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| ID | Type | Description | Link |
|---|---|---|---|
| 2013-004382-13 | EudraCT Number |
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This open-label, multicenter study will assess the safety, tolerability, and pharmacokinetics of intravenous (IV) dosing of atezolizumab in combination with oral erlotinib or alectinib in participants with NSCLC.
This study has two stages. In the erlotinib group, the combination treatment will be given to participants with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI)-treatment-naive, advanced (nonresectable) NSCLC in a safety-evaluation stage and to participants with previously untreated EGFR mutation-positive, advanced NSCLC in an expansion stage (Stage 2). In the alectinib group, for both the safety-evaluation and expansion stages (Stages 1 and 2), the combination will be given to participants who are treatment-naive with anaplastic lymphoma kinase (ALK)-positive advanced NSCLC.
In Stage 1, erlotinib will be given at a starting dose of 150 milligrams (mg) by mouth (PO) once daily (QD) and the starting dose of alectinib will be 600 mg twice daily (BID), for 28 consecutive days during Cycle 1 and on Days 1 through 21 of each cycle thereafter. The starting dose of atezolizumab will be 1200 mg, administered every 3 weeks (q3W) starting on Day 8 of Cycle 1. If the starting regimen for a combination treatment is not tolerated, alternative doses and/or schedules of erlotinib and atezolizumab or alectinib and atezolizumab may be tested to determine potential recommended Phase 2 dose (RP2D) for that combination treatment. In Stage 2, a potential RP2D and schedule for each combination treatment will be investigated in an expansion cohort.
For both stages, continuation of treatment beyond Cycle 1 will be at the discretion of the treating investigator. Study treatment will be discontinued in participants who experience disease progression or unacceptable toxicity, are not compliant with the study protocol, or, in their opinion or in the opinion of the investigator, are not benefiting from study treatment. However, in the absence of unacceptable toxicity, participants with second-line or greater NSCLC who are still receiving atezolizumab at the time of radiographic disease progression may be permitted to continue study treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stage 1: Alectinib and Atezolizumab | Experimental | In Stage 1, starting dose of atezolizumab will be 1200 mg IV q3w administered on Day 8 of Cycle 1 and on Day 1 (21-day cycle) of each cycle thereafter along with alectinib at a starting dose of 600 mg PO BID for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter; unless maximum tolerable dose (MTD) is exceeded. The combination will be given to treatment-naive participants with ALK-positive, locally advanced or metastatic NSCLC. |
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| Stage 1: Erlotinib and Atezolizumab | Experimental | In Stage 1, starting dose of atezolizumab will be 1200 mg IV q3w administered on Day 8 of Cycle 1 and on Day 1 (21-day cycles) of each cycle thereafter along with erlotinib at a starting dose of 150 mg PO QD, for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter; unless MTD is exceeded. The combination will be given to participants with EGFR TKI treatment-naive, locally advanced or metastatic NSCLC. |
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| Stage 2: Alectinib and Atezolizumab | Experimental | In Stage 2, participants received the RP2D on the basis of the MTD or maximum allowed dose (MAD) of the combination treatment established in Stage 1. Treatment-naive participants with ALK-positive, locally advanced or metastatic NSCLC will be included. |
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| Stage 2: Erlotinib and Atezolizumab | Experimental | In Stage 2, participants received the RP2D on the basis of the MTD or MAD of the combination treatment established in Stage 1. Previously untreated (or with one prior treatment that was not an EGFR TKI), EGFR mutation positive, locally advanced or metastatic NSCLC participants will be included. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Alectinib | Drug | Participants will receive 600 mg PO alectinib BID for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter (21-day cycles from Cycle 2 onwards) in Stage 1 and RP2D PO BID in Stage 2. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants with Dose-Limiting Toxicities (DLTs) | 28 days | |
| Recommended Phase II Dose (RP2D) of Atezolizumab and Erlotinib | 28 days | |
