This open-label, randomized, multicenter study will evaluate the efficacy and safety of bevacizumab (Avastin) in combination with standard of care (SOC) treatment in participants with advanced non-squamous NSCLC. Participants will be enrolled at documentation of progression of disease (PD) after 4-6 cycles of first-line treatment with bevacizumab plus a platinum doublet-containing therapy and a minimum of two cycles of bevacizumab maintenance treatment prior to PD. Participants will be randomly assigned to one of two treatment arms to receive either bevacizumab plus SOC treatment or SOC treatment alone.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
485
Participants will receive bevacizumab 7.5 or 15 milligrams per kilogram (mg/kg) intravenously.
Docetaxel 60 or 75 milligram per meter square (mg/m\^2) on Day 1 every 21 days.
Erlotinib 150 mg daily taken on an empty stomach at least one hour before or two hours after the ingestion of food.
Pemetrexed 500 mg/m\^2 IV over 10 minutes on Day 1 every 21 days.
USA Mitchell Cancer Institute
Mobile, Alabama, United States
Palo Verde Hema/Onc
Glendale, Arizona, United States
Arizona Center for Cancer Care
Glendale, Arizona, United States
Clopton Clinic
Jonesboro, Arkansas, United States
East Valley Hematology ; Oncology Medical Group
Burbank, California, United States
Overall Survival (OS)
Overall survival (OS) was defined as the time from the date of randomization at first progression of disease to the date of death, regardless of the cause of death.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Progression-free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
PFS was defined as the time from start of treatment to the first event of death or PD. Tumor response was assessed by the IRF according to RECIST v1.1. Disease progression or PD was defined as ≥20% increase in sum LD in reference to the smallest on-study sum LD, or the appearance of new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PFS2 is defined as the time between randomization at PD1 and the date of PD2 or death, whichever occurs first. PFS3 is defined as the time between PD2 and the date of PD3 or death, whichever occurs first.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Percentage of Participants With Objective Response According to RECIST v1.1
The objective response is defined as complete response (CR) or partial response (PR) assessed according to the RECIST v.1.1 criteria with baseline tumour assessment as the reference. CR was defined as disappearance of all target and non-target lesions and (if applicable) normalization of tumor marker levels. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR was defined as greater than or equal to (≥) 30 percent (%) decrease in sum of longest diameter (LD) of target lesions in reference to Baseline sum LD. Response was to be confirmed ≥4 weeks after the initial assessment of CR or PR.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Percentage of Participants With Disease Control According to RECIST v1.1
The disease control rate is defined as CR or PR or stable disease (SD) assessed according to the RECIST v.1.1 criteria with baseline tumour assessment as the reference. SD was defined as neither sufficient shrinkage to qualify for a PR nor sufficient increase to qualify for PD, taking as reference the smallest sum of the longest diameter since treatment started for target lesions and the persistence of 1 or more non-target lesions.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Duration of Response (DoR) According to RECIST v1.1
Duration of response is defined as the time that measurement criteria are met for objective response (CR/PR) (whichever status is recorded first) until the first date of progression or death is documented. CR was defined as disappearance of all target and non-target lesions and (if applicable) normalization of tumor marker levels. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than \< 10 mm. PR was defined as greater than or equal to ≥30 % decrease in sum of longest diameter of target lesions in reference to baseline sum longest diameter.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug. Preexisting conditions that worsened during the study and laboratory or clinical tests that resulted in a change in treatment or discontinuation from study drug were reported as adverse events. A SAE was any experience that: resulted in death, was life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or was medically significant.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Time to Progression (TTP) According to RECIST v1.1
The time to progression was defined as the time from baseline until disease progression as determined by the RECIST v1.1. TTP2 is defined as the interval between the day of randomization at PD1 and PD2. TTP3 is defined as the interval between the day of PD2 and PD3. PD was defined as ≥20% increase in sum LD in reference to the smallest on-study sum LD, or the appearance of new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
Time frame: Up to data cut-off date 24 June 2016 (approximately 5 years)
Percentage of Participants Who Are Alive at Month 6, 12, and 18
Percentage of participants who were alive at Month 6, 12 and 18 were reported.
Time frame: Month 6, 12, 18
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California Cancer Associates for Research & Excellence, Inc.
Encinitas, California, United States
Scripps Clinic; Hematology & Oncology
La Jolla, California, United States
Sutter Cancer Center
Sacramento, California, United States
Coastal Integrative Cancer Care
San Luis Obispo, California, United States
Innovative Clinical Research Institute
Whittier, California, United States
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