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A Study Evaluating the Efficacy and Tolerability of Veliparib in Combination With Paclitaxel/Carboplatin-Based Chemoradiotherapy Followed by Veliparib and Paclitaxel/Carboplatin Consolidation in Adults With Stage III Non-Small Cell Lung Cancer (NSCLC)

A Phase 1 Dose Escalation and Phase 2 Randomized, Placebo-Controlled Study of the Efficacy and Tolerability of Veliparib in Combination With Paclitaxel/Carboplatin-Based Chemoradiotherapy Followed by Veliparib and Paclitaxel/Carboplatin Consolidation in Subjects With Stage III Non-Small Cell Lung Cancer (NSCLC)

Status
Terminated
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02412371
Enrollment
48
Registered
2015-04-09
Start date
2015-04-30
Completion date
2019-08-05
Last updated
2020-07-22

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

Conditions

Non-small Cell Lung Cancer Stage III

Keywords

veliparib, PARP inhibitor, ABT-888, first line, previously untreated, stage III, non-small cell lung cancer, radiotherapy, paclitaxel, carboplatin

Brief summary

This study seeks to establish * the recommended Phase 2 dose (RPTD) of veliparib in combination with concurrent paclitaxel/carboplatin-based chemoradiotherapy (CRT) and consolidation with paclitaxel/carboplatin-based chemotherapy (Phase 1 portion), and * to assess whether the addition of oral veliparib versus placebo to paclitaxel/carboplatin-based chemoradiotherapy with paclitaxel/carboplatin consolidation will improve progression-free survival (PFS) in adults with Stage III non-small cell lung cancer (Phase 2 portion). A strategy decision was made not to proceed to Phase 2 portion of this study due to change in standard of care.

Detailed description

This was to be a 2-phase study consisting of 1. A Phase 1, dose escalation study of veliparib to determine a RPTD for combination with concurrent paclitaxel/carboplatin-based CRT and paclitaxel/carboplatin-based consolidation chemotherapy; followed by 2. A Phase 2, randomized, double-blinded study to determine whether veliparib improved outcome relative to placebo when added to paclitaxel/carboplatin based CRT followed by consolidation paclitaxel/carboplatin in adults with previously untreated Stage III NSCLC. In the dose escalation phase (Phase 1) of the study participants will be assigned to ascending doses of veliparib in combination with carboplatin, paclitaxel, and thoracic radiotherapy for 7 weeks following a traditional 3 + 3 design. The first cohort of at least 3 - 6 participants will receive veliparib 60 mg twice a day (BID) throughout CRT. Dose limiting toxicity (DLT) events will be collected for each dosing cohort until a new dosing cohort is opened or until the RPTD is identified. Participants will also receive a consolidation dose of veliparib of 120 mg BID + carboplatin and paclitaxel for up to two 21-day cycles. Once the concurrent CRT RPTD is identified, an additional cohort will be enrolled to explore the tolerability of a consolidation dose of veliparib at 240 mg BID + carboplatin + paclitaxel for up to two 21-day cycles. Following the dose escalation portion of the study, the RPTD will be determined by the sponsor and the Phase 2 portion of the study will begin with patient randomization in a 1:1:1 ratio to concurrent paclitaxel/carboplatin/radiotherapy/veliparib followed by consolidation paclitaxel/carboplatin/veliparib, concurrent paclitaxel/carboplatin/radiotherapy/veliparib followed by consolidation paclitaxel/carboplatin/placebo, or concurrent paclitaxel/carboplatin/radiotherapy/placebo followed by consolidation paclitaxel/carboplatin/placebo. Randomization will be stratified by tumor volume (≤ 90 versus \> 90 cm³) and smoking history (current smoker versus former smoker versus never smoked). Phase 2 was not carried out since during the study there was a change in standard of care for patients with newly diagnosed, unresectable Stage III NSCLC.

