Non-Squamous Non-Small Cell Lung CancerPhase 3NCT00961415
AVAPERL1 Study: A Study of Avastin (Bevacizumab) With or Without Pemetrexed as Maintenance Therapy After Avastin in First Line in Patients With Non-Squamous Non-Small Cell Lung Cancer
A Phase 3 study testing bevacizumab [Avastin], cisplatin and pemetrexed in people with Non-Squamous Non-Small Cell Lung Cancer, run by Hoffmann-La Roche at 91 sites in 12 countries.
Trial summary
This open-label study will assess the efficacy and safety of Avastin with or without pemetrexed as maintenance therapy in patients with advanced, metastatic or recurrent non-small cell lung cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-Squamous Non-Small Cell Lung Cancer
- What is being tested?
- bevacizumab [Avastin], cisplatin and pemetrexed
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 376 participants
- Where
- 91 sitesin 12 countries
- Study dates
- Aug 2009to May 2011
- Phase
- Phase 3
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- adults >/=18 years of age
- inoperable, locally advanced, metastatic or recurrent non-squamous non-small cell lung cancer (NSCLC)
- at least 1 measurable lesion meeting RECIST criteria
- ECOG performance status 0-2
- adequate hematological, liver and renal function
Who cannot join
- prior chemotherapy or treatment with another systemic anti-cancer agent
- malignancies other than NSCLC within 5 years prior to randomization, except for adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer or DCIS
- evidence of tumor invading major blood vessels
- current or recent use of aspirin (>325mg/day) or full-dose anticoagulants or thrombolytic agents for therapeutic purposes
- history of haemoptysis >/=grade 2
- clinically significant cardiovascular disease
Trial locations and contacts
91 sites in 12 countries.
91 sites in 12 countries
France27 sites
Study site
Béziers, 34500
Study site
Bordeaux, 33077
Study site
Bron, 69677
Study site
Caen, 14033
Study site
Caen, 14076
Study site
Clermont-Ferrand, 63003
Study site
Créteil, 94010
Study site
Gap, 05007
Study site
Gleizé, 69400
Study site
La Source, 45100
Study site
La Tronche, 38700
Study site
Lille, 59037
Study site
Limoges, 87039
Study site
Lyon, 69317
Study site
Marseille, 13915
Study site
Nancy, 54100
Study site
Nîmes, 30900
Study site
Paris, 75571
Study site
Paris, 75674
Study site
Paris, 75970
Study site
Perpignan, 66046
Study site
Pierre-Bénite, 69495
Study site
Reims, 51092
Study site
Saint-Priest-en-Jarez, 42770
Study site
Strasbourg, 67065
Study site
Toulon, 83041
Study site
Tours, 37044
Germany17 sites
Study site
Augsburg, 86150
Study site
Bad Berka, 99437
Study site
Berlin, 13125
Study site
Bonn, 53113
Study site
Ebensfeld, 96250
Study site
Frankfurt, 60488
Study site
Freiburg im Breisgau, 79106
Study site
Gauting, 82131
Study site
Großhansdorf, 22927
Study site
Halle, 06120
Study site
Hamburg, 21075
Study site
Immenhausen, 34376
Study site
Karlsruhe, 76137
Study site
Leipzig, 04103
Study site
Minden, 32429
Study site
München, 80336
Study site
Oldenburg, 26121
Netherlands11 sites
Study site
's-Hertogenbosch, 5211 RW
Study site
Amersfoort, 3818 ES
Study site
Amsterdam, 1066 CX
Study site
Breda, 4818 CK
Study site
Eindhoven, 5623 EJ
Study site
Haarlem, 2035 RC
Study site
Nieuwegein, 3435 CM
Study site
Rotterdam, 3045 PM
Study site
Sittard-Geleen, 6162 BG
Study site
The Hague, 2504 LN
Study site
Zaandam, 1502 DV
Italy8 sites
Study site
Aviano, Friuli Venezia Giulia, 33081
Study site
Lecce, Apulia, 73100
Study site
Naples, Campania, 80131
Study site
Novara, Piedmont, 28100
Study site
Padova, Veneto, 35128
Study site
Pisa, Tuscany, 56124
Study site
Rome, Lazio, 00168
Study site
Sassari, Sardinia, 07100
South Korea8 sites
Study site
Bundang City, 463-802
Study site
Daegu, 700-712
Study site
Gyeonggi-do, 410-769
Study site
Seoul, 110746
Study site
Seoul, 120-752
Study site
Seoul, 135-710
Study site
Seoul, 137-807
Study site
Seoul, 138-736
Spain6 sites
Study site
Las Palmas de Gran Canaria, Las Palmas, 35016
Study site
Madrid, Madrid, 28034
Study site
Madrid, Madrid, 28041
Study site
Madrid, Madrid, 28046
Study site
Palma de Mallorca, Balearic Islands, 07198
Study site
San Cristóbal de La Laguna, Tenerife, 38320
Russia5 sites
Study site
Balashikha, 143900
Study site
Irkutsk, 664035
Study site
Krasnodar, 350086
Study site
Moscow, 115478
Study site
Saint Petersburg, 197089
Sweden4 sites
Study site
Gävle, 80187
Study site
Linköping, 58185
Study site
Lund, 22185
Study site
Uppsala, 751 85
Turkey (Türkiye)2 sites
Study site
