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To Determine Safe and Effective Dose of ACE-011 for the Treatment of Chemotherapy Induced Anemia in Patients With Advanced Non-small Cell Lung Cancer

Primary Purpose

Anemia, Carcinoma, Non-Small-Cell Lung, Carcinoma, Small-Cell Lung

Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Sotatercept 15 mg
Sotatercept 30 mg
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Anemia focused on measuring Chemotherapy induced anemia, Non-small cell lung cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women > 18 years of age
  2. Part 1: Histologically confirmed (cytology or biopsy) solid tumor malignancy, excluding those solid tumors treated with curative intent.

    Part 2: Histologically confirmed non-small cell lung cancer

  3. Documented metastatic disease
  4. Measurable or non-measurable disease evaluable by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
  5. All of the following laboratory values:

    • Hemoglobin ≥ 6.5 to < 11.0 g/dL (≥ 65 to < 110 g/L), due to chemotherapy-induced anemia
    • Absolute neutrophil count ≥ 500/mm^3
    • Platelet count ≥ 75,000/mm^3 (> 72 hours since prior platelet transfusion
    • Adequate renal function

      • creatinine clearance ≥ 40mL/min or ≥ 50 mL/min if cisplatin is concomitantly administered and
      • urine protein / creatinine ratio ≤ 1.0; or ≤ 2.0 if bevacizumab (Avastin®) is concomitantly administered
    • Hepatic function (bilirubin < 1.5 x upper limits of normal (ULN); AST and ALT < 3.0 x ULN and ≤ 5.0 ULN for subjects with liver metastases)
  6. Subjects must have received:

    • at least one cycle and up to 4 cycles (q3w schedule) of platinum-based chemotherapy and be randomized prior to receiving Cycle 5 OR
    • at least one cycle and up to 3 months (depending upon regimen) of platinum-based chemotherapy
  7. >28 days since previous treatment with ESA
  8. >14 days since last red blood cell transfusions
  9. Eastern Oncology Cooperative Group (ECOG) Performance status 0-2
  10. For females of childbearing potential, highly effective method of birth control for at least 28 days before starting study, during participation and at least 112 days following last dose of ACE-011
  11. Males must use latex condom or non-latex condom not made of (animal) membrane during any sexual contact with female of childbearing potential
  12. Life expectancy of >3 months
  13. Willing to adhere to study visit schedule
  14. Understand and voluntarily sign informed consent

Exclusion Criteria:

Part 2 only, history of prior regimen(s)of platinum-based chemotherapy for metastatic NSCLC and/or history of adjuvant platinum-based chemotherapy with last dose received less than six months prior to the start of current first-line platinum-based chemotherapy for metastatic NSCLC.

  1. National Cancer Institute Common Terminology for Adverse Events Grade >3 toxicity
  2. Prior radiation to >20% of whole skeleton
  3. Prior regimen(s) of platinum based chemotherapy for metastatic disease and/or history of adjuvant platinum-based chemotherapy with the last dose received less than six months prior to the start of current first-line platinum-based chemotherapy for metastatic disease
  4. Central nervous system metastases
  5. Clinically significant pulmonary, endocrine, neurologic, gastrointestinal, hepatic, or genitourinary disease unrelated to underlying malignancy
  6. Classification of 3 or higher heart failure (as classified by New York Heart Association)
  7. History of thrombosis, deep vein thrombosis, pulmonary emboli, or embolic stroke, if not stable on anticoagulants and/or one of these events occurring in past 6 months
  8. Diagnosis of a myeloid malignancy or known history of myelodysplasia
  9. Recent history (within 14 days of Day 1) of IV/oral antibiotics due to post septic episode
  10. Uncontrolled hypertension. Controlled hypertension is considered clinically stable, and systolic blood pressure (SBP) must be < 150 mmHg and diastolic blood pressure (DBP) must be < 100 mmHg.
  11. Known human immunodeficiency virus (HIV)
  12. Known active hepatitis B or C antibody
  13. Iron deficiency
  14. History of anemia as a result of inherited hemoglobinopathy
  15. History of anemia due to autoimmune or hereditary hemolysis or gastrointestinal bleeding
  16. Received treatment with another investigational drug or device within 28 days prior to Day 1, or if the half life of the previous product is known, within 5 times the half life prior to dosing, whichever may be longer.
  17. Any prior use of Sotatercept (ACE-011).
  18. Pregnant or lactating females or females planning to become pregnant
  19. History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational product (Refer to the Investigator's Brochure for further information).
  20. Major surgery within 30 days prior to Day 1 (subjects must have completely recovered from any previous surgery prior to Day 1).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Sotatercept - 15 mg

    Sotatercept 30 mg

    Arm Description

    Sotatercept 15 mg Subcutaneous (SC) Day 1 every 42 days

    Sotatercept 30 mg SC Day 1 every 42 days

    Outcomes

    Primary Outcome Measures

    Hematopoietic response
    Hematopoietic response in ~70% of subjects (defined as an increase in hemoglobin of > 1.0g/dL, above the study baseline for 4 consecutive weeks, in absence of red blood cell transfusion and/or Erythropoiesis-stimulating agents (ESAs).

