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Phase 2 Trial of Afatinib Plus Prednisone for Advanced Squamous NSCLC

Primary Purpose

Advanced Squamous Non Small Cell Lung Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Afatinib + Prednisone
Sponsored by
University of Texas Southwestern Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Squamous Non Small Cell Lung Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Written informed consent in accordance with federal, local, and institutional guidelines. The patient must provide informed consent prior to the first screening procedure.
  • Previously treated (up to three prior lines of therapy), histologically proven advanced squamous NSCLC.
  • No prior treatment with EGFR inhibitors, IMIDs (eg, thalidomide, lenalidomide), or anti-TNF antibodies.
  • No treatment with systemic glucocorticoids within 3 weeks of initiation of study therapy (topical and inhaled glucocorticoids are permitted).
  • Age ≥ 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Adequate organ and marrow function as defined below:
  • absolute neutrophil count ≥ 1,000/μL
  • platelets ≥ 50,000/μl
  • total bilirubin within normal institutional limits
  • AST(SGOT)/ALT(SPGT) ≤ 2.5 X institutional upper limit of normal
  • CrCl ≥ 45 ml/min
  • For both male and female patients, effective methods of contraception must be used throughout the study and for 3 months following the last dose of study treatment.
  • Adequate archival tissue (5-10 slides) for correlative studies.
  • Subject must have measurable disease per RECIST 1.1

Exclusion Criteria:

  • Chemotherapy, radiotherapy, or other cancer therapy within two weeks prior to starting study treatment. Subjects must have recovered from prior treatment-related to toxicities to grade 1 or baseline (excluding alopecia and clinically stable toxicities requiring ongoing medical management, such as hypothyroidism from prior immune checkpoint inhibitor treatment).
  • Subjects may not be receiving any other investigational agents for the treatment of the cancer under study.
  • Symptomatic brain metastases or brain metastases requiring escalating doses of corticosteroids
  • History of hypersensitivity or allergic reactions attributed to afatinib or prednisone.
  • Uncontrolled intercurrent illness including but not limited to poorly controlled diabetes (which may worsen in setting of chronic prednisone therapy), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that, in the opinion of the investigator, would limit compliance with study requirements.
  • Subjects must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants.

Sites / Locations

  • UT Southwestern Medical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Afatinib + Prednisone

Arm Description

Afatinib 40 mg PO daily Prednisone 40 mg PO daily starting 7 days after Afatinib

Outcomes

Primary Outcome Measures

Progression-free survival of combined afatinib and prednisone in previously treated NSCLC
Measure progression-free survival rate.

Secondary Outcome Measures

Response rate of combined afatinib and prednisone in previously treated NSCLC
Measure response rate by evaluation of target lesions by measuring disease.
Overall survival of combined afatinib and prednisone in previously treated NSCLC
Measure Overall Survival, as the time from the date of initiation of study treatment until death of any cause.
Safety of combined afatinib and prednisone in previously treated NSCLC
Measure risk to study participants by completing blood test and assessing according to the NCI Common Toxicity Criteria for Adverse Events (CTCAE), version 5.0.

