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
About this trial
This is an interventional treatment trial for Non-Small Cell Lung Carcinoma
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.
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
NCT ID
NCT02879097
First Posted
August 16, 2016
Last Updated
August 22, 2016
Sponsor
Cipla BioTec Pvt. Ltd.
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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