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ZACTIMA (an Anti-EGFR / Anti-VEGF Agent) Combined With Docetaxel Compared to Docetaxel in Non-small Cell Lung Cancer

A Phase III, Randomized, Double-Blinded, Multi-Center, Study to Assess the Efficacy of Docetaxel (TAXOTERE™) in Combination With ZD6474 (ZACTIMA™) Versus Docetaxel (TAXOTERE™) With Placebo in Subjects With Locally Advanced or Metastatic NSCLC

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00312377
Acronym
ZODIAC
Enrollment
1690
Registered
2006-04-10
Start date
2006-05-31
Completion date
2014-03-31
Last updated
2016-09-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lung Cancer, Non-small Cell Lung Cancer

Keywords

Non-small cell lung cancer, NSCLC

Brief summary

This large phase III clinical study is studying the effect of vandetanib (ZACTIMA) in treating non-small cell lung cancer (NSCLC). Vandetanib is a new type of agent that targets the blood supply to a cancer tumour (through it's anti-vascular endothelial growth factor receptor (VEGFR) properties) and the tumour cells themselves (through it's anti-endothelial growth factor receptor (EGFR) actions). This study will look at the effects of vandetanib in lung cancer patients who have had their cancer re-appear after treatment with standard chemotherapy. This clinical study will test if the vandetanib anti-VEGF and anti-EGFR characteristics can deliver longer improved progression free survival and improved overall survival than docetaxel (Taxotere) alone. All patients participating this clinical study will receive treatment with docetaxel, a commonly used treatment for recurrent non-small cell lung cancer. In addition, some patients will also receive vandetanib (ZACTIMA), an anti-EGFR / anti-VEGF agent. Recent clinical research shows that vascular endothelial growth factor receptor (VEGFR) inhibition, when used with standard chemotherapy, can lead to increased survival in advanced non-small cell lung cancer (NSCLC) patients. Other research shows that epidermal growth factor receptor (EGFR) inhibitors, like erlotinib (Tarceva) can also increase overall non-small cell lung cancer survival by killing tumour cells and stopping them from dividing.

Interventions

DRUGDocetaxel

infusion

DRUGVandetanib

oral

Sponsors

Genzyme, a Sanofi Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Lung cancer patients who answer true to the following statements are eligible to join this clinical study. * I have a confirmed diagnosis of locally advanced or metastatic non small cell lung cancer (Stage IIIb - IV) * I have had 1st line anti-cancer therapy. Previous treatment with Avastin (bevacizumab) in first line NSCLC is allowed.

Exclusion criteria

Lung cancer patients who answer true to the following are NOT eligible to join this clinical study. * I do not have non small cell lung cancer (NSCLC) * I have received treatment with docetaxel (Taxotere). Prior treatment with paclitaxel is acceptable. * I have received 2nd line anti-cancer therapy (For example, patients with previous 2nd line non small cell lung cancer (NSCLC) treatment with Tarceva (erlotinib, OSI-744), Alimta (pemetrexed) are not eligible) * I have been treated with VEGFR-tyrosine kinase inhibitors (TKIs) (sunitinib, sorafenib, other VEGF TKIs). Previous treatment with Avastin (bevacizumab) in 1st line non small cell lung cancer is permitted. * I have a history of uncontrolled irregular heartbeat * I have a history of high blood pressure which has not been controlled with medication If you are unsure of the meaning of the inclusion and

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival (PFS) in the Overall PopulationRECIST tumour assessments carried out every 6 weeks from randomisation until the date of first documented objective disease progression or date of death from any cause, whichever came first assessed up to 24 monthsMedian time (in weeks) from randomisation until objective disease progression or death (by any cause in the absence of objective progression) provided death is within 3 months from the last evaluable RECIST assessment. Progression was derived according to RECIST 1.0 and is defined as an increase of at least 20% in the total tumour size of measurable lesions over the nadir measurement, unequivocal progression in the non-target lesions or the appearance of one or more new lesions.
Progression-Free Survival (PFS) in the Female PopulationRECIST tumour assessments carried out every 6 weeks from randomisation until the date of first documented objective disease progression or date of death from any cause, whichever came first assessed up to 24 monthsMedian time (in weeks) from randomisation until objective disease progression or death (by any cause in the absence of objective progression) provided death is within 3 months from the last evaluable RECIST assessment. Progression was derived according to RECIST 1.0 and is defined as an increase of at least 20% in the total tumour size of measurable lesions over the nadir measurement, unequivocal progression in the non-target lesions or the appearance of one or more new lesions.

