Skip to content

A Study of Aflibercept Versus Placebo in Patients With Second-Line Docetaxel for Locally Advanced or Metastatic Non-Small-Cell Lung Cancer

A Multinational, Randomized, Double-Blind Study Comparing Aflibercept Versus Placebo in Patients Treated With Second-Line Docetaxel After Failure of One Platinum Based Therapy for Locally Advanced or Metastatic Non-Small-Cell Lung Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00532155
Acronym
VITAL
Enrollment
913
Registered
2007-09-20
Start date
2007-09-30
Completion date
2011-10-31
Last updated
2025-09-10

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

Conditions

Carcinoma, Non Small Cell Lung

Keywords

lung cancer, angiogenesis inhibitor, chemotherapy

Brief summary

The primary objective of the study was to demonstrate overall survival improvement for aflibercept + docetaxel compared to docetaxel + placebo as second line treatment for participants with locally advanced or metastatic non-small cell lung cancer (NSCLC). The secondary objectives were to compare other efficacy parameters, to assess the overall safety of the two treatment arms, to assess the pharmacokinetics of intravenous (IV) aflibercept in this participant population and to determine immunogenicity of IV aflibercept in all participants.

Detailed description

The study included: * A screening visit of up to 21 days prior to randomization * Randomization at baseline (Treatment was initiated with 3 days of randomization) * A treatment period with 3-week treatment cycles until the participant met the following discontinuation criteria: had progressive disease, had unacceptable toxicity, or refused further study treatment * A post study treatment follow-up period (a visit was scheduled every 8 weeks until death or end of study)

Interventions

6 mg/kg Aflibercept administered intravenously (IV) over 1 hour once on Day 1, every 3 weeks.

DRUGPlacebo

Matching placebo to Aflibercept administered intravenously (IV) over 1 hour once on Day 1, every 3 weeks.

75 mg/m² docetaxel in 250 mL dextrose 5% or NaCl 0.9% administered intravenously (IV) over 1 hour, on Day 1 every 3 weeks.

DRUGDexamethasone (pre- and post-medication for docetaxel)

As a pre- and post-medication for docetaxel, 8 mg dexamethasone was administered orally, the evening before Day 1, on Day 1 (early morning, 1 hour before docetaxel treatment, and evening) and on Day 2 (morning and evening).

Sponsors

Regeneron Pharmaceuticals
CollaboratorINDUSTRY
Sanofi
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

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

Inclusion criteria

* Histological/cytological proven locally advanced or metastatic non-small cell lung cancer * Disease progression during or after one, and only one, prior anticancer therapy which is platinum-based for advanced or metastatic disease * Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2 * Adequate renal, liver and bone marrow functions

Exclusion criteria

* Squamous histology/cytology * Less than 28 days elapsed from prior treatment with radiotherapy, surgery, or chemotherapy to the time of randomization * Prior isotope therapy, whole pelvic radiotherapy, or radiotherapy to \> 25% of bone marrow * Prior docetaxel treatment * Uncontrolled hypertension The above information was not intended to contain all considerations relevant to participation in a clinical trial.

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)Baseline to the date when 687 deaths occurred (26 January 2011)OS was time interval from the date of randomization to the date of death due to any cause. If death was not observed during the study, overall survival time was censored at the last date the participant was known to be alive, or the study cutoff date, whichever was earlier. The cut-off date for the OS was date when 687 deaths were observed. OS was estimated from Kaplan-Meier Curves.

