Carcinoma, Non-Small Cell Lung
Conditions
Keywords
Non-small cell lung cancer, sunitinib, erlotinib, Phase 3
Brief summary
This study will test whether treatment with erlotinib plus SU011248 is better than erlotinib alone in patients with advanced/metastatic lung cancer who have received previous treatment with a platinum-based regimen.
Interventions
plus erlotinib 150 mg daily by tablets in a continuous regimen until progression or unacceptable toxicity
Sunitinib 37.5 mg daily by oral capsules in a continuous regimen
Placebo daily by oral capsules in a continuous regimen
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients with locally advanced/metastatic non-small cell lung cancer * Prior treatment with no more than 2 chemotherapy regimens including a platinum-based regimen
Exclusion criteria
* Prior treatment with any receptor tyrosine kinase inhibitors, VEGF inhibitor (with the exception of bevacizumab) or other angiogenesis inhibitors * History of or known brain metastases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | Baseline to death or 28 days after last dose for the last participant | Overall survival is the duration from assignment to study medication to death. For participants who are alive, overall survival is censored at the last contact. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival (PFS) | Baseline to disease progression or death due to any cause or 28 days after last dose | Time in weeks from assignment to study medication to first documentation of objective tumor progression or death due to any cause. PFS was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\]), or from adverse event (AE) data (where the outcome was Death). |
| Percentage of Participants With Objective Response (OR) | Baseline to disease progression or discontinuation from study or 28 days after last dose | Percentage of participants with OR based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.0. Confirmed response are those that persist on repeat imaging study at least 4 weeks after initial documentation of response. CR are defined as disappearance of all lesions (target and/or non target). PR are those with at least 30% decrease in sum of the longest dimensions of target lesions taking as a reference the baseline sum longest dimensions, with non target lesions not increased or absent. |
| Duration of Response (DR) | Baseline to disease progression or death or discontinuation from study or 28 days after last dose | Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cause. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. |
| One-year Survival Probability | Baseline until death or until 28 days after last dose for the last participant | The 1 year survival probability was defined as the probability of survival at one year after the date of the start of the study treatment based on the Kaplan Meier estimate. |
| EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score | Baseline and End of Treatment (EOT) or Withdrawal | EQ-5D: participant rated questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state (eg, confined to bed). Scoring formula developed by EuroQol Group assigns a utility value for each domain in the profile. Score is transformed and results in total score range -0.594 to 1.000; higher score indicates better health state. |
Countries
Argentina, Austria, Belgium, Brazil, Canada, Chile, Colombia, Czechia, Denmark, Germany, Greece, Hong Kong, Hungary, Italy, Netherlands, Norway, Poland, Russia, Slovakia, South Korea, Spain, Switzerland, Taiwan, Thailand, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Sunitinib + Erlotinib Sunitinib capsule administered orally at a dose of 37.5 milligram (mg) daily (continuous regimen) in a 4 week cycle. Erlotinib administered orally at a dose of 150 mg daily. | 480 |
| Erlotinib Placebo capsule matched to sunitinib administered orally daily (continuous regimen) in a 4 week cycle. Erlotinib 150 mg tablet orally daily. | 480 |
| Total | 960 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 84 | 41 |
| Overall Study | Death | 106 | 106 |
| Overall Study | Global Deterioration of Health Status | 22 | 8 |
| Overall Study | Lost to Follow-up | 6 | 7 |
| Overall Study | Objective Progression or Relapse | 229 | 296 |
| Overall Study | Other | 7 | 4 |
| Overall Study | Protocol Violation | 4 | 3 |
| Overall Study | Randomized, Not Treated | 7 | 3 |
| Overall Study | Study Terminated by Sponsor | 1 | 4 |
| Overall Study | Withdrawal by Subject | 14 | 8 |
Baseline characteristics
| Characteristic | Sunitinib + Erlotinib | Erlotinib | Total |
|---|---|---|---|
| Age Continuous | 61.10 Years STANDARD_DEVIATION 9.97 | 60.80 Years STANDARD_DEVIATION 9.13 | 60.90 Years STANDARD_DEVIATION 9.56 |
| Sex: Female, Male Female | 183 Participants | 196 Participants | 379 Participants |
| Sex: Female, Male Male | 297 Participants | 284 Participants | 581 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 463 / 473 | 461 / 477 |
| serious Total, serious adverse events | 207 / 473 | 181 / 477 |
Outcome results
Overall Survival (OS)
Overall survival is the duration from assignment to study medication to death. For participants who are alive, overall survival is censored at the last contact.
