ClinicalTrials.gg
RecruitingNCT04181060Updated Nov 4, 2026

Osimertinib With or Without Bevacizumab as Initial Treatment for Patients With EGFR-Mutant Lung Cancer

A Phase 3 interventional study of Bevacizumab and Biospecimen Collection in Advanced Lung Non-Squamous Non-Small Cell Carcinoma, Metastatic Lung Non-Squamous Non-Small Cell Carcinoma and Recurrent Lung Non-Squamous Non-Small Cell Carcinoma, sponsored by National Cancer Institute (NCI). Recruiting at 604 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by National Cancer Institute (NCI) · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Dec 2020; still recruiting 5 years 10 months later.
Updated Nov 4, 2026Site recruiting status changedPrimary completion moved+3 moreGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
300
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This phase III trial compares the effect of bevacizumab and osimertinib combination vs. osimertinib alone for the treatment of non-small cell lung cancer that has spread outside of the lungs (stage IIIB-IV) and has a change (mutation) in a gene called EGFR. The EGFR protein is involved in cell signaling pathways that control cell division and survival. Sometimes, mutations in the EGFR gene cause EGFR proteins to be made in higher than normal amounts on some types of cancer cells. This causes cancer cells to divide more rapidly. Osimertinib may stop the growth of tumor cells by blocking EGFR that is needed for cell growth in this type of cancer. Bevacizumab is in a class of medications called antiangiogenic agents. It works by stopping the formation of blood vessels that bring oxygen and nutrients to tumor. This may slow the growth and spread of tumor. Giving osimertinib with bevacizumab may control cancer for longer and help patients live longer as compared to osimertinib alone.

Read the detailed description

PRIMARY OBJECTIVE:

I. To evaluate progression-free survival (PFS) of osimertinib (AZD9291) and bevacizumab versus osimertinib (AZD9291) alone as first-line treatment for patients with metastatic EGFR-mutant lung cancers.

SECONDARY OBJECTIVES:

I. To evaluate overall survival (OS). II. To evaluate best objective response rate and duration of objective response.

III. To evaluate time to central nervous system (CNS) progression and CNS PFS. IV. To evaluate toxicity of the combination regimen.

CORRELATIVE OBJECTIVES:

I. To characterize mechanisms of resistance to osimertinib (AZD9291) and osimertinib (AZD9291) with bevacizumab first-line therapy through post-progression circulating tumor-derived deoxyribonucleic acid (ctDNA).

II. To assess for ctDNA clearance on study treatment and associate ctDNA clearance with clinical outcomes.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive osimertinib orally (PO) once daily (QD) on days 1-21. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive osimertinib PO QD on days 1-21 and bevacizumab intravenously (IV) over 30-90 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Patients undergo echocardiography (ECHO), multigated acquisition scan (MUGA), computed tomography (CT) and may undergo magnetic resonance imaging (MRI) and blood and urine sample collection on study.

After completion of study treatment, patients are followed up every 3 months for 10 years.

02

Conditions studied

  • Advanced Lung Non-Squamous Non-Small Cell Carcinoma
  • Metastatic Lung Non-Squamous Non-Small Cell Carcinoma
  • Recurrent Lung Non-Squamous Non-Small Cell Carcinoma
  • Stage IIIB Lung Cancer AJCC v8
  • Stage IV Lung Cancer AJCC v8

Browse trials for

03

In context

Lung Neoplasms

5,422 studies on the registry are indexed under Lung Neoplasms; 1,346 are open to participants now.

This study's planned enrollment of 300 is above the median of 60 across 3,656 interventional studies indexed under Lung Neoplasms.

Browse Lung Neoplasms studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,556 studies on the registry; 336 are open to participants now.