Interventions

DRUGPaclitaxel

Administered via intravenous infusion on Day 1 of each treatment week (concurrent CRT) / cycle (consolidation)

DRUGPlacebo for Veliparib

Capsule for oral administration

DRUGCarboplatin

Administered via intravenous infusion on Day 1 of each treatment week (concurrent CRT) / cycle (consolidation)

DRUGVeliparib

Capsule for oral administration

RADIATIONRadiotherapy

Radiation treatment with total dose of 60 - 63 Gy administered on Days 1 to 5 of each week for 7 weeks

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Masking description

All participants will be treated with open-label paclitaxel and carboplatin (Phase 1 and Phase 2). Participants in Phase 1 will be treated with open-label veliparib. In Phase 2, the Sponsor, Investigator, study site personnel and participant were to be be blinded to each participant's treatment with veliparib or placebo throughout the course of the study.

Intervention model description

In the dose escalation phase (Phase 1) of the study participants will be enrolled sequentially to receive ascending dose of veliparib in combination with carboplatin + paclitaxel + thoracic radiotherapy. In the Phase 2 portion of the study participants were to be randomized in a 1:1:1 ratio to one of three treatment arms.

Eligibility

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

Inclusion criteria

1. Participants with histologically or cytologically confirmed Stage III non-small cell lung cancer (NSCLC). 2. Participants in the randomized portion of the study must have measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1 criteria. 3. Participants must have V20 (volume of lung to receive 20 Gy radiotherapy according to simulation) \< 35%. 4. Participant must have an Eastern Cooperative Oncology Group (ECOG) performance score of 0 - 1. 5. Participant must have adequate hematologic, renal, hepatic, and lung function. 6. Participant must consent to provide archived tissue or cytology sample of NSCLC lesion for analysis.

Exclusion criteria

1. Participants with prior chemotherapy or radiotherapy (RT) for current NSCLC. Participants curatively treated for past early stage NSCLC greater than 3 years ago may be included. 2. Participants with prior exposure to poly-adenosine diphosphate (ADP)-ribose polymerase (PARP) inhibitors. 3. Participants with known hypersensitivity to carboplatin, paclitaxel, or formulations containing polyethoxylated castor oil (Cremophor). 4. Participants with prior mediastinal or thoracic radiotherapy. Prior tangential radiotherapy to prior breast cancer is acceptable. 5. Participants with major surgery in the 4 weeks prior to randomization (Video-assisted thoracoscopic surgery (VATS) and/or mediastinoscopy is not considered major surgery). 6. Participants with a previous or concurrent malignancy except for treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient received potentially curative treatment and has been disease-free for 3 years or is considered cured by the investigator if has been disease-free for less than 3 years. 7. Participant is pregnant or lactating. 8. Participant with sensory peripheral neuropathy of ≥ Grade 2 at baseline, unable to swallow medication, or participants with prior history of seizure within the prior 12 months.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Dose-limiting Toxicities (DLTs)For Cohorts 1 - 5, from the start of veliparib dosing through 28 days after RT completion or until initiation of consolidation CT, approx. 10 weeks; For Cohort 6, 21 days from start of consolidation CT or until the start of cycle 2 consolidation therapy.DLTs were defined as the following events considered treatment-related by the Investigator, graded per Common Terminology Criteria for Adverse Events (CTCAE) v4.0. * Radiation-induced myelopathy/myelitis or ≥ Grade (G) 3 cardiac toxicity * Radiation-related pneumonitis resulting in delay in RT, CT, or veliparib of \>3 weeks or early discontinuation (DC) of RT (total dose \<50 Gy) * ≥G4 esophagitis or esophagitis, dysphagia, and odynophagia requiring treatment interruption of \>7 days despite medical management, neutropenia for \>7 days or neutropenic fever or thrombocytopenia * ≥G2 seizure * G4 diarrhea or nausea/vomiting despite antiemetic therapy for \>48 hours * Any other toxicity resulting in delay in RT, CT or veliparib \>14 days or early DC of RT * Other nonhematologic toxicities ≥G3, except anorexia, fatigue, G3 infection, G3 aspartate/alanine transferase (AST/ALT) elevations ≤7 days, infusion reactions, G3/4 lymphopenia or electrolyte abnormalities corrected to ≤G2 in \<48 hours

