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Dose Escalation of Bevacizumab With Ambulatory Blood Pressure Monitoring in Patients With Advanced Non-squamous NSCLC (AVF4759)

Primary Purpose

Advanced Non-squamous Non-Small Cell Lung Cancer

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Pemetrexed
Carboplatin
Bevacizumab 7.5 mg/kg
Bevacizumab 15 mg/kg
Sponsored by
University of Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Non-squamous Non-Small Cell Lung Cancer focused on measuring Non-squamous Non-Small Cell Lung Cancer, Bevacizumab, Ambulatory Blood Pressure Monitoring

Eligibility Criteria

18 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed, newly diagnosed Stage IIIB, stage IV, or recurrent non-squamous NSCLC for which they have not received chemotherapy.
  • Patients must have completed radiation therapy 2 weeks prior to enrollment. Patients may have received adjuvant therapy, provided the regimen included no more than one of the study agents.
  • Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension.
  • Age >18 years. •Life expectancy of greater than 4 months.
  • ECOG performance status of 0 or 1
  • Patients must have normal organ and marrow function
  • Patients on anticoagulation are allowed.
  • Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

Disease-Specific

  • Patients who have had received prior chemotherapy (in the setting of recurrent disease, other than their original adjuvant therapy)
  • Patients may not be receiving any other investigational agents.
  • Patients with histologic evidence of predominantly squamous lung cell cancer

    • General Medical Exclusions
  • Inability to comply with study and/or follow-up procedures
  • Malignancy other than superficial basal cell and superficial squamous of the skin or carcinoma in situ of the cervix within last five years

Bevacizumab-Specific Exclusions

  • Inadequately controlled hypertension
  • Prior history of hypertensive crisis or hypertensive encephalopathy
  • New York Heart Association Grade II or greater congestive heart failure
  • History of myocardial infarction or unstable angina within 6 months prior to Day 1
  • History of stroke or transient ischemic attack within 6 months prior to Day 1
  • Known CNS disease, except for treated brain metastasis.
  • Significant vascular disease within 6 months prior to Day 1
  • History of hemoptysis within 1 month prior to Day 1
  • Evidence of bleeding diathesis or significant coagulopathy
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 or anticipation of need for major surgical procedure during the course of the study
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1
  • History of diverticulitis, abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1
  • Serious, non-healing wound, active ulcer, or untreated bone fracture
  • Proteinuria as demonstrated by a UPC ratio 1.0 at screening
  • Known hypersensitivity to any component of bevacizumab
  • Pregnancy (positive pregnancy test) or lactation.
  • Mixed tumors will be categorized by the predominant cell type unless small cell elements are present.
  • Uncontrolled intercurrent illness including, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements.
  • Any unstable condition that in the opinion of the investigator is likely to interfere with collection of accurate blood pressure measurement data .
  • HIV-positive patients on combination antiretroviral therapy.

Sites / Locations

  • The University of Chicago Medical Center
  • North Shore University Health System
  • Ingalls Memorial Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Group A

Group B

Arm Description

Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg once, followed three weeks later by Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg and bevacizumab every 3 weeks for two doses

Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg once, followed three weeks later by Carboplatin+Pemetrexed+Bevacizumab 15 mg/kg and bevacizumab every 3 weeks for two doses

Outcomes

Primary Outcome Measures

Change in 24 Hour Diastolic Blood Pressure (DBP)
The change for each patient was calculated as mean 24 hour DBP during cycle 2 - mean 24 hour DBP during cycle 1

Secondary Outcome Measures

Response Rate
Percentage of patients with a complete or partial response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Change in Tumor Size From Baseline
Progression Free Survival
Time to progression or death from any cause, whichever comes first

Full Information

First Posted
February 3, 2010
Last Updated
October 28, 2019
Sponsor
University of Chicago
Collaborators
Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01063283
Brief Title
Dose Escalation of Bevacizumab With Ambulatory Blood Pressure Monitoring in Patients With Advanced Non-squamous NSCLC
Acronym
AVF4759
Official Title
A Randomized, Open-Label, Dose Escalation Study of Bevacizumab With Ambulatory Blood Pressure Monitoring in Previously Untreated Patients With Advanced Non-squamous Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
March 2010 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Chicago
Collaborators
Genentech, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to see if higher dose of bevacizumab can be taken safely by some patients and if changes in the dose of bevacizumab have any effect on blood pressure.
Detailed Description
Carboplatin and pemetrexed are FDA approved chemotherapy agents for patients with advanced non squamous non small cell lung cancer. Bevacizumab is also FDA approved in lung cancer , and the combination of all three drugs is promising. The doctors directing this research want to learn how to better personalize drug dosing of bevacizumab by identifying people who could safely take a higher dose of the drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Non-squamous Non-Small Cell Lung Cancer
Keywords
Non-squamous Non-Small Cell Lung Cancer, Bevacizumab, Ambulatory Blood Pressure Monitoring

