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Carcinoma, Non-Small-Cell LungPhase 2NCT00525148

LUX Lung 2 Phase II Single Arm BIBW 2992 "Afatinib" in NSCLC With EGFR Activating Mutations

A Phase 2 study testing BIBW 2992 in people with Carcinoma, Non-Small-Cell Lung, run by Boehringer Ingelheim at 30 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this open-label, single arm Phase II trial is to explore the efficacy of BIBW 2992 defined by the objective response rate (CR, PR) as determined by RECIST criteria in patients with advanced NSCLC Stage IIIB or IV whose tumors harbor activating mutations within exon 18 to exon 21 of the EGFR… Read more about this study

Who is it for?
Ages 18 to 99 years
Conditions the study is for
Carcinoma, Non-Small-Cell Lung
What is being tested?
BIBW 2992
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
129 participants
Where
30 sitesin 2 countries
Study dates
Aug 2007to Aug 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with pathologically confirmed diagnosis of NSCLC Stage IIIB (with pleural effusion) adenocarcinoma or Stage IV adenocarcinoma.
  • Presence of activating mutation(s) in exon 18 to exon 21 of the EGFR-receptor confirmed by direct DNA sequencing of NSCLC tumor tissue.
  • Progressive disease following a first line cytotoxic chemotherapy regimen or have recurrent disease after prior neoadjuvant or adjuvant chemotherapy. Patients who have not received first-line cytotoxic chemotherapy can be enrolled in stage 2 of the trial, if the criteria for entering stage 2 are met.
  • Patients with at least one tumor lesion that can accurately be measured by computed tomography (CT) or magnetic resonance imaging (MRI) in at least one dimension with longest diameter to be recorded as 20 mm using conventional techniques or 10 mm with spiral CT scan.
  • Male or female patient aged 18 years.
  • Life expectancy of at least three (3) months.
  • Written informed consents that is consistent with ICH-GCP guidelines.
  • Eastern Cooperative Oncology Group (ECOG) performance score 0, 1 or 2.

Who cannot join

  • More than one (1) prior cytotoxic chemotherapy treatment regimen for relapsed or metastatic NSCLC.
  • Chemo-, hormone- (other than Megace®) or immunotherapy within the past 4 weeks or within less than four half-lives of the previous drug prior to treatment with the trial drug and/or persistence of toxicities of prior anticancer therapies which are deemed to be clinically relevant.
  • Previous treatment with erlotinib (Tarceva®), gefitinib (Iressa®) or any other EGFR inhibiting small molecule or antibody.
  • Brain metastases, which are symptomatic; patients with treated, asymptomatic brain metastases are eligible with stable brain disease for at least four (4) weeks without the requirement for steroids or anti-epileptic therapy.
  • Significant or recent acute gastrointestinal disorders with diarrhea as a major symptom e.g., Crohns disease, malabsorption, or CTCAE Grade >2 diarrhea of any etiology at baseline.
  • Patients who have any other life-threatening illness or organ system dysfunction, which in the opinion of the investigator, would either compromise patient safety or interfere with the evaluation of the safety of the test drug.
Show all 24Show fewer
  • Other malignancies diagnosed within the past five (5) years (other than non-melanomatous skin cancer and in situ cervical cancer).
  • Radiotherapy within the past 2 weeks prior to treatment with the trial drug.
  • Patients with any serious active infection (i.e., requiring an IV antibiotic, antifungal, or antiviral agents).
  • Patients with known HIV, active hepatitis B or active hepatitis C.
  • Known or suspected active drug or alcohol abuse.
  • Women of child-bearing potential or men who are able to father a child unwilling to use a medically acceptable method of contraception during the trial.
  • Pregnancy or breast feeding.
  • Patient unable to comply with the protocol.
  • History of clinically significant or uncontrolled cardiac disease, including congestive heart failure, angina, myocardial infarction, arrhythmia, including New York Heart Association (NYHA) functional classification of 3.
  • Cardiac left ventricular function with resting ejection fraction of less than 50% measured by multigated blood pool imaging of the heart (MUGA scan) or echocardiogram.
  • QTc interval greater than 0.47 second.
  • Prior treatment with anthracyclines with a cumulative dose of doxorubicin (or equivalent) greater than 400 mg/m2.
  • Absolute neutrophil count (ANC) less than 1500/mm3.
  • Platelet count less than 100 000 /mm3.
  • Bilirubin greater than 1.5 mg / dl (greater than 26 micromol / L, SI unit equivalent).
  • Aspartate amino transferase (AST) or alanine amino transferase (ALT) greater than three times the upper limit of normal (if related to liver metastases greater than five times the upper limit of normal).
  • Serum creatinine greater than 1.5 times of the upper normal limit or calculated/measured creatinine clearance equal or less than 45 ml / min.
  • Patients with known pre-existing interstitial lung disease

Trial locations and contacts

30 sites in 2 countries.

