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NCT00548093

PF-00299804 As A Single Agent, In Patients With Advanced Non-Small Cell Lung Cancer Who Have Failed Chemotherapy And Erlotinib

Completed Phase 2 Results posted Last updated 21 May 2019
What this trial tests

Phase 2 trial testing PF-00299804 in Carcinoma, Non Small Cell Lung in 66 participants. Completed in 11 June 2012.

Timeline
29 April 2008
Primary endpoint
16 March 2010
11 June 2012

Quick facts

Lead sponsorPfizer
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Maskingnone
Primary purposetreatment
Enrollment66
Start date29 April 2008
Primary completion16 March 2010
Estimated completion11 June 2012
Sites19 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer — full company profile →

Who can join

Adults 18 to 99, any sex, with Carcinoma, Non Small Cell Lung. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Best Overall Response (BOR) in Participants With Adenocarcinoma Histology Primary · Baseline, end of every even-numbered cycle up to end of treatment (Day 936)

BOR:best response recorded from treatment start until disease progression as per Response Evaluation Criteria in Solid Tumors (RECIST). Complete Response: disappearance of all lesions. Partial Response (PR):greater than or equal to (\>=)30% decrease in sum of longest diameters (SLDs) of target lesions (TLs) taking as reference baseline SLD. Progressive disease (PD):\>=20% increase in SLD of TLs taking as reference smallest SLD since treatment start, or appearance of \>=1 new lesion. Stable disease:neither shrinkage for PR nor increase for PD taking as reference smallest SLD since treatment sta

Complete response
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)0
Partial response
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)2
Stable or No response
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)28
Objective progression
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)12
Indeterminate
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)0
Best Overall Response (BOR) in Participants With Non-Adenocarcinoma Histology Secondary · Baseline, end of every even-numbered cycle up to end of treatment (Day 936)

BOR: best response recorded from treatment start until disease progression as per RECIST. Complete Response: disappearance of all lesions. PR: \>=30% decrease in SLDs of TLs taking as reference baseline SLD. PD: \>=20% increase in SLD of TLs taking as reference smallest SLD since treatment start, or appearance of \>=1 new lesion. Stable disease: neither shrinkage for PR nor increase for PD taking as reference smallest SLD since treatment start.

Complete response
GroupValue95% CI
PF-00299804 (Non-adenocarcinoma Histology)0
Partial response
GroupValue95% CI
PF-00299804 (Non-adenocarcinoma Histology)1
Stable or no response
GroupValue95% CI
PF-00299804 (Non-adenocarcinoma Histology)8
Objective progression
GroupValue95% CI
PF-00299804 (Non-adenocarcinoma Histology)7
Indeterminate
GroupValue95% CI
PF-00299804 (Non-adenocarcinoma Histology)0
Duration of Response (DR) Secondary · Baseline, end of every even-numbered cycle up to end of treatment (Day 936)

Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cancer. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. DR was calculated for the subgroup of participants with a confirmed objective tumor response.

GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)45.224.1 – 66.3
PF-00299804 (Non-adenocarcinoma Histology)12.1NA – NA
Percent Probability of Progression-free Survival (PFS) at Month 6 Secondary · Up to 6 months after the start of study medication

Probability of being event free (event defined as PD or death due to any cause) at 6 months after the first dose of study treatment. PFS was defined as the time from the first dosing date to the date of first documentation of progression or death due to any cause, whichever occurs first. PFS was calculated as (first event date (if not reached, censored at the last known event-free date) minus first dosing date plus 1). Documentation of progression was determined from objective disease assessment based on RECIST v1.0 criteria. PD was defined as at least a 20% increase in the sum of the longest

GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)24.312.4 – 38.4
PF-00299804 (Non-adenocarcinoma Histology)8.00.5 – 29.8
Percent Probability of Overall Survival at Months 6 and 12 Secondary · Months 6, 12

Probability of being alive at 6 and 12 months after the first dose of study medication.

Month 6
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)71.556.7 – 82.1
PF-00299804 (Non-adenocarcinoma Histology)50.024.5 – 71.0
Month 12
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)46.331.4 – 59.9
PF-00299804 (Non-adenocarcinoma Histology)21.95.6 – 44.9
Area Under the Curve From Time Zero to 24 Hours [AUC (0-24)] Secondary · 0.5-2, 3-5, 6-8, 22-26 hours post dose on Day 1 of Cycle 1

The pharmacokinetic (PK) samples collected between 22-26 hours post dose on Day 1 of Cycle 1 were within the pre-specified time window for the 24-hour post dose sample and were used for calculation of AUC (0-24) on Day 1 of Cycle 1.

GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)390.8± 165.24
PF-00299804 (Non-adenocarcinoma Histology)397.9± 258.11
Maximum Observed Plasma Concentration (Cmax) Secondary · 0.5-2, 3-5, 6-8, 22-26 hours post dose on Day 1 of Cycle 1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)22.61± 10.315
PF-00299804 (Non-adenocarcinoma Histology)25.49± 22.533
Time to Reach Maximum Observed Plasma Concentration (Tmax) Secondary · 0.5-2, 3-5, 6-8, 22-26 hours post dose on Day 1 of Cycle 1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)6.083.00 – 25.1
PF-00299804 (Non-adenocarcinoma Histology)6.175.00 – 25.7
Human Epidermal Growth Factor-2 (HER-2) and Epidermal Growth Factor Receptor (EGFR) Levels in Serum Secondary · Baseline [pre-dose on Cycle 1 Day 1 (C1D1)], then pre-dose on Day 1 of each cycle, end of treatment (Day 936)

Human epidermal growth factor receptor 2 (HER2) is a transmembrane protein that plays a pivotal role in growth factor signal transduction and epidermal growth factor receptor (EGFR) is a cell surface protein that binds to epidermal growth factor. Levels of the HER-2 and EGFR extracellular domains in serum were assessed by enzyme-linked immunosorbent assay (ELISA).

EGFR: C1D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)51.25± 14.86
PF-00299804 (Non-adenocarcinoma Histology)57.28± 15.36
EGFR: C2D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)45.89± 12.42
PF-00299804 (Non-adenocarcinoma Histology)51.05± 11.35
EGFR: C3D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)44.91± 11.43
PF-00299804 (Non-adenocarcinoma Histology)46.79± 7.64
EGFR: C4D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)46.26± 11.7
PF-00299804 (Non-adenocarcinoma Histology)46.72± 9.01
EGFR: C5D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)45.35± 11.32
PF-00299804 (Non-adenocarcinoma Histology)51.2± 9.76
EGFR: C6D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)48.71± 12.01
PF-00299804 (Non-adenocarcinoma Histology)66.52± 20.19
EGFR: C7D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)52.85± 15.6
PF-00299804 (Non-adenocarcinoma Histology)44.29± 9.55
EGFR: C8D1
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)50.27± 17.05
PF-00299804 (Non-adenocarcinoma Histology)55.93± NA
Number of Participants With Human Epidermal Growth Factor Family (HER-Family) and Kirsten Rat Sarcoma (KRAS) Gene Mutation Status From Free Tumor Deoxy- Ribonucleic Acid (DNA) in Blood at Screening Secondary · Screening

HER-family is a family of transmembrane protein that plays a pivotal role in growth factor signal transduction and Kirsten Rat Sarcoma (KRAS) gene is an oncogene that encodes a small guanosine triphosphatase (GTPase) transductor protein called KRAS. The mutation status of HER and KRAS genes in tumor DNA present in plasma was determined using a polymerase chain reaction (PCR)-based assay. The gene that is most common in a particular natural population is known as the wild type. Any form of the gene other than the wild type is known as a mutant form. Number of participants with HER-Family and KR

KRAS mutation: Wild-type
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)39
PF-00299804 (Non-adenocarcinoma Histology)15
KRAS mutation: Mutant
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)0
PF-00299804 (Non-adenocarcinoma Histology)0
KRAS mutation: Unknown
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)11
PF-00299804 (Non-adenocarcinoma Histology)1
HER-2 mutation: Wild-type
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)29
PF-00299804 (Non-adenocarcinoma Histology)13
HER-2 mutation: Mutant
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)0
PF-00299804 (Non-adenocarcinoma Histology)0
HER-2 mutation: Unknown
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)21
PF-00299804 (Non-adenocarcinoma Histology)3
European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (EORTC QLQ- C30) Score Secondary · Baseline (C1D1), C2D1 thereafter every subsequent cycle up to C43

EORTC QLQ-C30: included functional scales (physical, role, cognitive, emotional, and social), global health status (GHS), symptom scales (fatigue, pain, nausea/vomiting), and single items (dyspnoea, appetite loss, insomnia, constipation/diarrhea, and financial difficulties). Most questions used 4- point scale (1 'Not at All' to 4 'Very Much'); 2 questions used 7-point scale (1 'Very Poor' to 7 'Excellent'). Scores averaged, transformed to 0-100 scale; higher score=better level of functioning or greater degree of symptoms.