Of its 411 completed or terminated interventional studies of FDA-regulated products, 373 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Patient must have a -confirmed diagnosis of non-squamous, non-small cell lung cancer (NSCLC)
  • Patient must have advanced disease, defined as - either stage IV disease, stage IIIB disease not amenable to definitive multi-modality therapy, or recurrent disease after a prior diagnosis of stage I-III disease. All staging is via the American Joint Committee on Cancer (AJCC)/International Association for the Study of Lung Cancer (IASLC) 8th edition staging criteria
  • Patient must have somatic activating sensitizing mutation in EGFR (e.g. but not limited to Exon 19 deletion, L858R, E709X, G719X, exon 19 insertions, L861Q, S768I). Patients with non-sensitizing mutations in EGFR (EGFR exon 20 insertions) are not eligible. Test results originating from a Clinical Laboratory Improvement Act (CLIA)-certified or similarly accredited laboratory are acceptable; no specific assay is mandated. Plasma, cytology, or tumor tissue can be utilized for mutation testing
  • Patient must not have received any prior treatment with an anti-VEGF agent

    • NOTE: Prior treatment with an EGFR TKI is not allowed, however if a candidate for this study has already started osimertinib within 21 days prior to randomization, the exact osimertinib start date is known, and the patient had the required study baseline imaging completed prior to the osimertinib start date, the patient will be eligible
  • Patients that have received prior radiation therapy are eligible. Radiation (limited field stereotactic radiation or conventional radiation) must have been completed at least one week prior to study drug initiation and more extensive field radiation (i.e., whole-brain radiotherapy [WBRT]) must have been completed at least two weeks prior to drug initiation
  • Patient must not have any risk factors for anti-VEGF administration, specifically, hemoptysis, active cardiovascular disease, uncontrolled hypertension, significant proteinuria (screening urinalysis > 300 mg/dl) and tumor invading major blood vessels
  • Patient must have . Baseline measurements of sites of disease must be obtained within 4 weeks prior to study randomization. If a potential target lesion is previously irradiated without subsequent growth and/or is radiated after the imaging from which baseline measurements are obtained, they cannot be included as target lesions, and additional target lesions are required to meet criteria for measurable disease
  • Patient must not have had any prior systemic treatment for disease
  • Patient must be ≥ 18 years of age
  • Patient must have an (ECOG) performance status of 0 to 2
  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used
  • All females of must have a blood test or urine study within 14 days prior to randomization to rule out pregnancy
  • A female of childbearing potential is defined as any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
  • Patient of childbearing potential and sexually active males must not expect to conceive or father children by using accepted and effective method(s) of or by abstaining from sexual intercourse for 2 weeks prior to the start of treatment, while on study treatment, and for

