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Non Small Cell Lung CancerPhase 2NCT02323126

Study of Efficacy and Safety of Nivolumab in Combination With EGF816 and of Nivolumab in Combination With INC280 in Patients With Previously Treated Non-small Cell Lung Cancer

A Phase 2 study testing EGF816, INC280 and Nivolumab in people with Non Small Cell Lung Cancer, run by Novartis Pharmaceuticals at 13 sites in 8 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

To determine the efficacy and safety of nivolumab in combination with EGF816 and of nivolumab in combination with INC280 in previously treated NSCLC patients Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non Small Cell Lung Cancer
What is being tested?
EGF816, INC280 and Nivolumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
64 participants
Where
13 sitesin 8 countries
Study dates
9 Feb 2015to 5 Feb 2021
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent must be obtained prior to any screening procedures
  • Presence of at least one measurable lesion according to RECIST v.1.1
  • ECOG performance status ≤ 2
  • Patients with histologically documented locally advanced, recurrent and/or metastatic NSCLC
  • Tumor tissue for determination and/or confirmation of genetic pre-requisites (i.e. EGFR T790M positivity post progression on EGFR TKI for Group 1; cMet status for Group 2) must be provided for analysis
  • Group 1 patients:
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  • Patients with EGFR T790M NSCLC (adenocarcinoma)
  • Documented progression of disease according to RECIST v1.1 following primary standard of care (e.g. erlotinib, gefitinib)
  • Group 2 patients:
  • Patients with EGFR wild-type NSCLC
  • Documented progression of disease according to RECIST v1.1 following standard of care (e.g. platinum doublet).

Who cannot join

  • Patients who have received more than one prior line of EGFR TKI therapy1 (applies only to Group 1)
  • Previous treatment with a c-MET inhibitor or HGF-targeting therapy (applies only to Group 2)
  • Patients with brain metastases. However, if radiation therapy and/or surgery has been completed and serial evaluation by CT (with contrast enhancement) or MRI over a minimum of one month demonstrates the disease to be stable and if the patient remains asymptomatic without the need for treatment with steroids
  • Patients who require emergent use of systemic steroids, chronic use of prednisone (greater than 10mg or an equivalent steroid dose daily) or emergent surgery and/or radiotherapy.
  • History of allergy or hypersensitivity to nivolumab components
  • Patients with any known or suspected, current or past history of, autoimmune disease. Patients with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll
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  • Patients with a condition requiring chronic systemic treatment with either corticosteroids(> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of treatment start. Inhaled or topical steroids, and adrenal replacement steroid doses> 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease
  • Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
  • Any positive test for hepatitis B virus or hepatitis C virus indicating acute or chronic infection
  • Patients with interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity
  • Patients who have been treated with prior PD-1 and PD-L1 agents
  • Patients who previously received agents targeting c-MET and/or EGFR T790M Note: Previous treatment with afatinib may be allowable after discussions between Novartis and Investigator.
  • Patients with the following laboratory abnormalities:
  • Absolute Neutrophil Count (ANC) <1.5 x 109/L
  • Hemoglobin (Hgb) <9 g/dL
  • Platelets <100 x 109/L
  • Total bilirubin >1.5 x upper limit of normal (ULN). For patients with Gilbert's syndrome total bilirubin >2.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >3 x ULN
  • Serum creatinine >1.5 x ULN and/or measured or calculated creatinine clearance <75% LLN
  • For patients being screened for Group 2, asymptomatic serum amylase > CTCAE Grade 2 (1.5-2.0 x ULN). Patients with Grade 1 or Grade 2 serum amylase at the beginning of the study must be confirmed to have no signs or symptoms suggesting pancreatitis or pancreatic injury (e.g., elevated P-amylase, abnormal imaging findings of pancreas, etc.)
  • For patients being screened for Group 2: Serum lipase > ULN
  • Female patients who are either pregnant or nursing.
  • Women of child bearing potential who refuse or are not able to use a highly effective method of contraception as defined in the study protocol.
  • Sexually active males unless they use a condom during intercourse while taking drug and for 31 weeks after the last dose of study treatment.

Trial locations and contacts

13 sites in 8 countries.