Secondary

MeasureTime frameDescription
Progression Free Survival (PFS)Baseline to data cut-off (26 January 2011)PFS was defined as the time interval between the date of randomization and the time of occurrence of the first radiological tumor progression detected by a computer tomography (CT) scan and /or by Magnetic Resonance Imaging (MRI); or death due to any cause; whichever was earlier. Participants without disease progression were censored at the earliest date between their last valid tumour assessment and the data cutoff date. PFS was estimated from Kaplan-Meier Curves.
Overall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaBaseline to data cut-off (26 January 2011)Participants with OR were those who had a confirmed complete response \[CR\] or a confirmed partial response \[PR\], based on RECIST criteria, in which * CR refected the disappearance of all tumor lesions (with no new tumors) * PR reflected a pre-defined decrease in tumor burden - a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD * OR was CR + PR The response rate was the percent of participants with a response. To determine a response, tumors were assessed by the investigators using Computerized Tomography (CT) scans or Magnetic Resonance Imaging (MRI) scans; and an observed response was confirmed by repeated imaging after 4 - 6 weeks.
Health Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Baseline (prior to first dose), at cycles 2 and 4 and at the end of study therapy.HRQL assessments were performed by participants using a self-administered LCSS questionnaire. LCSS is a 9-item questionnaire, six measuring major symptoms for lung malignancies (appetite, fatigue, cough, dyspnea, hemoptysis and pain), and 3 summation items related to total symptomatic distress, activity status and overall quality of life. Participant responses were measured using visual analogue scales (VAS) with 100-mm lines. The LCSS total score was defined as the mean of the 9 items of the scale, each scored between 0 (for best outcome) to 100 (for worst outcome).
Health Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Baseline (prior to first dose), at cycles 2 and 4 and at the end of study therapy.HRQL assessments were performed by participants using a self-administered LCSS questionnaire. LCSS is a 9-item questionnaire, six measuring major symptoms for lung malignancies, and 3 summation items related to total symptomatic distress, activity status and overall quality of life. Participant responses were measured using visual analogue scales (VAS) with 100-mm lines. ABSI was the mean score for the six major lung cancer symptoms (appetite, fatigue, cough, dyspnea, hemoptysis and pain), each scored between 0 (for best outcome) to 100 (for worst outcome).

Countries

Argentina, Australia, Austria, Brazil, Bulgaria, Canada, Chile, China, Czechia, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, India, Italy, Malaysia, Netherlands, Poland, Portugal, Romania, Russia, Singapore, South Korea, Spain, Sweden, Taiwan, Turkey (Türkiye), United Kingdom, United States

Participant flow

Pre-assignment details

A total of 1130 participants signed an informed consent to enter the study. Amongst these, 913 were randomized to the two arms in this study. 217 participants were screen failures.

Participants by arm

ArmCount
Placebo/Docetaxel
Participants with Non-Small-Cell Lung Cancer (NSCLC) were administered Placebo immediately followed by Docetaxel every three weeks until disease progression, unacceptable toxicity, or participant's refusal.
457
Aflibercept/Docetaxel
Participants with Non-Small-Cell Lung Cancer (NSCLC) were administered Aflibercept immediately followed by Docetaxel every three weeks until disease progression, unacceptable toxicity, or participant's refusal.
456
Total913

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event66123
Overall StudyConsent withdrawn57
Overall StudyDid not receive study medication26
Overall StudyHad brain metastasis, was mis-randomized10
Overall StudyLack of Efficacy332255
Overall StudyLost to Follow-up20
Overall StudyMoved10
Overall StudyOccurence of a secondary cancer01
Overall StudyOccurence of a second cancer01
Overall StudyPhysician Decision1615
Overall StudyPre-existing brain metastasis (by MRI)10
Overall StudyProgressive disease (by incorrect scan)01
Overall StudyPromotor ended study10
Overall StudyProtocol Violation13
Overall StudyStudy stopped10
Overall StudyStudy terminated by sponsor10
Overall StudyStudy termination stop further treatment40
Overall StudyWithdrawal by Subject2344

