Title

Evaluation of FKB238 and Avastin in Patients With Advanced/Recurrent Non-squamous Non-small Cell Lung Cancer
A Randomised, Parallel, Double Blinded Study to Compare the Efficacy and Safety of FKB238 to Avastin® In 1st Line Treatment for Patients With Advanced/Recurrent Non Squamous NSCLC in Combination of Paclitaxel and Carboplatin
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    731
The purpose of this research study is to compare the effectiveness and safety of FKB238 against Avastin® in men and women with advanced/recurrent non squamous non-small cell lung cancer
Study Started
Sep 07
2016
Primary Completion
Jan 24
2019
Study Completion
Jan 26
2022
Results Posted
Mar 19
2020
Last Update
Mar 10
2022

Drug FKB238 (bevacizumab)

Drug Avastin (bevacizumab)

Drug Paclitaxel

Drug Carboplatin

FKB238 / paclitaxel / carboplatin Experimental

Drug: FKB238: 15 mg/kg IV infusion on Day 1 of each 21-day cycle. Drug: Paclitaxel: 200 mg/m2 IV infusion on Day 1 of each 21-day cycle for at least 4 and no more than 6 cycles. Drug: Carboplatin: Area Under Curve (AUC) = 6.0 IV infusion on Day 1 of each 21-day cycle for at least 4 and no more than 6 cycles.

Avastin / paclitaxel / carboplatin Active Comparator

Drug: Avastin: 15 mg/kg IV infusion on Day 1 of each 21-day cycle. Drug: Paclitaxel: 200 mg/m2 IV infusion on Day 1 of each 21-day cycle for at least 4 and no more than 6 cycles. Drug: Carboplatin: AUC = 6.0 IV infusion on Day 1 of each 21-day cycle for at least 4 and no more than 6 cycles.

Criteria

Inclusion Criteria:

Patients aged 18 years or older
Newly diagnosed advanced (stage IV) /recurrent non-squamous NSCLC for which they had not received any systemic anti-cancer therapy for metastatic disease
Histologically or cytologically confirmed diagnosis of predominantly non-squamous NSCLC
Existence of at least 1 measurable lesion by RECIST v1.1
Adequate hematological, renal and liver function
Eastern Collaborative Oncology Group Performance Status (ECOG PS) 0 or 1
Life expectancy longer than 6 months

Exclusion Criteria:

Small cell lung cancer (SCLC) or combination SCLC and NSCLC. Squamous-cell tumors and mixed adenosquamous carcinomas of predominantly squamous nature
Any unresolved toxicities from prior systemic therapy
Known sensitizing epidermal growth factor receptor (EGFR) mutations or echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation positive mutations
Previous dosing with vascular endothelial growth factor (VEGF) inhibitor
Known hypersensitivity to any excipients of the Investigational Products (IPs) and combination chemotherapy
Use of prohibited concomitant medication
Known Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV) infection
Fertile men or women of childbearing potential not using adequate contraception.

Other inclusion/exclusion criteria may apply.

Summary

Avastin / Paclitaxel / Carboplatin

FKB238 / Paclitaxel / Carboplatin

All Events

Event Type Organ System Event Term FKB238 / Paclitaxel / Carboplatin Avastin / Paclitaxel / Carboplatin

Overall Response Rate (ORR) Assessed as the Proportion of Patients With a Best Overall Response (BOR) of Either Complete Response (CR) or Partial Response (PR)

The primary variable in this study was ORR, defined as the proportion of patients with a BOR of CR or PR (by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)). A BOR was defined as the best response (in the order of CR, PR, stable disease (SD), no evidence of disease (NED), progressive disease (PD), and not evaluable (NE)) among all post-baseline disease assessments that occurred until progression, or last evaluable assessment in the absence of progression prior to the initiation of subsequent anti-cancer therapy, irrespective of whether or not patients discontinued the study treatment. The 95% Pearson-Clopper confidence interval (CI) of ORR for each treatment arm was provided. Per RECIST v1.1 for target lesions and assessed by computed tomography (CT) or, if contraindicated, magnetic resonance imaging (MRI): CR=disappearance of all target lesions; PR=at least 30% decrease from baseline in the sum of diameters of target lesions. Overall Response=CR+PR.

