Trial Outcomes & Findings for Efficacy, Safety, Tolerability of Gefitinib as 1st Line in Caucasian Patients With EGFR Mutation Positive Advanced NSCLC (NCT NCT01203917)

NCT ID: NCT01203917

Last Updated: 2017-01-02

Results Overview

% of patients in the Full analysis set who have a complete response \[CR\] or partial response \[PR\] confirmed by repeat imaging at least 4 weeks later with no evidence of progression between confirmation visits (as defined by Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1)). CR: disappearance of all target lesions (TLs) \& non-target lesions (NTLs). PR: \>= 30% decrease in the sum of diameters compared to baseline (with no evidence of progression) and the NTLs are at least stable with no evidence of new lesions. Outcome is based on measurements made at site by investigator.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

1060 participants

Primary outcome timeframe

Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Results posted on

2017-01-02

Participant Flow

1060 Caucasian patients with locally advanced or metastatic NSCLC were screened, and 118 patients had activating sensitizing EGFR mutation eligible for the study (EGFR M+). 106 EGFR M+ patients received at least 1 dose of gefitinib. One patient had EGFR mutation not eligible for the study (EGFR M+I) and was started on gefitinib in error.

Participant milestones

Participant milestones
Measure
Gefitinib
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Overall Study
STARTED
107
Overall Study
COMPLETED
71
Overall Study
NOT COMPLETED
36

Reasons for withdrawal

Reasons for withdrawal
Measure
Gefitinib
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Overall Study
Death
29
Overall Study
Lost to Follow-up
2
Overall Study
Withdrawal by Subject
3
Overall Study
Due to objective disease progression
1
Overall Study
Due to EGFR M+I patient
1

Baseline Characteristics

Efficacy, Safety, Tolerability of Gefitinib as 1st Line in Caucasian Patients With EGFR Mutation Positive Advanced NSCLC

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Age, Continuous
64.0 Years
STANDARD_DEVIATION 11.81 • n=99 Participants
Age, Customized
> =18 to < 65 Years
52 Participants
n=99 Participants
Age, Customized
> =65 to < 75 Years
28 Participants
n=99 Participants
Age, Customized
> =75 Years
26 Participants
n=99 Participants
Gender
Female
75 Participants
n=99 Participants
Gender
Male
31 Participants
n=99 Participants
Race/Ethnicity, Customized
White
106 Participants
n=99 Participants
Race/Ethnicity, Customized
Other
0 Participants
n=99 Participants

PRIMARY outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

% of patients in the Full analysis set who have a complete response \[CR\] or partial response \[PR\] confirmed by repeat imaging at least 4 weeks later with no evidence of progression between confirmation visits (as defined by Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1)). CR: disappearance of all target lesions (TLs) \& non-target lesions (NTLs). PR: \>= 30% decrease in the sum of diameters compared to baseline (with no evidence of progression) and the NTLs are at least stable with no evidence of new lesions. Outcome is based on measurements made at site by investigator.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Objective Response Rate (ORR) (Investigator)
% Responders
69.8 Percentage of Participants
Objective Response Rate (ORR) (Investigator)
% Non-responders
30.2 Percentage of Participants

SECONDARY outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

DCR is calculated as the % of the FAS patient population with a best visit response of CR, PR (a visit response of CR or PR which is confirmed at least 4 weeks later) or stable disease (SD). SD is defined as no evidence of CR, PR or progression and must have occurred at a minimum of 6 weeks after first dose of study treatment. (progression is defined as ≥20% increase in the sum of the diameters of target lesions from minimum; clinically significant progression in non-target lesions; the presence of a new lesion or death). Outcome is based on measurements made at site by investigator.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Disease Control Rate (DCR) (Investigator)
% Uncontrolled
9.4 Percentage of Participants
Disease Control Rate (DCR) (Investigator)
% Controlled
90.6 Percentage of Participants

SECONDARY outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

PFS was defined as the time from the first dose of gefitinib study treatment until objective disease progression as defined by RECIST 1.1 (≥20% increase in the sum of the diameters of target lesions from minimum, clinically significant progression in non-target lesions or the presence of a new lesion) or death (by any cause in the absence of progression). Progression is based on measurements made at site by investigator.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Progression - Free Survival (PFS) (Investigator)
9.72 Months
Interval 8.48 to 11.04

SECONDARY outcome

Timeframe: Survival follow up from first dose of gefitinib till death of the patient or till end of study in absence of death.

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

OS was defined as the time from first dose of gefitinib study treatment until death by any cause. Patients who had not died at the time of analysis were censored at the last date the patient was known to be alive.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Overall Survival (OS)
19.22 Months
Interval 16.95 to
The upper limit of 95% Confidence interval for Overall Survival was longer than 19.22 and was not observed during the trial period.

OTHER_PRE_SPECIFIED outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

DCR is calculated as the % of the FAS patient population with a best visit response of CR, PR (a visit response of CR or PR which is confirmed at least 4 weeks later) or stable disease (SD). SD is defined as no evidence of CR, PR or progression and must have occurred at a minimum of 6 weeks after first dose of study treatment. (progression is defined as ≥20% increase in the sum of the diameters of target lesions from minimum; clinically significant progression in non-target lesions; the presence of a new lesion or death). Outcome is based on measurements of scans by central review.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Disease Control Rate (DCR) (Independent Central Review)
% Controlled
88.7 Percentage of Participants
Disease Control Rate (DCR) (Independent Central Review)
% Uncontrolled
11.3 Percentage of Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

