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A Study of Avastin (Bevacizumab) in Combination With Gemcitabine With or Without Cisplatin in First-Line Treatment of Elderly Patients With Non-Small Cell Lung Cancer

Randomised Phase II Trial of Bevacizumab (AVASTIN®) in Combination With Gemcitabine or Attenuated Doses of Cisplatin and Gemcitabine as First-line Treatment of Elderly Patients With Advanced Non-squamous Non-small Cell Lung Cancer - EAGLES

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01077713
Enrollment
86
Registered
2010-03-01
Start date
2010-02-28
Completion date
2014-07-31
Last updated
2015-10-08

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

Conditions

Non-Squamous Non-Small Cell Lung Cancer

Brief summary

This 2 arm study will evaluate the efficacy and safety of Avastin + gemcitabine, and Avastin + gemcitabine + attenuated doses of cisplatin, as first line treatment in elderly patients with non-squamous non-small cell lung cancer. Patients will be randomised to receive either Avastin 7.5mg/kg iv on day 1 + gemcitabine 1200mg/m2 on days 1-8 of each 3 week cycle, or Avastin 7.5mg/kg iv on day 1 + cisplatin 60mg/m2 on day 1 + gemcitabine 1000mg/m2 on days 1-8 of each 3 week cycle. After 6 cycles of combination therapy, all patients will continue to receive Avastin monotherapy. The anticipated time on study treatment is until disease progression, and the target sample size is \<100 individuals.

Interventions

DRUGbevacizumab [Avastin]

7.5mg/kg iv on day 1 of each 3 week cycle

DRUGcisplatin

60mg/m2 on day 1 of each 3 week cycle

DRUGgemcitabine

1200mg/m2 on days 1-8 of each 3 week cycle

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* adult patients, \>=70 years of age; * inoperable, locally advanced, metastatic non-squamous non-small cell lung cancer; * \>=1 measurable lesion; * ECOG performance status 0-1.

Exclusion criteria

* neoadjuvant/adjuvant chemotherapy within 6 months prior to enrollment; * radical radiotherapy with curative intent within 28 days prior to enrollment; * history of \>=grade 2 hemoptysis in 3 months prior to enrollment; * evidence of CNS metastases; * current or recent (within 10 days of first dose of Avastin)use of aspirin (\>325 mg/day)or full dose anticoagulants or thrombolytic agents for therapeutic purposes.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Alive and Without Progressive Disease at Month 6Month 6Disease progression was assessed according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria version 1.1 (v 1.1). Disease progression was defined at least a 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 millimeter (mm), progression of existing non-target lesions, or presence of new lesions.

Secondary

MeasureTime frameDescription
Progression Free Survival (PFS)Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death, or consent withdrawal (up to 53 months)PFS was defined as the interval between the date of randomization and the first documentation of progressive disease or death from any cause. Disease progression was assessed according to RECIST criteria v 1.1. Disease progression was defined at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions. PFS was estimated using Kaplan Meier method.
Percentage of Participants Alive at 12 Months After Randomization1 year
Percentage of Participants Who DiedFrom randomization to death or end of the study (up to 53 months)
Overall Survival (OS)From randomization to death or end of the study (up to 53 months)OS was defined as the interval between the date of randomization and death from any cause. OS was estimated using Kaplan Meier method.
Percentage of Participants With Disease Progression or DeathBaseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death, or consent withdrawal (up to 53 months)Disease progression was assessed according to RECIST criteria v1.1. Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions.
Percentage of Participants With an Objective ResponseCycle 3 Day 15, Cycle 6 Day 15 and at Month 6Objective response was defined as having a CR or PR according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions.
Percentage of Participants With Disease ControlCycle 3 Day 15, Cycle 6 Day 15 and at Month 6Disease control was defined as having CR/PR/SD as per RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions.
Duration of Response (DoR)Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death or consent withdrawal (up to 53 months)DoR was defined for participants who had achieved an objective response (CR/PR) (whichever status was recorded first) as the time period from first documentation of a response to the date of first occurrence of investigator documented disease progression or death. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Disease progression was defined as increase by at least 20% in the sum of the longest diameters of each target lesion, taking as a reference the smallest sum of the longest diameters or appearance of one or more new lesions. DoR was estimated using Kaplan Meier method.
Percentage of Participants by Best Overall ResponseBaseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death or consent withdrawal (up to 53 months)Best overall response was defined as the best response recorded from the start of the treatment until disease progression/recurrence, assessed according to RECIST criteria v 1.1. Complete Response (CR): disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to less than (\<) 10 millimeter (mm) in short axis; Partial Response (PR): at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesion, and no new lesions; Progressive Disease (PD): at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions; Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Countries

