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A Study of Necitumumab and Chemotherapy in Participants With Stage IV Squamous Non-Small Cell Lung Cancer

A Randomized, Multicenter, Open-Label, Phase 2 Study of Paclitaxel-Carboplatin Chemotherapy Plus Necitumumab (IMC-11F8) Versus Paclitaxel-Carboplatin Chemotherapy Alone in the First-Line Treatment of Patients With Stage IV Squamous Non-Small Cell Lung Cancer (NSCLC)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01769391
Enrollment
167
Registered
2013-01-16
Start date
2013-01-31
Completion date
2017-07-31
Last updated
2019-09-20

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

Conditions

Squamous Non Small Cell Lung Cancer

Keywords

NSCLC

Brief summary

The main purpose of this study is to evaluate if necitumumab added to standard chemotherapy of paclitaxel and carboplatin is more effective to treat cancer than the standard chemotherapy of paclitaxel and carboplatin alone.

Interventions

Administered IV

DRUGPaclitaxel

Administered IV

DRUGCarboplatin

Administered IV

Sponsors

Eli Lilly and Company
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

* Histologically or cytologically confirmed squamous NSCLC * Stage IV disease at time of study entry based on American Joint Committee on Cancer (AJCC) 7th edition * Measurable disease at time of study entry as defined by Response Evaluation Criteria in Solid Tumors, (RECIST) Version 1.1 * Archived or recent tumor tissue (minimum of 5 unstained tissue slides or a paraffin-embedded tissue block) available for analysis of epidermal growth factor receptor (EGFR) protein expression by immunohistochemistry (IHC) and other biomarker assessments

Exclusion criteria

* Nonsquamous NSCLC * Prior anticancer therapy with monoclonal antibodies, signal transduction inhibitors, or any therapies targeting the EGFR, vascular endothelial growth factor (VEGF), or VEGF receptor * Previous chemotherapy for NSCLC * Major surgery or received any investigational therapy in the 4 weeks prior to randomization * Chest irradiation within 12 weeks prior to randomization (except palliative irradiation of bone lesions, which is allowed) * Brain metastases that are symptomatic or require ongoing treatment with steroids or anticonvulsants (Participants who have undergone previous radiotherapy for brain metastases, who are now nonsymptomatic and no longer require treatment with steroids or anticonvulsants, are eligible)

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR) (Objective Response Rates [ORR])Baseline to Disease Progression or Death (Up to 24 Months)The denominator of ORR (Objective Response Rate) includes each participant enrolled who received any amount of study drug (necitumumab, gemcitabine, and/or cisplatin), and who had a complete radiographic assessment at baseline and at least one complete radiographic assessment post-baseline. The numerator includes those participants counted in the denominator with a confirmed best overall tumor response of partial or complete response (Complete Response (CR): disappearance of all non-nodal target lesions, with the short axes of any target lymph nodes reduced to \<10 millimeters (mm). Partial Response (PR): at least a 30% decrease in the sum of the diameters of target lesions (including the short axes of any target lymph nodes), taking as reference the baseline sum diameter.) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Secondary

MeasureTime frameDescription
Pharmacokinetics (PK): Maximum Concentration (Cmax) of NecitumumabPre-infusion Cycle 1, Day 1; Cycle 3, Day 1; Cycle 5; Day 1 (within 2 hours prior to beginning of infusion)
Percentage of Participants With Anti Necitumumab AntibodiesBaseline to End of Cycle 6
Progression-Free SurvivalRandomization to Progressive Disease or Death (Up to 24 Months)Progression-Free Survival (PFS) is defined as the time from randomization until the first radiographically documented progressive disease (PD) or death from any cause. PD defined by Response Evaluation Criteria in Solid Tumors Criteria (RECIST version 1.1) as at least a 20% increase in the sum of the diameters of target lesions,taking as reference the smallest sum on study (including the baseline sum if that is the smallest). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. For participants not known to have died as of the data cut-off date and who do not have objective PD, PFS will be censored at the date of the last complete radiographic assessment.
Overall Survival (OS)Randomization to Date of Death (Up to 24 Months)OS defined as the time from the date of randomization to the date of death from any cause. For participants not known to have died as of the data cut-off date, OS was censored at the last contact date (last contact for participants in post-discontinuation = last known alive date in mortality status).
Percent Change in Tumor Size (CTS)Baseline to Progressive Disease or Death (Up to 24 Months)CTS is defined as maximum percent change from baseline in the sum of target lesions.
Pharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 1, Day 8 ; Cycle 2, Day 1; Cycle 3, Day 1;Cycle 4, Day1;Cycle 5, Day 1; Cycle 6, Day 1 (within 2 hours prior to beginning of infusion)
Percentage of Participants Who Achieve Best Overall Disease Response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD) (Disease Control Rate [DCR])Baseline to Progressive Disease and/or Death (Estimated up to 24 Months)Defined using the same denominator as defined in ORR. Among participants counted in the denominator, the numerator counts those with a confirmed best tumor response of SD, PR, or CR per RECIST 1.1. (SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD; PR at least 30% decrease in the sum of diameter of target lesions; CR: disappearance of all target lesions).

