A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab...

21
A Randomized, Double-blind, Placebo- controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy with Bevacizumab for 1st-line Treatment of Locally-advanced, Recurrent, or Metastatic Non-small Cell Lung Cancer (NSCLC)

Transcript of A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab...

Page 1: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion

of Chemotherapy with Bevacizumab for 1st-line Treatment of Locally-advanced, Recurrent, or

Metastatic Non-small Cell Lung Cancer (NSCLC)

Page 2: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

Background & Rationale

Adapted from: 1Sandler A, et al., N Engl J Med 2006; 2Shepherd FA, et al., N Engl J Med 2005; 3Ciuleanu T, et al., ASCO 2008; 4Herbst RS, et al., J Clin Oncol 2007; 5Hainsworth J, et al., IASLC 2008.

Page 3: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Study Design

Carboplatin/paclitaxel; cisplatin/vinorelbine; carboplatin or cisplatin/gemcitabine; carboplatin or cisplatin/docetaxel.

Page 4: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Objective

Page 5: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Randomized Patients by Region

Page 6: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Statistical Considerations

Page 7: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Analysis Populations

<2% of patients were lost to follow-up or withdrew consent.

As of data cutoff date: 18 July 2008.

*The randomized safety population consists of all randomized patients who received at least one dose of bevacizumab, erlotinib or placebo during the post-chemotherapy phase.

Page 8: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Baseline Characteristics (ITT population)

*Patients randomized as of July 18, 2008.

Page 9: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Baseline Characteristics (cont.)

Page 10: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Efficacy Results

Page 11: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Progression-free Survival(ITT population, investigator assessment)

Page 12: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Additional PFS Outcome Measures(ITT population)

Page 13: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Progression-free Survival in Subgroups

*Includes <1% patients with ECOG PS 2.

Page 14: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Progression-free Survival in Subgroups(ITT population)

Page 15: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Preliminary Analysis of Subsequent Therapies Received (ITT population)

*Pemetrexed was most commonly used.

Page 16: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Safety Results

Page 17: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Summary for Post Chemotherapy Treatment Phase (Safety population)

Formal statistical comparison testing between treatment arms was not done.

Page 18: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Causes of Death (Safety population)

*Other causes of death reported by investigators: carcinomatous meningitis, breast cancer, respiratory failure, unexplained pneumonia.

Page 19: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Adverse Events of Special Interest during the Post-chemotherapy Phase (Safety population)

Grade 5 events: Bevacizumab + Placebo: 1 (0.3%) CHF; Bevacizumab + Erlotinib: 2 (0.5%) Cardiovascular other than HTN, 1 (0.3%) ATE; 1 (0.3%) VTE.

Page 20: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS: Adverse Events of Special Interest (Cont.)

Grade 5 events: Bevacizumab + Placebo: 1 (0.3%) infection.

*Renal failure and hepatic events were reversible.

Page 21: A Randomized, Double-blind, Placebo-controlled, Phase IIIb Trial (ATLAS) Comparing Bevacizumab Therapy with or without Erlotinib, after Completion of Chemotherapy.

ATLAS Conclusions & Next Steps