (Group A) or Lorlatinib (Group B) After Single Dose of Avelumab Pre-dose, 1, and 168 hours post dose of avelumab on Cycle 1 Day 1. Cmax of avelumab in the presence of crizotinib was observed directly from the data in Group A. Cmax of avelumab in the presence of lorlatinib was observed directly from the data in Group B.
Cmax of Avelumab in The Presence of Crizotinib (Group A) or Lorlatinib (Group B) After Multiple Doses of Avelumab Pre-dose, 1, and 168 hours post dose of avelumab on Cycle 2 Day 1 Cmax of avelumab in the presence of crizotinib was observed directly from the data in Group A. Cmax of avelumab in the presence of lorlatinib was observed directly from the data in Group B.
Trough Serum Concentration (Ctrough) of Avelumab in The Presence of Crizotinib (Group A) Following Multiple Doses of Avelumab Pre-dose on Day 1 of Cycles 2-5, 11, 17, 23, 29, 35, and 47. Ctrough is defined as predose concentration following multiple doses. Ctrough of avelumab in the presence of crizotinib was observed directly from the data in Group A.
Trough Serum Concentration (Ctrough) of Avelumab in The Presence of Lorlatinib (Group B) Following Multiple Doses of Avelumab Pre-dose on Day 1 of Cycles 2-5, 11, 17, 23, 29, 35, 41, and 47. Ctrough is defined as predose concentration following multiple doses. Ctrough of avelumab in the presence of lorlatinib was observed directly from the data in Group B.
Number of Participants With Anti-Drug Antibodies (ADA) Against Avelumab by Never and Ever Positive Status Day 1 of Cycles 1-5, then every 12 weeks thereafter, end of treatment/withdrawal, and 30 days after last avelumab dose (up to a maximum of 5 years) ADA never-positive was defined as no positive ADA results at any time point. ADA ever-positive was defined as at least one positive ADA result at any time point. Baseline is defined as the last assessment on or prior to the date/time of the first dose of avelumab.
Number of Participants With Positive Programmed Death Ligand-1 (PD-L1) Biomarker Expression Baseline PD-L1 protein expression is determined by using Combined Positive Score (CPS), which is the percentage of viable tumor and tumor-infiltrated immune cells (restricted to lymphocytes and macrophages) within or directly associated with tumor cell strands showing partial or complete membrane staining using the SP263 antibody. Positive is defined as CPS\>=1% and negative is defined as CPS \<1%.
Number of Participants With Positive Tumor Infiltrating CD8+ Lymphocytes Baseline Tumor infiltrating CD8+ lymphocytes is defined as the number of CD8+ cells per unit area and the percent of counted cells. Positive is defined as \>=1% and negative is defined as \<1%.
Trial Locations
- Locations (20)
Ophthalmic Consultants of Boston Inc (OCB)
🇺🇸Boston, Massachusetts, United States
Aichi cancer center central hospital
🇯🇵Nagoya, Aichi, Japan
Hospital Universitari de la Vall d'Hebron
🇪🇸Barcelona, Spain
Institut Catala d'Oncologia de Badalona
🇪🇸Badalona, Barcelona, Spain
Peter MacCallum Cancer Centre
🇦🇺Melbourne, Victoria, Australia
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Chris O'Brien Lifehouse
🇦🇺Camperdown, New South Wales, Australia
Emory University Hospital Midtown
🇺🇸Atlanta, Georgia, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
National Hospital Organization Kyushu Cancer Center
🇯🇵Fukuoka, Japan
The Prince Charles Hospital
🇦🇺Chermside, Queensland, Australia
Hospital Quiron Barcelona
🇪🇸Barcelona, Spain
National Cancer Center
🇰🇷Goyang-Si, Gyeonggi-do, Korea, Republic of
Emory University Hospital
🇺🇸Atlanta, Georgia, United States
The Cancer Institute Hospital of JFCR
🇯🇵Koto-ku, Tokyo, Japan
The Emory Clinic
🇺🇸Atlanta, Georgia, United States
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Winship Cancer Institute of Emory University
🇺🇸Atlanta, Georgia, United States
Tennessee Oncology, PLLC
🇺🇸Nashville, Tennessee, United States