Secondary

MeasureTime frameDescription
Overall Survival (OS) in the Female PopulationTime to death in monthsOverall survival is defined as the time from date of randomization until death. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive (ie their status must be known at the censored date and should not be lost to follow up or unknown).
Objective Response Rate (ORR)Each patient was assessed for objective response from the sequence of RECIST scan data up to data cut off. RECIST tumour assessments carried out every 6 weeks from randomisation until objective progressionThe ORR is the number of patients that are responders ie those patients with a confirmed best objective response of complete response (CR) or partial response (PR) as determined according to RECIST 1.0. CR is defined as the disappearance of all target lesions with no evidence of tumour elsewhere and PR is defined as at least a 30% reduction in the total tumour size of measurable lesions with no new lesions and no progression in the non-target lesions.
Disease Control Rate (DCR)RECIST tumour assessments carried out every 6 weeks from randomisation until objective progressionDisease control rate is defined as the number of patients who achieved disease control at least 6 weeks following randomisation. Disease control at 6 weeks is defined as a best objective response of complete response (CR), partial response (PR) or stable disease (SD) \>= 6 weeks as determined according to RECIST 1.0. CR is defined as the disappearance of all target lesions with no evidence of tumour elsewhere, PR is defined as at least a 30% reduction in the total tumour size of measurable lesions with no new lesions and no progression in the non-target lesions and SD \>= 6 is assigned to patients who have not responded and have no evidence of progression at least 6 weeks after randomisation.
Duration of Response (DoR)RECIST tumour assessments carried out every 6 weeks from randomisation until objective progressionResponse is defined as a confirmed best objective response of CR or PR. Duration of response is defined as time from the date of first documented response until date of documented progression or death in the absence of disease progression (provided death is within 3 months of last RECIST assessment)
Time to Deterioration of Disease-related Symptoms (TDS) by FACT-L Pulmonary Symptom Index (PSI)FACT-L questionnaires are to be administered every 3 weeks after randomisationThe pulmonary symptom index (PSI) consists of 4 items of the LCS relating to pulmonary symptoms (i.e. 3 items relating to breathing/dyspnea, and 1 item relating to cough). The PSI score is the sum of the scores from the 4 items. Time to deterioration is defined as the interval from the date of randomization to the first assessment of worsened without an improvement in the next 21 days. A patient will be defined as having a deterioration in symptoms if they have a single visit assessment of 'worsened' with no visit assessment of 'improved' within the next 21 days.
Time to Deterioration of Disease-related Symptoms (TDS) by Functional Assessment of Cancer Therapy - Lung (FACT-L) Lung Cancer Subscale (LCS).FACT-L questionnaires are to be administered every 3 weeks after randomisationThe lung cancer subscale (LCS) consists of 7 items of the FACT-L (3 items relating to breathing/dyspnea, and 1 item each relating to cough, weight loss, appetite, and cognition). The LCS total score is the sum of the scores from the 7 items. Time to deterioration is defined as the interval from the date of randomization to the first assessment of worsened without an improvement in the next 21 days. A patient will be defined as having a deterioration in symptoms if they have a single visit assessment of 'worsened' with no visit assessment of 'improved' within the next 21 days.
Overall Survival (OS) in the Overall PopulationTime to death in monthsOverall survival is defined as the time from date of randomization until death. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive (ie their status must be known at the censored date and should not be lost to follow up or unknown).