Countries

Germany, Mexico, Poland, Russia, South Korea, United States

Participant flow

Pre-assignment details

A completer is defined as having a complete radiographic assessment at baseline and at least one complete post-baseline radiographic assessment of CR, PR , SD or PD.

Participants by arm

ArmCount
Necitumumab +Paclitaxel+Carboplatin
Necitumumab 800 milligram (mg) administered intravenously (IV) on Days 1 and 8 of every 3 week cycle. Paclitaxel 200 milligram per square meter (mg/m\^2) administered IV on Day 1 of every 3 week cycle. Carboplatin AUC6 administered IV on Day 1 of every 3 week cycle.
110
Paclitaxel + Carboplatin
Paclitaxel 200 mg/m² administered IV on Day 1 of every 3 week cycle. Carboplatin AUC6 administered IV on Day 1 of every 3 week cycle. The combination of paclitaxel-carboplatin may continue for a maximum of 6 cycles.
57
Total167

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event03
Overall StudyDeath101
Overall StudyInvestigator Decision20
Overall StudyProgressive Disease12
Overall StudyWithdrawal by Subject43

Baseline characteristics

CharacteristicTotalPaclitaxel + CarboplatinNecitumumab +Paclitaxel+Carboplatin
Age, Continuous65.3 years
STANDARD_DEVIATION 8.98
64.7 years
STANDARD_DEVIATION 8.27
65.5 years
STANDARD_DEVIATION 9.36
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants4 Participants3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
158 Participants53 Participants105 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants0 Participants2 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants2 Participants0 Participants
Race (NIH/OMB)
Asian
16 Participants6 Participants10 Participants
Race (NIH/OMB)
Black or African American
5 Participants2 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
144 Participants47 Participants97 Participants
Region of Enrollment
Germany
8 Participants4 Participants4 Participants
Region of Enrollment
Mexico
6 Participants3 Participants3 Participants
Region of Enrollment
Poland
19 Participants7 Participants12 Participants
Region of Enrollment
Russia
40 Participants12 Participants28 Participants
Region of Enrollment
South Korea
16 Participants6 Participants10 Participants
Region of Enrollment
United States
78 Participants25 Participants53 Participants
Sex: Female, Male
Female
36 Participants13 Participants23 Participants
Sex: Female, Male
Male
131 Participants44 Participants87 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
102 / 10649 / 55
serious
Total, serious adverse events
43 / 10621 / 55

Outcome results

Primary

Percentage of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR) (Objective Response Rates [ORR])

The denominator of ORR (Objective Response Rate) includes each participant enrolled who received any amount of study drug (necitumumab, gemcitabine, and/or cisplatin), and who had a complete radiographic assessment at baseline and at least one complete radiographic assessment post-baseline. The numerator includes those participants counted in the denominator with a confirmed best overall tumor response of partial or complete response (Complete Response (CR): disappearance of all non-nodal target lesions, with the short axes of any target lymph nodes reduced to \<10 millimeters (mm). Partial Response (PR): at least a 30% decrease in the sum of the diameters of target lesions (including the short axes of any target lymph nodes), taking as reference the baseline sum diameter.) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Time frame: Baseline to Disease Progression or Death (Up to 24 Months)

Population: All randomized participants that received at least 1 dose of study drug, who had a complete radiographic assessment at baseline and at least 1 complete radiographic assessment post-baseline.

ArmMeasureValue (NUMBER)
Necitumumab +Paclitaxel+CarboplatinPercentage of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR) (Objective Response Rates [ORR])48.9 percentage of participants
Paclitaxel + CarboplatinPercentage of Participants Who Achieve Best Overall Tumor Response of Complete Response (CR) or Partial Response (PR) (Objective Response Rates [ORR])40.0 percentage of participants
Secondary

Overall Survival (OS)

OS defined as the time from the date of randomization to the date of death from any cause. For participants not known to have died as of the data cut-off date, OS was censored at the last contact date (last contact for participants in post-discontinuation = last known alive date in mortality status).

Time frame: Randomization to Date of Death (Up to 24 Months)

Population: All randomized participants; (49 and 19 censored participants in Paclitaxel + Carboplatin + Necitumumab and Paclitaxel + Carboplatin Arms, respectively.

ArmMeasureValue (MEDIAN)
Necitumumab +Paclitaxel+CarboplatinOverall Survival (OS)13.2 months
Paclitaxel + CarboplatinOverall Survival (OS)11.2 months
Secondary

Percentage of Participants Who Achieve Best Overall Disease Response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD) (Disease Control Rate [DCR])

Defined using the same denominator as defined in ORR. Among participants counted in the denominator, the numerator counts those with a confirmed best tumor response of SD, PR, or CR per RECIST 1.1. (SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD; PR at least 30% decrease in the sum of diameter of target lesions; CR: disappearance of all target lesions).

