MedPath

BIBW 2992 (Afatinib) Versus Chemotherapy as First Line Treatment in NSCLC With EGFR Mutation

Phase 3
Completed
Conditions
Carcinoma, Non-Small-Cell Lung
Adenocarcinoma
Interventions
Registration Number
NCT00949650
Lead Sponsor
Boehringer Ingelheim
Brief Summary

This randomised, open label phase III trial will be performed in patients with adenocarcinoma of the lung with tumours harbouring an Epidermal Growth Factor Receptor activating mutation. The objectives of the trial are to compare the efficacy of single agent BIBW 2992, Arm A, with Pemetrexed/Cisplatin chemotherapy, Arm B, as first line treatment for this group of patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
345
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BIBW 2992BIBW 2992BIBW 2992 tablet once daily until progression
Cisplatin/PemetrexedPemetrexedCisplatin and Pemetrexed IV once every 3 weeks for up to 6 cycles
Cisplatin/PemetrexedCisplatinCisplatin and Pemetrexed IV once every 3 weeks for up to 6 cycles
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) TimeTumour assessments were performed at Screening, Week 6, Week 12, Week 18 and then every 12-18 weeks until disease progression

PFS was defined as time from randomisation to disease progression or death whichever occured first. Assessed by central independent review according to the Response Evaluation Criteria in Solid Tumours (RECIST 1.1). Median time results from unstratified Kaplan-Meier estimates.

Secondary Outcome Measures
NameTimeMethod
Percentage of Patients With Objective Response (OR)Tumour assessments were performed at Screening, Week 6, Week 12, Week 18 and then every 12-18 weeks until disease progression

OR was defined as Complete Response (CR) or Partial Response (PR). Assessed by central independent review according to RECIST 1.1.

Percentage of Participants With Disease Control (DC)Tumour assessments were performed at Screening, Week 6, Week 12, Week 18 and then every 12-18 weeks until disease progression

DC was defined as a patient with OR or Stable Disease (SD). Assessed by central independent review according to the RECIST 1.1.

Overall Survival (OS) TimeFrom randomisation to cut-off date (17MAR2017).

OS was defined as time from randomisation to death.

Tumour ShrinkageTumour assessments were performed at Screening, Week 6, Week 12, Week 18 and then every 12-18 weeks until disease progression

Tumour shrinkage was calculated as the minimum Sum of Diameters (SoD) of target lesions from all post-baseline tumour assessments, as read by the central independent review. The mean of these minimum values were presented after adjusting for baseline SoD, EGFR mutation group and race.

Change From Baseline in Body WeightBaseline and throughout the trial until progression (every 3 weeks), up to 28 months.

Because the PFS was longer for patients in the Afatinib arm than for patients in the chemotherapy arm, the period of data collection for ECOG status and body weight continued for a longer time in the Afatinib arm.

Eastern Cooperative Oncology Group (ECOG) Performance Status (PS)Throughout the trial until progression (every 3 weeks), up to 28 months.

ECOG PS measured on 6 point scale to assess participant's performance status. 0=Fully active, able to carry on all pre-disease activities without restriction.

1. Restricted in physically strenuous activity, but ambulatory and able to carry out light or sedentary work.

2. Ambulatory (\>50 percent of waking hours), capable of all self-care, unable to carry out any work activities.

3. Capable of only limited self-care, confined to bed or chair more than 50 percent of waking hours.

4. Completely disabled, cannot carry on any self-care, totally confined to bed or chair.

5. Dead.

Trough Plasma Concentrations of Afatinib at Day 22Day 22.

Trough plasma concentrations of Afatinib at Day 22 (course 2, visit 1) after multiple daily dosing of 40 mg Afatinib and after dose escalation to 50 mg or dose reduction to 30 mg or 20 mg.

Trough Plasma Concentrations of Afatinib at Day 43Day 43.

Trough plasma concentrations of Afatinib at Day 43 (course 3, visit 1) after multiple daily dosing of 40 mg Afatinib and after dose escalation to 50 mg or dose reduction to 30 mg or 20 mg.

Health Related Quality of Life (HRQOL): Time to Deterioration in CoughingThroughout the trial until progression (every 3 weeks).

HRQOL was measured by European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire C30 (QLQ-C30) and its lung cancer specific module LC13 (QLQ-LC13). Analysis for cough is based on QLQ-LC13 question 1. Time to deterioration was defined as the time from randomisation to a score increased (worsened) by at least 10 points from baseline (0-100 point scale). Patients were considered deteriorated at time of death. Median time results from unstratified Kaplan-Meier estimates.