Baseline characteristics

CharacteristicPlacebo/DocetaxelAflibercept/DocetaxelTotal
Age, Continuous59.6 Years
STANDARD_DEVIATION 9.4
59.6 Years
STANDARD_DEVIATION 9.5
59.6 Years
STANDARD_DEVIATION 9.4
Age, Customized
<65 years
316 participants315 participants631 participants
Age, Customized
>=75 years
19 participants20 participants39 participants
Age, Customized
>= and <75 years
122 participants121 participants243 participants
Body Surface Area (BSA)1.8 m²
STANDARD_DEVIATION 0.2
1.8 m²
STANDARD_DEVIATION 0.2
1.8 m²
STANDARD_DEVIATION 0.2
Eastern Cooperative Oncology Group (ECOG) performance status score (as per IVRS)
Participants with ECOG Score = 0
151 participants149 participants300 participants
Eastern Cooperative Oncology Group (ECOG) performance status score (as per IVRS)
Participants with ECOG Score = 1
283 participants286 participants569 participants
Eastern Cooperative Oncology Group (ECOG) performance status score (as per IVRS)
Participants with ECOG Score = 2
23 participants21 participants44 participants
Prior Bevacizumab (as per IVRS)
No
404 participants405 participants809 participants
Prior Bevacizumab (as per IVRS)
Yes
53 participants51 participants104 participants
Race/Ethnicity, Customized
Asian/Oriental
40 participants34 participants74 participants
Race/Ethnicity, Customized
Black
10 participants7 participants17 participants
Race/Ethnicity, Customized
Caucasian/White
405 participants411 participants816 participants
Race/Ethnicity, Customized
Other
2 participants4 participants6 participants
Sex/Gender, Customized
Female
157 participants151 participants308 participants
Sex/Gender, Customized
Male
300 participants305 participants605 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
388 / 453402 / 452
serious
Total, serious adverse events
159 / 453218 / 452

Outcome results

Primary

Overall Survival (OS)

OS was time interval from the date of randomization to the date of death due to any cause. If death was not observed during the study, overall survival time was censored at the last date the participant was known to be alive, or the study cutoff date, whichever was earlier. The cut-off date for the OS was date when 687 deaths were observed. OS was estimated from Kaplan-Meier Curves.

Time frame: Baseline to the date when 687 deaths occurred (26 January 2011)

Population: All randomized participants.

ArmMeasureValue (MEDIAN)
Placebo/DocetaxelOverall Survival (OS)10.41 months
Aflibercept/DocetaxelOverall Survival (OS)10.05 months
p-value: 0.898595% CI: [0.868, 1.174]Stratified log-rank test
Secondary

Health Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)

HRQL assessments were performed by participants using a self-administered LCSS questionnaire. LCSS is a 9-item questionnaire, six measuring major symptoms for lung malignancies, and 3 summation items related to total symptomatic distress, activity status and overall quality of life. Participant responses were measured using visual analogue scales (VAS) with 100-mm lines. ABSI was the mean score for the six major lung cancer symptoms (appetite, fatigue, cough, dyspnea, hemoptysis and pain), each scored between 0 (for best outcome) to 100 (for worst outcome).

Time frame: Baseline (prior to first dose), at cycles 2 and 4 and at the end of study therapy.

Population: ITT population with questionnaires evaluable for ABSI.

ArmMeasureGroupValue (MEAN)Dispersion
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Baseline (N=429, N=429)26.17 units on a scaleStandard Deviation 16.3
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Cycle 2 (N=327, N=316)26.23 units on a scaleStandard Deviation 15.93
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Cycle 4 (N=211, N=241)24.52 units on a scaleStandard Deviation 15.22
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)End of treatment (N=253, N=239)30.73 units on a scaleStandard Deviation 17.26
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)End of treatment (N=253, N=239)31.19 units on a scaleStandard Deviation 18.12
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Baseline (N=429, N=429)28.24 units on a scaleStandard Deviation 16.91
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Cycle 4 (N=211, N=241)26.19 units on a scaleStandard Deviation 16.38
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Average Symptom Burden Index (ASBI)Cycle 2 (N=327, N=316)27.05 units on a scaleStandard Deviation 15.92
Secondary

Health Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)

HRQL assessments were performed by participants using a self-administered LCSS questionnaire. LCSS is a 9-item questionnaire, six measuring major symptoms for lung malignancies (appetite, fatigue, cough, dyspnea, hemoptysis and pain), and 3 summation items related to total symptomatic distress, activity status and overall quality of life. Participant responses were measured using visual analogue scales (VAS) with 100-mm lines. The LCSS total score was defined as the mean of the 9 items of the scale, each scored between 0 (for best outcome) to 100 (for worst outcome).