Secondary

MeasureTime frameDescription
Objective Response RateTumor assessments were performed prior to consolidation chemotherapy, 24 weeks after start of treatment, every 8 weeks until 1 year after start of treatment, and then every 12 weeks until disease progression; median time on follow-up was 11 months.Objective response rate (ORR) is defined as the percentage of participants who have a confirmed complete response (CR) or partial response (PR) as assessed by the investigator using RECIST v1.1. Participants who did not meet complete response or partial response, including those who did not have post-baseline radiological assessments were considered as non-responders. Complete Response (CR): The disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. Normalization of tumor marker level. All lymph nodes must be non-pathological in size (\< 10 mm 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. Response must have been confirmed 4 weeks after the first documentation.

Countries

United States

Participant flow

Recruitment details

This study enrolled 48 participants at 10 sites in the United States. The study was designed as a 2-phase study consisting of a Phase 1, dose escalation of veliparib in combination with concurrent chemoradiotherapy (CRT) and consolidation chemotherapy (CT) and a Phase 2, randomized, double-blinded study.

Pre-assignment details

Participants in Phase 1 were sequentially assigned to ascending dose levels of veliparib in combination with carboplatin/paclitaxel chemoradiotherapy. Phase 2 was not conducted since there was a change in standard of care for newly diagnosed, unresectable Stage III non-small cell lung cancer (NSCLC). Results are reported for Phase 1.

Participants by arm

ArmCount
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CT
Participants received 60 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 120 mg BID with carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
7
Veliparib 80 mg BID + CRT -> Veliparib 120 mg BID + CT
Participants received 80 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 120 mg BID with carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
9
Veliparib 120 mg BID + CRT -> Veliparib 120 mg BID + CT
Participants received 120 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 120 mg BID with carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
7
Veliparib 200 mg BID + CRT -> Veliparib 120 mg BID + CT
Participants received 200 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 120 mg BID, carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
8
Veliparib 240 mg BID + CRT -> Veliparib 120 mg BID + CT
Participants received 240 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 120 mg BID with carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
12
Veliparib 240 mg BID + CRT -> Veliparib 240 mg BID + CT
Participants received 240 mg veliparib BID in combination with carboplatin at an AUC 2 mg/mL/min and paclitaxel 45 mg/m² once a week plus thoracic radiotherapy for 7 weeks. After completion of concurrent CRT participants received up to 2 cycles of consolidation therapy consisting of veliparib 240 mg BID, carboplatin AUC 6 mg/mL/min and paclitaxel 200 mg/m² administered on Day 1 of each 21-day cycle.
5
Total48

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyDeath421352
Overall StudyOther210013
Overall StudySponsor Discontinued Study146450
Overall StudyWithdrawal by Subject020110

