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A Clinical Trial of Fruquintinib in Patients With Advanced Non-small Cell Lung Cancer

Primary Purpose

Non-small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Fruquintinib
Placebo
Sponsored by
Hutchison Medipharma Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-small Cell Lung Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Fully understand the study and sign the informed consent form voluntarily;
  2. Histologically and/or cytologically diagnosed with local advanced and/or metastatic stage IIIB/IV non-squamous NSCLC;
  3. Previously failed to two chemotherapy regimens(treatment failure is defined as disease progression or intolerable toxicity), patients with positive EGFR mutation permitted to treated by EGFR-TKI previously; patients with EGFR wild type or unknown whether or not treated by EGFR-TKI previously;
  4. Aged 18-75 years (inclusive);
  5. Body weight ≥40 kg;
  6. Evident measurable lesion(s) (according to RECIST1.1);
  7. ECOG Performance Status 0-1;
  8. Expected survival >12 weeks

Exclusion Criteria:

  1. Treatment in another clinical trials in the past 3 weeks; or treatment with systemic anti-tumor chemotherapy, radiotherapy or biotherapy within 3 weeks prior to administration of the study drug;
  2. Previous therapy with VEGF/VEGFR inhibitors;
  3. Unrecovered from toxicity caused by previous anti-cancer treatment (CTCAE >grade 1), or not completely recovered from previous surgery;
  4. Previous active brain metastasis (without radiotherapy previously, or symptoms stable < 4 weeks, or with clinical symptoms, or with medication to control symptoms);
  5. Other malignancies except basal cell carcinoma or cervical carcinoma in situ in the past 5 years;
  6. Uncontrolled clinical active infection, e.g. acute pneumonia and active hepatitis B;
  7. Dysphagia or known drug malabsorption;
  8. Present active duodenal ulcer, ulcerative colitis, intestinal obstruction and other gastrointestinal diseases or other conditions that may lead to gastrointestinal bleeding or perforation according to the investigators' judgment; or with a history of intestinal perforation or intestinal fistula;
  9. Have evidence or a history of thrombosis or bleeding tendency, regardless of seriousness;
  10. Stroke and/or transient ischemic attack within 12 months prior to enrollment;
  11. Appropriate organ function. Patients with any of the following conditions will be excluded:

    • Absolute neutrophil count (ANC) <1.5×109/L, platelet <100×109/L or hemoglobin <9 g/dL within 1 week prior to enrollment;
    • Serum total bilirubin >1.5 upper limit of normal (ULN), alanine transaminase and aspartate transferase >1.5×ULN; ALT and AST > 3×ULN in patients with liver metastasis;
    • Electrolyte abnormality of clinical significance;
    • Blood creatinine >ULN and creatinine clearance <60 ml/min;
    • Urine protein 2+ or above, or 24 h urine protein quantification ≥1.0 g/24 h;
    • Activated partial thromboplastin time (APTT) or/and INR and prothrombin time (PT) >1.5×ULN (according to reference range in each clinical study center);
  12. Uncontrolled hypertension, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg with medication; or heart failure NYHA classification ≥ grade 2;
  13. Heart function evaluation: left ventricular ejection fraction <50% (echocardiography);
  14. Acute myocardial infarction, severe/unstable angina or coronary bypass surgery within 6 months prior to enrollment; history of arterial thrombosis or deep venous thrombosis;
  15. Skin wound, surgical site, wound site, severe mucosal ulcer or fracture without complete healing;
  16. Female subjects who are pregnant or lactating or of child bearing potential with positive pregnancy test result before the first dose;
  17. Patients with child bearing potential who or whose sexual partners are not willing to take contraceptive measures;
  18. Any clinical or laboratory abnormalities unfit to participate in this clinical trial according to the investigator's judgment;
  19. Serious psychological or psychiatric disorders which may affect subject compliance in this clinical study;
  20. Allergy to Fruquintinib and/or excipient contained in trial drugs.

Sites / Locations

  • 307 Hospital of PLA
  • Beijing Cancer Hospital
  • Beijing Chest Hospital
  • Xi Nan Hospital, Third Military Medical University
  • Guangdong General Hospital
  • Nantong Tumor Hospital
  • The First Hospital of Jilin University
  • Linyi Tumor Hospital
  • The Cancer Hospital of Fudan University
  • Shanghai Chest Hospital
  • West China Hospital
  • The First Affiliated Hosptial of College of Medicine, Zhejiang University

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Control Group

Treatment Group

Arm Description

Placebo is a capsule in the form of 1mg and 5 mg, orally, once daily, 3 weeks on/1week off with best supportive care.