HRQOL: Time to Deterioration in DyspnoeaThroughout the trial until progression (every 3 weeks).

HRQOL was measured by EORTC QLQ-C30 and its lung cancer specific module QLQ-LC13. Analysis for dyspnoea is based on composite of QLQ-LC13 questions 3-5. Time to deterioration was defined as the time from randomisation to a score increased (worsened) by at least 10 points from baseline (0-100 point scale). Patients were considered deteriorated at time of death. Median time results from unstratified Kaplan-Meier estimates.

Trough Plasma Concentrations of Afatinib at Day 29Day 29.

Trough plasma concentrations of Afatinib at day 29 (course 2, visit 2) after multiple daily dosing of 40 mg Afatinib and after dose escalation to 50 mg or dose reduction to 30 mg or 20 mg.

HRQOL: Time to Deterioration in PainThroughout the trial until progression (every 3 weeks).

HRQOL was measured by EORTC QLQ-C30 and its lung cancer specific module QLQ-LC13. Analysis for pain is based on composite of QLQ-C30 questions 9 and 19. Time to deterioration was defined as the time from randomisation to a score increased (worsened) by at least 10 points from baseline (0-100 point scale). Patients were considered deteriorated at time of death. Median time results from unstratified Kaplan-Meier estimates.

Trial Locations

Locations (132)

Imcaba S.R.L.