    • 6 weeks after the last dose of protocol treatment for female patients on the osimertinib (AZD9291) alone arm
    • 4 months after the last dose of protocol treatment for male patients on osimertinib (AZD9291) alone arm
    • 6 months after the last dose of protocol treatment for all patients on osimertinib (AZD9291) plus bevacizumab combination arm
    • NOTE: Female patients should also not breastfeed while on treatment and for 6 months after the last dose bevacizumab
  • Leukocytes >= 3,000/mcL (obtained =\< 14 days prior to randomization)
  • >= 1,500/mcL (obtained =\< 14 days prior to randomization)
  • >= 100,000/mcL (obtained =\< 14 days prior to randomization)
  • >= 9 g/dL (obtained =\< 14 days prior to randomization)
  • Total and creatinine =\< 1.5 x institutional (ULN) (obtained =\< 14 days prior to randomization)
  • (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =\< 2.5 x institutional ULN (obtained =\< 14 days prior to randomization)
  • (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
  • For patients with evidence of chronic virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
  • Patients with a history of virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
  • Patients with treated are eligible if neurologically stable without therapy after the stated from radiation therapy (RT) or surgery provided the metastatic lesions are non-hemorrhagic
  • Patients with untreated brain metastases or are eligible if the treating physician determines that immediate CNS specific treatment is not required provided the metastatic lesions are non-hemorrhagic and are neurologically stable without glucocorticoid therapy
  • Patients with a prior or concurrent whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the regimen are eligible for this trial
  • Patients with known history or current symptoms of cardiac disease, should have a clinical risk assessment of cardiac function using the Functional Classification. To be eligible for this trial, patients should be class 2B or better
  • Patient must have the ability to understand and the willingness to sign a written document and comply with study requirements
  • Patient must not have had treatment with any investigational drug within five half-lives or 3 months (whichever is greater), prior to study initiation
  • Patient must not be currently receiving (or unable to stop use prior to receiving the first dose of study treatment) medications or herbal supplements known to be strong inducers of . For any patient currently receiving such inducers of CYP3A4, they must discontinue use prior to first dose of study treatment. All patients must try to avoid concomitant use of any medications, herbal supplements and/or ingestion of foods with known inducer effects on CYP3A4
  • Patient must not have any unresolved toxicities from prior therapy greater than (CTCAE) grade 1 at the time of randomization, with the exception of alopecia and grade 2 prior platinum-therapy-related neuropathy
  • Patient must not have any evidence of severe or uncontrolled systemic diseases, including uncontrolled hypertension and active bleeding diatheses, which in the investigator's opinion makes it challenging for the patient to participate in the study. Screening for chronic conditions is not required
  • Patient must not have nausea and vomiting, chronic gastrointestinal diseases, the inability to swallow the osimertinib tablets or previous significant bowel resection that would preclude adequate absorption of osimertinib
  • Patient must not have a medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease
  • Patient must not have a history of to active or inactive of osimertinib or drugs with a similar chemical structure or class to osimertinib
  • Patient must not have mean resting interval (QTc) > 470 msec obtained from 3 (ECGs), using the screening clinic ECG machine derived QTc value (using Bazett's correction)
  • Patient must not have any abnormalities in rhythm, conduction or morphology of resting ECG e.g. complete left bundle branch block, third degree heart block and second-degree heart block
  • Patient must not have any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, electrolyte abnormalities (including: potassium \< lower limit of normal [LLN]; magnesium \< LLN; calcium \< LLN), congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age in first degree relatives or any concomitant medication known to prolong the QT interval and cause torsades de pointes
Terms in these criteria, in plain language(32)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
300 participants (estimated)

Study arms

  • Active comparator
    Arm A (osimertinib)

    Patients receive osimertinib PO QD on days 1-21. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO, MUGA, CT and may undergo MRI and blood and urine sample collection on study.

    Procedure: Biospecimen Collection · Procedure: Computed Tomography · Procedure: Echocardiography Test · Procedure: Magnetic Resonance Imaging · Procedure: Multigated Acquisition Scan · Drug: Osimertinib

  • Experimental
    Arm B (osimertinib, bevacizumab)

    Patients receive osimertinib PO QD on days 1-21 and bevacizumab IV over 30-90 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO, MUGA, CT and may undergo MRI and blood and urine sample collection on study.

    Biological: Bevacizumab · Procedure: Biospecimen Collection · Procedure: Computed Tomography · Procedure: Echocardiography Test · Procedure: Magnetic Resonance Imaging · Procedure: Multigated Acquisition Scan · Drug: Osimertinib