Countries

Argentina, Austria, Belgium, Brazil, Canada, China, Denmark, France, Germany, Greece, India, Indonesia, Italy, Japan, Malaysia, Mexico, Netherlands, Portugal, Singapore, South Korea, Spain, Thailand, Turkey (Türkiye), United States, Vietnam

Participant flow

Recruitment details

First patient enrolled 08 May 2006, last patient enrolled 14 March 2008, cut off date 22 August 2008

Participants by arm

ArmCount
Vandetanib 100 mg Plus Docetaxel
Vandetanib 100 mg plus docetaxel
694
Placebo Plus Docetaxel
Placebo plus docetaxel
697
Total1,391

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath403418
Overall StudyDiscontinue treatment survival follow up202200
Overall StudyLost to Follow-up912
Overall StudyNon-compliance02
Overall StudyRandomised but never received treatment66
Overall StudySite ended participation in study10
Overall StudyWithdrawal by Subject2330

Baseline characteristics

CharacteristicVandetanib 100 mg Plus DocetaxelPlacebo Plus DocetaxelTotal
Age, Continuous58.5 years58.4 years58.45 years
Sex: Female, Male
Female
497 Participants473 Participants970 Participants
Sex: Female, Male
Male
197 Participants224 Participants421 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
637 / 694630 / 697
serious
Total, serious adverse events
263 / 694232 / 697

Outcome results

Primary

Progression-Free Survival (PFS) in the Female Population

Median time (in weeks) from randomisation until objective disease progression or death (by any cause in the absence of objective progression) provided death is within 3 months from the last evaluable RECIST assessment. Progression was derived according to RECIST 1.0 and is defined as an increase of at least 20% in the total tumour size of measurable lesions over the nadir measurement, unequivocal progression in the non-target lesions or the appearance of one or more new lesions.

Time frame: RECIST tumour assessments carried out every 6 weeks from randomisation until the date of first documented objective disease progression or date of death from any cause, whichever came first assessed up to 24 months

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelProgression-Free Survival (PFS) in the Female Population20.1 Weeks
Placebo Plus DocetaxelProgression-Free Survival (PFS) in the Female Population18.3 Weeks
Primary

Progression-Free Survival (PFS) in the Overall Population

Median time (in weeks) from randomisation until objective disease progression or death (by any cause in the absence of objective progression) provided death is within 3 months from the last evaluable RECIST assessment. Progression was derived according to RECIST 1.0 and is defined as an increase of at least 20% in the total tumour size of measurable lesions over the nadir measurement, unequivocal progression in the non-target lesions or the appearance of one or more new lesions.

Time frame: RECIST tumour assessments carried out every 6 weeks from randomisation until the date of first documented objective disease progression or date of death from any cause, whichever came first assessed up to 24 months

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelProgression-Free Survival (PFS) in the Overall Population17.3 Weeks
Placebo Plus DocetaxelProgression-Free Survival (PFS) in the Overall Population14 Weeks
Secondary

Disease Control Rate (DCR)

Disease control rate is defined as the number of patients who achieved disease control at least 6 weeks following randomisation. Disease control at 6 weeks is defined as a best objective response of complete response (CR), partial response (PR) or stable disease (SD) \>= 6 weeks as determined according to RECIST 1.0. CR is defined as the disappearance of all target lesions with no evidence of tumour elsewhere, PR is defined as at least a 30% reduction in the total tumour size of measurable lesions with no new lesions and no progression in the non-target lesions and SD \>= 6 is assigned to patients who have not responded and have no evidence of progression at least 6 weeks after randomisation.

Time frame: RECIST tumour assessments carried out every 6 weeks from randomisation until objective progression

ArmMeasureValue (NUMBER)
Vandetanib 100 mg Plus DocetaxelDisease Control Rate (DCR)413 Participants
Placebo Plus DocetaxelDisease Control Rate (DCR)380 Participants
Secondary

Duration of Response (DoR)

Response is defined as a confirmed best objective response of CR or PR. Duration of response is defined as time from the date of first documented response until date of documented progression or death in the absence of disease progression (provided death is within 3 months of last RECIST assessment)

Time frame: RECIST tumour assessments carried out every 6 weeks from randomisation until objective progression

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelDuration of Response (DoR)29.9 Weeks
Placebo Plus DocetaxelDuration of Response (DoR)19.7 Weeks
Secondary

Objective Response Rate (ORR)

The ORR is the number of patients that are responders ie those patients with a confirmed best objective response of complete response (CR) or partial response (PR) as determined according to RECIST 1.0. CR is defined as the disappearance of all target lesions with no evidence of tumour elsewhere and PR is defined as at least a 30% reduction in the total tumour size of measurable lesions with no new lesions and no progression in the non-target lesions.