    Secondary Outcome Measures

    Adverse Events
    Number of participants with adverse events
    Disease progression
    Time to progression (TTP) TTP was the time between randomization and disease progression
    Progression free survival (PFS)
    PFS was defined as the time from the start of study drug therapy to the first observation of disease progression or death due to any cause, whichever came first
    Overall survival (OS)
    OS was defined as the time between randomization and death
    Overall response rate (ORR)
    Overall Response is defined as the percent of participants who achieve an objective confirmed complete (CR) or partial response (PR). Response was determined according to Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1 guidelines. CR: The disappearance of all known disease and no new sites or disease-related symptoms confirmed at least 4 weeks after initial documentation. All sites must be assessed, including non-measurable sites, such as effusions, or markers. PR: At least a 30% decrease in the sum of the longest diameters of target lesions, taking as a reference the baseline sum of the longest diameters confirmed at least 4 weeks after initial documentation and no new non-target lesions and/or unequivocal progression of existing non-target lesions. PR is also recorded when all measurable disease has completely disappeared, but a non-measurable component (i.e., ascites) is still present but not progressing.
    Serum concentration of ACE-011
    Serum concentration of ACE-011; AUC-t: area under the plasma concentration time-curve from Time 0 to the time of the last quantifiable concentration (Ct) of Sotatercept
    Maximum ACE-011 concentration
    Cmax; maximum observed concentration after the first dose of Sotatercept
    Quality of Life
    Quality of Life (QoL) assessment: Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale (Version 4) and Lung Cancer Symptom Scale (LCSS)
    Time to reach the maximum ACE-011 concentration
    Time to first maximum observed plasma concentration of ACE-011 in days
    Area under the concentration versus time curve
    Area under the concentration-time curve AUC-t: area under the plasma concentration time-curve from Time 0 to the time of the last quantifiable concentration (Ct) after the first dose
    Terminal Elimination Half-life
    Terminal elimination half-life (t1/2) in plasma, was calculated as t1/2,z
    Apparent Serum Clearance (CL/F)
    Apparent total plasma clearance of ACE-011 - milliliters/minute
    Apparent Volume of distribution (Vz)
    Apparent Volume of distribution of ACE-011 after first dose - liters

    Full Information

    First Posted
    December 17, 2010
    Last Updated
    December 20, 2022
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01284348
    Brief Title
    To Determine Safe and Effective Dose of ACE-011 for the Treatment of Chemotherapy Induced Anemia in Patients With Advanced Non-small Cell Lung Cancer
    Official Title
    An Open-Label Randomized, Phase 2A, Dose-ranging Study of Sotatercept (ACE-011) for Chemotherapy-Induced Anemia in Subjects With Advanced or Metastatic Solid Tumors Treated With Platinum-Based Chemotherapeutic Regimens
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2022
    Overall Recruitment Status
    Terminated
    Why Stopped
    Persistent low enrollment made study continuation no longer feasible
    Study Start Date
    March 25, 2011 (Actual)
    Primary Completion Date
    September 21, 2012 (Actual)
    Study Completion Date
    September 21, 2012 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study was to determine an effective and safe dose of ACE-011 for the treatment of chemotherapy induced anemia (CIA) in participants with metastatic non-small cell lung cancer who are being treated with first-line platinum based chemotherapy.
    Detailed Description
    The ACE-011-NSCL-001 Phase 2a study was an open-label, randomized, dose-ranging study designed to assess the efficacy, safety, tolerability, pharmacokinetic and quality of life of sotatercept (ACE-011) for treatment of CIA in participants with advanced or metastatic solid tumors treated with platinum-based chemotherapeutic regimens. Other objectives included the effect of sotatercept treatment on bone metabolism, the evaluation of the expression of Activin A and other proteins/biomarkers (including myostatin and follistatin) and the assessment of renal function biomarkers. The study consisted of a Screening Period, a Treatment Period of approximately 6 months (up to 4 doses of sotatercept at either 15 mg or 30 mg administered subcutaneously every 42 days) and a Post-treatment Follow-up Period or End of Treatment (42 days after the last dose of sotatercept). The study was terminated early due to a slower than expected rate of enrollment as a result of substantial changes in the standard of care for cancer participants with anemia which resulted in challenges to timely accrual and completion of the study. Therefore, 26 participants were randomized into the study and the planned Part 2 of the study consisting of a double-blind, randomized, placebo-controlled Phase 2b/3 study conducted at the optimal dose of sotatercept (ACE-011) in up to 750 subjects with metastatic NSCLC was not performed. Due to the small sample size and variability of the data, changes were made to modify the study endpoints and revise them to be exploratory only.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Anemia, Carcinoma, Non-Small-Cell Lung, Carcinoma, Small-Cell Lung, Bladder Cancer, Cancer of Head and Neck, Uterine Cervical Cancer
    Keywords
    Chemotherapy induced anemia, Non-small cell lung cancer