Italy

Participant flow

Participants by arm

ArmCount
Bevacizumab + Gemcitabine
Participants received bevacizumab 7.5 mg/kg IV infusion on Day 1 and gemcitabine 1200 mg/m\^2 IV infusion on Days 1 and 8 of each 21-day cycle for a maximum of 6 cycles. After Cycle 6, participants continued treatment with bevacizumab 7.5 mg/kg IV infusion on Day 1 of every 21-day cycle until progressive disease, death, or intolerable toxicity.
44
Bevacizumab + Gemcitabine + Cisplatin
Participants received bevacizumab 7.5 mg/kg IV infusion and cisplatin 60 mg/m\^2 IV infusion on Day 1 and gemcitabine 1000 mg/m\^2 IV infusion on Days 1 and 8 of each 21-day cycle for a maximum of 6 cycles. After Cycle 6, participants continued treatment with bevacizumab 7.5 mg/kg IV infusion on Day 1 of every 21 day cycle until progressive disease, death, or intolerable toxicity.
42
Total86

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event21
Overall StudyDeath2829
Overall StudyLost to Follow-up11
Overall StudyOther42
Overall StudyProgressive Disease (PD)01
Overall StudyWithdrawal by Subject12

Baseline characteristics

CharacteristicBevacizumab + GemcitabineBevacizumab + Gemcitabine + CisplatinTotal
Age, Continuous74.2 years
STANDARD_DEVIATION 3.2
73.8 years
STANDARD_DEVIATION 3.5
74.0 years
STANDARD_DEVIATION 3.3
Sex: Female, Male
Female
16 Participants12 Participants28 Participants
Sex: Female, Male
Male
28 Participants30 Participants58 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
38 / 4337 / 40
serious
Total, serious adverse events
17 / 4310 / 40

Outcome results

Primary

Percentage of Participants Alive and Without Progressive Disease at Month 6

Disease progression was assessed according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria version 1.1 (v 1.1). Disease progression was defined at least a 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 millimeter (mm), progression of existing non-target lesions, or presence of new lesions.

Time frame: Month 6

Population: Intent-to-treat (ITT) set included all participants in the RND set who received at least one dose of any study medication; participants were classified according to treatment received.

ArmMeasureValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants Alive and Without Progressive Disease at Month 625.6 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants Alive and Without Progressive Disease at Month 630.0 percentage of participants
Secondary

Duration of Response (DoR)

DoR was defined for participants who had achieved an objective response (CR/PR) (whichever status was recorded first) as the time period from first documentation of a response to the date of first occurrence of investigator documented disease progression or death. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Disease progression was defined as increase by at least 20% in the sum of the longest diameters of each target lesion, taking as a reference the smallest sum of the longest diameters or appearance of one or more new lesions. DoR was estimated using Kaplan Meier method.

Time frame: Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death or consent withdrawal (up to 53 months)

Population: ITT set.

ArmMeasureValue (MEDIAN)
Bevacizumab + GemcitabineDuration of Response (DoR)5.23 months
Bevacizumab + Gemcitabine + CisplatinDuration of Response (DoR)5.97 months
Secondary

Overall Survival (OS)

OS was defined as the interval between the date of randomization and death from any cause. OS was estimated using Kaplan Meier method.