Time frame: Each patient was assessed for objective response from the sequence of RECIST scan data up to data cut off. RECIST tumour assessments carried out every 6 weeks from randomisation until objective progression

ArmMeasureValue (NUMBER)
Vandetanib 100 mg Plus DocetaxelObjective Response Rate (ORR)120 Participants
Placebo Plus DocetaxelObjective Response Rate (ORR)71 Participants
Secondary

Overall Survival (OS) in the Female Population

Overall survival is defined as the time from date of randomization until death. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive (ie their status must be known at the censored date and should not be lost to follow up or unknown).

Time frame: Time to death in months

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelOverall Survival (OS) in the Female Population12.7 Months
Placebo Plus DocetaxelOverall Survival (OS) in the Female Population14.2 Months
Secondary

Overall Survival (OS) in the Overall Population

Overall survival is defined as the time from date of randomization until death. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive (ie their status must be known at the censored date and should not be lost to follow up or unknown).

Time frame: Time to death in months

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelOverall Survival (OS) in the Overall Population10.6 Months
Placebo Plus DocetaxelOverall Survival (OS) in the Overall Population10 Months
Secondary

Time to Deterioration of Disease-related Symptoms (TDS) by FACT-L Pulmonary Symptom Index (PSI)

The pulmonary symptom index (PSI) consists of 4 items of the LCS relating to pulmonary symptoms (i.e. 3 items relating to breathing/dyspnea, and 1 item relating to cough). The PSI score is the sum of the scores from the 4 items. Time to deterioration is defined as the interval from the date of randomization to the first assessment of worsened without an improvement in the next 21 days. A patient will be defined as having a deterioration in symptoms if they have a single visit assessment of 'worsened' with no visit assessment of 'improved' within the next 21 days.

Time frame: FACT-L questionnaires are to be administered every 3 weeks after randomisation

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelTime to Deterioration of Disease-related Symptoms (TDS) by FACT-L Pulmonary Symptom Index (PSI)12.3 Weeks
Placebo Plus DocetaxelTime to Deterioration of Disease-related Symptoms (TDS) by FACT-L Pulmonary Symptom Index (PSI)11.9 Weeks
Secondary

Time to Deterioration of Disease-related Symptoms (TDS) by Functional Assessment of Cancer Therapy - Lung (FACT-L) Lung Cancer Subscale (LCS).

The lung cancer subscale (LCS) consists of 7 items of the FACT-L (3 items relating to breathing/dyspnea, and 1 item each relating to cough, weight loss, appetite, and cognition). The LCS total score is the sum of the scores from the 7 items. Time to deterioration is defined as the interval from the date of randomization to the first assessment of worsened without an improvement in the next 21 days. A patient will be defined as having a deterioration in symptoms if they have a single visit assessment of 'worsened' with no visit assessment of 'improved' within the next 21 days.

Time frame: FACT-L questionnaires are to be administered every 3 weeks after randomisation

ArmMeasureValue (MEDIAN)
Vandetanib 100 mg Plus DocetaxelTime to Deterioration of Disease-related Symptoms (TDS) by Functional Assessment of Cancer Therapy - Lung (FACT-L) Lung Cancer Subscale (LCS).15 Weeks
Placebo Plus DocetaxelTime to Deterioration of Disease-related Symptoms (TDS) by Functional Assessment of Cancer Therapy - Lung (FACT-L) Lung Cancer Subscale (LCS).11.9 Weeks

Source: ClinicalTrials.gov · Data processed: Mar 31, 2026