13 sites in 8 countries

Spain4 sites
  • Novartis Investigative Site

    Alicante, Valencia, 03010

  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    Madrid, 28040

  • Novartis Investigative Site

    Málaga, Andalusia, 29010

Other trials in Spain

Australia2 sites
  • Novartis Investigative Site

    Camperdown, New South Wales, 2050

  • Novartis Investigative Site

    Chermside, Queensland, 4032

Other trials in Australia

Italy2 sites
  • Novartis Investigative Site

    Aviano, PN, 33081

  • Novartis Investigative Site

    Perugia, PG, 06129

Other trials in Italy

United States1 site
  • University of Texas MD Anderson Cancer Center Thoractic Head/Neck Med.Onc(2)

    Houston, Texas, 77030

Other trials in United States

France1 site
  • Novartis Investigative Site

    La Tronche, 38700

Other trials in France

Germany1 site
  • Novartis Investigative Site

    Cologne, North Rhine-Westphalia, 50937

Other trials in Germany

Singapore1 site
  • Novartis Investigative Site

    Singapore, 169610

Other trials in Singapore

Switzerland1 site
  • Novartis Investigative Site

    Chur, 7000

Other trials in Switzerland

About this study

Official title: A Phase II, Multicenter, Open-label Study of EGF816 in Combination With Nivolumab in Adult Patients With EGFR Mutated Non-small Cell Lung Cancer and of INC280 in Combination With Nivolumab in Adult Patients With cMet Positive Non-small Cell Lung Cancer

To determine the efficacy and safety of nivolumab in combination with EGF816 and of nivolumab in combination with INC280 in previously treated NSCLC patients

Read the detailed description

This was a phase II, multi-center, open-label study in patients with advanced non-small cell lung cancer (NSCLC). Patients were allocated based on their epidermal growth factor receptor (EGFR) status to one of the 2 groups: Group 1 - EGFR T790M NSCLC treated with EGF816 150 mg once daily (QD) + nivolumab 3 mg/kg every 2 weeks (Q2W), and Group 2 - EGFR wild type (wt) NSCLC treated with INC280 400 mg twice daily (BID) + nivolumab 3 mg/kg Q2W. Patients in Group 2 were subdivided into 2 subgroups based on c-Mesenchymal-epithelial transition (cMet) status: Subgroup A - high cMet (referred to as Group 2A) and Subgroup B- low cMet (referred to as Group 2B).

Patients could continue study treatment until patients experienced unacceptable toxicity that precluded any further treatment, disease progression and/or treatment was discontinued at the discretion of the investigator or withdrawal of consent, or the patient was transferred to a Novartis roll-over study or an alternative treatment option that could continue to provide study treatments. Following the approval of a protocol amendment, the maximum treatment duration for nivolumab could not exceed 2 years and patients who had received nivolumab beyond 2 years were discontinued from nivolumab treatment and continued on EGF816 or INC280 alone.

The primary objective of the trial was to estimate the clinical activity of nivolumab in combination with EGF816 or INC280.

Being tested
EGF816, INC280, Nivolumab
Keywords
Non small cell lung cancer, NSCLC, EGFR-mutated, EGF816, INC280, Nivolumab, EGFR-T790M NSCLC, EGFR wild-type (wt), cMET positive NSCLC, cMET negative NSCLC
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.

  • EGF816Drug

    EGF816 150 mg once daily (QD) administered orally as a capsule

  • INC280Drug

    INC280 400 mg twice daily (BID) administered orally as a tablet

  • NivolumabDrug

    Nivolumab 3 mg/kg every 2 weeks (Q2W) administered by intravenous infusion

Study groups in NCT02323126
Study groupRoleWhat they receive
Nivolumab and EGF816ExperimentalGroup 1: EGF816 150 mg QD + Nivolumab 3 mg/kg Q2W
Receives: Drug: EGF816; Drug: Nivolumab
Nivolumab and INC280, high cMetExperimentalGroup 2A: INC280 400 mg BID, High cMET + Nivolumab 3 mg/kg Q2W
Receives: Drug: INC280; Drug: Nivolumab
Nivolumab and INC280, low cMetExperimentalGroup 2B: INC280 400 mg BID, Low cMet + Nivolumab 3 mg/kg Q2W
Receives: Drug: INC280; Drug: Nivolumab

What is being measured

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

  1. Progression-Free Survival (PFS) Rate at 6 Months Per RECIST v1.1

    PFS rate represents the percentage of participants without a first documented progression or death due to any cause after the start of study treatment. Tumor response was based on local investigator assessment as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1).