Interventions

  • BiologicalBevacizumab

    Given IV

    Also known as: ABP 215, ABP-215, ABP215, Alymsys, Anti-VEGF, Anti-VEGF Humanized Monoclonal Antibody, Anti-VEGF Monoclonal Antibody SIBP04, Anti-VEGF rhuMAb, Avastin, Avegra, Avzivi, Aybintio, BAT 1706, BAT-1706, BAT1706, BAT1706 Biosimilar, Bevacizumab awwb, Bevacizumab Biosimilar ABP 215, Bevacizumab Biosimilar BAT1706, Bevacizumab Biosimilar BEVZ92, Bevacizumab Biosimilar BI 695502, Bevacizumab Biosimilar CBT 124, Bevacizumab Biosimilar CT-P16, Bevacizumab Biosimilar FKB238, Bevacizumab Biosimilar GB-222, Bevacizumab Biosimilar HD204, Bevacizumab Biosimilar HLX04, Bevacizumab Biosimilar IBI305, Bevacizumab Biosimilar LY01008, Bevacizumab Biosimilar MB02, Bevacizumab Biosimilar MIL60, Bevacizumab Biosimilar Mvasi, Bevacizumab Biosimilar MYL-1402O, Bevacizumab Biosimilar QL 1101, Bevacizumab Biosimilar QL1101, Bevacizumab Biosimilar RPH-001, Bevacizumab Biosimilar SCT501, Bevacizumab Biosimilar Zirabev, Bevacizumab-adcd, Bevacizumab-aveg, Bevacizumab-awwb, Bevacizumab-aybi, Bevacizumab-bvzr, Bevacizumab-byva, Bevacizumab-equi, Bevacizumab-maly, Bevacizumab-nwgd, Bevacizumab-onbe, Bevacizumab-tnjn, BP102, BP102 Biosimilar, Byvasda, CT P16, CT-P16, CTP16, Equidacent, FKB 238, FKB-238, FKB238, HD204, IBI 305, IBI-305, IBI305, Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer, Jobevne, MB 02, MB-02, MB02, Mvasi, MYL-1402O, Onbevzi, Oyavas, PF 06439535, PF-06439535, PF06439535, QL1101, Recombinant Humanized Anti-VEGF Monoclonal Antibody, rhuMab-VEGF, SCT501, SIBP 04, SIBP-04, SIBP04, Vegzelma, Zirabev

  • ProcedureBiospecimen Collection

    Undergo blood and urine sample collection

    Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection

  • ProcedureComputed Tomography

    Undergo CT

    Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography

  • ProcedureEchocardiography Test

    Undergo ECHO

    Also known as: EC, Echocardiography

  • ProcedureMagnetic Resonance Imaging

    Undergo MRI

    Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI

  • ProcedureMultigated Acquisition Scan

    Undergo MUGA

    Also known as: Blood Pool Scan, Equilibrium Radionuclide Angiography, Gated Blood Pool Imaging, Gated Heart Pool Scan, MUGA, MUGA Scan, Multi-Gated Acquisition Scan, Radionuclide Ventriculogram Scan, Radionuclide Ventriculography, RNV Scan, RNVG, SYMA Scanning, Synchronized Multigated Acquisition Scanning

  • Given PO

    Also known as: AZD 9291, AZD-9291, AZD9291, Mereletinib

06

What researchers measure

Primary outcomes

  1. Progression-free survival (PFS)

    Will be estimated using the Kaplan-Meier method, and Cox proportional hazards models will be used to estimate the treatment hazard ratios. PFS will use a logrank test stratified on the randomization stratification factors with a one-sided type I error rate of 2.5%.

    Time frame: From randomization to documented disease progression per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or death from any cause, whichever occurs first, assessed up to 10 years

Secondary outcomes

  1. Overall survival (OS)

    Will be estimated using the Kaplan-Meier method, and Cox proportional hazards models will be used to estimate the treatment hazard ratios. OS will be tested at the one-sided 10% level.

    Time frame: From randomization to death from any cause, assessed up to 10 years

  2. Best objective response rate

    Best objective response will be evaluated via RECIST 1.1 criteria. Will be compared using Fisher's exact tests with a one-sided type I error rate of 2.5%; multivariable logistic regression modeling will be used to adjust for the effect of any covariates that are associated with these categorical outcomes.

    Time frame: Up to 10 years

  3. Time to central nervous system progression

    Will be estimated using competing risks methodology, adjusting for death and progression as competing events. Regular central nervous system imaging will occur when patients are on treatment. After they discontinue study treatment, central nervous system imaging will be symptom-prompted during follow up.

    Time frame: From study randomization to evidence of central nervous system progressive disease, with death and progression as competing events, assessed up to 10 years

  4. Central nervous system progression-free survival

    Will be estimated using the Kaplan-Meier method.

