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A Study of MM-121 Combination Therapy in Patients With Advanced Non-Small Cell Lung Cancer

A Phase 1-2 Trial of MM-121 in Combination With Erlotinib in Three Groups of Patients With Non-Small Cell Lung Cancer

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00994123
Enrollment
162
Registered
2009-10-14
Start date
2010-02-28
Completion date
2015-06-30
Last updated
2016-08-22

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

Non-Small Cell Lung Cancer, NSCLC, Advanced Non-Small Cell Lung Cancer, Metastatic Non-Small Cell Lung Cancer, Lung Cancer, Erlotinib, Tarceva, MM-121, ErbB3, Her3, Epidermal Growth Factor Receptor, anti-ErbB3 human monoclonal antibody, ErbB3 antagonist

Brief summary

A Phase 1-2 study of MM-121 in combination with standard therapy for non-small cell lung cancer (NSCLC).

Detailed description

Phase 1: Patients with Non-Small Cell Lung Cancer (NSCLC) may be enrolled to evaluate the safety, tolerability and recommended Phase 2 dose of MM-121 in combination with standard therapy. Phase 2: Patients with Non-Small Cell Lung Cancer (NSCLC) may be enrolled to estimate the progression-free survival of the MM-121 + standard therapy.

Interventions

DRUGMM-121

MM-121 (SAR256212) = intravenous solution

DRUGErlotinib

erlotinib = daily oral tablet

Sponsors

Merrimack Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Patients with locally advanced or metastatic non-small cell lung cancer. * Patients must be \>/= 18 years of age. * Patients must have adequate Performance Status (PS) as measured by ECOG and adequate end organ function.

Exclusion criteria

* Patients with a recent history (within 5 years) of another malignancy. * Patients who are pregnant or nursing. * Patients with clinically significant heart failure. * Patients with clinically significant eye or gastrointestinal abnormalities.

Design outcomes

Primary

MeasureTime frameDescription
Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.From date of first dose to 30 days after termination, the longest 175 weeksTo establish the safety of escalating doses of MM-121 in combination with erlotinib in order to determine the recommended phase 2 dose of the combination for the second part of the study. Dose-escalation conducted using standard 3+3 model to determine maximum tolerated dose. Reports of Dose-Limiting Toxicities (DLTs) were assessed to determine the MTD.
Phase 1: Determine the Maximum Tolerated Dose Dependent on Reports of Dose-limiting ToxicitiesFrom date of first dose to 30 days after termination, the longest 175 weeksUsing a 3+3 dose escalation model, the maximum tolerated dose was determined by assessing dose-limiting toxicities in each cohort. If 3 patients were treated and passed the observation window, escalation to the next cohort was initiated. If a DLT was reported, 3-4 additional patients were enrolled and observed. If a DLT was observed in the expanded cohort, this dose was considered to be the maximum tolerated dose. The maximum tolerated dose was defined at the cohort in which two dose-limiting toxicities were observed, or as the highest target dose tested in the absence of DLTs. The determined MTD was used as the recommended Phase 2 dose.
Phase 2: Progression-free Survival of the MM-121 + Erlotinib CombinationTime from first dose to date of progression, with a median of 8.1 weeksThis was a time-to-event measure using Progression-Free Survival (PFS) comparing MM-121 + erlotinib vs.erlotinib alone. Progression of disease is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Progression free survival was defined as the number of weeks from the date of randomization to the date of death or progression. If neither death nor progression was observed during the study, PFS data was censored at the last non-progressive disease valid tumor assessment unless the patient was discontinued due to symptomatic deterioration. If this occurred, the patient was counted as having progressive disease (PD).

Countries

Canada, Germany, South Korea, Spain, Taiwan, United States

Participant flow

Participants by arm

ArmCount
Phase 1: MM-121 + Erlotinib
Escalating doses of MM-121 + Erlotinib in patients with NSCLC
33
Phase 2: MM-121 + Erlotinib
EGFR wild-type, EGFR-TKI naive patients randomized to receive: MM-121 every other week at a dose of 20 mg/kg IV in combination with daily 100 mg erlotinib p.o.
85
Phase 2: Erlotinib
EGFR wild-type, EGFR-TKI naive patients randomized to receive: daily 150 mg erlotinib p.o. alone
44
Total162

