AZD9291 in Combination with Ascending Doses of Novel Therapeutics

Exclusion Criteria

• Treatment with an EGFR TKI within approximately 5x half-life (eg, within
• 8 days for erlotinib, gefitinib or afatanib, or within 10 days for dacomitinib) of
• the first dose of study treatment.
• Any cytotoxic chemotherapy, investigational agents or other anticancer drugs
• for the treatment of advanced NSCLC from a previous treatment regimen or
• clinical study within 14 days of the first dose of study treatment
• Patients currently receiving medications or herbal supplements known to be potent inducers of CYP3A4 (at least 3 weeks prior). For AZD6094 patients currently receiving prior to receiving the first dose, medications known to be strong inhibitors of CYP1A2.
• Prior AZD9291 dosing in the present study. Prior treatment with a
• 3rd generation (T790M-directed) therapy (eg, AZD9291, rociletinib or
• HM61713) outside of this study is permitted if allocated to the 3rd generation
• EGFR TKI cohort.
• Prior or current treatment with AZD6094 or another cMET inhibitor (eg,
• foretinib, crizotinib, cabozantinib, onartuzumab) if allocated to AZD9291 plus
• AZD6094 combination.
• Radiotherapy with a limited field of radiation for palliation within 1 week of the
• first dose of study treatment, with the exception of patients receiving radiation
• to more than 30% of the bone marrow or with a wide field of radiation which
• must be completed within ≥4 weeks of the first dose of study treatment
• Major surgical procedure, or significant traumatic injury within 4 weeks of the first dose of study treatment, or have an anticipated need for major surgery during the study.
• Currently receiving treatment with warfarin sodium. LMWH is allowed.
• Active gastrointestinal disease or other condition that will interfere significantly with the absorption, distribution, metabolism, or excretion of oral therapy
• Any of the following cardiac diseases currently or within the last 6 months: Unstable angina pectoris, Congestive heart failure (NYHA ≥ Grade 2), Acute myocardial infarction, Stroke or transient ischemic attack.
• Known hypersensitivity to the active or inactive excipients of AZD6094.
• Uncontrolled hypertension (BP ≥150/95 mmHg despite medical therapy)
• Mean resting correct QT interval (QTcF) >470 msec for women and >450 msec for men or factors that may increase the risk of QTcF prolongation such as chronic hypokalaemia not correctable with supplements, congenital or familial long QT syndrome, or family history of unexplained sudden death under 40 years of age in first degree relatives or any concomitant medication known to prolong the QT interval and cause Torsade de Pointes.
• Any clinically important abnormalities in rhythm, conduction or morphology of resting electrocardiograms (ECGs), e.g. complete left bundle branch block, third
• degree heart block, second degree heart block, PR interval >250 msec.
• Serious underlying medical condition at the time of treatment that would impair the ability of the patient to receive protocol treatment.
• Active hepatitis B (positive HBsAg result) or hepatitis C (HCV). Patients with a past or resolved HBV infection are eligible if negative for HBsAg and positive for anti-HBc or positive for HBsAg, but for > 6 months have had normal transaminases and HBV DNA levels between 0–2000 IU/ml (inactive carrier state) and willing to start and maintain antiviral treatment for at least the duration of the study. HBV DNA levels > 2000 IU/ml but on prophylactic antiviral treatment for the past 3 months and will maintain the antiviral treatment during the study. Patients with positive HCV antibody are eligible only if the polymerase chain reaction is negative for HCV RNA.
• Known serious active infection including, but not limited to, tuberculosis, or human immunodeficiency virus (positive HIV 1/2 antibodies).
• Presence of other active cancers, or history of treatment for invasive cancer, within the last 5 years. Patients with Stage I cancer who have received definitive local treatment at least 3 years previously, and are considered unlikely to recur are eligible. All patients with previously treated in situ carcinoma (i.e., non-invasive) are eligible, as are patients with history of non-melanoma skin cancer.
• Women who are either pregnant or breast feeding.
• Previous allogeneic bone marrow transplant
• Judgment 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.