FKB238 / Paclitaxel / Carboplatin

51.6
percentage of participants
95% Confidence Interval: 46.38 to 56.89

Avastin / Paclitaxel / Carboplatin

53.7
percentage of participants
95% Confidence Interval: 48.43 to 58.87

ORR at Week 19

ORR (by RECIST v1.1) at Week 19 was defined as the proportion of patients with a BOR of CR or PR assessed at Week 19. Only tumor assessments performed up until 19 weeks (i.e. Week 18 assessment + 7 day assessment window) from randomization were considered in this analysis. Per RECIST v1.1 for target lesions and assessed by CT or, if contraindicated, MRI: CR=disappearance of all target lesions; PR=at least 30% decrease from baseline in the sum of diameters of target lesions. Overall Response=CR+PR.

FKB238 / Paclitaxel / Carboplatin

47.8
percentage of participants
95% Confidence Interval: 42.57 to 53.07

Avastin / Paclitaxel / Carboplatin

51.0
percentage of participants
95% Confidence Interval: 45.71 to 56.18

Progression-free Survival (PFS)

The event of interest for PFS was defined as the interval from the date of randomization until first documented disease progression or death from any cause, whichever occurs first. Disease progression was based on tumor assessments according to RECIST v1.1 criteria. The items of the overall response CR, PR, SD and NED were taken as progression-free whereas PD denoted disease progression. PFS was summarized using Kaplan-Meier estimates of the quartiles for each treatment arm, and 95% CIs for the medians were calculated. Per RECIST v1.1 for target lesions and assessed by CT or, if contraindicated, MRI: PD=at least a 20% increase in the sum of the longest diameter of target lesions, unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions.

FKB238 / Paclitaxel / Carboplatin

7.72
Months (Median)
95% Confidence Interval: 7.46 to 7.98

Avastin / Paclitaxel / Carboplatin

7.62
Months (Median)
95% Confidence Interval: 6.9 to 7.82

Overall Survival (OS)

The event of interest was defined as death from any cause. OS was defined as the interval from date of randomization until the date of death due to any cause. OS was summarized using Kaplan-Meier estimates of the quartiles for each treatment arm, and 95% CIs for the medians were calculated.

FKB238 / Paclitaxel / Carboplatin

14.13
Months (Median)
95% Confidence Interval: 12.52 to 16.56

Avastin / Paclitaxel / Carboplatin

16.95
Months (Median)
95% Confidence Interval: 14.65 to 19.02

Duration Of Response (DOR)

DOR was evaluated in this study as a secondary efficacy endpoint. Only the patients defined as responders in the primary analysis of ORR were taken into account for the analysis of DOR. The event of interest was defined as first documented disease progression or death due to any reason, whichever occurred first. DOR was defined as the interval from the first documented response (as defined per RECIST v1.1) until the earlier date of the first documented disease progression or death due to any reason. The date of first documented response was taken as the date of the first tumor assessment with an overall visit response of CR or PR. Per RECIST v1.1 for target lesions and assessed by CT or, if contraindicated, MRI: CR=disappearance of all target lesions; PR=at least 30% decrease from baseline in the sum of diameters of target lesions. DOR was calculated in units of months.