Full Information

First Posted
May 22, 2020
Last Updated
October 17, 2023
Sponsor
University of Texas Southwestern Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT04497584
Brief Title
Phase 2 Trial of Afatinib Plus Prednisone for Advanced Squamous NSCLC
Official Title
An Investigator-sponsored Phase 2 Trial of Afatinib Plus Prednisone for Advanced Squamous Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 4, 2021 (Actual)
Primary Completion Date
September 1, 2024 (Anticipated)
Study Completion Date
September 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Texas Southwestern Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine the efficacy of combined afatinib and prednisone in previously treated advanced squamous NSCLC
Detailed Description
This two-stage phase 2 study will determine the safety, tolerability, recommended phase 2 dose/maximum tolerated dose, preliminary efficacy and predictive/pharmacodynamic biomarkers of combined EGFR inhibition (afatinib) and TNF inhibition (prednisone) in previously treated NSCLC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Squamous Non Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Afatinib 40 mg PO daily Prednisone 40 mg PO daily (starting 7 days after afatinib)
Masking
None (Open Label)
Allocation
N/A
Enrollment
37 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Afatinib + Prednisone
Arm Type
Experimental
Arm Description
Afatinib 40 mg PO daily Prednisone 40 mg PO daily starting 7 days after Afatinib
Intervention Type
Drug
Intervention Name(s)
Afatinib + Prednisone
Intervention Description
Afatinib (40mg) will be taken by mouth daily starting on Cycle 1, Day -7. Prednisone (40mg) will be taken by mouth daily starting on Cycle 1, Day 1.
Primary Outcome Measure Information:
Title
Progression-free survival of combined afatinib and prednisone in previously treated NSCLC
Description
Measure progression-free survival rate.
Time Frame
From date of enrollment to date of documented progression or death from any cause, whichever came first, assessed up to 60 months
Secondary Outcome Measure Information:
Title
Response rate of combined afatinib and prednisone in previously treated NSCLC
Description
Measure response rate by evaluation of target lesions by measuring disease.
Time Frame
From date of enrollment to date of documented progression or death from any cause, whichever came first, assessed up to 60 months
Title
Overall survival of combined afatinib and prednisone in previously treated NSCLC
Description
Measure Overall Survival, as the time from the date of initiation of study treatment until death of any cause.
Time Frame
From date of enrollment to date of documented progression or death from any cause, whichever came first, assessed up to 60 months
Title
Safety of combined afatinib and prednisone in previously treated NSCLC
Description
Measure risk to study participants by completing blood test and assessing according to the NCI Common Toxicity Criteria for Adverse Events (CTCAE), version 5.0.
Time Frame
From date of enrollment to date of documented progression or death from any cause, whichever came first, assessed up to 60 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent in accordance with federal, local, and institutional guidelines. The patient must provide informed consent prior to the first screening procedure. Previously treated (up to three prior lines of therapy), histologically proven advanced squamous NSCLC. No prior treatment with EGFR inhibitors, IMIDs (eg, thalidomide, lenalidomide), or anti-TNF antibodies. No treatment with systemic glucocorticoids within 3 weeks of initiation of study therapy (topical and inhaled glucocorticoids are permitted). Age ≥ 18 years. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Adequate organ and marrow function as defined below: absolute neutrophil count ≥ 1,000/μL platelets ≥ 50,000/μl total bilirubin within normal institutional limits AST(SGOT)/ALT(SPGT) ≤ 2.5 X institutional upper limit of normal CrCl ≥ 45 ml/min For both male and female patients, effective methods of contraception must be used throughout the study and for 3 months following the last dose of study treatment. Adequate archival tissue (5-10 slides) for correlative studies. Subject must have measurable disease per RECIST 1.1 Exclusion Criteria: Chemotherapy, radiotherapy, or other cancer therapy within two weeks prior to starting study treatment. Subjects must have recovered from prior treatment-related to toxicities to grade 1 or baseline (excluding alopecia and clinically stable toxicities requiring ongoing medical management, such as hypothyroidism from prior immune checkpoint inhibitor treatment). Subjects may not be receiving any other investigational agents for the treatment of the cancer under study. Symptomatic brain metastases or brain metastases requiring escalating doses of corticosteroids History of hypersensitivity or allergic reactions attributed to afatinib or prednisone. Uncontrolled intercurrent illness including but not limited to poorly controlled diabetes (which may worsen in setting of chronic prednisone therapy), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that, in the opinion of the investigator, would limit compliance with study requirements. Subjects must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sheena Bhalla, MD
Phone
214-648-4180
Email
sheena.bhalla@utsouthwestern.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Ebele Mbanugo
Email
ebele.mbanugo@utsouthwestern.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sheena Bhalla, MD
Organizational Affiliation
UT Southwestern Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ebele Mbanugo
Email
ebele.mbanugo@utsouthwestern.edu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase 2 Trial of Afatinib Plus Prednisone for Advanced Squamous NSCLC

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