    7. Study Design

    Primary Purpose
    Supportive Care
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    25 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Sotatercept - 15 mg
    Arm Type
    Experimental
    Arm Description
    Sotatercept 15 mg Subcutaneous (SC) Day 1 every 42 days
    Arm Title
    Sotatercept 30 mg
    Arm Type
    Experimental
    Arm Description
    Sotatercept 30 mg SC Day 1 every 42 days
    Intervention Type
    Drug
    Intervention Name(s)
    Sotatercept 15 mg
    Other Intervention Name(s)
    ACE-011
    Intervention Description
    Sotatercept 15 mg SC injection every 42 days, up to 4 doses/cycles
    Intervention Type
    Drug
    Intervention Name(s)
    Sotatercept 30 mg
    Other Intervention Name(s)
    ACE-011
    Intervention Description
    Sotatercept 30 mg subcutaneous injection Day 1 every 42 days, up to 4 doses/cycles
    Primary Outcome Measure Information:
    Title
    Hematopoietic response
    Description
    Hematopoietic response in ~70% of subjects (defined as an increase in hemoglobin of > 1.0g/dL, above the study baseline for 4 consecutive weeks, in absence of red blood cell transfusion and/or Erythropoiesis-stimulating agents (ESAs).
    Time Frame
    Up to Day 43
    Secondary Outcome Measure Information:
    Title
    Adverse Events
    Description
    Number of participants with adverse events
    Time Frame
    Up to 6 months
    Title
    Disease progression
    Description
    Time to progression (TTP) TTP was the time between randomization and disease progression
    Time Frame
    Up to 6 months
    Title
    Progression free survival (PFS)
    Description
    PFS was defined as the time from the start of study drug therapy to the first observation of disease progression or death due to any cause, whichever came first
    Time Frame
    6 months
    Title
    Overall survival (OS)
    Description
    OS was defined as the time between randomization and death
    Time Frame
    Up to 24 months
    Title
    Overall response rate (ORR)
    Description
    Overall Response is defined as the percent of participants who achieve an objective confirmed complete (CR) or partial response (PR). Response was determined according to Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1 guidelines. CR: The disappearance of all known disease and no new sites or disease-related symptoms confirmed at least 4 weeks after initial documentation. All sites must be assessed, including non-measurable sites, such as effusions, or markers. PR: At least a 30% decrease in the sum of the longest diameters of target lesions, taking as a reference the baseline sum of the longest diameters confirmed at least 4 weeks after initial documentation and no new non-target lesions and/or unequivocal progression of existing non-target lesions. PR is also recorded when all measurable disease has completely disappeared, but a non-measurable component (i.e., ascites) is still present but not progressing.
    Time Frame
    Up to Day 15
    Title
    Serum concentration of ACE-011
    Description
    Serum concentration of ACE-011; AUC-t: area under the plasma concentration time-curve from Time 0 to the time of the last quantifiable concentration (Ct) of Sotatercept
    Time Frame
    Up to 5 months
    Title
    Maximum ACE-011 concentration
    Description
    Cmax; maximum observed concentration after the first dose of Sotatercept
    Time Frame
    Up to 5 months
    Title
    Quality of Life
    Description
    Quality of Life (QoL) assessment: Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale (Version 4) and Lung Cancer Symptom Scale (LCSS)
    Time Frame
    Up to 6 months
    Title
    Time to reach the maximum ACE-011 concentration
    Description
    Time to first maximum observed plasma concentration of ACE-011 in days
    Time Frame
    Up to 5 months
    Title
    Area under the concentration versus time curve
    Description
    Area under the concentration-time curve AUC-t: area under the plasma concentration time-curve from Time 0 to the time of the last quantifiable concentration (Ct) after the first dose
    Time Frame
    Up to 5 months
    Title
    Terminal Elimination Half-life
    Description
    Terminal elimination half-life (t1/2) in plasma, was calculated as t1/2,z
    Time Frame
    Up to 5 months
    Title
    Apparent Serum Clearance (CL/F)
    Description
    Apparent total plasma clearance of ACE-011 - milliliters/minute
    Time Frame
    Up to 5 months
    Title
    Apparent Volume of distribution (Vz)
    Description
    Apparent Volume of distribution of ACE-011 after first dose - liters