Time frame: Baseline to death or 28 days after last dose for the last participant
Population: The Full Analysis (FA) set included all participants who were randomized, with study drug assignment designated according to actual randomization, regardless of whether participants received study drug according to the randomization schedule, or received a different drug from that to which they were randomized.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib + Erlotinib | Overall Survival (OS) | 9.0 Months |
| Erlotinib | Overall Survival (OS) | 8.5 Months |
Duration of Response (DR)
Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cause. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7.
Time frame: Baseline to disease progression or death or discontinuation from study or 28 days after last dose
Population: DR was calculated for the subgroup of participants from the FA set, with a confirmed objective tumor response.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib + Erlotinib | Duration of Response (DR) | 39.6 Weeks |
| Erlotinib | Duration of Response (DR) | 32.3 Weeks |
EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score
EQ-5D: participant rated questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state (eg, confined to bed). Scoring formula developed by EuroQol Group assigns a utility value for each domain in the profile. Score is transformed and results in total score range -0.594 to 1.000; higher score indicates better health state.
Time frame: Baseline and End of Treatment (EOT) or Withdrawal
Population: Patients Reported Outcome (PRO) Analysis Set included participants from the FA population who had at least one EQ-5D assessment while on treatment. The 'n' signifies those participants who received study drug and were evaluated for this measure at the timepoint for each group respectively.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib + Erlotinib | EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score | Baseline | 0.750 Units on a scale | Standard Deviation 0.239 |
| Sunitinib + Erlotinib | EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score | End of Treatment (n= 285, 301) | 0.615 Units on a scale | Standard Deviation 0.348 |
| Erlotinib | EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score | Baseline | 0.716 Units on a scale | Standard Deviation 0.263 |
| Erlotinib | EuroQol 5-Dimension Questionnaire (EQ-5D)- Health State Profile Utility Score | End of Treatment (n= 285, 301) | 0.598 Units on a scale | Standard Deviation 0.339 |
One-year Survival Probability
The 1 year survival probability was defined as the probability of survival at one year after the date of the start of the study treatment based on the Kaplan Meier estimate.
Time frame: Baseline until death or until 28 days after last dose for the last participant
Population: The FA set included all participants who were randomized, with study drug assignment designated according to actual randomization, regardless of whether participants received study drug according to the randomization schedule, or received a different drug from that to which they were randomized.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sunitinib + Erlotinib | One-year Survival Probability | 40.0 Percent chance of survival |
| Erlotinib | One-year Survival Probability | 37.0 Percent chance of survival |
Percentage of Participants With Objective Response (OR)
Percentage of participants with OR based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.0. Confirmed response are those that persist on repeat imaging study at least 4 weeks after initial documentation of response. CR are defined as disappearance of all lesions (target and/or non target). PR are those with at least 30% decrease in sum of the longest dimensions of target lesions taking as a reference the baseline sum longest dimensions, with non target lesions not increased or absent.
Time frame: Baseline to disease progression or discontinuation from study or 28 days after last dose
Population: The FA set included all participants who were randomized, with study drug assignment designated according to actual randomization, regardless of whether participants received study drug according to the randomization schedule, or received a different drug from that to which they were randomized.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sunitinib + Erlotinib | Percentage of Participants With Objective Response (OR) | 10.60 Percentage of participants |
| Erlotinib | Percentage of Participants With Objective Response (OR) | 6.90 Percentage of participants |
Progression-Free Survival (PFS)
Time in weeks from assignment to study medication to first documentation of objective tumor progression or death due to any cause. PFS was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\]), or from adverse event (AE) data (where the outcome was Death).
Time frame: Baseline to disease progression or death due to any cause or 28 days after last dose
Population: The FA set included all participants who were randomized, with study drug assignment designated according to actual randomization, regardless of whether participants received study drug according to the randomization schedule, or received a different drug from that to which they were randomized.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib + Erlotinib | Progression-Free Survival (PFS) | 15.5 Weeks |
| Erlotinib | Progression-Free Survival (PFS) | 8.7 Weeks |