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A
Arm Type
Active Comparator
Arm Description
Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg once, followed three weeks later by Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg and bevacizumab every 3 weeks for two doses
Arm Title
Group B
Arm Type
Active Comparator
Arm Description
Carboplatin and Pemetrexed with Bevacizumab 7.5 mg/kg once, followed three weeks later by Carboplatin+Pemetrexed+Bevacizumab 15 mg/kg and bevacizumab every 3 weeks for two doses
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Intervention Description
Pemetrexed 500 mg/m^2 intravenously over 10 minutes
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Carboplatin at a dose calculated to produce an area under the concentration-time curve of 6 mg/ml•min intravenously over 30 minutes
Intervention Type
Drug
Intervention Name(s)
Bevacizumab 7.5 mg/kg
Intervention Description
Bevacizumab at 7.5 mg/kg intravenously over 90 minutes
Intervention Type
Drug
Intervention Name(s)
Bevacizumab 15 mg/kg
Intervention Description
Bevacizumab at 15 mg/kg intravenously over 90 minutes
Primary Outcome Measure Information:
Title
Change in 24 Hour Diastolic Blood Pressure (DBP)
Description
The change for each patient was calculated as mean 24 hour DBP during cycle 2 - mean 24 hour DBP during cycle 1
Time Frame
2 cycles
Secondary Outcome Measure Information:
Title
Response Rate
Description
Percentage of patients with a complete or partial response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Time Frame
2 years
Title
Change in Tumor Size From Baseline
Time Frame
2 years
Title
Progression Free Survival
Description
Time to progression or death from any cause, whichever comes first
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically or cytologically confirmed, newly diagnosed Stage IIIB, stage IV, or recurrent non-squamous NSCLC for which they have not received chemotherapy. Patients must have completed radiation therapy 2 weeks prior to enrollment. Patients may have received adjuvant therapy, provided the regimen included no more than one of the study agents. Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension. Age >18 years. •Life expectancy of greater than 4 months. ECOG performance status of 0 or 1 Patients must have normal organ and marrow function Patients on anticoagulation are allowed. Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation. Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Disease-Specific Patients who have had received prior chemotherapy (in the setting of recurrent disease, other than their original adjuvant therapy) Patients may not be receiving any other investigational agents. Patients with histologic evidence of predominantly squamous lung cell cancer General Medical Exclusions Inability to comply with study and/or follow-up procedures Malignancy other than superficial basal cell and superficial squamous of the skin or carcinoma in situ of the cervix within last five years Bevacizumab-Specific Exclusions Inadequately controlled hypertension Prior history of hypertensive crisis or hypertensive encephalopathy New York Heart Association Grade II or greater congestive heart failure History of myocardial infarction or unstable angina within 6 months prior to Day 1 History of stroke or transient ischemic attack within 6 months prior to Day 1 Known CNS disease, except for treated brain metastasis. Significant vascular disease within 6 months prior to Day 1 History of hemoptysis within 1 month prior to Day 1 Evidence of bleeding diathesis or significant coagulopathy Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 or anticipation of need for major surgical procedure during the course of the study Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1 History of diverticulitis, abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1 Serious, non-healing wound, active ulcer, or untreated bone fracture Proteinuria as demonstrated by a UPC ratio 1.0 at screening Known hypersensitivity to any component of bevacizumab Pregnancy (positive pregnancy test) or lactation. Mixed tumors will be categorized by the predominant cell type unless small cell elements are present. Uncontrolled intercurrent illness including, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements. Any unstable condition that in the opinion of the investigator is likely to interfere with collection of accurate blood pressure measurement data . HIV-positive patients on combination antiretroviral therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Maitland, MD., Ph.d
Organizational Affiliation
The University of Chicago Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Michael Maitland, MD., PhD
Organizational Affiliation
The University of Chicago Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Chicago Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
North Shore University Health System
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Facility Name
Ingalls Memorial Hospital
City
Harvey
State/Province
Illinois
ZIP/Postal Code
60426
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Dose Escalation of Bevacizumab With Ambulatory Blood Pressure Monitoring in Patients With Advanced Non-squamous NSCLC

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