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Efficacy-Safety-Immunogenicity Study of CBT124&EU-sourced Avastin® in Stage 4 NSCLC

Primary Purpose

Non-Small Cell Lung Carcinoma

Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
CBT124
EU-sourced Avastin®
Carboplatin
Paclitaxel
Sponsored by
Cipla BioTec Pvt. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Carcinoma

Eligibility Criteria

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

Inclusion Criteria: Subjects may be entered in the study only if they meet all of the following criteria:

  • Adult subjects aged ≥ 18 to 75 years (≥ 18 to 65 years for India) with histologically or cytologically confirmed advanced non-squamous NSCLC.
  • Epidermal growth factor receptor (EGFR) negative or wild type mutations
  • Stage IV (Unresectable recurrent disease or metastatic) NSCLC
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1.
  • Evaluable disease status or measurable tumor
  • Adequate hepatic, renal, and bone marrow function
  • Subjects with pre-existing hypertension must be well controlled on a stable regimen of antihypertensive therapy. Have systolic blood pressure ≤ 140 and ≥ 90 mmHg, diastolic blood pressure ≤ 90 and ≥ 50 mmHg and heart rate ≥ 40 and ≤ 90 bpm at screening and admission.
  • Ability to understand risks of participation in the study and willingness provide informed consent.

Exclusion Criteria: Subjects will not be entered in the study for any of the following reasons:

  • Small cell lung cancer (SCLC) or combination of SCLC and NSCLC. Squamous-cell tumors and mixed adenosquamous carcinomas of predominantly squamous nature
  • Prior therapy with monoclonal antibodies or small molecule inhibitors against VEGF or VEGF receptors, including bevacizumab
  • Prior therapy with carboplatin or paclitaxel
  • Prior systemic therapy for metastatic disease. Prior systemic anticancer therapy or radiotherapy for locally-advanced NSCLC if completed < 12 months prior to screening
  • Evidence of a tumor that compresses or invades major blood vessels or tumor cavitation that in the opinion of the Investigator is likely to bleed
  • Symptomatic brain metastasis
  • Previous malignancy other than NSCLC in the last 5 years except for basal cell cancer of the skin or pre-invasive cancer of the cervix
  • Any unresolved toxicity > Common Toxicity Criteria Grade 1 (except alopecia) from previous anticancer therapy (including radiotherapy)
  • History or evidence of inherited bleeding diathesis or coagulopathy with the risk of bleeding. Thrombotic or hemorrhagic event ≤ 6 months prior to screening
  • History of hemoptysis greater than ½ teaspoon of bright red (fresh) blood in the past 4 weeks
  • Subjects receiving long-term aspirin (> 325 mg/day), or other non-steroidal anti-inflammatory agents, or other drugs known to inhibit platelet function, treatment with dipyridamole, ticlopidine, or clopidogrel
  • Subjects receiving anticoagulants
  • Subjects who plan to undergo surgery during the study period
  • Subjects who have undergone a major surgery, or have had a significant traumatic injury within 4 weeks prior to randomization
  • Subjects who have a significant non-healing wound, or bone fracture within 4 weeks prior to randomization
  • Subjects with history of gastrointestinal perforation or fistula formation
  • Subjects with known hypersensitivity to any of the ingredients of the investigational products, or mammalian cell-derived products
  • Female subjects who are pregnant, breast-feeding, planning to be pregnant during the study, or women of child-bearing potential (any woman who is not surgically sterile i.e., bilateral tubal ligation, total hysterectomy or < 2 years post menopause) not using a reliable method of double contraception (e.g. condom plus diaphragm, condom or diaphragm plus spermicidal gel/foam, tubal ligation, or stable dose of hormonal contraception) throughout the study period
  • Male subject with a partner of childbearing potential who does not consent to the use of a reliable method of double contraception
  • Subjects with uncontrolled hypertension
  • Subjects with active infection assessed to be clinically significant by Investigator
  • Known history of, or positive test result for human immunodeficiency virus (HIV), hepatitis C virus (test for hepatitis C virus antibody [HCVAb]) or hepatitis B virus (test for Hepatitis B surface Antigen [HBsAg])
  • History of alcohol or substance abuse
  • Prior treatment with any investigational drug within the 30 days prior to screening, or within 5 half-lives of the drug, whichever is longer
  • Inability to comply with study requirements
  • Other unspecified reasons that, in the opinion of the Investigator or Sponsor, make the subject unsuitable for enrollment.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    CBT124 arm