C1D1: GHS
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)65.83± 24.99
PF-00299804 (Non-adenocarcinoma Histology)60.56± 25.87
C1D1: Physical functioning
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)74.70± 22.17
PF-00299804 (Non-adenocarcinoma Histology)70.22± 27.24
C1D1: Role functioning
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)72.67± 33.46
PF-00299804 (Non-adenocarcinoma Histology)74.44± 32.04
C1D1: Emotional Functioning
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)77.72± 23.87
PF-00299804 (Non-adenocarcinoma Histology)77.22± 16.51
C1D1: Cognitive Functioning
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)81.33± 24.89
PF-00299804 (Non-adenocarcinoma Histology)76.67± 28.73
C1D1: Social Functioning
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)76.33± 30.69
PF-00299804 (Non-adenocarcinoma Histology)67.78± 26.33
C1D1: Fatigue
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)36.44± 25.99
PF-00299804 (Non-adenocarcinoma Histology)44.44± 26.89
C1D1: Nausea, vomiting
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)10.33± 18.10
PF-00299804 (Non-adenocarcinoma Histology)10.00± 17.59
European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Lung Cancer-13 (QLQ- LC13) Score Secondary · Baseline (C1D1), C2D1 thereafter every subsequent cycle up to C43

QLQ-LC13 consisted of 13 questions relating to disease symptoms specific to lung cancer and treatment side effects typical of treatment with chemotherapy and radiotherapy. The 13 questions comprised 1 multi-item scale for dyspnoea and 10 single-item symptoms and side effects (coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, chest pain, arm pain, other pain, and medicine for pain). Recall period: past week; response range: not at all to very much. Scale score range: 0 to 100. Higher symptom score = greater degree of symptoms.

C1D1: Dyspnoea
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)25.85± 22.84
PF-00299804 (Non-adenocarcinoma Histology)26.98± 21.67
C1D1: Coughing
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)33.33± 30.12
PF-00299804 (Non-adenocarcinoma Histology)33.33± 25.20
C1D1: Hemoptysis
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)2.00± 10.45
PF-00299804 (Non-adenocarcinoma Histology)4.44± 11.73
C1D1: Sore mouth
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)3.33± 10.10
PF-00299804 (Non-adenocarcinoma Histology)6.67± 18.69
C1D1: Dysphagia
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)2.67± 9.13
PF-00299804 (Non-adenocarcinoma Histology)0.00± 0.00
C1D1: Peripheral neuropathy
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)10.00± 18.13
PF-00299804 (Non-adenocarcinoma Histology)13.33± 24.56
C1D1: Alopecia
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)8.16± 25.94
PF-00299804 (Non-adenocarcinoma Histology)22.22± 37.09
C1D1: Chest pain
GroupValue95% CI
PF-00299804 (Adenocarcinoma Histology)14.67± 27.07
PF-00299804 (Non-adenocarcinoma Histology)20.00± 30.34

Adverse events — posted to ClinicalTrials.gov

Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

PF-00299804 (Adenocarcinoma Histology)
Serious: 9/50 (18%)
Deaths:
PF-00299804 (Non-adenocarcinoma Histology)
Serious: 6/16 (38%)
Deaths:

Serious adverse events (24 terms)

ReactionSystemPF-00299804 (Adenocarcinom…PF-00299804 (Non-adenocarc…
Disease progressionGeneral disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
Abdominal painGastrointestinal disorders
ConstipationGastrointestinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
PancreatitisGastrointestinal disorders
VomitingGastrointestinal disorders
AstheniaGeneral disorders
CystitisInfections and infestations
PneumoniaInfections and infestations
Hip fractureInjury, poisoning and procedural complications
Spinal compression fractureInjury, poisoning and procedural complications
DehydrationMetabolism and nutrition disorders
HypercalcaemiaMetabolism and nutrition disorders
Non-small cell lung cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Renal failure acuteRenal and urinary disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
HypoxiaRespiratory, thoracic and mediastinal disorders
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders
HypotensionVascular disorders
Other adverse events (185 terms — click to expand)