Baseline characteristics

CharacteristicVeliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTVeliparib 80 mg BID + CRT -> Veliparib 120 mg BID + CTVeliparib 120 mg BID + CRT -> Veliparib 120 mg BID + CTVeliparib 200 mg BID + CRT -> Veliparib 120 mg BID + CTVeliparib 240 mg BID + CRT -> Veliparib 120 mg BID + CTVeliparib 240 mg BID + CRT -> Veliparib 240 mg BID + CTTotal
Age, Continuous69.1 years
STANDARD_DEVIATION 6.39
65.7 years
STANDARD_DEVIATION 7.55
66.9 years
STANDARD_DEVIATION 9.84
59.8 years
STANDARD_DEVIATION 6.07
67.3 years
STANDARD_DEVIATION 9.39
65.6 years
STANDARD_DEVIATION 11.84
65.8 years
STANDARD_DEVIATION 8.6
Age, Customized
40 - < 60 years
0 Participants1 Participants2 Participants3 Participants2 Participants1 Participants9 Participants
Age, Customized
≥ 60 years
7 Participants8 Participants5 Participants5 Participants10 Participants4 Participants39 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Score
Grade 0 (Fully active)
3 Participants3 Participants3 Participants4 Participants6 Participants4 Participants23 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Score
Grade 1 (Restricted but ambulatory)
4 Participants6 Participants4 Participants4 Participants6 Participants1 Participants25 Participants
Race/Ethnicity, Customized
Black
1 Participants0 Participants1 Participants0 Participants1 Participants2 Participants5 Participants
Race/Ethnicity, Customized
White
6 Participants9 Participants6 Participants8 Participants11 Participants3 Participants43 Participants
Sex: Female, Male
Female
4 Participants6 Participants5 Participants6 Participants5 Participants3 Participants29 Participants
Sex: Female, Male
Male
3 Participants3 Participants2 Participants2 Participants7 Participants2 Participants19 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
5 / 73 / 91 / 73 / 86 / 123 / 5
other
Total, other adverse events
7 / 79 / 97 / 78 / 812 / 125 / 5
serious
Total, serious adverse events
2 / 75 / 94 / 73 / 83 / 122 / 5

Outcome results

Primary

Number of Participants With Dose-limiting Toxicities (DLTs)

DLTs were defined as the following events considered treatment-related by the Investigator, graded per Common Terminology Criteria for Adverse Events (CTCAE) v4.0. * Radiation-induced myelopathy/myelitis or ≥ Grade (G) 3 cardiac toxicity * Radiation-related pneumonitis resulting in delay in RT, CT, or veliparib of \>3 weeks or early discontinuation (DC) of RT (total dose \<50 Gy) * ≥G4 esophagitis or esophagitis, dysphagia, and odynophagia requiring treatment interruption of \>7 days despite medical management, neutropenia for \>7 days or neutropenic fever or thrombocytopenia * ≥G2 seizure * G4 diarrhea or nausea/vomiting despite antiemetic therapy for \>48 hours * Any other toxicity resulting in delay in RT, CT or veliparib \>14 days or early DC of RT * Other nonhematologic toxicities ≥G3, except anorexia, fatigue, G3 infection, G3 aspartate/alanine transferase (AST/ALT) elevations ≤7 days, infusion reactions, G3/4 lymphopenia or electrolyte abnormalities corrected to ≤G2 in \<48 hours

Time frame: For Cohorts 1 - 5, from the start of veliparib dosing through 28 days after RT completion or until initiation of consolidation CT, approx. 10 weeks; For Cohort 6, 21 days from start of consolidation CT or until the start of cycle 2 consolidation therapy.

Population: Participants who received at least 1 dose of veliparib

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)0 Participants
Veliparib 80 mg BID + CRT -> Veliparib 120 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)0 Participants
Veliparib 120 mg BID + CRT -> Veliparib 120 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)0 Participants
Veliparib 200 mg BID + CRT -> Veliparib 120 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)1 Participants
Veliparib 240 mg BID + CRT -> Veliparib 120 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)0 Participants
Veliparib 240 mg BID + CRT -> Veliparib 240 mg BID + CTNumber of Participants With Dose-limiting Toxicities (DLTs)2 Participants
Secondary

Objective Response Rate

Objective response rate (ORR) is defined as the percentage of participants who have a confirmed complete response (CR) or partial response (PR) as assessed by the investigator using RECIST v1.1. Participants who did not meet complete response or partial response, including those who did not have post-baseline radiological assessments were considered as non-responders. Complete Response (CR): The disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. Normalization of tumor marker level. All lymph nodes must be non-pathological in size (\< 10 mm 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. Response must have been confirmed 4 weeks after the first documentation.

