A Novel Erythropoiesis Stimulating Protein (NESP; Darbopoetin Alfa) for the Treatment of Anemia in Lung Cancer Patients Receiving Multi-cycle Platinum-Containing Chemotherapy

Amgen

Status and phase: Completed; Phase 3

Conditions: Anemia

Treatments: Drug: Placebo; Drug: Darbepoetin alfa

Study type: Interventional

Funder types: Industry

Identifiers

NCT03776032

00980297

Details and patient eligibility

About

The primary objective of this study was to compare the effectiveness of darbopoetin alfa to placebo in the treatment of anemia in adults with lung cancer receiving multicycle platinum-containing chemotherapy, by assessing the percentage of participants who received red blood cell (RBC) transfusions during weeks 5-12 inclusive.

Enrollment: 320 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Lung cancer (either small cell [SCLC] or non-small cell [NSCLC])
• At least 12 additional weeks of platinum containing cyclic chemotherapy planned regardless of cycle length
• Anemia (hemoglobin ≤ 11.0 g/dL) as assessed by a local or central laboratory result within 7 days before study day 1 (the first scheduled day of on-study chemotherapy and the first day of study drug administration)
• Life expectancy of at least 6 months, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
• Anemia predominantly due to the cancer or chemotherapy (i.e.. serum folate ≥ 4.5 nmol/L (≥ 2.0 ng/mL) and vitamin B 12 ≥ 148 pmol/L (≥ 200 pg/mL), no overt hemolysis, and no overt gastrointestinal bleeding or bleeding due to recent surgery)
• Adequate renal function (creatinine ≤ 177gmol/L (≤ 2.0 mg/dL) and adequate hepatic function (bilirubin ≤ 1.5 times central laboratory's upper limit of normal range)
• Available for 4 weeks post administration of the last dose of study drug
• Legal age for informed consent, and written informed consent must be obtained

Exclusion criteria

• History of any primary hematological disorder which could cause anemia (e.g., sickle cell anemia)
• Received prior whole pelvis radiation therapy
• Uncontrolled angina, congestive heart failure (New York Heart Association > class II or known ejection fraction < 40%)], or uncontrolled cardiac arrhythmia.
• History of primary or metastatic malignancy involving the central nervous system (CNS). Subjects with a previous history of primary or metastatic malignancy involving the CNS will be eligible for the study providing they have had no clinical signs of nor treatment for CNS disease and no history of seizures within previous 2 years
• Uncontrolled hypertension (i.e., diastolic blood pressure > 100 mm Hg)
• History of seizures. Subjects with a previous history of seizures will be eligible for the study providing they have had no evidence of seizure activity and have been free of anti-seizure medication for the previous 5 years
• Evidence of clinically significant systemic active infection or chronic inflammatory disease (e.g., rheumatoid arthritis)
• Iron deficiency (transferrin saturation < 15% and ferritin < 10 μg/L (< 10 ng/mL))
• Received > 2 RBC transfusions within 4 weeks before randomization or any RBC transfusion within 2 weeks before randomization
• Received erythropoietin therapy within 8 weeks before randomization
• Known positive test for human immunodeficiency virus (HIV) infection
• Receiving, or not yet 30 days past the end of receiving, another investigational agent or device not approved in any indication.
• Pregnant or breast feeding females.
• Not using adequate contraceptive precautions
• Prior treatment with NESP
• Previously randomized in this study
• Known hypersensitivity to mammalian-derived product
• Concerns for subject's compliance with the protocol procedure, including completion of the quality of life surveys (QOLS)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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320 participants in 2 patient groups, including a placebo group

Darbepoetin alfa

Experimental group

Description:

Participants received once a week darbepoetin alfa, administered by subcutaneous injection at a starting dose of 2.25 µg/kg for up to 12 weeks. The dose of darbepoetin alfa may have been adjusted based on hemoglobin levels to a maximum dose of 4.5 µg/kg /week.

Treatment:

Drug: Darbepoetin alfa

Placebo

Placebo Comparator group

Description:

Participants received once a week placebo, administered by subcutaneous injection for up to 12 weeks.

Treatment:

Drug: Placebo