Time frame: Baseline (prior to first dose), at cycles 2 and 4 and at the end of study therapy.

Population: ITT population with questionnaires evaluable for LCSS.

ArmMeasureGroupValue (MEAN)Dispersion
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Baseline (N=431, N=428)29.52 units on a scaleStandard Deviation 17.03
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Cycle 2 (N=329, N=315)29.50 units on a scaleStandard Deviation 16.72
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Cycle 4 (N=211, N=240)27.67 units on a scaleStandard Deviation 16.24
Placebo/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)End of treatment (N=254, N=240)34.82 units on a scaleStandard Deviation 18.34
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)End of treatment (N=254, N=240)36.07 units on a scaleStandard Deviation 18.81
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Baseline (N=431, N=428)31.54 units on a scaleStandard Deviation 18.03
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Cycle 4 (N=211, N=240)29.61 units on a scaleStandard Deviation 16.92
Aflibercept/DocetaxelHealth Related Quality of Life (HRQL) Assessed by the Lung Cancer Symptom Scale (LCSS)Cycle 2 (N=329, N=315)30.54 units on a scaleStandard Deviation 16.78
Secondary

Overall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) Criteria

Participants with OR were those who had a confirmed complete response \[CR\] or a confirmed partial response \[PR\], based on RECIST criteria, in which * CR refected the disappearance of all tumor lesions (with no new tumors) * PR reflected a pre-defined decrease in tumor burden - a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD * OR was CR + PR The response rate was the percent of participants with a response. To determine a response, tumors were assessed by the investigators using Computerized Tomography (CT) scans or Magnetic Resonance Imaging (MRI) scans; and an observed response was confirmed by repeated imaging after 4 - 6 weeks.

Time frame: Baseline to data cut-off (26 January 2011)

Population: Evaluable population: All ITT participants with measurable disease at study entry, and with at least one valid post baseline tumor evaluation, except if the participant died due to progressive disease or had documented (ie, radiological) progression before having any post-baseline tumor evaluation.

ArmMeasureGroupValue (NUMBER)
Placebo/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaComplete Response (CR) rate0.2 percentage of participants
Placebo/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaPartial Response (PR) rate8.6 percentage of participants
Placebo/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaOverall Response (OR) rate8.9 percentage of participants
Aflibercept/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaComplete Response (CR) rate0.2 percentage of participants
Aflibercept/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaPartial Response (PR) rate23.0 percentage of participants
Aflibercept/DocetaxelOverall Response (OR) Rate as Per Response Evaluation Criteria in Solid Tumours (RECIST) CriteriaOverall Response (OR) rate38.6 percentage of participants
Secondary

Progression Free Survival (PFS)

PFS was defined as the time interval between the date of randomization and the time of occurrence of the first radiological tumor progression detected by a computer tomography (CT) scan and /or by Magnetic Resonance Imaging (MRI); or death due to any cause; whichever was earlier. Participants without disease progression were censored at the earliest date between their last valid tumour assessment and the data cutoff date. PFS was estimated from Kaplan-Meier Curves.

Time frame: Baseline to data cut-off (26 January 2011)

Population: Intent to treat (ITT) population. The results are based on a total of 865 PFS events (434 in the placebo group and 431 in the aflibercept group) at the time of cutoff.

ArmMeasureValue (MEDIAN)
Placebo/DocetaxelProgression Free Survival (PFS)4.11 months
Aflibercept/DocetaxelProgression Free Survival (PFS)5.19 months
p-value: 0.003595% CI: [0.716, 0.937]Stratified Log-Rank test

Source: ClinicalTrials.gov · Data processed: Mar 27, 2026