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A Study of Avastin (Bevacizumab) Added to a Chemotherapeutic Regimen in Patients With Metastatic Pancreatic Cancer

A Randomized, Double-blind Study of the Effect of Avastin Plus Gemcitabine and Erlotinib Compared With Placebo Plus Gemcitabine and Erlotinib on Overall Survival in Patients With Metastatic Pancreatic Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01214720
Enrollment
607
Registered
2010-10-05
Start date
2005-07-31
Completion date
2008-10-31
Last updated
2014-08-13

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

Conditions

Pancreatic Cancer

Brief summary

This study will evaluate efficacy, safety and tolerability of Avastin versus placebo added to a chemotherapeutic regimen in patients with metastatic pancreatic cancer. The anticipated time of study treatment is until confirmed evidence of disease progression, and the target sample size is 500+ individuals.

Interventions

DRUGbevacizumab [Avastin]

Intervenous repeating dose

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE

Eligibility

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

Inclusion criteria

* adult patients, \>=18 years of age; * metastatic pancreatic cancer (adenocarcinoma); * good liver, kidney, and bone marrow function.

Exclusion criteria

* previous systemic treatment for metastatic pancreatic cancer; * pregnant or lactating females; * fertile men, or women of childbearing potential, not using adequate contraception; * major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study treatment start; * current or recent treatment (within 30 days prior to starting study treatment) with another investigational drug, or participation in another investigational study.

Design outcomes

Primary

MeasureTime frameDescription
Duration of Overall Survival - Percentage of Participants With an EventRandomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomizedDuration of overall survival (OS) was defined as the time between date of randomization and date of death due to any cause. Participants without an event were censored at the date last known to be alive. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization.
Duration of Overall Survival - Time to EventRandomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomizedDuration of OS was defined as the time between date of randomization and date of death due to any cause. Participants without an event were censored at the date last known to be alive. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization. Median duration of survival was estimated using the Kaplan-Meier method.

Secondary

MeasureTime frameDescription
Progression-Free Survival (PFS) - Time to EventScreening, Weeks 8, 16, 24, 32, 40, and every 12 weeks thereafter or until confirmed evidence of disease progressionPFS was defined as the time between the date of randomization and the date of documented PD (per RECIST), or date of death due to any cause. Data for participants without an event were censored at the date of last follow up for progression, or date of last available tumor assessment if no further follow up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization. Median PFS was estimated using the Kaplan-Meier method.
Clinical Benefit Response (CBR)Randomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomized
Bevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeeks 1, 3, 5, 7, and 9Blood samples were collected from a subgroup of participants, in selected centers for the determination of bevacizumab serum concentration before the first bevacizumab/placebo exposure (Week 1) and at Weeks 3, 5, 7, and 9. Each time blood samples were collected just (preferably within 1 hour) before the start of the study treatment.
Percentage of Participants With Complete Response (CR), Partial Response (PR), or Stable Disease (SD) at First Postbaseline Tumor AssessmentBaseline and Week 8Percentage of participants with CR, PR, or SD according to modified RECIST evaluation at the first postbaseline tumor assessment. CR equaled (=) complete disappearance of all target lesions and non-target disease, with normalization of tumor marker level. PR is greater than or equal to (≥) a 30% decrease of the sum of the LD of all target lesions as referenced to the baseline sum LD of all target lesions. Persistence of one or more non-target lesions(s) and/or maintenance of tumor marker level above normal limits. SD=neither sufficient shrinkage of target lesions to qualify for PR nor sufficient increase to qualify for PD with persistence of one or more non-target lesions(s) and/or maintenance of tumor marker level above normal limits.
Progression-Free Survival (PFS) - Percentage of Participants With an EventScreening, Weeks 8, 16, 24, 32, 40, and every 12 weeks thereafter or until confirmed evidence of disease progressionPFS was defined as the time between the date of randomization and the date of documented progressive disease (PD) defined according to modified Response Evaluation Criteria in Solid Tumors (RECIST) evaluation, or date of death due to any cause. PD was defined as at least a 20 percent (%) increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum (LD) recorded since the treatment started. Participants without an event were censored at the date of last follow up for progression, or date of last available tumor assessment if no further follow up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization.

