International Multicenter Randomized Double Blind Phase III Trial Comparing Safety and Efficacy of BCD-021 (CJSC BIOCAD, Russia) and Paclitaxel + Carboplatin to Avastin® (F. Hoffmann-La Roche Ltd, Switzerland) and Paclitaxel + Carboplatin in Inoperable or Advanced Non-squamous Non-small-cell Lung Cancer (NSCLC) Patients
Inclusion Criteria:
- Written informed consent;
- Newly diagnosed histologically or cytologically confirmed NSCLC excluding squamous
NSCLC (mixed cancer types should be classified according to the prevalent cell type);
- IIIb or IV stage of NSCLC (TNM classification version 6);
- Age ≥ 18 years and age ≤ 70 years (both inclusive);
- Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2, (not
declining within 2 weeks prior to the first dose of investigational product);
- Life expectancy - 12 weeks or more from the moment of randomization;
- Presence of at least 1 measurable tumour with a size not less than 1 cm (revealed
with CT slice thickness not more than 5 mm), as defined by modified Response
Evaluation Criteria in Solid Tumors (RECIST) criteria (specifically, no ascites,
pleural, or pericardial effusions, osteoblastic bone metastases, or carcinomatous
lymphangitis of the lung as only lesion;
- Patients should be able to follow the Protocol procedures (according to
Investigator's assessment);
- Patients must implement reliable contraceptive measures during all the study
treatment, starting 4 weeks prior to the administration of the first dose of
investigational product until 6 months after the last dose of investigational
product. This requirement does not apply to participants who have undergone surgical
sterilization, or patients who are postmenopausal (documented) for the past 2 years.
Reliable contraceptive measures include two methods of contraception, including one
barrier method
Exclusion Criteria:
- Squamous NSCLC;
- Proven coagulopathy, clinically significant hemorrhage in the past including nasal
hemorrhage;
- absolute neutrophil count <1500/mm3;
- Platelets <100 000/mm3;
- Hemoglobin < 90 g/L;
- Creatinine level ≥1.5 mg/dL;
- Bilirubin level ≥1.5 × upper limit of normal (ULN);
- Aspartate-aminotransferase(AST) and alanine-aminotransferase (ALT) levels ≥2.5 × ULN
(≥5 × ULN for patients with liver metastases);
- Alkaline phosphatase level ≥5 × ULN;
- Current therapeutic anticoagulation treatment, aspirin (more than 325 mg/day),
nonsteroidal anti-inflammatory drugs, antiplatelet agents or protracted treatment
with these drugs less than 1 month before entering the study;
- Uncontrolled hypertension comprising all cases of arterial hypertension when no
decrease in blood pressure could be achieved despite treatment with a combination of
3 antihypertensive drugs including one diuretic and non-medical correction methods
(low salt diet, physical exercise);
- Previous anticancer therapy of metastatic NSCLC;
- Radiation or hormone therapy within 21 days prior to randomization;
- Major surgery 28 days before inclusion into the study;
- Previous antiangiogenic therapy;
- Hypersensitivity to taxanes, platinum agents, recombinant murine proteins, contrast
agents, premedication agents specified by Protocol (dexamethasone, diphenhydramine,
ranitidine) or excipients of investigational products;
- NSCLC metastases in central nervous system excluding metastases non-progressing
without glucocorticosteroids within 4 weeks before inclusion into the trial;
- Cardiovascular system pathology (CHF stage III-IV according to New York Heart
Association (NYHA) classification);
- Pregnancy or lactation;
- Conditions limiting patient's adherence to Protocol requirements (dementia,
neurologic or psychiatric disorders, drug addiction, alcoholism and others);
- Stage II-IV neuropathy according to Common Terminology Criteria for Adverse Events
(CTCAE) v.4.0;
- Simultaneous participation in other clinical trials, previous participation in other
clinical trials within 30 days before entering into the trial, previous participation
in the same trial;
- Any other concomitant cancer revealed within 5 years prior to screening, except
curatively treated intraductal carcinoma in situ, curatively treated cervical
carcinoma in situ or curatively treated basal cell or squamous cell carcinoma;
- Acute or active chronic infections;
- Hepatitis C virus, hepatitis B virus, HIV, or syphilis infections;
- Obstacles in intravenous administration of study drugs