    Time Frame
    Up to 5 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Men and women > 18 years of age Part 1: Histologically confirmed (cytology or biopsy) solid tumor malignancy, excluding those solid tumors treated with curative intent. Part 2: Histologically confirmed non-small cell lung cancer Documented metastatic disease Measurable or non-measurable disease evaluable by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 All of the following laboratory values: Hemoglobin ≥ 6.5 to < 11.0 g/dL (≥ 65 to < 110 g/L), due to chemotherapy-induced anemia Absolute neutrophil count ≥ 500/mm^3 Platelet count ≥ 75,000/mm^3 (> 72 hours since prior platelet transfusion Adequate renal function creatinine clearance ≥ 40mL/min or ≥ 50 mL/min if cisplatin is concomitantly administered and urine protein / creatinine ratio ≤ 1.0; or ≤ 2.0 if bevacizumab (Avastin®) is concomitantly administered Hepatic function (bilirubin < 1.5 x upper limits of normal (ULN); AST and ALT < 3.0 x ULN and ≤ 5.0 ULN for subjects with liver metastases) Subjects must have received: at least one cycle and up to 4 cycles (q3w schedule) of platinum-based chemotherapy and be randomized prior to receiving Cycle 5 OR at least one cycle and up to 3 months (depending upon regimen) of platinum-based chemotherapy >28 days since previous treatment with ESA >14 days since last red blood cell transfusions Eastern Oncology Cooperative Group (ECOG) Performance status 0-2 For females of childbearing potential, highly effective method of birth control for at least 28 days before starting study, during participation and at least 112 days following last dose of ACE-011 Males must use latex condom or non-latex condom not made of (animal) membrane during any sexual contact with female of childbearing potential Life expectancy of >3 months Willing to adhere to study visit schedule Understand and voluntarily sign informed consent Exclusion Criteria: Part 2 only, history of prior regimen(s)of platinum-based chemotherapy for metastatic NSCLC and/or history of adjuvant platinum-based chemotherapy with last dose received less than six months prior to the start of current first-line platinum-based chemotherapy for metastatic NSCLC. National Cancer Institute Common Terminology for Adverse Events Grade >3 toxicity Prior radiation to >20% of whole skeleton Prior regimen(s) of platinum based chemotherapy for metastatic disease and/or history of adjuvant platinum-based chemotherapy with the last dose received less than six months prior to the start of current first-line platinum-based chemotherapy for metastatic disease Central nervous system metastases Clinically significant pulmonary, endocrine, neurologic, gastrointestinal, hepatic, or genitourinary disease unrelated to underlying malignancy Classification of 3 or higher heart failure (as classified by New York Heart Association) History of thrombosis, deep vein thrombosis, pulmonary emboli, or embolic stroke, if not stable on anticoagulants and/or one of these events occurring in past 6 months Diagnosis of a myeloid malignancy or known history of myelodysplasia Recent history (within 14 days of Day 1) of IV/oral antibiotics due to post septic episode Uncontrolled hypertension. Controlled hypertension is considered clinically stable, and systolic blood pressure (SBP) must be < 150 mmHg and diastolic blood pressure (DBP) must be < 100 mmHg. Known human immunodeficiency virus (HIV) Known active hepatitis B or C antibody Iron deficiency History of anemia as a result of inherited hemoglobinopathy History of anemia due to autoimmune or hereditary hemolysis or gastrointestinal bleeding Received treatment with another investigational drug or device within 28 days prior to Day 1, or if the half life of the previous product is known, within 5 times the half life prior to dosing, whichever may be longer. Any prior use of Sotatercept (ACE-011). Pregnant or lactating females or females planning to become pregnant History of severe allergic or anaphylactic reactions or hypersensitivity to recombinant proteins or excipients in the investigational product (Refer to the Investigator's Brochure for further information). Major surgery within 30 days prior to Day 1 (subjects must have completely recovered from any previous surgery prior to Day 1).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php

    Learn more about this trial

    To Determine Safe and Effective Dose of ACE-011 for the Treatment of Chemotherapy Induced Anemia in Patients With Advanced Non-small Cell Lung Cancer

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