Time frame: From randomization to death or end of the study (up to 53 months)

Population: ITT set

ArmMeasureValue (MEDIAN)
Bevacizumab + GemcitabineOverall Survival (OS)5.66 months
Bevacizumab + Gemcitabine + CisplatinOverall Survival (OS)12.0 months
Secondary

Percentage of Participants Alive at 12 Months After Randomization

Time frame: 1 year

Population: ITT set

ArmMeasureValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants Alive at 12 Months After Randomization37.2 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants Alive at 12 Months After Randomization47.5 percentage of participants
Secondary

Percentage of Participants by Best Overall Response

Best overall response was defined as the best response recorded from the start of the treatment until disease progression/recurrence, assessed according to RECIST criteria v 1.1. Complete Response (CR): disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to less than (\<) 10 millimeter (mm) in short axis; Partial Response (PR): at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesion, and no new lesions; Progressive Disease (PD): at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions; Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Time frame: Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death or consent withdrawal (up to 53 months)

Population: ITT set

ArmMeasureGroupValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants by Best Overall ResponsePR14.0 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants by Best Overall ResponsePD16.3 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants by Best Overall ResponseSD39.5 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants by Best Overall ResponseNot Assessable30.2 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants by Best Overall ResponseCR0.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants by Best Overall ResponseNot Assessable15.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants by Best Overall ResponseCR0.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants by Best Overall ResponsePR35.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants by Best Overall ResponseSD37.5 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants by Best Overall ResponsePD12.5 percentage of participants
Secondary

Percentage of Participants Who Died

Time frame: From randomization to death or end of the study (up to 53 months)

Population: ITT set

ArmMeasureValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants Who Died69.8 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants Who Died72.5 percentage of participants
Secondary

Percentage of Participants With an Objective Response

Objective response was defined as having a CR or PR according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions.

Time frame: Cycle 3 Day 15, Cycle 6 Day 15 and at Month 6

Population: ITT set

ArmMeasureGroupValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants With an Objective ResponseCycle 311.6 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants With an Objective ResponseCycle 69.3 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants With an Objective ResponseMonth 64.7 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With an Objective ResponseCycle 615.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With an Objective ResponseCycle 327.5 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With an Objective ResponseMonth 610.0 percentage of participants
Secondary

Percentage of Participants With Disease Control

Disease control was defined as having CR/PR/SD as per RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions.

Time frame: Cycle 3 Day 15, Cycle 6 Day 15 and at Month 6

Population: ITT set

ArmMeasureGroupValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants With Disease ControlCycle 353.5 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants With Disease ControlCycle 627.9 percentage of participants
Bevacizumab + GemcitabinePercentage of Participants With Disease ControlMonth 625.6 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With Disease ControlCycle 367.5 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With Disease ControlCycle 637.5 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With Disease ControlMonth 630.0 percentage of participants
Secondary

Percentage of Participants With Disease Progression or Death

Disease progression was assessed according to RECIST criteria v1.1. Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions.

Time frame: Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death, or consent withdrawal (up to 53 months)

Population: ITT set

ArmMeasureValue (NUMBER)
Bevacizumab + GemcitabinePercentage of Participants With Disease Progression or Death86.0 percentage of participants
Bevacizumab + Gemcitabine + CisplatinPercentage of Participants With Disease Progression or Death90.0 percentage of participants
Secondary

Progression Free Survival (PFS)

PFS was defined as the interval between the date of randomization and the first documentation of progressive disease or death from any cause. Disease progression was assessed according to RECIST criteria v 1.1. Disease progression was defined at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, progression of existing non-target lesions, or presence of new lesions. PFS was estimated using Kaplan Meier method.

Time frame: Baseline; Day 15 of Cycles 3 and 6; Month 6 and then every 3 months until disease progression, death, or consent withdrawal (up to 53 months)

Population: ITT set

ArmMeasureValue (MEDIAN)
Bevacizumab + GemcitabineProgression Free Survival (PFS)4.33 months
Bevacizumab + Gemcitabine + CisplatinProgression Free Survival (PFS)6.82 months

Source: ClinicalTrials.gov · Data processed: Feb 21, 2026