    EU Sourced Avastin® arm

    Arm Description

    CBT124 plus carboplatin and paclitaxel

    EU-sourced Avastin® plus carboplatin and paclitaxel

    Outcomes

    Primary Outcome Measures

    Objective Response Rate (ORR)
    Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumours (RECIST) criteria (version 1.1). Defined as the proportion of subjects whose best confirmed overall response over Week 1 to Week 19 is either Complete Response (CR) or Partial Response (PR). Confirmed best overall response (complete or partial response) may be claimed only if the criteria for each are met after a repeat radiologic tumor assessment (using RECIST criteria version 1.1) 6 weeks later.

    Secondary Outcome Measures

    Progression-free survival (PFS) rate at 1 year
    Duration of response.
    Overall Survival (OS) rate at 1 year
    Duration of response.
    Pharmacokinetics: Cmax and Ctrough
    Cycle 1: Cmax; Cycle 2-6: Ctrough
    Proportion of subjects with selected adverse events (AE)
    Proportion of subjects with selected adverse events (AE) of gastrointestinal perforation, hypertension, proteinuria, and pulmonary haemorrhage
    Proportion of subjects with other selected AEs
    Proportion of subjects with other selected AEs of hemorrhages, wound healing complications, abscess, and fistula formation
    Proportion of subjects with other selected AEs/ SAEs/ Vital signs/Lab abnormalities
    proportion of subjects with other selected AEs of Anaphylactic/ hypersensitivity/ infusion-related reactions, arterial and venous thromboembolic events, and febrile neutropenia Incidence of AEs (overall), serious adverse events (SAEs), including changes in vital signs and laboratory abnormalities
    Incidence of anti-drug (bevacizumab) antibody formation
    Incidence of anti-drug (bevacizumab) antibody formation, including incidence of neutralizing antibodies; Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy.
    Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy
    Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy

    Full Information

    First Posted
    August 16, 2016
    Last Updated
    August 22, 2016
    Sponsor
    Cipla BioTec Pvt. Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02879097
    Brief Title
    Efficacy-Safety-Immunogenicity Study of CBT124&EU-sourced Avastin® in Stage 4 NSCLC
    Official Title
    Efficacy, Safety & Immunogenicity Study of CBT124 & EU-sourced Avastin® in Combination With Carboplatin and Paclitaxel in First-line Treatment in (NSCLC)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2016
    Overall Recruitment Status
    Unknown status
    Study Start Date
    December 2016 (undefined)
    Primary Completion Date
    December 2017 (Anticipated)
    Study Completion Date
    May 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Cipla BioTec Pvt. Ltd.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to determine whether CBT124 and Avastin® are comparable in terms of efficacy, safety, immunogenicity; and whether the pharmacokinetics of CBT124 matches that of Avastin® (pharmacokinetics is nested in this study for Indian patients).
    Detailed Description
    The purpose of this study is to determine whether CBT124 and Avastin® are comparable in terms of efficacy, safety, immunogenicity; and whether the pharmacokinetics of CBT124 matches that of Avastin® (pharmacokinetics is nested in this study for Indian patients). To test the clinical equivalence in terms of efficacy and safety, a two-sided test approach based on a pre-specified range to test the null hypothesis that the proposed biosimilar is either (1) inferior to the reference product or (2) superior to the reference product based on the pre-specified equivalence margin will be used. The equivalence margins are chosen to enable detection of clinically meaningful differences in effectiveness between CBT124, candidate biosimilar bevacizumab and reference product (EU-sourced Avastin®) at the 95% confidence interval (CI). In this trial, asymmetric equivalence margins will be used, i.e., the upper (superiority) and the lower (inferiority) bounds of the equivalence margin are not symmetric. The goal is to reject the null hypothesis of non-equivalence and accept the alternative hypothesis that the two treatments (in this case, CBT124 and EU-sourced Avastin®) are equivalent (i.e., the differences between the two are not clinically and statistically meaningful). The hypothesis testing will be performed by determining if the difference in the primary end point (Objective Response Rate [ORR]) between the reference product (EUsourced Avastin®) and proposed biosimilar (CBT124) is within the equivalence margin at the 95% CI.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    200 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CBT124 arm
    Arm Type
    Experimental
    Arm Description
    CBT124 plus carboplatin and paclitaxel
    Arm Title
    EU Sourced Avastin® arm
    Arm Type
    Active Comparator
    Arm Description
    EU-sourced Avastin® plus carboplatin and paclitaxel
    Intervention Type
    Biological
    Intervention Name(s)
    CBT124
    Intervention Description
    Induction Phase: CBT124 15 mg/kg IV infusion-Day 1 of each 3-week Cycle for 6 cycles; Carboplatin AUC 6 mgXmin/mL (calculation-Calvert formula recommended) on Day 1 of each 3-week Cycle for 6 cycles; Paclitaxel 200 mg/m2 on Day 1 of each 3-week Cycle for 6 cycles. Maintenance Phase: All the subjects who complete the induction phase and are alive at Week 19 without progression of the disease can be included in the maintenance phase and receive CBT124 (bevacizumab, 15 mg/kg, intravenous infusion on Day 1 of each 3-week Cycle) up to disease progression or unacceptable toxicity (that precludes further treatment with bevacizumab) or death.
    Intervention Type
    Biological
    Intervention Name(s)
    EU-sourced Avastin®
    Intervention Description
    Induction Phase: EU-sourced Avastin® 15 mg/kg IV infusion-Day 1 of each 3-week Cycle for 6 cycles; Carboplatin AUC 6 mgXmin/mL (calculation-Calvert formula recommended) on Day 1 of each 3-week Cycle for 6 cycles; Paclitaxel 200 mg/m2 on Day 1 of each 3-week Cycle for 6 cycles. Maintenance Phase: All the subjects who complete the induction phase and are alive at Week 19 without progression of the disease can be included in the maintenance phase and receive CBT124 (bevacizumab, 15 mg/kg, intravenous infusion on Day 1 of each 3-week Cycle) up to disease progression or unacceptable toxicity (that precludes further treatment with bevacizumab) or death.
    Intervention Type
    Drug
    Intervention Name(s)
    Carboplatin
    Intervention Description
    Induction Phase: Carboplatin AUC 6 mgXmin/mL (calculation-Calvert formula recommended) on Day 1 of each 3-week Cycle for 6 cycles.
    Intervention Type
    Drug
    Intervention Name(s)
    Paclitaxel
    Intervention Description
    Induction Phase: Paclitaxel 200 mg/m2 on Day 1 of each 3-week Cycle for 6 cycles.
    Primary Outcome Measure Information:
    Title
    Objective Response Rate (ORR)
    Description
    Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumours (RECIST) criteria (version 1.1). Defined as the proportion of subjects whose best confirmed overall response over Week 1 to Week 19 is either Complete Response (CR) or Partial Response (PR). Confirmed best overall response (complete or partial response) may be claimed only if the criteria for each are met after a repeat radiologic tumor assessment (using RECIST criteria version 1.1) 6 weeks later.
    Time Frame
    19 weeks
    Secondary Outcome Measure Information:
    Title
    Progression-free survival (PFS) rate at 1 year
    Description
    Duration of response.
    Time Frame
    1 year
    Title
    Overall Survival (OS) rate at 1 year
    Description
    Duration of response.
    Time Frame
    1 year
    Title
    Pharmacokinetics: Cmax and Ctrough
    Description
    Cycle 1: Cmax; Cycle 2-6: Ctrough
    Time Frame
    Cycle 6
    Title
    Proportion of subjects with selected adverse events (AE)
    Description
    Proportion of subjects with selected adverse events (AE) of gastrointestinal perforation, hypertension, proteinuria, and pulmonary haemorrhage
    Time Frame
    1 year
    Title
    Proportion of subjects with other selected AEs
    Description
    Proportion of subjects with other selected AEs of hemorrhages, wound healing complications, abscess, and fistula formation
    Time Frame
    1 year
    Title
    Proportion of subjects with other selected AEs/ SAEs/ Vital signs/Lab abnormalities
    Description
    proportion of subjects with other selected AEs of Anaphylactic/ hypersensitivity/ infusion-related reactions, arterial and venous thromboembolic events, and febrile neutropenia Incidence of AEs (overall), serious adverse events (SAEs), including changes in vital signs and laboratory abnormalities
    Time Frame
    1 year
    Title
    Incidence of anti-drug (bevacizumab) antibody formation
    Description
    Incidence of anti-drug (bevacizumab) antibody formation, including incidence of neutralizing antibodies; Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy.
    Time Frame
    1 year
    Title
    Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy
    Description
    Analysis of anti-drug antibody (ADA) positive and negative sub-population for PK, safety and efficacy
    Time Frame
    1 year