    Time frame: From study randomization to evidence of central nervous system progressive disease or death from any cause, whichever occurs first, assessed up to 10 years

  5. Incidence of adverse events

    Toxicity will be determined using the Common Terminology Criteria for Adverse Events (CTCAE). Will be compared using Fisher's exact tests with a one-sided type I error rate of 2.5%; multivariable logistic regression modeling will be used to adjust for the effect of any covariates that are associated with these categorical outcomes.

    Time frame: Up to 30 days after the last administration of investigational agent

Other outcomes

  1. Mechanisms of resistance to AZD9291 (osimertinib) and AZD9291 (osimertinib) with bevacizumab first-line therapy through post-progression circulating tumor-derived deoxyribonucleic acid (ctDNA)

    Preliminary analyses of these data will utilize tests for association comparing the frequency of a particular genomic aberration at baseline and at progression (for example, using McNemar's test) and association between alterations and baseline characteristics (for example, using Fisher's exact test). More sophisticated analyses may include multivariable logistic regression modeling and/or competing risks analysis.

    Time frame: Up to 10 years

  2. Circulating tumor deoxyribonucleic acid (ctDNA) clearance on study treatment

    Will assess ctDNA clearance on study treatment and associate ctDNA clearance with clinical outcomes. Cox regression analysis will be used to assess whether EGFR ctDNA clearance is an independent predictor for PFS (and OS), adjusted by treatment effect, the presence of brain metastasis (yes versus \[vs.\] no), EGFR exon 19 deletion/L858R vs other, Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs 2) and other possible clinical and biological risk factors.

    Time frame: Up to 10 years

07

Study locations

328 of 604 sites recruiting

Showing the first 100 of 604 sites. Choose a country and city above to see the rest.

08

References and documents

Individual participant data

Plan to share: Yes — NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Data sharing details ↗ · grants.nih.gov

No publications or documents are linked to this record.

09

Timeline

14 registry updates since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Dec 2020 (actual). Primary completion is estimated for Jun 2029, 102 months after the start.

Of 66 non-industry phase 3 interventional studies under Lung Neoplasms, half reached primary completion within 66 months of starting (the median), counting those still running; a quarter within 42 and three quarters within 99. This study's planned 102 months is above that.

Counting every sponsor, half of 128 studies reached it within 43 months; a quarter within 30 and three quarters within 80.

