Lung Cancer, Non-small Cell Lung Cancer
Conditions
Keywords
NSCLC, bevacizumab, avastin
Brief summary
This study is designed to establish biosimilarity of SB8, a proposed biosimilar product of bevacizumab, to EU-sourced bevacizumab, in patients with metastatic or recurrent non-squamous non-small cell lung cancer (NSCLC).
Detailed description
Standard efficacy parameters, safety profiles, pharmacokinetics and immunogenicity will be compared between SB8 and bevacizumab.
Interventions
Avastin® 15 mg/kg IV every 3 weeks on Day 1
SB8 15 mg/kg IV every 3 weeks on Day 1
Carboplatin AUC 6 IV every 3 weeks on Day 1 for 4-6 cycles
Paclitaxel 200 mg/m2 IV every 3 weeks on Day 1 for 4-6 cycles
Sponsors
Study design
Eligibility
Inclusion criteria
1. Aged ≥ 18 years 2. ECOG performance status of 0-1 3. Histologically-confirmed metastatic or recurrent non-squamous non-small cell lung cancer 4. At least one measurable lesion according to RECIST v1.1. 5. Able to receive bevacizumab, carboplatin and paclitaxel based on adequate laboratory and clinical parameters
Exclusion criteria
1. Diagnosis of small cell carcinoma of the lung or squamous cell carcinoma 2. Sensitizing EGFR mutations or ALK rearrangements 3. Increased risk of bleeding determined by investigator based on radiographic / clinical findings 4. History of systemic chemotherapy administered in the first-line setting for metastatic or recurrent disease of NSCLC.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Best Overall Response (Best Overall Response Rate[ORR]) by 24 Weeks | 24 weeks from randomisation | The best ORR was defined as the proportion of subjects whose best overall response was either Complete Response (CR) or Partial Response (PR) according to RECIST v1.1 during the induction treatment period by 24 weeks. CR: Disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression Free Survival | from the date of randomisation to the date of disease progression or death up to 12 months from randomisation of the last subject | PFS is defined as the time from the date of Randomisation to the date of disease progression (progressive disease \[PD\]) or death regardless of the cause of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression). |
| Overall Survival | from the date of randomisation to the date of death up to 12 months from randomisation of the last subject | OS was defined as the time from the date of randomisation to the date of death regardless of the cause of death. Subjects who were alive at the time of analysis were censored at the date of last known alive. |
| Duration of Response (DoR) | from documented tumour response until disease progression up to 12 months from randomisation of the last subject | DoR in subjects with response from documented tumour response until disease progression up to 12 months from randomisation of the last subject |
| Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | AEs were reported from the time the informed consent form (ICF) was signed until the EOT visit, approximately 24 months from study initiation. | After the end of treatment (EOT) visit, SAEs should be reported to the Sponsor if the Investigator becomes aware of them. Severity Grade of NCI-CTCAE v4.03 Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL) (Instrumental ADL refers to preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc.) Grade 3: Severe or medically significant but not immediately life-threatening; hospitalisation or prolongation of hospitalisation indicated; disabling; limiting self-care ADL (Self-care ADL refer to bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not bedridden.) Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death related to AE |
| Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Up to 21 weeks (Cycle 1,3,5 and 7. Each cycle is 21 days.) | Maximum Plasma Concentration (Cmax) at selected cycles (i.e., Cycle 1, 3, 5 and 7) |
| Immunogenicity Assessments (Anti-drug Antibodies) | Up to 21 weeks (Cycle 1,3,5, 7 and EOT visit. Each cycle is 21 days.), approximately 24 months from study initiation. | Incidence of anti-drug (bevacizumab) antibodies (ADA) The incidence of overall ADA results (i.e. Positive, Negative, Inconclusive) was presented by treatment group at Cycle 7 and the end of treatment (EOT). Overall ADA result was defined as below: * 'Positive' for a subject with treatment-induced or treatment-boosted ADA, where treatment-induced ADA indicated at least one positive result after pre-dose of Cycle 1 for subjects with negative ADA at pre-dose of Cycle 1, and treatment-boosted ADA indicated at least one positive result with higher titre level compared to pre-dose of Cycle 1 after pre-dose of Cycle 1 for subjects with positive ADA at pre-dose of Cycle 1. * 'Negative' for a subject without positive ADA until Cycle 7 and EOT. * 'Inconclusive' for a subject with positive ADA at Cycle 1 and without positive result with higher titre level observed after pre-dose of Cycle 1 up to Cycle 7 and EOT. |