Antalya, 07070
Study site
Izmir, 35110
About this study
Official title: Open-label Study of Bevacizumab Maintenance Therapy (AVASTIN®) With or Without Pemetrexed After First-line Chemotherapy With Bevacizumab-cisplatin-pemetrexed in Patients With Advanced, Metastatic or Recurrent Non-squamous Non-small Cell Lung Cancer (NSCLC)
This open-label study will assess the efficacy and safety of Avastin with or without pemetrexed as maintenance therapy in patients with advanced, metastatic or recurrent non-small cell lung cancer. In Part 1, patients will receive 4 cycles of treatment with Avastin (7.5mg/kg iv) plus cisplatin (75mg/m2 iv) plus pemetrexed (500mg/m2 iv) on day 1 of each 3-week cycle. In Part 2, patients responding to treatment will be randomized to receive further treatment cycles of Avastin (7.5mg/kg iv every 3 weeks) with or without pemetrexed (500mg/m2 iv every 3 weeks). Anticipated time on study treatment is until disease progression. Target sample size is <500 individuals.
- Conditions
- Non-Squamous Non-Small Cell Lung Cancer
- Being tested
- bevacizumab [Avastin], cisplatin, pemetrexed
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
bevacizumab [Avastin]Drug
7.5mg/kg iv on day 1 of each 3-week cycle
cisplatinDrug
75mg/m2 iv on day 1 of each 3-week cycle
pemetrexedDrug
500mg/m2 iv on day 1 of each 3-week cycle
| Study group | Role | What they receive |
|---|---|---|
| Part 1 | Experimental | Not described Receives: Drug: bevacizumab [Avastin]; Drug: cisplatin; Drug: pemetrexed |
| Part 2A | Experimental | Not described Receives: Drug: bevacizumab [Avastin] |
| Part 2B | Active comparator | Not described Receives: Drug: bevacizumab [Avastin]; Drug: pemetrexed |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression Free Survival During Maintenance Treatment Phase
Progression free survival (PFS) is defined as the time from randomization to the date of documented disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST v1.1) , or the date of occurrence of a second primary cancer, or date of death from any cause, whichever comes first. Progression is defined using (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, the appearance of new lesions and increase of at least 5 mm in the sum of diameters of target lesions.Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
Measured: Up to 21 months
Secondary outcomes (7)
Overall Survival During Maintenance Treatment Phase
Overall survival (OS) is assessed from the date of first induction treatment until the date of death. Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
Measured: Up to 21 months
Best Overall Response Rate During Maintenance Treatment Phase
The best overall response rate (BORR) is defined as the percentage of participants having achieved confirmed Complete Response (CR) and Partial Response (PR) as the best overall response. CR was defined as complete disappearance of all target lesions and non-target disease. PR was defined as a greater than or equal to (≥) 30% decrease under baseline of the sum of diameters of all target lesions. Stable disease (SD) is defined as steady state of disease with neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD).Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
Measured: Up to 21 months
Duration of Response During Maintenance Treatment Phase
Duration of response is defined as the time in months from the initial start of response PR or better to the earlier of documented PD or death due to any cause. Participants who had neither progressed nor died at the date of clinical cutoff, who withdrew from the study, were lost to follow-up, or were without documented disease progression were censored at the date of the last available tumor assessment. The analysis was based on all participants with measurable disease at baseline who achieved response.Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
Measured: Up to 21 months
Duration of Disease Control During Maintenance Treatment Phase
Duration of disease control is defined as the time in months from randomization to the earlier of documented PD or death due to any cause. Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
Measured: Up to 21 months
Incidence of Adverse Events and Serious Adverse Event
An adverse events (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not considered related to the medicinal (investigational) product. An serious adverse event (SAE) is any experience that suggests a significant hazard, contraindication, side effect, or precaution.