30 sites in 2 countries

United States23 sites
  • 1200.22.10 Boehringer Ingelheim Investigational Site

    Atlanta, Georgia

  • 1200.22.28 Boehringer Ingelheim Investigational Site

    Bakersfield, California

  • 1200.22.3 Boehringer Ingelheim Investigational Site

    Bethesda, Maryland

  • 1200.22.32 Boehringer Ingelheim Investigational Site

    Beverly Hills, California

  • 1200.22.14 Boehringer Ingelheim Investigational Site

    Boston, Massachusetts

  • 1200.22.6 Boehringer Ingelheim Investigational Site

    Canton, Ohio

  • 1200.22.18 Boehringer Ingelheim Investigational Site

    Chicago, Illinois

  • 1200.22.31 Boehringer Ingelheim Investigational Site

    Fairfax, Virginia

  • 1200.22.24 Boehringer Ingelheim Investigational Site

    Flint, Michigan

  • 1200.22.19 Boehringer Ingelheim Investigational Site

    Fort Lauderdale, Florida

  • 1200.22.5 Boehringer Ingelheim Investigational Site

    Minneapolis, Minnesota

  • 1200.22.4 Boehringer Ingelheim Investigational Site

    Mission Hills, California

  • 1200.22.22 Boehringer Ingelheim Investigational Site

    Mt. Pleasant, South Carolina

  • 1200.22.15 Boehringer Ingelheim Investigational Site

    New York, New York

  • 1200.22.26 Boehringer Ingelheim Investigational Site

    New York, New York

  • 1200.22.29 Boehringer Ingelheim Investigational Site

    North Miami Beach, Florida

  • 1200.22.16 Boehringer Ingelheim Investigational Site

    Orange, California

  • 1200.22.40 Boehringer Ingelheim Investigational Site

    Renton, Washington

  • 1200.22.1 Boehringer Ingelheim Investigational Site

    Rochester, New York

  • 1200.22.33 Boehringer Ingelheim Investigational Site

    Seattle, Washington

  • 1200.22.27 Boehringer Ingelheim Investigational Site

    Syracuse, New York

  • 1200.22.25 Boehringer Ingelheim Investigational Site

    Valhalla, New York

  • 1200.22.7 Boehringer Ingelheim Investigational Site

    Wynnewood, Pennsylvania

Other trials in United States

Taiwan7 sites
  • 1200.22.88604 Taichung Veterans General Hospital

    Taichung

  • 1200.22.88605 China Medical University Hospital

    Taichung

  • 1200.22.88606 Boehringer Ingelheim Investigational Site

    Tainan

  • 1200.22.88601 National Taiwan University Hospital

    Taipei

  • 1200.22.88602 Veterans General Hospital

    Taipei

  • 1200.22.88607 Boehringer Ingelheim Investigational Site

    Taipei

  • 1200.22.88603 Chang Gung Memorial Hosp-Linkou

    Taoyuan

Other trials in Taiwan

About this study

Official title: LUX Lung 2 A Phase II Single-arm Trial of BIBW 2992 in Non-small Cell Lung Cancer Patients With EGFR Activating Mutations

The primary objective of this open-label, single arm Phase II trial is to explore the efficacy of BIBW 2992 defined by the objective response rate (CR, PR) as determined by RECIST criteria in patients with advanced NSCLC Stage IIIB or IV whose tumors harbor activating mutations within exon 18 to exon 21 of the EGFR receptor. Patients progressing or relapsing after one prior cytotoxic chemotherapy regimen as well as chemotherapy naïve patients (only in stage 2) will be allowed to enter into the trial.

Being tested
BIBW 2992
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BIBW 2992Drug

    This is an open label study. Patients are treated with BIBW 2992 until disease progression or undue AEs

Study groups in NCT00525148
Study groupRoleWhat they receive
BIBW 2992ExperimentalPatients start continuous once daily oral treatment of BIBW 2992 at high dose, until progression or undue Adverse Events (AEs) develop. Patients can be dose-reduced up to two times if needed after temporary discontinuation of treatment due to drug-related AEs. After protocol amendment 2 (17 Dec 2008), the starting dose of BIBW 2992 was reduced to a medium dose, with 2 possible dose reductions if needed after discontinuation due to drug-related AEs.
Receives: Drug: BIBW 2992

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Objective Response (OR) as Determined by RECIST 1.0

    Objective response (OR) was assessed for all treated patients by independent review as determined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.0. OR included complete response (CR) and partial response (PR), where CR or PR must have been confirmed by a subsequent response in ≥28 days.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