| Immunogenicity Assessments (Neutralizing Antibodies) | Up to 21 weeks (Cycle 1,3,5, 7 and EOT visit. Each cycle is 21 days.), approximately 24 months from study initiation. | Incidence of anti-drug (bevacizumab) antibodies (ADA) - neutralizing antibodies (NAb) The analysis was performed using the Safety Set (SAF). Overall Number of Participants Analyzed represents the number of subjects in SAF. The total number is not the sum of the number of subjects of each visits, since NAb results only for subjects with ADA positive against SB8 or Avastin were used for the summary. Number Analyzed of each visit is equal to the number of subjects with ADA positive of each visit, which is displayed in 8. Secondary Outcome: Immunogenicity Assessments (Anti-drug Antibodies). |
| Pharmacokinetics: Trough Level [Ctrough] | Up to 21 weeks (Cycle 1,3,5 and 7. Each cycle is 21 days.) | Ctrough at selected cycles (i.e., Cycle 1, 3, 5 and 7) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Best Objective Response Rate by 11 and 17 Weeks | 11 weeks and 17 weeks from randomisation | Best Objective Response Rate (ORR) by 11 weeks and 17 weeks |
Countries
Belarus, Georgia, Germany, Hungary, Poland, Romania, Russia, Serbia, South Korea, Spain, Taiwan, Thailand, Ukraine
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Bevacizumab (Avastin) Avastin® + Carboplatin/Paclitaxel
Bevacizumab: Avastin® 15 mg/kg IV every 3 weeks on Day 1
Carboplatin: Carboplatin AUC 6 IV every 3 weeks on Day 1 for 4-6 cycles
Paclitaxel: Paclitaxel 200 mg/m2 IV every 3 weeks on Day 1 for 4-6 cycles | 384 |
| SB8 (A Proposed Bevacizumab Biosimilar) SB8 + Carboplatin/Paclitaxel
SB8: SB8 15 mg/kg IV every 3 weeks on Day 1
Carboplatin: Carboplatin AUC 6 IV every 3 weeks on Day 1 for 4-6 cycles
Paclitaxel: Paclitaxel 200 mg/m2 IV every 3 weeks on Day 1 for 4-6 cycles | 379 |
| Total | 763 |
Baseline characteristics
| Characteristic | Bevacizumab (Avastin) | SB8 (A Proposed Bevacizumab Biosimilar) | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 115 Participants | 124 Participants | 239 Participants |
| Age, Categorical Between 18 and 65 years | 269 Participants | 255 Participants | 524 Participants |
| Age, Continuous | 60.0 years STANDARD_DEVIATION 9.18 | 60.2 years STANDARD_DEVIATION 8.95 | 60.1 years STANDARD_DEVIATION 20.84 |
| Body Mass Index (BMI) | 25.49 kg/m^2 STANDARD_DEVIATION 4.707 | 25.50 kg/m^2 STANDARD_DEVIATION 4.809 | 25.50 kg/m^2 STANDARD_DEVIATION 4.755 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 35 Participants | 32 Participants | 67 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 348 Participants | 347 Participants | 695 Participants |
| Sex: Female, Male Female | 128 Participants | 127 Participants | 255 Participants |
| Sex: Female, Male Male | 256 Participants | 252 Participants | 508 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 171 / 380 | 166 / 378 |
| other Total, other adverse events | 316 / 380 | 323 / 378 |
| serious Total, serious adverse events | 81 / 380 | 75 / 378 |
Outcome results
Percentage of Participants With Best Overall Response (Best Overall Response Rate[ORR]) by 24 Weeks
The best ORR was defined as the proportion of subjects whose best overall response was either Complete Response (CR) or Partial Response (PR) according to RECIST v1.1 during the induction treatment period by 24 weeks. CR: Disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: 24 weeks from randomisation
Population: The Full Analysis Set consisted of all randomised subjects. The subjects were analysed based on the treatment they were randomised to by intention-to-treat principle. However, subjects who did not qualify for randomisation and were inadvertently randomised into the study were excluded from FAS, provided these subjects did not receive any IP, and there was one subject who met these criteria. So, there is a difference between Started in Participant Flow module and Analysis Population.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bevacizumab (Avastin) | Percentage of Participants With Best Overall Response (Best Overall Response Rate[ORR]) by 24 Weeks | 42.8 percentage of participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Percentage of Participants With Best Overall Response (Best Overall Response Rate[ORR]) by 24 Weeks | 47.6 percentage of participants |
Duration of Response (DoR)
DoR in subjects with response from documented tumour response until disease progression up to 12 months from randomisation of the last subject
Time frame: from documented tumour response until disease progression up to 12 months from randomisation of the last subject
Population: Full Analysis Set (FAS): Consisted of all randomised subjects. The subjects were analysed based on the treatment they were randomised to by intention-to-treat principle.~Per-protocol Set (PPS): Consisted of all FAS subjects who completed at least first 2 cycles of combination chemotherapy with a tumour assessment and did not have any major protocol deviations that impacted the primary efficacy assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Bevacizumab (Avastin) | Duration of Response (DoR) | FAS | 6.38 months | Standard Deviation 3.773 |
| Bevacizumab (Avastin) | Duration of Response (DoR) | PPS | 6.33 months | Standard Deviation 3.784 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Duration of Response (DoR) | FAS | 6.79 months | Standard Deviation 4.117 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Duration of Response (DoR) | PPS | 6.81 months | Standard Deviation 4.177 |
Immunogenicity Assessments (Anti-drug Antibodies)
