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About
AMAZE-lung is a multicenter single-arm phase II trial. The protocol treatment consists of amivantamab, lazertinib and bevacizumab (Zirabev®), given in a three-weekly regimen. The primary objective of the trial is to assess the efficacy of amivantamab and bevacizumab added to continued treatment with the third-generation EGFR-TKI lazertinib, in patients with EGFR-mutant advanced NSCLC, who have been previously treated with a third-generation EGFR-TKI in order to provide data on treatment effect and sample size required for a future phase III trial.
In addition, the safety of the treatment combination will be evaluated.
Enrollment
Sex
Ages
Volunteers
Inclusion criteria
Histologically confirmed non-squamous NSCLC, stage IIIB/C (not amenable to radical therapy) or stage IV according to 8th TNM classification.
Presence of a sensitising EGFR-mutation (only patients with exon 19 deletion and/or L858R are eligible) and documentation of T790M status, tested locally by an accredited laboratory.
Radiologically confirmed disease progression on previous treatment with osimertinib or lazertinib.Treatment with osimertinib must have been stopped at least 8 days before enrolment.
Achieved objective clinical benefit from osimertinib or lazertinib treatment (e.g., documented PR/ CR or SD for ≥6 months while on osimertinib or lazertinib treatment).
Measurable disease as defined according to RECIST v1.1.
Age ≥18 years.
Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
Life expectancy ≥12 weeks.
Adequate haematological function:
Adequate renal function:
Adequate liver function:
Women of childbearing potential, including women who had their last menstruation in the last 2 years, must have a negative pregnancy test (b-human chorionic gonadotropin [b-hCG]) within 5 weeks before enrolment and within 3 days before the first dose of protocol treatment. Women of childbearing potential must use highly effective contraceptive methods.
Written IC for trial participation must be signed and dated by the patient and the investigator prior to any trial-related intervention.
Exclusion criteria
Patients with known small cell lung carcinoma (SCLC) transformation.
Patients with symptomatic brain metastases. Patients with asymptomatic or previously treated and stable brain metastases may participate in this study. Patients who have received definitive radiotherapy or surgery for symptomatic or unstable brain metastases and have been clinically stable and asymptomatic for at ≥2 weeks before enrolment are eligible, provided they have been either off corticosteroid treatment or are receiving low-dose corticosteroid treatment (≤10 mg/day prednisone or equivalent) for at least 2 weeks prior to enrolment.
Patients with an active or past medical history of leptomeningeal disease.
Patients with untreated spinal cord compression. Patients who have been definitively treated with surgery or radiotherapy and have a stable neurological status for ≥2 weeks prior to enrolment are eligible provided they are off corticosteroid treatment or are receiving low-dose corticosteroid treatment ≤10 mg/day prednisone or equivalent.
Patients with unresolved adverse events (other than alopecia) from prior anticancer therapy that have not resolved to grade ≤1 or baseline.
Patients with positive hepatitis B (hepatitis B virus [HBV]) surface antigen (HBsAg) test.
Patients with positive hepatitis C antibody (anti-HCV) test.
Patients with other clinically active infectious liver disease.
Patients who are known positive for HIV, with one or more of the following:
Patients with active cardiovascular disease including, but not limited to:
Patients with interstitial lung disease (ILD), including drug-induced ILD or radiation pneumonitis.
Patients with a history of haemoptysis (≥2.5 mL of bright red blood per episode) within 1 month prior to enrolment.
Patients with evidence of bleeding diathesis or coagulopathy (in the absence of therapeutic anticoagulation).
Patients with current or recent (within 10 days before enrolment) use of aspirin (>325 mg/day) or treatment with dipyridamole, ticlopidine, clopidogrel, and clostazol.
Patients with current use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purposes that has not been stable for >2 weeks prior to enrolment.
Patients with serious, non-healing wound, active ulcer, or untreated bone fracture.
Patients who had a core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to enrolment.
Patients who had major surgery or significant traumatic injury within 28 days prior to enrolment.
Patients who had placement of a vascular access device within 2 days prior to prior to enrolment.
Patients with a history of abdominal or tracheoesophageal fistula or gastrointestinal perforation within 6 months prior to enrolment.
Patients with clinical signs of gastrointestinal obstruction or requirement for routine parenteral hydration, parenteral nutrition, or tube feeding.
Patients with evidence of abdominal free air not explained by paracentesis or recent surgical procedure.
Patients with concurrent or prior malignancy other than the disease under study.
Some exceptions require consultation with the ETOP IBCSG Partners
Patients with uncontrolled illness, including but not limited to:
History of hypersensitivity to either the drug substance or any excipients in amivantamab, lazertinib and/ or bevacizumab.
Prior chemotherapy for NSCLC.
Prior treatment with bevacizumab or another anti-angiogenic inhibitor.
Prior treatment with a MET/EGFR-targeting antibody.
Judgement by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements.
Women who are pregnant or in the period of lactation.
Women of childbearing potential or men who are sexually active with a woman of childbearing potential, who are not willing to use at least one method of highly effective contraception while receiving protocol treatment and for at least 6 months after the last dose of protocol treatment.
Primary purpose
Allocation
Interventional model
Masking
60 participants in 1 patient group
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Central trial contact
Susanne Roux; Heidi Roschitzki, PhD
Data sourced from clinicaltrials.gov
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