Measured: Up to 21 months
Number of Participants With Marked Laboratory Abnormalities
Marked laboratory abnormalities were defined as those values that were outside the reference range and showed a clinically relevant change from Baseline. The reference range for Platelets was 100-550 (10^9/L), for White blood cells (WBC) was 3.0-18.0 (10^9/L), for Lymphocytes was 0.70-7.60 (10^9/L), and Neutrophil 1.50-9.25 (10^9/L ).
Measured: Up to 21 months
Quality of Life
European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Cancer 30 (EORTC QLQ-C30): included functional scales (physical, role, cognitive, emotional, and social), global health status, symptom scales (fatigue, pain, nausea/vomiting) and single items (dyspnoea, appetite loss, insomnia, constipation/diarrhea and financial difficulties). The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Lung Cancer 13 [EORTC QLQ-LC13]consisted of 1 multi-item scale and 9 single items that assessed the specific symptoms (dyspnea, cough, hemoptysis, and site specific pain), side effects (sore mouth, dysphagia, neuropathy, and alopecia), and pain medication use of lung cancer participants receiving chemotherapy. Scale score range: 0 to 100. Higher symptom score = greater degree of symptom severity. QOL was assessed using Pre-Induction Baseline (Pre-ind BL), Maintenance (MTC), End of study (EOS) cycles.
Measured: Up to 21 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Aug 2009 (estimated)
- Study startAug 2009
- Primary completionMay 2011
- Study completionMay 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Non-Squamous Non-Small Cell Lung CancerStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 376 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00961415
- Sponsor's protocol ID
- MO22089
- Other IDs
- 2008-007008-27, 2008
- Status last verified
- Jan 2016
- First submitted
- 18 Aug 2009
- Last updated
- 22 Feb 2016
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Barlesi F, Scherpereel A, Rittmeyer A, Pazzola A, Ferrer Tur N, Kim JH, Ahn MJ, Aerts JG, Gorbunova V, Vikstrom A, Wong EK, Perez-Moreno P, Mitchell L, Groen HJ. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non-small-cell lung cancer: AVAPERL (MO22089). J Clin Oncol. 2013 Aug 20;31(24):3004-11. doi: 10.1200/JCO.2012.42.3749. Epub 2013 Jul 8.