Countries

Australia, Austria, Belgium, Canada, China, Czechia, Finland, France, Germany, Israel, Italy, Netherlands, New Zealand, Peru, Poland, Singapore, South Africa, Spain, Sweden, Taiwan, United Kingdom

Participant flow

Participants by arm

ArmCount
Bevacizumab + Gemcitabine + Erlotinib
Cycle 1 (8-week cycle): Participants received bevacizumab 5 mg/kg IV on Days 1, 15, 29, and 43 (followed by 1 week off); gemcitabine 1000 mg/m\^2 IV on Days 1, 8, 15, 22, 29, 36, and 43 (followed by 1 week off); and erlotinib 100 mg tablets/capsules, PO, QD for 8 weeks. Cycles 2 and beyond (4-week cycle): Participants received bevacizumab 5 mg/kg IV on Days 1 and 15 (followed by 2 weeks off); gemcitabine 1000 mg/m\^2 IV on Days 1, 8, and 15 (followed by 1 week off); and erlotinib 100 mg tablets/capsules PO QD. Participants continued on treatment until disease progression, unacceptable toxicity, or participant withdrawal.
306
Placebo + Gemcitabine + Erlotinib
Cycle 1 (8-week cycle): Participants received placebo IV on Days 1, 15, 29, and 43 (followed by 1 week off); gemcitabine 1000 mg/m\^2 IV on Days 1, 8, 15, 22, 29, 36, and 43 (followed by 1 week off); and erlotinib 100 mg tablets/capsules, PO, QD for 8 weeks. Cycles 2 and beyond (4-week cycle): Participants received placebo IV on Days 1 and 15 (followed by 2 weeks off); gemcitabine 1000 mg/m\^2 IV on Days 1, 8, and 15 (followed by 1 week off); and erlotinib 100 mg tablets/capsules PO QD. Participants continued on treatment until disease progression, unacceptable toxicity, or participant withdrawal.
301
Total607

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAlive and in follow-up4548
Overall StudyAlive and still on treatment3418
Overall StudyLost to Follow-up62

Baseline characteristics

CharacteristicBevacizumab + Gemcitabine + ErlotinibPlacebo + Gemcitabine + ErlotinibTotal
Age, Continuous61.5 years
STANDARD_DEVIATION 10.36
61.0 years
STANDARD_DEVIATION 10.03
61.2 years
STANDARD_DEVIATION 10.19
Sex: Female, Male
Female
132 Participants113 Participants245 Participants
Sex: Female, Male
Male
174 Participants188 Participants362 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
290 / 297276 / 286
serious
Total, serious adverse events
139 / 297119 / 286

Outcome results

Primary

Duration of Overall Survival - Percentage of Participants With an Event

Duration of overall survival (OS) was defined as the time between date of randomization and date of death due to any cause. Participants without an event were censored at the date last known to be alive. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization.

Time frame: Randomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomized

Population: ITT population.

ArmMeasureValue (NUMBER)
Bevacizumab + Gemcitabine + ErlotinibDuration of Overall Survival - Percentage of Participants With an Event72.2 percentage of participants
Placebo + Gemcitabine + ErlotinibDuration of Overall Survival - Percentage of Participants With an Event77.4 percentage of participants
Primary

Duration of Overall Survival - Time to Event

Duration of OS was defined as the time between date of randomization and date of death due to any cause. Participants without an event were censored at the date last known to be alive. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization. Median duration of survival was estimated using the Kaplan-Meier method.

Time frame: Randomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomized

Population: ITT Population.

ArmMeasureValue (MEDIAN)
Bevacizumab + Gemcitabine + ErlotinibDuration of Overall Survival - Time to Event7.1 months
Placebo + Gemcitabine + ErlotinibDuration of Overall Survival - Time to Event6.0 months
p-value: 0.208795% CI: [0.74, 1.07]Log Rank
Secondary

Bevacizumab Concentration in the Presence of Gemcitabine and Erlotinib

Blood samples were collected from a subgroup of participants, in selected centers for the determination of bevacizumab serum concentration before the first bevacizumab/placebo exposure (Week 1) and at Weeks 3, 5, 7, and 9. Each time blood samples were collected just (preferably within 1 hour) before the start of the study treatment.