    PFS was modeled using a Weibull distribution and the PFS rate at 6 months was estimated from the posterior distribution.

    Measured: 6 months

Secondary outcomes (18)
  1. Overall Response Rate (ORR) Per RECIST v1.1

    Tumor response was based on local investigator assessment as per RECIST v1.1. ORR per RECIST 1.1 is defined as the percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR).

    For RECIST v1.1, CR=Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR= At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters.

    Measured: From start of treatment until end of treatment, assessed up to 4.7 years

  2. Disease Control Rate (DCR) Per RECIST v1.1

    Tumor response was based on local investigator assessment as per RECIST v1.1. DCR per RECIST 1.1 is defined as the percentage of participants with a best overall response of Complete Response (CR), Partial Response (PR) or Stable Disease (SD).

    For RECIST v1.1, CR=Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm; PR= At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters; SD= Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for progression.

    Measured: From start of treatment until end of treatment, assessed up to 4.7 years

  3. Median Progression-Free Survival (PFS) Per RECIST v1.1

    PFS is the time from the date of start of treatment to the date of event defined as the first documented progression or death due to any cause. If a patient has not had an event, progression-free survival is censored at the date of last adequate tumor assessment. The median PFS was estimated using the Kaplan-Meier method.

    Tumor response was based on local investigator assessment as per RECIST v1.1

    Measured: From start of treatment to first documented progression or death, assessed up to 5 years

  4. Progression-Free Survival (PFS) Rate at 3 Months Per RECIST v1.1

    PFS rate represents the percentage of participants without a first documented progression or death due to any cause after the start of study treatment. Tumor response was based on local investigator assessment as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1).

    The PFS rate at 3 months was estimated using the Kaplan-Meier method.

    Measured: 3 months

  5. Overall Survival (OS) at 1 Year

    OS represents the percentage of participants who are alive after the start of study treatment. OS at 1 year was estimated using the Kaplan-Meier method.

    Measured: 1 year

  6. Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Number of participants with AEs and SAEs, including changes from baseline in vital signs, electrocardiograms and laboratory results qualifying and reported as AEs.

    AE grades were based on the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

    Measured: From first dose of study medication up to 100 days after last dose of study medication, with a maximum duration of 5 years

  7. Number of Participants With Dose Reductions and Dose Interruptions of EGF816, INC280 and Nivolumab

    Number of participants with at least one dose reduction of EGF816, INC280 or nivolumab and number of participants with at least one dose interruption of EGF816, INC280 or nivolumab.

    Dose reduction was not allowed for nivolumab in this study.

    Measured: From first dose of study treatment until last dose of study treatment, up to maximum 4.7 years

  8. Dose Intensity of EGF816 and INC280

    Dose intensity (mg/day) of EGF816 and INC280 was calculated as actual cumulative dose in milligrams divided by duration of exposure in days.

    Measured: From first dose of study treatment until last dose of study treatment, up to maximum 4.7 years

  9. Dose Intensity of Nivolumab

    Dose intensity (mg/kg biweekly) of nivolumab was calculated as actual cumulative dose in mg/kg divided by duration of exposure in days and then multiplied by 14 days (2 weeks).

    Measured: From first dose of study treatment until last dose of study treatment, up to maximum 4.7 years

  10. Maximum Observed Plasma Concentration (Cmax) of EGF816

    Pharmacokinetic (PK) parameters were calculated based on EGF816 plasma concentrations by using non-compartmental methods. Cmax is defined as the maximum (peak) observed plasma concentration following a dose.

    Measured: pre-dose, 1, 3, 6 and 8 hours post EGF816 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  11. Time to Reach Maximum Plasma Concentration (Tmax) of EGF816

    Pharmacokinetic (PK) parameters were calculated based on EGF816 plasma concentrations by using non-compartmental methods. Tmax is defined as the time to reach maximum (peak) plasma concentration following a dose.