Incidence of anti-drug (bevacizumab) antibodies (ADA) The incidence of overall ADA results (i.e. Positive, Negative, Inconclusive) was presented by treatment group at Cycle 7 and the end of treatment (EOT). Overall ADA result was defined as below: * 'Positive' for a subject with treatment-induced or treatment-boosted ADA, where treatment-induced ADA indicated at least one positive result after pre-dose of Cycle 1 for subjects with negative ADA at pre-dose of Cycle 1, and treatment-boosted ADA indicated at least one positive result with higher titre level compared to pre-dose of Cycle 1 after pre-dose of Cycle 1 for subjects with positive ADA at pre-dose of Cycle 1. * 'Negative' for a subject without positive ADA until Cycle 7 and EOT. * 'Inconclusive' for a subject with positive ADA at Cycle 1 and without positive result with higher titre level observed after pre-dose of Cycle 1 up to Cycle 7 and EOT.
Time frame: Up to 21 weeks (Cycle 1,3,5, 7 and EOT visit. Each cycle is 21 days.), approximately 24 months from study initiation.
Population: The analysis was performed using the Safety Set (SAF). The SAF consisted of all subjects who received the study drug at least once. This analysis set was used for the safety analyses. The subjects were analysed based on the treatment they received.~There were 4 subjects in Avastin group and 1 subject in SB8 group who had not received any IP or non-IP treatment.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Positive | 15 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Negative | 357 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Inconclusive (only applicable for Overall) | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Positive | 29 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Negative | 309 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Inconclusive (only applicable for Overall) | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Positive | 15 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Negative | 286 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Inconclusive (only applicable for Overall) | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Positive | 28 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Negative | 238 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Inconclusive (only applicable for Overall) | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Positive | 21 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Negative | 129 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Inconclusive (only applicable for Overall) | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Positive | 46 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Negative | 284 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Inconclusive (only applicable for Overall) | 11 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Positive | 55 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Negative | 276 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Inconclusive (only applicable for Overall) | 10 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Negative | 259 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Positive | 15 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Positive | 37 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Negative | 356 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Inconclusive (only applicable for Overall) | 0 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 1 (BL) | Inconclusive (only applicable for Overall) | 0 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Negative | 294 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Positive | 22 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Positive | 9 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Negative | 316 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Inconclusive (only applicable for Overall) | 9 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 3 | Inconclusive (only applicable for Overall) | 0 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Negative | 152 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Positive | 21 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Inconclusive (only applicable for Overall) | 9 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Negative | 275 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT | Inconclusive (only applicable for Overall) | 0 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 5 | Inconclusive (only applicable for Overall) | 0 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | EOT Overall | Negative | 291 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 | Positive | 20 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Anti-drug Antibodies) | Cycle 7 Overall | Positive | 34 Participants |
Immunogenicity Assessments (Neutralizing Antibodies)
Incidence of anti-drug (bevacizumab) antibodies (ADA) - neutralizing antibodies (NAb) The analysis was performed using the Safety Set (SAF). Overall Number of Participants Analyzed represents the number of subjects in SAF. The total number is not the sum of the number of subjects of each visits, since NAb results only for subjects with ADA positive against SB8 or Avastin were used for the summary. Number Analyzed of each visit is equal to the number of subjects with ADA positive of each visit, which is displayed in 8. Secondary Outcome: Immunogenicity Assessments (Anti-drug Antibodies).