Secondary outcomes (9)
  1. Clinical Benefit as Determined by RECIST 1.0

    Clinical benefit was evaluated according to RECIST 1.0 by independent review assessment. Patients whose best RECIST 1.0 assessment was stable disease (SD), partial response (PR), or complete response (CR) were considered to have derived a clinical benefit from treatment.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

  2. Duration of Clinical Benefit

    Duration of clinical benefit (disease control) as per independent review was defined as the time from the start of treatment to the time of progression or death (whichever occurred first), among patients with evidence of SD, PR or CR.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

  3. Duration of Objective Response

    Duration of objective response (OR) was measured from the time the criteria for CR or PR (whichever was documented first) were first met until the first date that progressive disease or death (or date of censoring for PFS) was objectively documented as per independent review.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

  4. Time to Objective Response

    Time to objective response was defined as the number of days from the start of treatment to the first recorded objective response. Patients who did not experience objective response during the study were censored at the time of treatment discontinuation.

    The results are provided as the percentage of participants for this Outcome Measure.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

  5. Progression-free Survival

    Progression-free survival (PFS) as per independent review was defined as the duration of time from the start of treatment until the day of objective tumor progression was confirmed by tumor imaging (Progressive Disease according to RECIST 1.0) or death, whichever came first. Patients with unknown progression status or unknown date of progression were reviewed on a case-by-case basis. Patients known to be alive without progression at the end of the trial or the last follow-up visit were censored at the date of the last imaging when the patient was known to be alive and progression-free. Medians are calculated from the Kaplan-Meier estimates and 95% confidence intervals, using Greenwood's standard error estimate.

    Measured: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.

  6. Overall Survival Time

    Overall survival time (OS) was also evaluated and was defined as the duration of time from start of treatment to time of death up to 93 months, regardless of the cause of death. Medians are calculated from the Kaplan-Meier estimates and 95% confidence intervals, using Greenwood's standard error estimate.

    Measured: Start of treatment to time to all death, up to 93 months

  7. Cpre,ss,29

    Predose concentration of the analyte in plasma at steady state immediately before administration of the 29th dose (Cpre,ss,29).

    Measured: -0:05h (pre-dose) on Day 29

  8. Safety of BIBW 2992 as Indicated by Incidence of Specified Adverse Events.

    Safety of afatinib as indicated by incidence of specified adverse events: skin reactions (a preferred term of the system organ class: Skin and subcutaneous tissue disorders) and gastrointestinal (GI) (a system organ class).

    Measured: First administration of trial medication until 28 days after last administration of trial medication, up to 93 months.

  9. Safety of BIBW 2992 as Indicated by Intensity and Incidence of Worst Adverse Events Graded According to NCI CTCAE Version 3.0

    Safety of afatinib as indicated by intensity and incidence of worst adverse events graded according to National Cancer Institute (NCI) Common terminology criteria for adverse events (CTCAE) Version 3.0 (R04-0474).

    Measured: First administration of trial medication until 28 days after last administration of trial medication, up to 93 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Sep 2007 (estimated)
  2. Study startAug 2007
  3. Primary completionFeb 2010
  4. Study completionAug 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
129 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00525148
Sponsor's protocol ID
1200.22
Status last verified
Jul 2016
First submitted
3 Sep 2007
Last updated
16 Sep 2016

Publications

  • Yang JC, Sequist LV, Geater SL, Tsai CM, Mok TS, Schuler M, Yamamoto N, Yu CJ, Ou SH, Zhou C, Massey D, Zazulina V, Wu YL. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol. 2015 Jul;16(7):830-8. doi: 10.1016/S1470-2045(15)00026-1. Epub 2015 Jun 4.

    PubMed 26051236
  • Yang JC, Shih JY, Su WC, Hsia TC, Tsai CM, Ou SH, Yu CJ, Chang GC, Ho CL, Sequist LV, Dudek AZ, Shahidi M, Cong XJ, Lorence RM, Yang PC, Miller VA. Afatinib for patients with lung adenocarcinoma and epidermal growth factor receptor mutations (LUX-Lung 2): a phase 2 trial. Lancet Oncol. 2012 May;13(5):539-48. doi: 10.1016/S1470-2045(12)70086-4. Epub 2012 Mar 26.

    PubMed 22452895

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing BIBW 2992 in people with Carcinoma, Non-Small-Cell Lung, run by Boehringer Ingelheim at 30 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 30 sites in United States, Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Oct 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response (OR) as Determined by RECIST 1.0 (time frame: Response assessment is done at end of Week 4 (after Course 1), Week 8 (after Course 2), Week 12 (after Course 3) and at 8-week intervals thereafter, up to 93 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00525148, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2016.

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