The subjects will receive oral Fruquintinib at fasting state 5mg+best supportive care, once daily for the first 3 consecutive weeks and dose holiday for 1 week according to their dose regimens until the occurrence of disease progression, unacceptable toxicity, or withdrawal of consent

Outcomes

Primary Outcome Measures

Progressive free survival (PFS)
To compare the Progressive Free Survival (PFS) of Fruquintinib plus best supportive care (BSC) versus placebo plus BSC in patients advanced non-squamous NSCLC patients who failed to standard second-line chemotherapy according to RECIST 1.1

Secondary Outcome Measures

Objective response rate (ORR)
To evaluate objective response rate (ORR) in the two groups according to RECIST 1.1
Disease control rate (DCR)
To evaluate disease control rate (DCR) in the two groups according to RECIST 1.1
Overall survival (OS)
To evaluate overall survival (OS) in the two groups
safety and tolerability by incidence, severity and outcome of adverse events
To evaluate the safety and tolerability in the two groups by incidence, severity and outcomes of AEs and categorized by severity in accordance with the NCI CTC AE Version 4.0.

Full Information

First Posted
March 26, 2015
Last Updated
February 12, 2020
Sponsor
Hutchison Medipharma Limited
Collaborators
Shanghai Chest Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02590965
Brief Title
A Clinical Trial of Fruquintinib in Patients With Advanced Non-small Cell Lung Cancer
Official Title
A Randomized, Double-blind, Placebo-controlled, Multi-center Phase II Clinical Trial to Evaluate the Efficacy and Safety of Fruquintinib Plus Best Supportive Care in Patients With Advanced Non-squamous Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
May 29, 2014 (Actual)
Primary Completion Date
August 7, 2015 (Actual)
Study Completion Date
February 10, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hutchison Medipharma Limited
Collaborators
Shanghai Chest Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a randomized, double-blind, placebo-controlled, multi-center Phase II clinical trial to evaluate the efficacy and safety of Fruquintinib plus best supportive care in patients with advanced non-squamous non-small cell lung cancer who failed to second-line standard chemotherapy.
Detailed Description
Approximately 90 subjects will be randomized to Fruquintinib plus best supportive care or placebo plus best supportive care at a 2:1 ratio. Randomization will be stratified by EGFR (epidermal growth factor receptor) gene status: mutant vs. wild type vs. unknown. All subjects will receive Fruquintinib/placebo for consecutive 3 weeks, followed by one-week rest. A treatment cycle consists of 4 weeks. Tumor assessment will be performed every 4 weeks in the first 3 cycles, and every 8 weeks since the 4th cycle, until disease progression. Further treatment and survival follow-up after progression will be recorded.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
91 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Control Group
Arm Type
Placebo Comparator
Arm Description
Placebo is a capsule in the form of 1mg and 5 mg, orally, once daily, 3 weeks on/1week off with best supportive care.
Arm Title
Treatment Group
Arm Type
Experimental
Arm Description
The subjects will receive oral Fruquintinib at fasting state 5mg+best supportive care, once daily for the first 3 consecutive weeks and dose holiday for 1 week according to their dose regimens until the occurrence of disease progression, unacceptable toxicity, or withdrawal of consent
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Other Intervention Name(s)
HMPL-013
Intervention Description
After checking eligibility criteria, subjects will be randomized into Fruquintinib plus best supportive care group (treatment group) or placebo plus best supportive care group (control group) in a ration of 2:1.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
HMPL-013-placebo
Intervention Description
Placebo is a capsule in the form of 1mg and 5mg, orally, once daily, 3 weeks on/1 week off
Primary Outcome Measure Information:
Title
Progressive free survival (PFS)
Description
To compare the Progressive Free Survival (PFS) of Fruquintinib plus best supportive care (BSC) versus placebo plus BSC in patients advanced non-squamous NSCLC patients who failed to standard second-line chemotherapy according to RECIST 1.1
Time Frame
measured every 4 weeks at first 2 cycles and every 8 weeks since the third cycle from randomization to disease progression, assessed up to one year
Secondary Outcome Measure Information:
Title
Objective response rate (ORR)
Description
To evaluate objective response rate (ORR) in the two groups according to RECIST 1.1
Time Frame
measured every 4 weeks at first 2 cycles and every 8 weeks since the third cycle from randomization to disease progression, assessed up to one year
Title
Disease control rate (DCR)
Description
To evaluate disease control rate (DCR) in the two groups according to RECIST 1.1
Time Frame
measured every 4 weeks at first 2 cycles and every 8 weeks since the third cycle from randomization to disease progression, assessed up to one year
Title
Overall survival (OS)
Description
To evaluate overall survival (OS) in the two groups
Time Frame
every 2 months from randomization to death, assessed up to one year
Title
safety and tolerability by incidence, severity and outcome of adverse events
Description
To evaluate the safety and tolerability in the two groups by incidence, severity and outcomes of AEs and categorized by severity in accordance with the NCI CTC AE Version 4.0.
Time Frame