PubMed 23835708
Study at a glance
From the registry record, last updated by the sponsor on 22 Feb 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Open-label Study of Bevacizumab Maintenance Therapy (AVASTIN®) With or Without Pemetrexed After First-line Chemotherapy With Bevacizumab-cisplatin-pemetrexed in Patients With Advanced, Metastatic or Recurrent Non-squamous Non-small Cell Lung Cancer (NSCLC)
- ClinicalTrials.gov ID
- NCT00961415
- Acronym / sponsor ID
- MO22089
- Conditions
- Non-Squamous Non-Small Cell Lung Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 376 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- Aug 2009
- Primary completion
- May 2011 (actual)
- Study completion
- May 2011 (actual)
- First posted
- 19 Aug 2009 (estimated)
- Results
- Posted 22 Feb 2016
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This open-label study will assess the efficacy and safety of Avastin with or without pemetrexed as maintenance therapy in patients with advanced, metastatic or recurrent non-small cell lung cancer. In Part 1, patients will receive 4 cycles of treatment with Avastin (7.5mg/kg iv) plus cisplatin (75mg/m2 iv) plus pemetrexed (500mg/m2 iv) on day 1 of each 3-week cycle. In Part 2, patients responding to treatment will be randomized to receive further treatment cycles of Avastin (7.5mg/kg iv every 3 weeks) with or without pemetrexed (500mg/m2 iv every 3 weeks). Anticipated time on study treatment is until disease progression. Target sample size is <500 individuals.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Part 1 | Experimental | Drug: bevacizumab [Avastin], Drug: cisplatin, Drug: pemetrexed |
| Part 2A | Experimental | Drug: bevacizumab [Avastin] |
| Part 2B | Active comparator | Drug: bevacizumab [Avastin], Drug: pemetrexed |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- adults >/=18 years of age
- inoperable, locally advanced, metastatic or recurrent non-squamous non-small cell lung cancer (NSCLC)
- at least 1 measurable lesion meeting RECIST criteria
- ECOG performance status 0-2
- adequate hematological, liver and renal function
Key exclusion criteria (6 listed)
- prior chemotherapy or treatment with another systemic anti-cancer agent
- malignancies other than NSCLC within 5 years prior to randomization, except for adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer or DCIS
- evidence of tumor invading major blood vessels
- current or recent use of aspirin (>325mg/day) or full-dose anticoagulants or thrombolytic agents for therapeutic purposes
- history of haemoptysis >/=grade 2
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| bevacizumab [Avastin]7.5mg/kg iv on day 1 of each 3-week cycle | Drug | Part 1, Part 2A, Part 2B |
| cisplatin75mg/m2 iv on day 1 of each 3-week cycle | Drug | Part 1 |
| pemetrexed500mg/m2 iv on day 1 of each 3-week cycle | Drug | Part 1, Part 2B |
Primary outcome
Progression Free Survival During Maintenance Treatment Phase
Time frame: Up to 21 months
Progression free survival (PFS) is defined as the time from randomization to the date of documented disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST v1.1) , or the date of occurrence of a second primary cancer, or date of death from any cause, whichever comes first. Progression is defined using (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, the appearance of new lesions and increase of at least 5 mm in the sum of diameters of target lesions.Tumor assessment was done before Cycle 3, at Cycle 2 of maintenance therapy and every nine weeks thereafter.
7 secondary outcomes
Overall Survival During Maintenance Treatment Phase
Time frame: Up to 21 months
Best Overall Response Rate During Maintenance Treatment Phase
Time frame: Up to 21 months
Duration of Response During Maintenance Treatment Phase
Time frame: Up to 21 months
Duration of Disease Control During Maintenance Treatment Phase
Time frame: Up to 21 months
Incidence of Adverse Events and Serious Adverse Event
Time frame: Up to 21 months
Number of Participants With Marked Laboratory Abnormalities
Time frame: Up to 21 months
Quality of Life
Time frame: Up to 21 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Feb 2016.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 23835708Barlesi F, Scherpereel A, Rittmeyer A, Pazzola A, Ferrer Tur N, Kim JH, Ahn MJ, Aerts JG, Gorbunova V, Vikstrom A, Wong EK, Perez-Moreno P, Mitchell L, Groen HJ. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non-small-cell lung cancer: AVAPERL (MO22089). J Clin Oncol. 2013 Aug 20;31(24):3004-11. doi: 10.1200/JCO.2012.42.3749. Epub 2013 Jul 8.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Trials study director
Hoffmann-La Roche
91 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing bevacizumab [Avastin], cisplatin and pemetrexed in people with Non-Squamous Non-Small Cell Lung Cancer, run by Hoffmann-La Roche at 91 sites in 12 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 5 inclusion and 6 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 22 Feb 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 91 sites in France, Germany, Netherlands, Italy, South Korea and 7 more countries. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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 22 Feb 2016). 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?
Progression Free Survival During Maintenance Treatment Phase (time frame: Up to 21 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 NCT00961415, which also lists 1 linked publication.
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 22 Feb 2016.