% of patients in the Full analysis set who have a complete response \[CR\] or partial response \[PR\] confirmed by repeat imaging at least 4 weeks later with no evidence of progression between confirmation visits (as defined by Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1)). CR: disappearance of all target lesions (TLs) \& non-target lesions (NTLs). PR: \>= 30% decrease in the sum of diameters compared to baseline (with no evidence of progression) and the NTLs are at least stable with no evidence of new lesions. Outcome is based on measurements of scans by central review.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Objective Response Rate (ORR) (Independent Central Review))
% Responders
50.0 Percentage of Participants
Objective Response Rate (ORR) (Independent Central Review))
% Non-responders
50.0 Percentage of Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Scans taken at baseline and then follow up assessments taken every 6 weeks until progression, or last evaluable assessment in the absence of progression, assessed up to 23 months

Population: Full analysis set, EGFR M+ patients who had taken at least 1 dose of gefitinib

PFS was defined as the time from the first dose of gefitinib study treatment until objective disease progression as defined by RECIST 1.1 (≥20% increase in the sum of the diameters of target lesions from minimum, clinically significant progression in non-target lesions or the presence of a new lesion) or death (by any cause in the absence of progression). Progression is based on measurements of scans by central review.

Outcome measures

Outcome measures
Measure
Gefitinib
n=106 Participants
Gefitinib 250 mg oral tablets once daily, administered continuously from Visit 2 until objective disease progression was documented or any other criterion for discontinuation was met. Gefitinib tablets were taken at approximately the same time each day.
Progression - Free Survival (PFS) (Independent Central Review)
6.97 Months
Interval 6.41 to 9.86

Adverse Events

Gefitinib 250 mg

Serious events: 21 serious events
Other events: 87 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Gefitinib 250 mg
n=107 participants at risk
Blood and lymphatic system disorders
ANAEMIA
0.93%
1/107 • Number of events 1
Cardiac disorders
CARDIAC FAILURE
1.9%
2/107 • Number of events 3
Ear and labyrinth disorders
VERTIGO
0.93%
1/107 • Number of events 1
Gastrointestinal disorders
DIARRHOEA
1.9%
2/107 • Number of events 2
Gastrointestinal disorders
VOMITING
2.8%
3/107 • Number of events 3
General disorders
ASTHENIA
0.93%
1/107 • Number of events 1
Infections and infestations
GASTROENTERITIS
0.93%
1/107 • Number of events 1
Infections and infestations
PNEUMONIA
2.8%
3/107 • Number of events 3
Infections and infestations
POSTOPERATIVE WOUND INFECTION
0.93%
1/107 • Number of events 1
Infections and infestations
VIRAL INFECTION
0.93%
1/107 • Number of events 1
Injury, poisoning and procedural complications
ANKLE FRACTURE
0.93%
1/107 • Number of events 1
Injury, poisoning and procedural complications
FEMORAL NECK FRACTURE
0.93%
1/107 • Number of events 1
Injury, poisoning and procedural complications
RADIUS FRACTURE
0.93%
1/107 • Number of events 1
Injury, poisoning and procedural complications
TIBIA FRACTURE
0.93%
1/107 • Number of events 1
Metabolism and nutrition disorders
DECREASED APPETITE
0.93%
1/107 • Number of events 1
Nervous system disorders
DEMENTIA ALZHEIMER'S TYPE
0.93%
1/107 • Number of events 1
Nervous system disorders
HYPOAESTHESIA
0.93%
1/107 • Number of events 1
Nervous system disorders
SENILE DEMENTIA
0.93%
1/107 • Number of events 1
Nervous system disorders
TRANSIENT ISCHAEMIC ATTACK
0.93%
1/107 • Number of events 1
Respiratory, thoracic and mediastinal disorders
HAEMOPTYSIS
0.93%
1/107 • Number of events 1
Respiratory, thoracic and mediastinal disorders
PLEURAL EFFUSION
1.9%
2/107 • Number of events 2
Respiratory, thoracic and mediastinal disorders
PULMONARY EMBOLISM
0.93%
1/107 • Number of events 1
Skin and subcutaneous tissue disorders
SKIN NECROSIS
0.93%
1/107 • Number of events 1
Vascular disorders
HYPERTENSION
1.9%
2/107 • Number of events 2

Other adverse events

Other adverse events
Measure
Gefitinib 250 mg
n=107 participants at risk
Gastrointestinal disorders
DIARRHOEA
29.0%
31/107 • Number of events 55
Gastrointestinal disorders
NAUSEA
10.3%
11/107 • Number of events 14
Gastrointestinal disorders
VOMITING
11.2%
12/107 • Number of events 13
General disorders
ASTHENIA
11.2%
12/107 • Number of events 12
Infections and infestations
URINARY TRACT INFECTION
6.5%
7/107 • Number of events 10
Investigations
ALANINE AMINOTRANSFERASE INCREASED
8.4%
9/107 • Number of events 10
Investigations
ASPARTATE AMINOTRANSFERASE INCREASED
6.5%
7/107 • Number of events 8
Metabolism and nutrition disorders
DECREASED APPETITE
9.3%
10/107 • Number of events 11
Nervous system disorders
HEADACHE
5.6%
6/107 • Number of events 6
Respiratory, thoracic and mediastinal disorders
COUGH
11.2%
12/107 • Number of events 12
Respiratory, thoracic and mediastinal disorders
DYSPNOEA
6.5%
7/107 • Number of events 7
Skin and subcutaneous tissue disorders
DERMATITIS ACNEIFORM
6.5%
7/107 • Number of events 7
Skin and subcutaneous tissue disorders
DRY SKIN
11.2%
12/107 • Number of events 13
Skin and subcutaneous tissue disorders
RASH
46.7%
50/107 • Number of events 65
Vascular disorders
HYPERTENSION
5.6%
6/107 • Number of events 6

Additional Information

Haiyi Jiang

AstraZeneca

Phone: +86 21 60302408

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60