Since we started tracking on Sep 25, 2026, the dates moved once, on Sep 29, 2026: primary completion Dec 2026 → Jun 2029 and completion Dec 2026 → Jun 2029.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Nov 27, 2019
First posted
Nov 29, 2019
StartActual
Dec 28, 2020
Primary completionEst.
Jun 30, 2029was Dec 2026
CompletionEst.
Jun 30, 2029was Dec 2026
Last update
Nov 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
4 sites added, 3 sites removed. 15 sites changed recruiting status (9 now recruiting, 5 now suspended, …)
Show 15 sites
  • Smilow Cancer Hospital Care Center at Glastonbury · Glastonbury, United StatesRecruiting→Suspended
  • Smilow Cancer Hospital Care Center at Saint Francis · Hartford, United StatesRecruiting→Suspended
  • Upper Valley Medical Center · Troy, United StatesSuspended→Recruiting
  • Greater Regional Medical Center · Creston, United StatesSuspended→Active, not recruiting
  • Alaska Oncology and Hematology LLC · Anchorage, United StatesRecruiting→Suspended
  • Providence Newberg Medical Center · Newberg, United StatesSuspended→Recruiting
  • Providence Willamette Falls Medical Center · Oregon City, United StatesSuspended→Recruiting
  • PeaceHealth Saint John Medical Center · Longview, United StatesSuspended→Recruiting
  • Robert Wood Johnson University Hospital Somerset · Somerville, United StatesSuspended→Recruiting
  • Parkland Memorial Hospital · Dallas, United StatesSuspended→Recruiting
  • UT Southwestern Simmons Cancer Center - RedBird · Dallas, United StatesSuspended→Recruiting
  • UT Southwestern/Simmons Cancer Center-Fort Worth · Fort Worth, United StatesSuspended→Recruiting
  • UT Southwestern Clinical Center at Richardson/Plano · Richardson, United StatesSuspended→Recruiting
  • Novant Health Cancer Institute - Mount Airy · Mount Airy, United StatesRecruiting→Suspended
  • Rush-Copley Medical Center · Aurora, United StatesRecruiting→Suspended
Show 4 added (4 United States)
  • Vandalia Health/CAMC Institute for Academic Medicine · Charleston, United States
  • Saint Anne Hospital · Burien, United States
  • Trinity Health IHA Medical Group-Alice Gustafson Center · Pontiac, United States
  • UCSF Cancer Center Burlingame · Burlingame, United States
Show 3 removed
  • West Virginia University Charleston Division · Charleston, United States
  • Highline Medical Center-Main Campus · Burien, United States
  • Newland Medical Associates-Pontiac · Pontiac, United States
across 13 updates, Oct 1, 2026 – Nov 4, 2026
Primary completion
Dec 31, 2026→Jun 30, 2029
Sep 29, 2026
Study completion
Dec 31, 2026→Jun 30, 2029
Sep 29, 2026
Site contacts
Changed at 18 sites. See the sites
Show 18 sites
  • West Virginia University Charleston Division · Charleston, United StatesContact none listed→C•••@vandaliahealth.org
  • Smilow Cancer Hospital Care Center at Glastonbury · Glastonbury, United StatesContact removed c•••@yale.edu · •••5702Contact removed (no phone or email listed)
  • Smilow Cancer Hospital Care Center at Saint Francis · Hartford, United StatesContact removed c•••@yale.edu · •••5702Contact removed (no phone or email listed)
  • Genesis Healthcare System Cancer Care Center · Zanesville, United StatesContact added J•••@columbusccop.org · •••2745Contact added (no phone or email listed)
  • Providence Portland Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Providence Saint Vincent Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Upper Valley Medical Center · Troy, United StatesContact added c•••@daytonncorp.org · •••2900Contact added (no phone or email listed)
  • Alaska Oncology and Hematology LLC · Anchorage, United StatesContact removed A•••@providence.org · •••6871Contact removed (no phone or email listed)
  • Providence Newberg Medical Center · Newberg, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • Providence Willamette Falls Medical Center · Oregon City, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  • PeaceHealth Saint John Medical Center · Longview, United StatesContact added k•••@peacehealth.org · •••2016Contact added (no phone or email listed)
  • Robert Wood Johnson University Hospital Somerset · Somerville, United StatesContact added S•••@rwjbh.org · •••2481Contact added (no phone or email listed)
  • Parkland Memorial Hospital · Dallas, United StatesContact added c•••@utsouthwestern.edu · •••5582Contact added (no phone or email listed)
  • UT Southwestern Simmons Cancer Center - RedBird · Dallas, United StatesContact added c•••@utsouthwestern.edu · •••7097Contact added (no phone or email listed)
  • UT Southwestern/Simmons Cancer Center-Fort Worth · Fort Worth, United StatesContact added c•••@utsouthwestern.edu · •••7097Contact added (no phone or email listed)