Time frame: Baseline to Progressive Disease and/or Death (Estimated up to 24 Months)

Population: All randomized participants who received at least 1 dose of study drug and who had a complete radiographic assessment.

ArmMeasureValue (NUMBER)
Necitumumab +Paclitaxel+CarboplatinPercentage of Participants Who Achieve Best Overall Disease Response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD) (Disease Control Rate [DCR])87.2 percentage of participants
Paclitaxel + CarboplatinPercentage of Participants Who Achieve Best Overall Disease Response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD) (Disease Control Rate [DCR])84.0 percentage of participants
Secondary

Percentage of Participants With Anti Necitumumab Antibodies

Time frame: Baseline to End of Cycle 6

Population: All participants who received any amount of necitumumab and had post baseline antibody data.

ArmMeasureValue (NUMBER)
Necitumumab +Paclitaxel+CarboplatinPercentage of Participants With Anti Necitumumab Antibodies2.8 percentage of participants
Secondary

Percent Change in Tumor Size (CTS)

CTS is defined as maximum percent change from baseline in the sum of target lesions.

Time frame: Baseline to Progressive Disease or Death (Up to 24 Months)

Population: All randomized participants who received at least 1 dose of study drug and who had a decrease from baseline in the sum of target lesions.

ArmMeasureValue (MEAN)Dispersion
Necitumumab +Paclitaxel+CarboplatinPercent Change in Tumor Size (CTS)-44.3 percent change in tumor sizeStandard Deviation 22.8
Paclitaxel + CarboplatinPercent Change in Tumor Size (CTS)-38.65 percent change in tumor sizeStandard Deviation 24.4
Secondary

Pharmacokinetics (PK): Maximum Concentration (Cmax) of Necitumumab

Time frame: Pre-infusion Cycle 1, Day 1; Cycle 3, Day 1; Cycle 5; Day 1 (within 2 hours prior to beginning of infusion)

Population: All participants who received at least one dose of necitumumab and had evaluable PK data.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Maximum Concentration (Cmax) of NecitumumabCycle 1, Day 1 (n=92)262.418 microgram/milliliter (μg/mL)Geometric Coefficient of Variation 32.84
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Maximum Concentration (Cmax) of NecitumumabCycle 3, Day 1 (n=72)296.843 microgram/milliliter (μg/mL)Geometric Coefficient of Variation 62.97
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Maximum Concentration (Cmax) of NecitumumabCycle 5, Day 1 (n=62)303.475 microgram/milliliter (μg/mL)Geometric Coefficient of Variation 53.75
Secondary

Pharmacokinetics (PK): Minimum Concentration (Cmin) of Necitumumab

Time frame: Cycle 1, Day 8 ; Cycle 2, Day 1; Cycle 3, Day 1;Cycle 4, Day1;Cycle 5, Day 1; Cycle 6, Day 1 (within 2 hours prior to beginning of infusion)

Population: All participants who received at least one dose of study drug and had evaluable PK data.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 1, Day 8 (n-85)59.269 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 59.06
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 2, Day 1 (n=79)47.874 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 79.89
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 3, Day 1 (n=76)78.142 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 70.99
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 4, Day 1 (n=70)80.392 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 74.42
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 5, Day 1 (n=62)89.137 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 88.94
Necitumumab +Paclitaxel+CarboplatinPharmacokinetics (PK): Minimum Concentration (Cmin) of NecitumumabCycle 6, Day 1 (n=59)87.043 nanogram/milliliter (ng/mL)Geometric Coefficient of Variation 85.02
Secondary

Progression-Free Survival

Progression-Free Survival (PFS) is defined as the time from randomization until the first radiographically documented progressive disease (PD) or death from any cause. PD defined by Response Evaluation Criteria in Solid Tumors Criteria (RECIST version 1.1) as at least a 20% increase in the sum of the diameters of target lesions,taking as reference the smallest sum on study (including the baseline sum if that is the smallest). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. For participants not known to have died as of the data cut-off date and who do not have objective PD, PFS will be censored at the date of the last complete radiographic assessment.

Time frame: Randomization to Progressive Disease or Death (Up to 24 Months)

Population: All randomized participants; with 15 and 7 censored participants in Paclitaxel +Carboplatin + Necitumumab and Paclitaxel +Carboplatin Arms, respectively.

ArmMeasureValue (MEDIAN)
Necitumumab +Paclitaxel+CarboplatinProgression-Free Survival5.4 months
Paclitaxel + CarboplatinProgression-Free Survival5.6 months

Source: ClinicalTrials.gov · Data processed: Mar 3, 2026