🇦🇷

Capital Federal, Argentina

Lungenklinik Hemer

🇩🇪

Hemer, Germany

Hospital São Lucas da Pontifícia Universidade Católica

🇧🇷

Porto Alegre, Brazil

Klinikum Wels - Grieskirchen GmbH

🇦🇹

Wels, Austria

Lehigh Valley Hospital / Lehigh Valley Health Network

🇺🇸

Allentown, Pennsylvania, United States

IMAI Research

🇦🇷

Capital Federal, Argentina

Calvary Mater Newcastle Hospital

🇦🇺

Waratah, New South Wales, Australia

HOP - HIA Sainte Anne

🇫🇷

Toulon, France

UZ Leuven

🇧🇪

Leuven, Belgium

Highlands Oncology Group

🇺🇸

Fayetteville, Arkansas, United States

Zala County Hospital, Zalaegerszeg

🇭🇺

Zalaegerszeg, Hungary

Lifehouse

🇦🇺

Camperdown, New South Wales, Australia

Insituto de Oncologia do Paraná

🇧🇷

Curitiba, Brazil

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

National Hospital Organization Nagoya Medical Center

🇯🇵

Aichi, Nagoya, Japan

Instituto de Medicina Nuclear de Bahía Blanca

🇦🇷

Bahía Blanca, Argentina

Universitätsklinikum Benjamin Franklin, Berlin

🇩🇪

Berlin, Germany

Az. USL 4 di Prato

🇮🇹

Prato, Italy

Clinical Trials and Research Associates Inc

🇺🇸

Montebello, California, United States

Centro Oncológico de Rosario

🇦🇷

Rosario, Argentina

HOP Sud-Réunion, Pneumo, Saint Pierre

🇫🇷

Saint Pierre - La Réunion, France

Instituto Alexander Fleming

🇦🇷

Capital Federal, Argentina

Centro de Pesquisa do Hospital Lifecenter

🇧🇷

Belo Horizonte, Brazil

UNIV UZ Gent

🇧🇪

Gent, Belgium

The Prince Charles Hospital

🇦🇺

Chermside, Queensland, Australia

The Burnside War Memorial Hospital

🇦🇺

Toorak Gardens, South Australia, Australia

Charles LeMoyne Hospital

🇨🇦

Greenfield Park, Migration Data, Canada

UNIFESP Departamento de Medicina de Pneumologia

🇧🇷

Sao Paulo, Brazil

Centro de Pesquisas Clínicas em Oncología

🇧🇷

Cachoeiro de Itapemirim, Brazil

HOP d'Angers

🇫🇷

Angers, France

Chonnam National University Hwasun Hospital

🇰🇷

Hwasun, Korea, Republic of

Kanazawa University Hospital

🇯🇵

Ishikawa, Kanazawa, Japan

Hematologiste et oncologue medical CHUM - Hopital Notre-Dame

🇨🇦

Montreal, Migration Data, Canada

Brussels - UNIV UZ Brussel

🇧🇪

Jette, Belgium

National Cancer Center Hospital East

🇯🇵

Chiba, Kashiwa, Japan

Ospedale San Donato di Arezzo

🇮🇹

Arezzo, Italy

McGill University, Department of Oncology

🇨🇦

Montreal, Migration Data, Canada

HOP Nord Michallon

🇫🇷

La Tronche, France

CTR René Gauducheau

🇫🇷

Saint Herblain, France

Kanagawa Cardiovascular and Respiratory Center

🇯🇵

Kanagawa, Yokohama, Japan

Instituto Oncológico Limitada Viña del Mar

🇨🇱

Reñaca, Chile

University Malaya Medical Centre

🇲🇾

Wilayah Persekutuan, Malaysia

National Hospital Organization Kinki-Chuo Chest Medical Center

🇯🇵

Sakai, Osaka, Japan

Markusovszky County Hospital, Szombathely

🇭🇺

Szombathely, Hungary

Royal Surrey County Hospital

🇬🇧

Guildford, United Kingdom

The Royal Marsden Hospital

🇬🇧

Sutton, United Kingdom

Srinagarind Hospital

🇹🇭

Khonkaen, Thailand

Chungbuk National University Hospital

🇰🇷

Cheongju, Korea, Republic of

National Taiwan University Hospital

🇩🇪

Taipei, Germany

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

National Hospital Organization Shikoku Cancer Center

🇯🇵

Ehime, Matsuyama, Japan

Royal Cornwall Hospital

🇬🇧

Truro, United Kingdom

Hospital Nacional Guillermo Almenara Irigoyen

🇵🇪

La Victoria, Peru

Seoul National University Bundang Hospital

🇰🇷

Seongnam, Korea, Republic of

FSBSI "N.N Blokhin Medical Research Center of Oncology"

🇷🇺

Moscow, Russian Federation

Osaka City Hospital Organization Osaka City General Hospital

🇯🇵

Osaka, Osaka, Japan

Ulsan University Hospital

🇰🇷

Ulsan, Korea, Republic of

Azienda Ospedaliera Sant'Andrea-Università di Roma La Sapienza

🇮🇹

Roma, Italy

Chang Gung Memorial Hospital Kaohsiung

🇨🇳

Kaohsiung, Taiwan

Hokkaido University Hospital

🇯🇵

Hokkaido, Sapporo, Japan

Royal Devon and Exeter Hospital

🇬🇧

Exeter, United Kingdom

Scunthorpe General Hospital, Oncology

🇬🇧

Scunthorpe, United Kingdom

Shizuoka Cancer Center

🇯🇵

Shizuoka, Sunto-gun, Japan

Mount Medical Centre

🇦🇺

Perth, Western Australia, Australia

Kurashiki Central Hospital

🇯🇵

Okayama, Kurashiki, Japan

HOP Côte de Nacre

🇫🇷

Caen Cedex 5, France

HOP Croix Rousse, Pneumo, Lyon

🇫🇷

Lyon Cedex 4, France

INS Curie

🇫🇷

Paris Cedex 05, France

St. Vincents Hospital (MEL)