| Recommended RP2D of Atezolizumab and Alectinib | 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Minimum Plasma Concentration (Cmin) of Alectinib and Major Metabolites, as Appropriate | Pre-dose (0 hour) on Day 1 of Cycles 1-4, Day 8 of Cycle 1 (Cycle 1 =28 days; Cycle 2 onwards=21 days) | |
| Progression-Free Survival (PFS) as Assessed Using the Response Evaluation Criteria in Solid Tumors (RECIST) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Clinical Trials | Hoffmann-La Roche | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UC Irvine Medical Center | Orange | California | 92868 | United States | ||
| Yale University School Of Medicine |
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| Atezolizumab | Drug | Participants will receive 1200 mg atezolizumab IV infusion q3w on Day 8 of Cycle 1 and on Day 1 of each cycle thereafter in Stage 1 and in Stage 2. |
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| Erlotinib | Drug | Participants will receive 150 mg erlotinib PO QD for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter in Stage 1 (21-day cycles from Cycle 2 onwards) and RP2D PO QD in Stage 2. |
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| First dose of study treatment up to disease progression or death from any cause (up to approximately 6 years) |
| Overall Survival | First dose of study treatment up to death from any cause during the study (up to approximately 6 years) |
| Percentage of Participants with Objective Response (Complete Response [CR] or Partial Response [PR]) Using RECIST | Baseline up to disease progression or death from any cause (up to approximately 6 years) |
| Percentage of Participants with Adverse Events | Baseline up to approximately 6 years |
| Percentage of Participants with Anti-Drug Antibodies (ADAs) Against Atezolizumab | Baseline up to approximately 6 years |
| Maximum Serum Concentration (Cmax) of Atezolizumab | Day 1 of Cycles 1-4, Day 8 of Cycle 1 (Cycle 1 =21 days; Cycle 2 onwards=28 days) |
| Minimum Serum Concentration (Cmin) of Atezolizumab | Pre-dose (0 hour) on Day 1 of Cycles 1, 2, 3, 4, 6, and 8 and at study termination (up to approximately 5 years; Cycle 1=21 days; Cycle 2 onwards=28 days) |
| Maximum Plasma Concentration (Cmax) of Erlotinib | Day 1 of Cycles 1-4, Day 8 of Cycle 1 (Cycle 1 =21 days; Cycle 2 onwards=28 days) |
| Minimum Plasma Concentration (Cmin) of Erlotinib | Pre-dose (0 hour) on Day 1 of Cycles 1-4, Day 8 of Cycle 1 (Cycle 1 =21 days; Cycle 2 onwards=28 days) |
| Maximum Plasma Concentration (Cmax) of Alectinib and Major Metabolites, as Appropriate | Day 1 of Cycles 1-4, Day 8 of Cycle 1 (Cycle 1 =21 days; Cycle 2 onwards=28 days) |
| Duration of Objective Response as Assessed Using RECIST | First occurrence of a documented objective response up to disease progression or death from any cause (up to approximately 6 years) |
| Percentage of Participants with Best Overall Response | Baseline up to disease progression or death from any cause (up to approximately 6 years) |
| New Haven |
| Connecticut |
| 06510 |
| United States |
| Florida Hospital Cancer Inst | Orlando | Florida | 32804 | United States |
| University of Chicago | Chicago | Illinois | 60637 | United States |
| Massachusetts General Hospital;Hematology/ Oncology | Boston | Massachusetts | 02114 | United States |
| Beth Israel Deaconess Med Ctr; Neurology/MS Center | Boston | Massachusetts | 02215 | United States |
| Dana Farber Cancer Institute | Boston | Massachusetts | 02215 | United States |
| Karmanos Cancer Center; Department of Oncology | Detroit | Michigan | 48201 | United States |
| Memorial Sloan Kettering - Basking Ridge | New York | New York | 10065 | United States |
| Case Western Reserve University; Medicine-Hematology and Oncology | Cleveland | Ohio | 44106 | United States |
| Institut Gustave Roussy | Villejuif | 94805 | France |
| The Chinese University of Hong Kong | Shatin | 123456 | Hong Kong |
| Seoul National University Hospital | Seoul | 03080 | South Korea |
| Asan Medical Center | Seoul | 05505 | South Korea |
| START Madrid. Centro Integral Oncologico Clara Campal; CIOCC | Madrid | 28050 | Spain |
| Hospital Clinico Universitario de Valencia | Valencia | 46010 | Spain |
| Queen Mary University of London | London | EC1M 6BQ | United Kingdom |
| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C582670 | alectinib |
| C000594389 | atezolizumab |
| D000069347 | Erlotinib Hydrochloride |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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