    Measured: pre-dose, 1, 3, 6 and 8 hours post EGF816 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  12. Area Under the Plasma Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUClast) of EGF816

    Pharmacokinetic (PK) parameters were calculated based on EGF816 plasma concentrations by using non-compartmental methods. The linear trapezoidal method was used for AUClast calculation.

    Measured: pre-dose, 1, 3, 6 and 8 hours post EGF816 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  13. Minimum Observed Plasma Concentration (Cmin) of EGF816

    Pharmacokinetic (PK) parameters were calculated based on EGF816 plasma concentrations by using non-compartmental methods. Cmin is defined as the minimum observed plasma concentration following a dose.

    Measured: pre-dose, 1, 3, 6 and 8 hours post EGF816 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  14. Maximum Observed Plasma Concentration (Cmax) of INC280

    Pharmacokinetic (PK) parameters were calculated based on INC280 plasma concentrations by using non-compartmental methods. Cmax is defined as the maximum (peak) observed plasma concentration following a dose.

    Measured: pre-dose, 1, 3, 6 and 8 hours post INC280 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  15. Time to Reach Maximum Plasma Concentration (Tmax) of INC280

    Pharmacokinetic (PK) parameters were calculated based on INC280 plasma concentrations by using non-compartmental methods. Tmax is defined as the time to reach maximum (peak) plasma concentration following a dose. Actual recorded sampling times were considered for the calculations.

    Measured: pre-dose, 1, 3, 6 and 8 hours post INC280 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  16. Area Under the Plasma Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUClast) of INC280

    Pharmacokinetic (PK) parameters were calculated based on INC280 plasma concentrations by using non-compartmental methods. The linear trapezoidal method was used for AUClast calculation.

    Measured: pre-dose, 1, 3, 6 and 8 hours post INC280 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  17. Minimum Observed Plasma Concentration (Cmin) of INC280

    Pharmacokinetic (PK) parameters were calculated based on INC280 plasma concentrations by using non-compartmental methods. Cmin is defined as the minimum observed plasma concentration following a dose.

    Measured: pre-dose, 1, 3, 6 and 8 hours post INC280 dose on Cycle 1 Day 15. The duration of one cycle was 28 days.

  18. Pre-dose Serum Concentration of Nivolumab

    Nivolumab serum concentrations were assessed in samples taken at pre-dose. Pre-dose samples were collected before the next dose administration.

    Measured: pre-dose on Cycle 1 Day 1 (groups 2A and 2B only) and pre-dose on Cycle 1 Day 15 and Cycle 2 Day 1 (all groups). The duration of one cycle was 28 days.

Timeline

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

  1. First posted23 Dec 2014 (estimated)
  2. Study start9 Feb 2015
  3. Primary completion23 Sep 2019
  4. Study completion5 Feb 2021

Why it stopped: Sponsor decision due to low patient recruitment caused by the change in the treatment landscape of NSCLC.

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
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02323126
Sponsor's protocol ID
CEGF816X2201C
Other IDs
2014-003731-20, 2014
Status last verified
Jan 2022
First submitted
18 Dec 2014
Last updated
28 Feb 2022
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Felip E, Metro G, Tan DSW, Wolf J, Mark M, Boyer M, Hughes BGM, Bearz A, Moro-Sibilot D, Le X, Puente J, Massuti B, Tiedt R, Wang Y, Xu C, Mardjuadi FI, Cobo M. Capmatinib plus nivolumab in pretreated patients with EGFR wild-type advanced non-small cell lung cancer. Lung Cancer. 2024 Jun;192:107820. doi: 10.1016/j.lungcan.2024.107820. Epub 2024 May 10.

    PubMed 38763104

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing EGF816, INC280 and Nivolumab in people with Non Small Cell Lung Cancer, run by Novartis Pharmaceuticals at 13 sites in 8 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 11 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: stopped early, as of the sponsor's last update on 28 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Spain, Australia, Italy, United States, France and 3 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 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 15 Jun 2021). 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 (PFS) Rate at 6 Months Per RECIST v1.1 (time frame: 6 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 NCT02323126, 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 28 Feb 2022.

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