    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: Subjects may be entered in the study only if they meet all of the following criteria: Adult subjects aged ≥ 18 to 75 years (≥ 18 to 65 years for India) with histologically or cytologically confirmed advanced non-squamous NSCLC. Epidermal growth factor receptor (EGFR) negative or wild type mutations Stage IV (Unresectable recurrent disease or metastatic) NSCLC Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1. Evaluable disease status or measurable tumor Adequate hepatic, renal, and bone marrow function Subjects with pre-existing hypertension must be well controlled on a stable regimen of antihypertensive therapy. Have systolic blood pressure ≤ 140 and ≥ 90 mmHg, diastolic blood pressure ≤ 90 and ≥ 50 mmHg and heart rate ≥ 40 and ≤ 90 bpm at screening and admission. Ability to understand risks of participation in the study and willingness provide informed consent. Exclusion Criteria: Subjects will not be entered in the study for any of the following reasons: Small cell lung cancer (SCLC) or combination of SCLC and NSCLC. Squamous-cell tumors and mixed adenosquamous carcinomas of predominantly squamous nature Prior therapy with monoclonal antibodies or small molecule inhibitors against VEGF or VEGF receptors, including bevacizumab Prior therapy with carboplatin or paclitaxel Prior systemic therapy for metastatic disease. Prior systemic anticancer therapy or radiotherapy for locally-advanced NSCLC if completed < 12 months prior to screening Evidence of a tumor that compresses or invades major blood vessels or tumor cavitation that in the opinion of the Investigator is likely to bleed Symptomatic brain metastasis Previous malignancy other than NSCLC in the last 5 years except for basal cell cancer of the skin or pre-invasive cancer of the cervix Any unresolved toxicity > Common Toxicity Criteria Grade 1 (except alopecia) from previous anticancer therapy (including radiotherapy) History or evidence of inherited bleeding diathesis or coagulopathy with the risk of bleeding. Thrombotic or hemorrhagic event ≤ 6 months prior to screening History of hemoptysis greater than ½ teaspoon of bright red (fresh) blood in the past 4 weeks Subjects receiving long-term aspirin (> 325 mg/day), or other non-steroidal anti-inflammatory agents, or other drugs known to inhibit platelet function, treatment with dipyridamole, ticlopidine, or clopidogrel Subjects receiving anticoagulants Subjects who plan to undergo surgery during the study period Subjects who have undergone a major surgery, or have had a significant traumatic injury within 4 weeks prior to randomization Subjects who have a significant non-healing wound, or bone fracture within 4 weeks prior to randomization Subjects with history of gastrointestinal perforation or fistula formation Subjects with known hypersensitivity to any of the ingredients of the investigational products, or mammalian cell-derived products Female subjects who are pregnant, breast-feeding, planning to be pregnant during the study, or women of child-bearing potential (any woman who is not surgically sterile i.e., bilateral tubal ligation, total hysterectomy or < 2 years post menopause) not using a reliable method of double contraception (e.g. condom plus diaphragm, condom or diaphragm plus spermicidal gel/foam, tubal ligation, or stable dose of hormonal contraception) throughout the study period Male subject with a partner of childbearing potential who does not consent to the use of a reliable method of double contraception Subjects with uncontrolled hypertension Subjects with active infection assessed to be clinically significant by Investigator Known history of, or positive test result for human immunodeficiency virus (HIV), hepatitis C virus (test for hepatitis C virus antibody [HCVAb]) or hepatitis B virus (test for Hepatitis B surface Antigen [HBsAg]) History of alcohol or substance abuse Prior treatment with any investigational drug within the 30 days prior to screening, or within 5 half-lives of the drug, whichever is longer Inability to comply with study requirements Other unspecified reasons that, in the opinion of the Investigator or Sponsor, make the subject unsuitable for enrollment.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Tamal Raha, PhD
    Phone
    +91 7774097577
    Email
    Tamal.Raha@Cipla.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Tamal Raha, PhD
    Organizational Affiliation
    Cipla BioTec
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    IPD Sharing Plan Description
    Study CBT124/CT/002 does not have a FDA regulated intervention.

    Learn more about this trial

    Efficacy-Safety-Immunogenicity Study of CBT124&EU-sourced Avastin® in Stage 4 NSCLC

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