ReactionSystemPF-00299804 (Adenocarcinom…PF-00299804 (Non-adenocarc…
DiarrhoeaGastrointestinal disorders
Dermatitis acneiformSkin and subcutaneous tissue disorders
FatigueGeneral disorders
Dry skinSkin and subcutaneous tissue disorders
Decreased appetiteMetabolism and nutrition disorders
PruritusSkin and subcutaneous tissue disorders
StomatitisGastrointestinal disorders
NauseaGastrointestinal disorders
Exfoliative rashSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
Weight decreasedInvestigations
DyspnoeaRespiratory, thoracic and mediastinal disorders
Upper respiratory tract infectionInfections and infestations
Aspartate aminotransferase increasedInvestigations
Muscle spasmsMusculoskeletal and connective tissue disorders
CoughRespiratory, thoracic and mediastinal disorders
Skin fissuresSkin and subcutaneous tissue disorders
CheilitisGastrointestinal disorders
ConstipationGastrointestinal disorders
ParonychiaInfections and infestations
HypoalbuminaemiaMetabolism and nutrition disorders
HypomagnesaemiaMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders
ErythemaSkin and subcutaneous tissue disorders
Nail disorderSkin and subcutaneous tissue disorders
Abdominal painGastrointestinal disorders
Chest painGeneral disorders
Mucosal inflammationGeneral disorders
Oedema peripheralGeneral disorders
Urinary tract infectionInfections and infestations
Blood alkaline phosphatase increasedInvestigations
HypocalcaemiaMetabolism and nutrition disorders
DysgeusiaNervous system disorders
EpistaxisRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
ConjunctivitisEye disorders
PainGeneral disorders
Alanine aminotransferase increasedInvestigations
HypokalaemiaMetabolism and nutrition disorders
HypophosphataemiaMetabolism and nutrition disorders

Most-reported serious reactions: Disease progression, Respiratory failure, Abdominal pain, Constipation, Pulmonary embolism, Anaemia, Diarrhoea, Nausea.

Data from ClinicalTrials.gov NCT00548093 adverse events section.

Sponsor's own description

To assess the antitumor efficacy measured by the objective response rate of oral PF-00299804 taken daily, as single agent in patients with advanced NSCLC who failed at least one chemotherapy + erlotinib.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small-cell lung cancers dependent on the epidermal growth factor receptor pathway.
    Nguyen KS, Kobayashi S, Costa DB. · · 2009 · cited 340× · PMID 19632948 · DOI 10.3816/clc.2009.n.039
  2. Phase I dose-escalation study of the pan-HER inhibitor, PF299804, in patients with advanced malignant solid tumors.
    Jänne PA, Boss DS, Camidge DR, Britten CD, et al · · 2011 · cited 146× · PMID 21220471 · DOI 10.1158/1078-0432.ccr-10-1220
  3. EGFR-mutated lung cancer: a paradigm of molecular oncology.
    Zhang Z, Stiegler AL, Boggon TJ, Kobayashi S, et al · · 2010 · cited 136× · PMID 21165163 · DOI 10.18632/oncotarget.186
  4. A phase 2 trial of dacomitinib (PF-00299804), an oral, irreversible pan-HER (human epidermal growth factor receptor) inhibitor, in patients with advanced non-small cell lung cancer after failure of prior chemotherapy and erlotinib.
    Reckamp KL, Giaccone G, Camidge DR, Gadgeel SM, et al · · 2014 · cited 102× · PMID 24501009 · DOI 10.1002/cncr.28561
  5. Tumor heterogeneity and resistance to EGFR-targeted therapy in advanced nonsmall cell lung cancer: challenges and perspectives.
    Cheng X, Chen H. · · 2014 · cited 61× · PMID 25285017 · DOI 10.2147/ott.s66502
  6. Use of <i>Ex</i> <i>Vivo</i> Patient-Derived Tumor Organotypic Spheroids to Identify Combination Therapies for <i>HER2</i> Mutant Non-Small Cell Lung Cancer.
    Ivanova E, Kuraguchi M, Xu M, Portell AJ, et al · · 2020 · cited 38× · PMID 32034078 · DOI 10.1158/1078-0432.ccr-19-1844
  7. Clinical evaluation of dacomitinib for the treatment of metastatic non-small cell lung cancer (NSCLC): current perspectives.
    Lavacchi D, Mazzoni F, Giaccone G. · · 2019 · cited 35× · PMID 31564835 · DOI 10.2147/dddt.s194231
  8. Dacomitinib in lung cancer: a "lost generation" EGFR tyrosine-kinase inhibitor from a bygone era?
    Ou SH, Soo RA. · · 2015 · cited 21× · PMID 26508839 · DOI 10.2147/dddt.s52787

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