Time frame: Weeks 1, 3, 5, 7, and 9

Population: ITT Population. Number (n) = number of participants assessed at a specific visit.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Bevacizumab + Gemcitabine + ErlotinibBevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeek 1 (n=4)0.52 micrograms/milliliterStandard Deviation 14.98
Bevacizumab + Gemcitabine + ErlotinibBevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeek 3 (n=78)27.09 micrograms/milliliterStandard Deviation 18.23
Bevacizumab + Gemcitabine + ErlotinibBevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeek 5 (n=73)35.23 micrograms/milliliterStandard Deviation 24.88
Bevacizumab + Gemcitabine + ErlotinibBevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeek 7 (n=72)41.19 micrograms/milliliterStandard Deviation 19.68
Bevacizumab + Gemcitabine + ErlotinibBevacizumab Concentration in the Presence of Gemcitabine and ErlotinibWeek 9 (n=61)44.60 micrograms/milliliterStandard Deviation 22.57
Secondary

Clinical Benefit Response (CBR)

Time frame: Randomization, Weeks 1-8 of Cycle 1, Weeks 1-3 of consecutive cycles, 28 days and 3 months after lst treatment, and every 3 months for up to 18 months from last participant randomized

Population: The analysis of the CBR was dependent on the calculation of analgesic therapy (AT); this calculation relies on established conversion factors for different morphine derivatives (MD). Many MD utilized by participants do not have well-established conversion factors, yielding uninterpretable results. Therefore, CBR was not analyzed in this study.

Secondary

Percentage of Participants With Complete Response (CR), Partial Response (PR), or Stable Disease (SD) at First Postbaseline Tumor Assessment

Percentage of participants with CR, PR, or SD according to modified RECIST evaluation at the first postbaseline tumor assessment. CR equaled (=) complete disappearance of all target lesions and non-target disease, with normalization of tumor marker level. PR is greater than or equal to (≥) a 30% decrease of the sum of the LD of all target lesions as referenced to the baseline sum LD of all target lesions. Persistence of one or more non-target lesions(s) and/or maintenance of tumor marker level above normal limits. SD=neither sufficient shrinkage of target lesions to qualify for PR nor sufficient increase to qualify for PD with persistence of one or more non-target lesions(s) and/or maintenance of tumor marker level above normal limits.

Time frame: Baseline and Week 8

Population: ITT Population.

ArmMeasureValue (NUMBER)
Bevacizumab + Gemcitabine + ErlotinibPercentage of Participants With Complete Response (CR), Partial Response (PR), or Stable Disease (SD) at First Postbaseline Tumor Assessment62.1 percentage of participants
Placebo + Gemcitabine + ErlotinibPercentage of Participants With Complete Response (CR), Partial Response (PR), or Stable Disease (SD) at First Postbaseline Tumor Assessment58.5 percentage of participants
p-value: 0.362195% CI: [-4.3, 11.6]Chi-squared
Secondary

Progression-Free Survival (PFS) - Percentage of Participants With an Event

PFS was defined as the time between the date of randomization and the date of documented progressive disease (PD) defined according to modified Response Evaluation Criteria in Solid Tumors (RECIST) evaluation, or date of death due to any cause. PD was defined as at least a 20 percent (%) increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum (LD) recorded since the treatment started. Participants without an event were censored at the date of last follow up for progression, or date of last available tumor assessment if no further follow up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization.

Time frame: Screening, Weeks 8, 16, 24, 32, 40, and every 12 weeks thereafter or until confirmed evidence of disease progression

Population: ITT population.

ArmMeasureValue (NUMBER)
Bevacizumab + Gemcitabine + ErlotinibProgression-Free Survival (PFS) - Percentage of Participants With an Event84.0 percentage of participants
Placebo + Gemcitabine + ErlotinibProgression-Free Survival (PFS) - Percentage of Participants With an Event92.4 percentage of participants
Secondary

Progression-Free Survival (PFS) - Time to Event

PFS was defined as the time between the date of randomization and the date of documented PD (per RECIST), or date of death due to any cause. Data for participants without an event were censored at the date of last follow up for progression, or date of last available tumor assessment if no further follow up assessment for progression was performed. Participants who were randomized but not exposed to study drug and had no further follow up were censored at the date of randomization. Median PFS was estimated using the Kaplan-Meier method.

Time frame: Screening, Weeks 8, 16, 24, 32, 40, and every 12 weeks thereafter or until confirmed evidence of disease progression

Population: ITT Population

ArmMeasureValue (MEDIAN)
Bevacizumab + Gemcitabine + ErlotinibProgression-Free Survival (PFS) - Time to Event4.6 months
Placebo + Gemcitabine + ErlotinibProgression-Free Survival (PFS) - Time to Event3.6 months
p-value: 0.000295% CI: [0.61, 0.86]Log Rank

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026