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| Name | Class |
|---|---|
| AstraZeneca | INDUSTRY |
| Boehringer Ingelheim | INDUSTRY |
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This is a multi-center open-label proof-of-concept study consisting of two parts: PART A - a phase I dose-finding study (3 + 3 classical design) evaluating the RP2D of afatinib in combination with selumetinib in KRASm NSCLC; and PART B - a randomized phase II study investigating the progression free survival and safety of selumetinib/afatinib combination therapy compared to standard of care chemotherapy in KRASm NSCLC.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Afatinib plus selumetinib | Experimental | Combination of afatinib and selumetinib at the optimal dose and regimen as determined in the phase I part of this study |
|
| Control | Active Comparator | Standard-of-care second line treatment for non small cell lung cancer (docetaxel) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Afatinib | Drug | Tablet |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Dose Limiting Toxicities (Phase I) | Incidence of DLTs in the first treatment cycle | Cycle 1 (4 weeks) |
| Progression Free Survival (Phase II) | PFS measured by RECIST v 1.1 | CT scan every 6 weeks and monthly phone call until start of subsequent anticancer therapy or until all patients have been followed up for at least 18 months of have been lost to follow up, whichever occurs first |
| Measure | Description | Time Frame |
|---|---|---|
| Tolerability (Incidence and severity of adverse events per CTCAE v4.03) | Incidence and severity of adverse events per CTCAE v4.03 | Up to 28 days after last study drug intake |
| Plasma concentrations of afatanib and selumetinib |
| Measure | Description | Time Frame |
|---|---|---|
| Determinants and mode of response - Target proteins | Change in expression and/or phosphorylation status target proteins (e.g. pERK, pS6, heregulin, HER2) before, during and after treatment | At baseline, cycle 1 day 15 and at treatment discontinuation (expected 6-9 months after start) |
| Pharmacogenetics profiling to assess predictors of response and resistance- inducing mutations |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| F Opdam, MD, PhD | Contact | +31 20 512 2446 | f.opdam@nki.nl | |
| S huijberts, MD | Contact | 0031205129111 | s.huijberts@nki.nl |
| Name | Affiliation | Role |
|---|---|---|
| F Opdam, MD, PhD | NKI-AvL | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UMC St. Radboud Nijmegen | Recruiting | Nijmegen | Gelderland | 6525GA | Netherlands |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Mar 5, 2021 | |
| Reset | Mar 31, 2021 | |
| Release | Aug 29, 2025 |
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| Selumetinib | Drug | Capsule |
|
|
| Docetaxel | Drug |
|
Plasma concentrations of afatanib and selumetinib will be measured at day 1,2,4,8,15, 22 in cycle 1, on day 1 and 2 in cycle 2 and subsequently before every treatment cycle to determine pharmacokinetics of both substances in combination and interindividual differences after a single dose and after multiple doses.
| On day 1, 2, 4, 8, 15, 22 in cycle 1, on day 1 and 2 in cycle 2 and subsequently at every treatment cycle pre-dose |
| Efficacy (Phase II) (Overall response rate (ORR), duration of response (DOR) , time to response (TTR) and overall survival (OS) per RECIST v1.1) | Overall response rate (ORR), duration of response (DOR) , time to response (TTR) and overall survival (OS) per RECIST v1.1 | Assessed by CT scans every 6 weeks and by monthly phone call until all patients have been followed up for at least 18 months or have been lost to follow up, whichever occurs first. |
Pharmacogenetic profiling to assess predictors of response and resistance- inducing mutations |
| Before treatment, every 6 weeks and at treatment discontinuation (expected 6-9 months after start) |
| Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital | Recruiting | Amsterdam | 1066CX | Netherlands |
|
| Reset | Sep 17, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Mar 5, 2021 | Mar 31, 2021 | |||
| Aug 29, 2025 | Sep 17, 2025 |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D010190 | Pancreatic Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D000077716 | Afatinib |
| C517975 | AZD 6244 |
| D000077143 | Docetaxel |
| ID | Term |
|---|---|
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D004224 | Diterpenes |
| D013729 | Terpenes |
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