FKB238 / Paclitaxel / Carboplatin

6.47
months (Median)
95% Confidence Interval: 5.39 to 7.69

Avastin / Paclitaxel / Carboplatin

6.31
months (Median)
95% Confidence Interval: 4.93 to 7.29

Disease Control Rate (DCR) Assessed as the Proportion of Patients With a BOR of Either CR, PR, SD or NED

The DCR was defined as the proportion of patients defined as responders. The number and percentage of responders and non-responders and the 95% Pearson-Clopper CI of DCR for each treatment arm was provided. The odds ratio for treatment (FKB238 arm versus Avastin arm) and the corresponding 95% Wald CI were produced based on a logistic regression analysis of DCR. Per RECIST v1.1 for target lesions and assessed by CT or, if contraindicated, MRI: CR=disappearance of all target lesions; PR=at least 30% decrease from baseline in the sum of diameters of target lesions; SD=neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum of diameters while on study. DCR=CR+PR+SD (≥ 6 weeks).

FKB238 / Paclitaxel / Carboplatin

87.6
percentage of participants with response
95% Confidence Interval: 83.81 to 90.84

Avastin / Paclitaxel / Carboplatin

87.5
percentage of participants with response
95% Confidence Interval: 83.64 to 90.68

Serum Trough Concentration (Ctrough)

Ctrough (pre-infusion) and serum maximum concentration (Cmax; at completion of infusion) were compared between treatment arms and time points, and descriptive statistics provided. Ctrough and Cmax concentrations were summarized using the pharmacokinetics (PK) population for each visit at which samples were taken. The pre-dose serum concentrations at Cycles 2, 4, and 6 were considered as Ctrough values and the post-dose serum concentrations at Cycles 1 and 4 were considered as Cmax values. PK data at Cycle 1 Day 1 pre-infusion were not calculable and are therefore not presented in the outcome measure data table. Data are only provided for the time points at which the serum trough concentration was measured.

FKB238 / Paclitaxel / Carboplatin

Cycle 1, Day 1 end of infusion

255.15
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 184.3

Cycle 2, Day 1 pre-infusion

42.74
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 91.9

Cycle 4, Day 1 end of infusion

339.91
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 91.3

Cycle 4, Day 1 pre-infusion

77.16
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 69.4

Cycle 6, Day 1 pre-infusion

87.25
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 124.5

Avastin / Paclitaxel / Carboplatin

Cycle 1, Day 1 end of infusion

245.11
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 206.8

Cycle 2, Day 1 pre-infusion

48.48
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 77.3

Cycle 4, Day 1 end of infusion

373.92
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 51.6

Cycle 4, Day 1 pre-infusion

83.26
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 85.5

Cycle 6, Day 1 pre-infusion

108.22
ug/ml (Geometric Mean)
Geometric Coefficient of Variation: 69.8

Proportion of Patients Developing Anti-drug Antibodies (ADAs)

The ADA levels were summarized at baseline and post-baseline time points using descriptive statistics.

FKB238 / Paclitaxel / Carboplatin

ADA prevalence (ADA positive, baseline or post)

3.0
percentage of participants

Treatment-emergent ADA positive (ADA incidence)

2.3
percentage of participants

Avastin / Paclitaxel / Carboplatin

ADA prevalence (ADA positive, baseline or post)

3.0
percentage of participants

Treatment-emergent ADA positive (ADA incidence)

2.3
percentage of participants

Adverse Events (AEs)

Outcome Measure Data Not Reported

Vital Signs

Outcome Measure Data Not Reported

Hematology

Outcome Measure Data Not Reported

Clinical Chemistry

Outcome Measure Data Not Reported

Urinalysis

Outcome Measure Data Not Reported

Electrocardiogram

Outcome Measure Data Not Reported

Eastern Collaborative Oncology Group Performance Status

Outcome Measure Data Not Reported

Physical Examination

Outcome Measure Data Not Reported

Total

731
Participants

Age, Customized

Race/Ethnicity, Customized

Sex: Female, Male

Overall Study

FKB238 / Paclitaxel / Carboplatin

Avastin / Paclitaxel / Carboplatin

Drop/Withdrawal Reasons

FKB238 / Paclitaxel / Carboplatin

Avastin / Paclitaxel / Carboplatin