Baseline characteristics

CharacteristicPhase 1: MM-121 + ErlotinibPhase 2: MM-121 + ErlotinibPhase 2: ErlotinibTotal
Age, Continuous63.5 years
STANDARD_DEVIATION 10.12
62.9 years
STANDARD_DEVIATION 10.74
63.9 years
STANDARD_DEVIATION 10.16
63.2 years
STANDARD_DEVIATION 10.53
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants3 Participants1 Participants6 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
31 Participants82 Participants43 Participants156 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
0 Participants7 Participants6 Participants13 Participants
Race (NIH/OMB)
Black or African American
2 Participants3 Participants2 Participants7 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
31 Participants74 Participants36 Participants141 Participants
Sex: Female, Male
Female
17 Participants35 Participants17 Participants69 Participants
Sex: Female, Male
Male
16 Participants50 Participants27 Participants93 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
85 / 8544 / 4433 / 33
serious
Total, serious adverse events
40 / 8518 / 4416 / 33

Outcome results

Primary

Phase 1: Determine the Maximum Tolerated Dose Dependent on Reports of Dose-limiting Toxicities

Using a 3+3 dose escalation model, the maximum tolerated dose was determined by assessing dose-limiting toxicities in each cohort. If 3 patients were treated and passed the observation window, escalation to the next cohort was initiated. If a DLT was reported, 3-4 additional patients were enrolled and observed. If a DLT was observed in the expanded cohort, this dose was considered to be the maximum tolerated dose. The maximum tolerated dose was defined at the cohort in which two dose-limiting toxicities were observed, or as the highest target dose tested in the absence of DLTs. The determined MTD was used as the recommended Phase 2 dose.

Time frame: From date of first dose to 30 days after termination, the longest 175 weeks

Population: All participants treated in the Phase 1 dose-escalation portion of the study

ArmMeasureValue (NUMBER)
Cohort 1Phase 1: Determine the Maximum Tolerated Dose Dependent on Reports of Dose-limiting ToxicitiesNA dose level of MTD
Primary

Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.

To establish the safety of escalating doses of MM-121 in combination with erlotinib in order to determine the recommended phase 2 dose of the combination for the second part of the study. Dose-escalation conducted using standard 3+3 model to determine maximum tolerated dose. Reports of Dose-Limiting Toxicities (DLTs) were assessed to determine the MTD.

Time frame: From date of first dose to 30 days after termination, the longest 175 weeks

ArmMeasureValue (NUMBER)
Cohort 1Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.0 participants reporting DLTs
Cohort 2Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.0 participants reporting DLTs
Cohort 3Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.1 participants reporting DLTs
Cohort 4Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.1 participants reporting DLTs
Cohort 5Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.1 participants reporting DLTs
Cohort 6Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.0 participants reporting DLTs
Cohort 7Phase 1: To Determine the Recommended Phase 2 Dose of the MM-121 + Erlotinib Combination Based Upon Either the Maximum Tolerated Dose (MTD) or the Maximum Feasible Dose of the Combination in Patients With NSCLC.0 participants reporting DLTs
Primary

Phase 2: Progression-free Survival of the MM-121 + Erlotinib Combination

This was a time-to-event measure using Progression-Free Survival (PFS) comparing MM-121 + erlotinib vs.erlotinib alone. Progression of disease is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Progression free survival was defined as the number of weeks from the date of randomization to the date of death or progression. If neither death nor progression was observed during the study, PFS data was censored at the last non-progressive disease valid tumor assessment unless the patient was discontinued due to symptomatic deterioration. If this occurred, the patient was counted as having progressive disease (PD).

Time frame: Time from first dose to date of progression, with a median of 8.1 weeks

ArmMeasureValue (MEDIAN)
Cohort 1Phase 2: Progression-free Survival of the MM-121 + Erlotinib Combination8.1 weeks
Cohort 2Phase 2: Progression-free Survival of the MM-121 + Erlotinib Combination7.7 weeks
Post Hoc

To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Erlotinib in Formalin Fixed (FFPE) Tumor Samples

Tumor tissue samples were obtained from patients prior to enrollment. Samples were analyzed using RNA-ISH for the expression of the biomarker, heregulin. Progression-free survival was assessed using RECIST v 1.1 to determine whether patients whose tumors express HRG have a lower PFS than those whose tumors do not express HRG, and to assess whether the addition of MM-121 to erlotinib can increase PFS in HRG-high patients.

Time frame: Time from first dose to date of progression, with a median of 8.1 weeks

Population: Patients with available tissue for heregulin testing

ArmMeasureValue (MEDIAN)
Cohort 1To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Erlotinib in Formalin Fixed (FFPE) Tumor Samples1.9 months PFS
Cohort 2To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Erlotinib in Formalin Fixed (FFPE) Tumor Samples1.7 months PFS
Cohort 3To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Erlotinib in Formalin Fixed (FFPE) Tumor Samples2.3 months PFS
Cohort 4To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Erlotinib in Formalin Fixed (FFPE) Tumor Samples1.6 months PFS
p-value: 0.00895% CI: [0.16, 0.76]Log Rank
p-value: 0.05995% CI: [0.97, 4.76]Log Rank

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026