A Study of Enzastaurin and Erlotinib in Participants With Solid Tumors and Lung Cancer

PFS was defined as the time from the date of study enrollment (baseline) to the first date of progressive disease (PD) (either objectively determined or clinical progression) or death from any cause. PD was defined by Response Evaluation Criteria in Solid Tumors \[RECIST, version (v) 1.0\] as at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as references the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. For participants not known to have died as of the data cut-off date and who did not have PD, PFS was censored at the date of the last visit with adequate assessment. For participants who received subsequent anticancer therapy (after discontinuation from study treatment) prior to disease progression or death, PFS was censored at the date of last visit with adequate assessment prior to the initiation of post discontinuation anticancer therapy.

Time frame: Phase 2: Baseline to measured PD (up to 20 months)

Population: Participants enrolled in Phase 2 who received at least 1 dose of study drug (either enzastaurin or erlotinib). Eight participants were censored.

The recommended Phase 2 daily dose level was to be either 1 dose level below that in which 2 of 6 participants experienced dose-limiting toxicities (DLTs) in Phase 1 or the full doses of both enzastaurin and erlotinib (Phase 1, Dose Level 2) in the event that no more than 1 DLT occurred at the highest dose level (Dose Level 2). DLTs were defined as any of the following events during Phase 1, Cycle 1 that were considered by the investigator to be attributable to enzastaurin or the combination of enzastaurin with erlotinib: Grade 4 hematologic events; Grade 3 or 4 nonhematologic events except toxicities explained by a coexisting condition such as glucose disturbances in a diabetic or electrolyte imbalances from diarrhea or vomiting, and toxicities of nausea, vomiting, diarrhea, or skin rash that were tolerable with appropriate treatment.

Time frame: Phase 1: Predose through end of Cycle 1 (28 days/cycle)

Population: Participants enrolled in Phase 1 who received at least 1 dose of study drug (either enzastaurin or erlotinib).

Duration of response: time from first objective assessment of complete response (CR) or partial response (PR) to first observation of PD. Using RECIST v1.0 criteria, CR was the disappearance of all target lesions; PR was either a ≥30% decrease in sum of LD of target lesions or a complete disappearance of target lesions, with persistence (but not worsening) of ≥1 nontarget lesion; PD was a ≥20% increase in sum of LD of target lesions, taking as references the smallest sum LD recorded since treatment started or the appearance of ≥1 new lesion. For responding participants not known to have died and who did not have PD, duration of response was censored at date of the last visit with adequate assessment. For responding participants who received subsequent anticancer therapy (after discontinuation from study treatment) prior to PD, duration of response was censored at the date of last visit with adequate assessment prior to the initiation of post discontinuation anticancer therapy.

Time frame: Phase 2: Date of first response to date of PD (up to 18 months)

Population: Participants enrolled in Phase 2 who received at least 1 dose of study drug (either enzastaurin or erlotinib) and had a CR or PR response. Two participants were censored.

A TEAE is any untoward medical occurrence that either occurred or worsened any time after treatment baseline, which did not necessarily have a causal relationship with this treatment. A summary of serious and other non-serious AEs, regardless of causality, is located in the Reported Adverse Events module.

Time frame: Phase 2: Baseline through 30 days post last dose (up to 24 Cycles, 28 days/cycle)

Population: Participants enrolled in Phase 2 who received at least 1 dose of study drug (either enzastaurin or erlotinib).

OS was defined as the time from the date of study enrollment (baseline) to the date of death from any cause. For participants not known to have died as of the data cutoff date, OS was censored at the last contact date (last contact for participants in post discontinuation was equal to the last known alive date in mortality status).

Time frame: Phase 2: Baseline to date of death from any cause (up to 23 months)

Population: Participants enrolled in Phase 2 who received at least 1 dose of study drug (either enzastaurin or erlotinib). Eighteen participants were censored.

Tumor response was defined using RECIST, v1.0 criteria. CR was the disappearance of all target lesions; PR was either a ≥30% decrease in sum of LD of target lesions or a complete disappearance of target lesions, with persistence (but not worsening) of ≥1 nontarget lesion. PD was a ≥20% increase in sum of LD of target lesions, taking as references the smallest sum LD recorded since treatment started or the appearance of ≥1 new lesion. Stable Disease (SD) was defined as small changes that did not meet the above criteria. Percentage of participants with tumor response=\[(number of participants with a CR, PR, SD, PD, and unknown response)/(total number of participants assessed)\]\*100.

Time frame: Phase 2: Baseline to date of PD (up to 18 months)

Population: Participants enrolled in Phase 2 who received at least 1 dose of study drug (either enzastaurin or erlotinib).

A TEAE is any untoward medical occurrence that either occurred or worsened any time after treatment baseline, which did not necessarily have a causal relationship with this treatment. A summary of serious and other non-serious AEs, regardless of causality, is located in the Reported Adverse Events module.

Time frame: Phase 1: First dose through 30 days post last dose (up to 14 Cycles, 28 days/cycle)

Population: Participants enrolled in Phase 1 who received at least 1 dose of study drug (either enzastaurin or erlotinib).

Clearance (CL) of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. CL obtained after an oral dose (apparent oral CL) is influenced by the fraction of the dose absorbed (F). Drug CL is a quantitative measure of the rate at which a drug substance is removed from the blood. Apparent oral CL of erlotinib over 10 hours at steady state (ss) on Day 22 was calculated.

Time frame: Phase 1: Cycle 1, Day 22 [predose, 2 hours (h), 4 h, 6 h, 10 h postdose]

Population: Participants enrolled in Phase 1 who received at least 1 dose of study drug (enzastaurin or erlotinib) and had adequate sample data to estimate CLss/F of erlotinib.

Area under the plasma concentration time curve AUC(Tau,ss) of enzastaurin, its active metabolite (LSN326020) and total analyte were reported.

Time frame: Phase 1, Cycle 1, Day 22 (predose, 2 h, 4 h, 6 h, and 8 h postdose)

Population: Participants enrolled in Phase 1 who received at least 1 dose of study drug (enzastaurin or erlotinib) and had adequate sample data to estimate AUC(Tau,ss) of enzastaurin, its active metabolite, and total analyte.

Maximum observed plasma concentration at steady state (Cmax,ss) of enzastaurin, its active metabolite (LSN326020) and total analyte were reported.

Time frame: Phase 1: Cycle 1, Day 22 (predose, 2 h, 4 h, 6 h, 8 h postdose)

Population: Participants enrolled in Phase 1 who received at least 1 dose of study drug (enzastaurin or erlotinib) and had adequate sample data to estimate Cmax,ss of enzastaurin, its active metabolite and total analyte.