Time frame: Tumor assessments were performed prior to consolidation chemotherapy, 24 weeks after start of treatment, every 8 weeks until 1 year after start of treatment, and then every 12 weeks until disease progression; median time on follow-up was 11 months.

Population: Participants who received at least 1 dose of veliparib and with at least one post-baseline tumor assessment

ArmMeasureValue (NUMBER)
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTObjective Response Rate50.0 percentage of participants
Veliparib 80 mg BID + CRT -> Veliparib 120 mg BID + CTObjective Response Rate50.0 percentage of participants
Veliparib 120 mg BID + CRT -> Veliparib 120 mg BID + CTObjective Response Rate100.0 percentage of participants
Veliparib 200 mg BID + CRT -> Veliparib 120 mg BID + CTObjective Response Rate62.5 percentage of participants
Veliparib 240 mg BID + CRT -> Veliparib 120 mg BID + CTObjective Response Rate72.7 percentage of participants
Veliparib 240 mg BID + CRT -> Veliparib 240 mg BID + CTObjective Response Rate0.0 percentage of participants
Post Hoc

Duration of Overall Response (DOR)

Duration of overall response was defined as time from the date of first response (CR or PR) to the earliest documentation of radiographic progressive disease or death due to disease progression, calculated using Kaplan-Meier methods. Participants who did not experience radiographic disease progression or death were censored at the date of the last disease assessment.

Time frame: Tumor assessments were performed prior to consolidation chemotherapy, 24 weeks after start of treatment, every 8 weeks until 1 year after start of treatment, and then every 12 weeks until disease progression; median time on follow-up was 11 months.

Population: Participants who received at least 1 dose of veliparib with at least 1 post-baseline tumor assessment and a confirmed response; DOR was prespecified as a secondary endpoint in Phase 2, which was not conducted. For Phase 1 DOR was not a prespecified endpoint and was only analyzed for all cohorts combined due to the small sample size of each cohort.

ArmMeasureValue (MEDIAN)
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTDuration of Overall Response (DOR)30.4 months
Post Hoc

Overall Survival

Overall survival (OS) was defined as the time from the participant's first dose of study drug to the date of death, and was calculated using Kaplan-Meier methods. Participants who did not die were censored at the date of last study visit or the last known date to be alive, whichever was later.

Time frame: From first dose of study drug until end of study; maximum time on follow-up was approximately 46 months.

Population: All participants who received veliparib; OS was pre-specified in the Protocol as a secondary endpoint in Phase 2, which was not conducted. For Phase 1 OS was not a pre-specified endpoint, and was only analyzed for all treatment cohorts combined due to the small sample sizes within each cohort.

ArmMeasureValue (MEDIAN)
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTOverall Survival32.6 months
Post Hoc

Progression-free Survival

Progression-free survival (PFS) was defined as the time from first dose of study drug to the date of earliest radiographic disease progression per investigator assessment based on Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death, and was calculated using Kaplan-Meier methods. All radiographic disease progression was included regardless whether the event occurred while the participant was taking study drug or had previously discontinued study drug. Participants who did not experience radiographic disease progression or death were censored at the date of the last disease assessment. Participants with no post-baseline disease assessment were censored at first dose date plus 1 day. Progressive disease (PD) was defined as at least a 20% increase in the size of target lesions with an absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions.

Time frame: From first dose until end of study; maximum time on follow-up was approximately 46 months.

Population: All participants who received veliparib; PFS was pre-specified in the Protocol as a primary endpoint in Phase 2, which was not conducted. For Phase 1 PFS was not a pre-specified endpoint, and was only analyzed for all treatment cohorts combined due to the small sample sizes within each cohort.

ArmMeasureValue (MEDIAN)
Veliparib 60 mg BID + CRT -> Veliparib 120 mg BID + CTProgression-free Survival19.6 months

Source: ClinicalTrials.gov · Data processed: Feb 26, 2026