Time frame: Up to 21 weeks (Cycle 1,3,5, 7 and EOT visit. Each cycle is 21 days.), approximately 24 months from study initiation.
Population: The analysis was performed using the Safety Set (SAF). The SAF consisted of all subjects who received the study drug at least once. This analysis set was used for the safety analyses. The subjects were analysed based on the treatment they received.~There were 4 subjects in Avastin group and 1 subject in SB8 group who had not received any IP or non-IP treatment.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 1 (BL) | Positive | 0 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 1 (BL) | Negative | 15 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 3 | Positive | 9 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 3 | Negative | 20 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 5 | Positive | 5 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 5 | Negative | 10 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 7 | Positive | 12 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 7 | Negative | 16 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | EOT | Positive | 9 Participants |
| Bevacizumab (Avastin) | Immunogenicity Assessments (Neutralizing Antibodies) | EOT | Negative | 12 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 7 | Negative | 9 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 1 (BL) | Positive | 1 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 5 | Negative | 13 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 1 (BL) | Negative | 14 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | EOT | Negative | 4 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 3 | Positive | 9 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 7 | Positive | 11 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 3 | Negative | 13 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | EOT | Positive | 5 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Immunogenicity Assessments (Neutralizing Antibodies) | Cycle 5 | Positive | 8 Participants |
Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03
After the end of treatment (EOT) visit, SAEs should be reported to the Sponsor if the Investigator becomes aware of them. Severity Grade of NCI-CTCAE v4.03 Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL) (Instrumental ADL refers to preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc.) Grade 3: Severe or medically significant but not immediately life-threatening; hospitalisation or prolongation of hospitalisation indicated; disabling; limiting self-care ADL (Self-care ADL refer to bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not bedridden.) Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death related to AE
Time frame: AEs were reported from the time the informed consent form (ICF) was signed until the EOT visit, approximately 24 months from study initiation.
Population: Safety Set (SAF): The Safety Set consisted of all subjects who received the study drug at least once.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | TEAEs | 348 Participants |
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 1 | 47 Participants |
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 2 | 127 Participants |
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 3 | 119 Participants |
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 4 | 33 Participants |
| Bevacizumab (Avastin) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 5 | 22 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 4 | 31 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | TEAEs | 346 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 3 | 97 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 1 | 57 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 5 | 27 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Number of Participants With Treatment-related Adverse Events Using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 | CTCAE Grade 2 | 134 Participants |
Overall Survival
OS was defined as the time from the date of randomisation to the date of death regardless of the cause of death. Subjects who were alive at the time of analysis were censored at the date of last known alive.
Time frame: from the date of randomisation to the date of death up to 12 months from randomisation of the last subject
Population: Full Analysis Set (FAS): Consisted of all randomised subjects. The subjects were analysed based on the treatment they were randomised to by intention-to-treat principle.~Per-protocol Set (PPS): Consisted of all FAS subjects who completed at least first 2 cycles of combination chemotherapy with a tumour assessment and did not have any major protocol deviations that impacted the primary efficacy assessment.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Bevacizumab (Avastin) | Overall Survival | FAS | 14.90 months |
| Bevacizumab (Avastin) | Overall Survival | PPS | 14.80 months |
| SB8 (A Proposed Bevacizumab Biosimilar) | Overall Survival | FAS | 15.80 months |
| SB8 (A Proposed Bevacizumab Biosimilar) | Overall Survival | PPS | 15.80 months |
Pharmacokinetics: Maximum Plasma Concentration [Cmax]
Maximum Plasma Concentration (Cmax) at selected cycles (i.e., Cycle 1, 3, 5 and 7)
Time frame: Up to 21 weeks (Cycle 1,3,5 and 7. Each cycle is 21 days.)
Population: Pharmacokinetic Population (PK Population): This set consisted of subjects allocated to PK sub-study who had at least one measured serum concentration of bevacizumab.~PK analyses were performed on the PK population. The number of participants analyzed in each Cycle is the number of participants in PK population with non-missing values or without protocol deviation for PK blood sampling at the cycle.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Bevacizumab (Avastin) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 1 | 306.0352 ug/mL | Standard Deviation 98.71872 |
| Bevacizumab (Avastin) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 3 | 374.9657 ug/mL | Standard Deviation 106.54366 |
| Bevacizumab (Avastin) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 5 | 389.3132 ug/mL | Standard Deviation 123.07791 |
| Bevacizumab (Avastin) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 7 | 397.5435 ug/mL | Standard Deviation 120.74092 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 7 | 426.1350 ug/mL | Standard Deviation 144.24538 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 1 | 302.6362 ug/mL | Standard Deviation 87.10467 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 5 | 397.6183 ug/mL | Standard Deviation 125.84175 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Maximum Plasma Concentration [Cmax] | Cycle 3 | 399.4598 ug/mL | Standard Deviation 136.27431 |
Pharmacokinetics: Trough Level [Ctrough]
Ctrough at selected cycles (i.e., Cycle 1, 3, 5 and 7)
Time frame: Up to 21 weeks (Cycle 1,3,5 and 7. Each cycle is 21 days.)