🇦🇺

Fitzroy, Victoria, Australia

Universitätsmedizin der Johannes Gutenberg-Universität Mainz

🇩🇪

Mainz, Germany

Medizinische Hochschule Hannover

🇩🇪

Hannover, Germany

Crescent City Research Consortiom

🇺🇸

Marrero, Louisiana, United States

Hospital Alemán

🇦🇷

Capital Federal, Argentina

PALIAR

🇦🇷

Capital Federal, Argentina

SMZ Baumgartner Hoehe Otto Wagner Spital

🇦🇹

Wien, Austria

Centre Hospitalier Universitaire de Liège

🇧🇪

Liège, Belgium

Instituto Clínico Oncológico del Sur - ICOS

🇨🇱

Temuco, Chile

HOP, Pneumo, Villefranche sur Saône

🇫🇷

Villefranche Sur Saône, France

Universitätsklinikum Münster

🇩🇪

Münster, Germany

Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH

🇩🇪

Essen, Germany

Pius-Hospital, Oldenburg

🇩🇪

Oldenburg, Germany

Osp. Silvestrin

🇮🇹

Sant'Andrea Delle Fratte (PG), Italy

Aichi Cancer Center Hospital

🇯🇵

Aichi, Nagoya, Japan

Institute of Biomedical Research and Innovation Hospital

🇯🇵

Hyogo, Kobe, Japan

National Hospital Organization Kyushu Cancer Center

🇯🇵

Fukuoka, Fukuoka, Japan

Okayama University Hospital

🇯🇵

Okayama, Okayama, Japan

Niigata Cancer Center Hospital

🇯🇵

Niigata, Niigata, Japan

Kindai University Hospital

🇯🇵

Osaka, Osaka-Sayama, Japan

Republic Clinical Oncology Dispensary, Dept. Chemotherapy

🇷🇺

Kazan, Russian Federation

St. Luke Medical Centre

🇵🇭

Quezon, Philippines

Instituto Nacional de Enfermedades Neoplásicas

🇵🇪

Surquillo, Peru

First Pavlov State Medical University Saint Petersburg

🇷🇺

St. Petersburg, Russian Federation

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Medical Radiology Science Centre

🇷🇺

Obninsk, Russian Federation

SPb SBIH "City Clinical Oncological Dispensary"

🇷🇺

St. Petersburg, Russian Federation

FSBI "N.N. Petrov National Medical Research Center of Oncology" of MoH of RF

🇷🇺

St. Petersburg, Russian Federation

Ramathibodi Hospital

🇹🇭

Bangkok, Thailand

Maidstone Hospital, Kent Oncology Centre

🇬🇧

Maidstone, United Kingdom

Flinders Medical Centre

🇦🇺

Bedford Park, South Australia, Australia

KH d. Elisabethinen Linz

🇦🇹

Linz, Austria

ONCOLAB SRL, Craiova

🇷🇴

Craiova, Romania

Brussels - UNIV St-Pierre

🇧🇪

Bruxelles, Belgium

Perpetual Succour Hospital (Cebu)

🇵🇭

Cebu City, Philippines

Taipe Veterans General Hospital

🇨🇳

Taipei, Taiwan

Hospital Dirección de Previsión de Carabineros

🇨🇱

Los Condes, Chile

Clínica Anglo Americana

🇵🇪

San Isidro, Peru

Institutul Oncologic "Prof. Dr. Ion Chiricuta"

🇷🇴

Cluj Napoca, Romania

Chang Gung Memorial Hospital(TaoYuan)

🇨🇳

Taoyuan, Taiwan

Songklanagarind Hospital

🇹🇭

Songkla, Thailand

Szent György Hospital, Szekesfehervar

🇭🇺

Szekesfehervar, Hungary

St James's Hospital

🇮🇪

Dublin 8, Ireland

Hospital Pulau Pinang

🇲🇾

Palau Pinang, Malaysia

Pusat Perubatan University Kebangsaan Malaysia

🇲🇾

Wilayah Persekutuan, Malaysia

Makati Medical Center

🇵🇭

Makati City, Philippines

Kaohsiung Medical University Chung-Ho Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

NCKUH

🇨🇳

Tainan, Taiwan

China Medical University Hospital

🇨🇳

Taichung, Taiwan

Maharaj Nakorn Chiang Mai Hospital

🇹🇭

Chiang Mai, Thailand

City Clinical Hospital #4, Dnipropetrovsk State Medical Academy

🇺🇦

Dnipropetrovsk, Ukraine

Kharkiv Regional Clinical Oncology Center

🇺🇦

Kharkiv, Ukraine

Lviv State Oncological Regional Treatment & Diagnostic CTR

🇺🇦

Lviv, Ukraine

Donetsk Regional Antitumor Centre

🇺🇦

Donetsk, Ukraine

Innovative Medical Research of South Florida

🇺🇸

Miami, Florida, United States

Royal North Shore Hospital

🇦🇺

St Leonards, New South Wales, Australia

Interlakes Foundation, Incorporated

🇺🇸

Rochester, New York, United States

Box Hill Hospital

🇦🇺

Box Hill, Victoria, Australia

Cross Cancer Institute (University of Alberta)

🇨🇦

Edmonton, Alberta, Canada

South Texas Institute of Cancer, Northwest Cancer Center

🇺🇸

Corpus Christi, Texas, United States

Tri-Service General Hospital

🇨🇳

Taipei, Taiwan

Hospital Militar Central

🇦🇷

Capital Federal, Argentina

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

Prince of Wales Hospital

🇭🇰

Shatin, Hong Kong

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