From randomization to 30 days after last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Fully understand the study and sign the informed consent form voluntarily; Histologically and/or cytologically diagnosed with local advanced and/or metastatic stage IIIB/IV non-squamous NSCLC; Previously failed to two chemotherapy regimens(treatment failure is defined as disease progression or intolerable toxicity), patients with positive EGFR mutation permitted to treated by EGFR-TKI previously; patients with EGFR wild type or unknown whether or not treated by EGFR-TKI previously; Aged 18-75 years (inclusive); Body weight ≥40 kg; Evident measurable lesion(s) (according to RECIST1.1); ECOG Performance Status 0-1; Expected survival >12 weeks Exclusion Criteria: Treatment in another clinical trials in the past 3 weeks; or treatment with systemic anti-tumor chemotherapy, radiotherapy or biotherapy within 3 weeks prior to administration of the study drug; Previous therapy with VEGF/VEGFR inhibitors; Unrecovered from toxicity caused by previous anti-cancer treatment (CTCAE >grade 1), or not completely recovered from previous surgery; Previous active brain metastasis (without radiotherapy previously, or symptoms stable < 4 weeks, or with clinical symptoms, or with medication to control symptoms); Other malignancies except basal cell carcinoma or cervical carcinoma in situ in the past 5 years; Uncontrolled clinical active infection, e.g. acute pneumonia and active hepatitis B; Dysphagia or known drug malabsorption; Present active duodenal ulcer, ulcerative colitis, intestinal obstruction and other gastrointestinal diseases or other conditions that may lead to gastrointestinal bleeding or perforation according to the investigators' judgment; or with a history of intestinal perforation or intestinal fistula; Have evidence or a history of thrombosis or bleeding tendency, regardless of seriousness; Stroke and/or transient ischemic attack within 12 months prior to enrollment; Appropriate organ function. Patients with any of the following conditions will be excluded: Absolute neutrophil count (ANC) <1.5×109/L, platelet <100×109/L or hemoglobin <9 g/dL within 1 week prior to enrollment; Serum total bilirubin >1.5 upper limit of normal (ULN), alanine transaminase and aspartate transferase >1.5×ULN; ALT and AST > 3×ULN in patients with liver metastasis; Electrolyte abnormality of clinical significance; Blood creatinine >ULN and creatinine clearance <60 ml/min; Urine protein 2+ or above, or 24 h urine protein quantification ≥1.0 g/24 h; Activated partial thromboplastin time (APTT) or/and INR and prothrombin time (PT) >1.5×ULN (according to reference range in each clinical study center); Uncontrolled hypertension, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg with medication; or heart failure NYHA classification ≥ grade 2; Heart function evaluation: left ventricular ejection fraction <50% (echocardiography); Acute myocardial infarction, severe/unstable angina or coronary bypass surgery within 6 months prior to enrollment; history of arterial thrombosis or deep venous thrombosis; Skin wound, surgical site, wound site, severe mucosal ulcer or fracture without complete healing; Female subjects who are pregnant or lactating or of child bearing potential with positive pregnancy test result before the first dose; Patients with child bearing potential who or whose sexual partners are not willing to take contraceptive measures; Any clinical or laboratory abnormalities unfit to participate in this clinical trial according to the investigator's judgment; Serious psychological or psychiatric disorders which may affect subject compliance in this clinical study; Allergy to Fruquintinib and/or excipient contained in trial drugs.
Facility Information:
Facility Name
307 Hospital of PLA
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100071
Country
China
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Facility Name
Beijing Chest Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
101149
Country
China
Facility Name
Xi Nan Hospital, Third Military Medical University
City
Chongqing
State/Province
Chongqing
ZIP/Postal Code
400038
Country
China
Facility Name
Guangdong General Hospital
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510080
Country
China
Facility Name
Nantong Tumor Hospital
City
Nantong
State/Province
Jiangsu
ZIP/Postal Code
226000
Country
China
Facility Name
The First Hospital of Jilin University
City
Changchun
State/Province
Jilin
ZIP/Postal Code
130021
Country
China
Facility Name
Linyi Tumor Hospital
City
Linyi
State/Province
Shandong
ZIP/Postal Code
276001
Country
China
Facility Name
The Cancer Hospital of Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Facility Name
Shanghai Chest Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200030
Country
China
Facility Name
West China Hospital
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China
Facility Name
The First Affiliated Hosptial of College of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
29528793
Citation
Lu S, Chang J, Liu X, Shi J, Lu Y, Li W, Yang JJ, Zhou J, Wang J, An T, Yang L, Liu Z, Zhou X, Chen M, Hua Y, Su W. Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase II Study of Fruquintinib After Two Prior Chemotherapy Regimens in Chinese Patients With Advanced Nonsquamous Non-Small-Cell Lung Cancer. J Clin Oncol. 2018 Apr 20;36(12):1207-1217. doi: 10.1200/JCO.2017.76.7145. Epub 2018 Mar 12.
Results Reference
derived

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A Clinical Trial of Fruquintinib in Patients With Advanced Non-small Cell Lung Cancer

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