A Study to Evaluate the Efficacy of Bevacizumab in Combination With Tarceva for Advanced Non-Small Cell Lung Cancer

A Phase III, Multicenter, Placebo-Controlled, Double-Blind, Randomized Clinical Trial to Evaluate the Efficacy of Bevacizumab in Combination With Tarceva (Erlotinib) Compared With Tarceva Alone for Treatment of Advanced Non-Small Cell Lung Cancer (NSCLC) After Failure of Standard First-Line Chemotherapy

This is a Phase III, multicenter, placebo-controlled, double-blind, randomized study. Approximately 650 patients will be randomized in a 1:1 ratio to one of two treatment arms.

Inclusion Criteria:

• Signed written informed consent
• Cytologically or histologically confirmed NSCLC
• Clinical or radiographic progression during or after first-line chemotherapy or chemoradiotherapy for NSCLC
• Consent to provide archival tissue for analysis is required for participation in this study
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
• Age ≥ 18 years
• Use of an acceptable means of contraception for men and women of childbearing potential
• International normalized ratio (INR) no greater than 1.3 and an aPTT no greater than the upper limits of normal within 28 days prior to enrollment for patients not on low-molecular-weight heparin or fondaparinux

Exclusion Criteria:

• Squamous cell carcinoma
• Prior treatment with an investigational or marketed inhibitor of the Epidermal Growth Factor Receptor (EGFR) pathway or anti-angiogenesis agent
• Systemic chemotherapy, radiotherapy, or investigational treatment within 28 days prior to randomization
• Local palliative radiotherapy within 14 days prior to randomization or persistent adverse effects from radiotherapy that have not resolved to Grade 2 or less following completion of treatment
• Whole brain radiotherapy or stereotactic radiosurgery for brain metastases within 4 weeks of Day 0
• Neurosurgery for brain metastases within 24 weeks of Day 0
• Brain biopsy within 12 weeks of Day 0
• Current use of dexamethasone for treatment associated with brain metastases
• History of gross hemoptysis within 3 months prior to randomization unless definitively treated with surgery or radiation
• History of any of the following within 6 months prior to Day 0: serious systemic disease, uncontrolled hypertension, unstable angina, New York Heart Association (NYHA) Grade 2 or greater Congestive Heart Failure (CHF), unstable symptomatic arrhythmia requiring medication, clinically significant peripheral vascular disease, abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess
• Evidence of bleeding diathesis or coagulopathy or other serious or acute internal bleeding within 6 months prior to randomization
• Central Nervous System (CNS) bleeding; history or clinical evidence of CNS stroke (hemorrhagic or thrombotic) within the last 6 months
• Progressive neurologic symptoms in patients with a history of brain metastases
• Full-dose anticoagulation with warfarin
• Chronic daily use of aspirin or other full-dose nonsteroidal anti-inflammatory drugs (NSAIDs) with anti-platelet activity
• In-patient surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to randomization
• Minor surgical procedure, fine needle aspirations or core biopsy within 7 days prior to randomization
• Anticipation of need for a major surgical procedure during the course of the study
• Serious, non-healing wound, ulcer, or bone fracture
• Inability to take oral medication or requirement for intravenous (IV) alimentation or total parenteral nutrition with lipids, or prior surgical procedures affecting absorption
• Pregnancy or breast-feeding
• Presence of another invasive cancer within 5 years prior to randomization
• Evidence of confusion or disorientation, or history of major psychiatric illness that may impair the patient's understanding of the Informed Consent Form or their ability to comply with study requirements