Population: Pharmacokinetic Population (PK Population): This set consisted of subjects allocated to PK sub-study who had at least one measured serum concentration of bevacizumab.~PK analyses were performed on the PK population. The number of participants analyzed in each Cycle is the number of participants in PK population with non-missing values or without protocol deviation for PK blood sampling at the cycle.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Bevacizumab (Avastin) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 1 | 0.0000 ug/mL | Standard Deviation 0 |
| Bevacizumab (Avastin) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 3 | 83.7568 ug/mL | Standard Deviation 44.49701 |
| Bevacizumab (Avastin) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 5 | 109.0906 ug/mL | Standard Deviation 50.65915 |
| Bevacizumab (Avastin) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 7 | 121.7382 ug/mL | Standard Deviation 62.6215 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 7 | 133.7669 ug/mL | Standard Deviation 58.84136 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 1 | 0.0000 ug/mL | Standard Deviation 0 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 5 | 119.9343 ug/mL | Standard Deviation 54.65786 |
| SB8 (A Proposed Bevacizumab Biosimilar) | Pharmacokinetics: Trough Level [Ctrough] | Cycle 3 | 102.3939 ug/mL | Standard Deviation 69.36822 |
Progression Free Survival
PFS is defined as the time from the date of Randomisation to the date of disease progression (progressive disease \[PD\]) or death regardless of the cause of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).
Time frame: from the date of randomisation to the date of disease progression or death up to 12 months from randomisation of the last subject
Population: Full Analysis Set (FAS): Consisted of all randomised subjects. The subjects were analysed based on the treatment they were randomised to by intention-to-treat principle. Per-protocol Set (PPS): Consisted of all FAS subjects who completed at least first 2 cycles of combination chemotherapy with a tumour assessment and did not have any major protocol deviations that impacted the primary efficacy assessment.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Bevacizumab (Avastin) | Progression Free Survival | FAS | 8.50 months |
| Bevacizumab (Avastin) | Progression Free Survival | PPS | 8.50 months |
| SB8 (A Proposed Bevacizumab Biosimilar) | Progression Free Survival | FAS | 7.90 months |
| SB8 (A Proposed Bevacizumab Biosimilar) | Progression Free Survival | PPS | 7.90 months |
Best Objective Response Rate by 11 and 17 Weeks
Best Objective Response Rate (ORR) by 11 weeks and 17 weeks
Time frame: 11 weeks and 17 weeks from randomisation
Population: Full Analysis Set (FAS): Consisted of all randomised subjects. The subjects were analysed based on the treatment they were randomised to by intention-to-treat principle.~Per-protocol Set (PPS): Consisted of all FAS subjects who completed at least first 2 cycles of combination chemotherapy with a tumour assessment and did not have any major protocol deviations that impacted the primary efficacy assessment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Bevacizumab (Avastin) | Best Objective Response Rate by 11 and 17 Weeks | 11 Weeks (FAS) | 107 Participants |
| Bevacizumab (Avastin) | Best Objective Response Rate by 11 and 17 Weeks | 11 Weeks (PPS) | 99 Participants |
| Bevacizumab (Avastin) | Best Objective Response Rate by 11 and 17 Weeks | 17 Weeks (FAS) | 159 Participants |
| Bevacizumab (Avastin) | Best Objective Response Rate by 11 and 17 Weeks | 17 Weeks (PPS) | 149 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Best Objective Response Rate by 11 and 17 Weeks | 17 Weeks (PPS) | 137 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Best Objective Response Rate by 11 and 17 Weeks | 11 Weeks (FAS) | 100 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Best Objective Response Rate by 11 and 17 Weeks | 17 Weeks (FAS) | 152 Participants |
| SB8 (A Proposed Bevacizumab Biosimilar) | Best Objective Response Rate by 11 and 17 Weeks | 11 Weeks (PPS) | 89 Participants |