Study of Nintedanib Plus Bevacizumab in Advanced Solid Tumors

Completed · Phase 1

Conditions studied: Renal Cell Carcinoma, Colorectal Adenocarcinoma, Non-squamous Non-small Cell Lung Cancer, Platinum-refractory Ovarian Carcinoma, Cervical Carcinoma

In brief

Angiogenesis, the development of new blood vessels, plays an important role in the disease development and tumor growth in many solid organ malignancies. Bevacizumab was the first anti-angiogenic drug to be approved in solid tumors and has shown advantageous activity with multiple tumor types. However, the responses from Bevacizumab are often transient due to the tumor's manipulative abilities to circumvent the usual pathways to find salvage pathways instead. Nintedanib has demonstrated anti-tumor activity in non-squamous non-small cell lung cancer, colorectal cancer, ovarian cancer, and renal cell cancer. The combination of Bevacizumab and Nintedanib are being proposed to target the tumor's manipulation processes to generate alternate pathways for angiogenesis thus creating a potential benefit to delay tumor growth.

Key facts

Study ID

NCT02835833

Run by

University of Alabama at Birmingham

People needed

21

Starts

2016-06-09

Expected to finish

2018-06-14

Last updated by the study team

2018-07-10

Who can join

Age: 19 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age >18
• Histologically proven advanced or metastatic solid cancer for which Bevacizumab has an indication: renal cell carcinoma, colorectal adenocarcinoma, non-squamous non-small cell lung cancer, platinum- refractory ovarian carcinoma, cervical carcinoma.
• Life expectancy at least 3 months
• ECOG performance status score 0-1
• Progression after at least first-line systemic therapy for metastatic disease
• At least one measurable lesion according to RECIST criteria or any other baseline prerequisite for the assessment of the principal judgement criteria.
• Signed and dated written informed consent prior to admission to the study
• Resolution of all acute adverse events resulting from prior cancer therapies to NCI CTCAE grade less than/equal to 1 or baseline (except alopecia)
• Adequate organ function as defined by the following criteria
• AST/ALT ≤ 2.5x upper limit of normal (ULN) in the case of liver metastases or AST/ALT ≤ 1.5 x ULN in patients without liver metastases
• total serum bilirubin within normal limits regardless of liver metastases
• absolute neutrophil count (ANC) > 1500
• Platelets > 100k without transfusion support in the past 28 days
• Hemoglobin > 9.0 without transfusion support in the past 28 days
• Serum creatinine < 1.5x ULN
• Prothrombin time/INR and partial thromboplastin time within normal limits
• Urinalysis ≤ 1+ protein
• Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures

You may not qualify if…

• Previous therapy with Bevacizumab is allowed, but patient who experienced serious dose-limiting toxicities while on prior Bevacizumab therapy are excluded
• Prior treatment with Nintedanib (BIBF1120). Known hypersensitivity to Nintedanib, peanut or soya or any other trial drug, their excipients or to contrast media
• Chemo-, hormone-, radio-(except for brain and extremities) or immunotherapy or therapy with monoclonal antibodies or small tyrosine kinase inhibitors within the past 4 weeks prior to treatment with the trial drug.
• Radiotherapy to the target lesion within the past 3 months prior to baseline imaging
• Persistence of clinically relevant therapy related toxicity from previous chemo and/or radiotherapy
• History of brain involvement with cancer, spinal cord compression, carcinomatous meningitis, or new evidence of brain or leptomeningeal disease. Patients with irradiated or resected brain lesions are permitted provided the lesions are fully treated and inactive, patients are asymptomatic, and no steroids have been used for at least 28 days.
• Leptomeningeal disease
• Centrally located tumours with radiographic evidence of local invasion of major blood vessels
• Treatment with other investigational drugs or treatment in another clinical trial within the past 4 weeks before start of therapy or concomitantly with the trial
• Therapeutic anticoagulation (except low-dose heparin and/or heparin flush as needed for maintenance of an in-dwelling intravenous devise) or anti-platelet therapy (except for low-dose therapy with acetylsalicylic acid <325mg per day.
• Major injuries and/or surgery within the past 4 weeks prior to start of study treatment with incomplete wound healing and/or planned surgery during the on-treatment study period.
• History of clinically significant hemorrhagic or thromboembolic event in the past 6 months.
• Known inherited predisposition to bleeding or thrombosis
• Significant cardiovascular diseases (i.e. uncontrolled hypertension, unstable angina, history of infarction within the past 6 months prior to start of study treatment, congestive heart failure >New York Heart Association II, serious cardiac arrhythmia, pericardial effusion)
• Proteinuria CTCAE grade 2 or greater
• Creatinine >1.5 ULN or GFR <45 ml/min
• Hepatic function: total bilirubin outside of normal limits; ALT or AST >2.5 ULN in pts without liver metastasis. For patients with liver metastasis: total bilirubin outside of normal limits, ALT or AST >5 x ULN
• Coagulation parameters: International normalized ratio (INR) >2, prothrombin time (PT) and partial thromboplastin time (PTT) >50% of deviation of institutional ULN
• Absolute neutrophil count (ANC) <1500/ml, platelets <100,000/ml, Hemoglobin <9.0 g/dl
• Other malignancies within the past 5 years other than basal cell skin cancer or carcinoma in situ of the cervix
• Active serious infections in particular if requiring systemic antibiotic or antimicrobial therapy
• Active or chronic hepatitis C and/or B infection
• Gastrointestinal disorders or abnormalities that would interfere with absorption of the study drug
• Serious illness or concomitant non-oncological disease such as neurologic, psychiatric, infectious disease or active ulcers (gastro-intestinal tract, skin) or laboratory abnormality that may increase the risk associated with study participation or study drug administration and in the judgment of the investigator would make the patient inappropriate for entry into the study.
• Patients who are sexually active and unwilling to use a medically acceptable method of contraception (e.g. such as implants, injectables, combined oral contraceptives, some intrauterine devices or vasectomized partner for participating females, condoms for participating males) during the trial and for at least three months after end of active therapy.

Where it is running

• University of Alabama at Birmingham Comprehensive Cancer Center — Birmingham, Alabama, United States

Full record on ClinicalTrials.gov

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