  • UT Southwestern Clinical Center at Richardson/Plano · Richardson, United StatesContact added S•••@utsouthwestern.edu · •••7044Contact added (no phone or email listed)
  • Novant Health Cancer Institute - Mount Airy · Mount Airy, United StatesContact removed a•••@novanthealth.org · •••8335Contact removed (no phone or email listed)
  • Rush-Copley Medical Center · Aurora, United StatesContact removed R•••@rush.edu · •••6212Contact removed (no phone or email listed)
across 10 updates, Sep 29, 2026 – Nov 3, 2026
Show all 14 updates
  1. Nov 4, 2026
    1 site added
    Show site
    • UCSF Cancer Center Burlingame · Burlingame, United States
  2. Nov 3, 2026
    Rush-Copley Medical Center is now Suspended
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Rush-Copley Medical Center · Aurora, United StatesContact removed R•••@rush.edu · •••6212Contact removed (no phone or email listed)
  3. Oct 27, 2026
    Novant Health Cancer Institute - Mount Airy is now Suspended
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Novant Health Cancer Institute - Mount Airy · Mount Airy, United StatesContact removed a•••@novanthealth.org · •••8335Contact removed (no phone or email listed)
  4. Oct 26, 2026
    1 site added, 1 site removed. 4 sites changed recruiting status (4 now recruiting)
    Show 4 sites
    • Parkland Memorial Hospital · Dallas, United StatesSuspended→Recruiting
    • UT Southwestern Simmons Cancer Center - RedBird · Dallas, United StatesSuspended→Recruiting
    • UT Southwestern/Simmons Cancer Center-Fort Worth · Fort Worth, United StatesSuspended→Recruiting
    • UT Southwestern Clinical Center at Richardson/Plano · Richardson, United StatesSuspended→Recruiting
    Show site
    • Trinity Health IHA Medical Group-Alice Gustafson Center · Pontiac, United States
    Show 1 removed
    • Newland Medical Associates-Pontiac · Pontiac, United States
    Site contacts Changed at 4 sites. See the sites
    Show 4 sites
    • Parkland Memorial Hospital · Dallas, United StatesContact added c•••@utsouthwestern.edu · •••5582Contact added (no phone or email listed)
    • UT Southwestern Simmons Cancer Center - RedBird · Dallas, United StatesContact added c•••@utsouthwestern.edu · •••7097Contact added (no phone or email listed)
    • UT Southwestern/Simmons Cancer Center-Fort Worth · Fort Worth, United StatesContact added c•••@utsouthwestern.edu · •••7097Contact added (no phone or email listed)
    • UT Southwestern Clinical Center at Richardson/Plano · Richardson, United StatesContact added S•••@utsouthwestern.edu · •••7044Contact added (no phone or email listed)
  5. Oct 22, 2026
    1 site added, 1 site removed
    Show site
    • Saint Anne Hospital · Burien, United States
    Show 1 removed
    • Highline Medical Center-Main Campus · Burien, United States
  6. Oct 20, 2026
    Robert Wood Johnson University Hospital Somerset is now Recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Robert Wood Johnson University Hospital Somerset · Somerville, United StatesContact added S•••@rwjbh.org · •••2481Contact added (no phone or email listed)
  7. Oct 16, 2026
    PeaceHealth Saint John Medical Center is now Recruiting
    Site contacts Changed at 1 site. See the sites
    Show the site
    • PeaceHealth Saint John Medical Center · Longview, United StatesContact added k•••@peacehealth.org · •••2016Contact added (no phone or email listed)
  8. Oct 14, 2026
    5 sites changed recruiting status (4 now recruiting, 1 now suspended)
    Show 5 sites
    • Alaska Oncology and Hematology LLC · Anchorage, United StatesRecruiting→Suspended
    • Providence Newberg Medical Center · Newberg, United StatesSuspended→Recruiting
    • Providence Willamette Falls Medical Center · Oregon City, United StatesSuspended→Recruiting
    • Providence Portland Medical Center · Portland, United StatesSuspended→Recruiting
    • Providence Saint Vincent Medical Center · Portland, United StatesSuspended→Recruiting
    Site contacts Changed at 5 sites. See the sites
    Show 5 sites
    • Alaska Oncology and Hematology LLC · Anchorage, United StatesContact removed A•••@providence.org · •••6871Contact removed (no phone or email listed)
    • Providence Newberg Medical Center · Newberg, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Willamette Falls Medical Center · Oregon City, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Portland Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
    • Providence Saint Vincent Medical Center · Portland, United StatesContact added C•••@providence.org · •••2614Contact added (no phone or email listed)
  9. Oct 9, 2026
    Greater Regional Medical Center is now Active, not recruiting
  10. Oct 7, 2026
    2 sites changed recruiting status (2 now recruiting)
    Show 2 sites
    • Upper Valley Medical Center · Troy, United StatesSuspended→Recruiting
    • Genesis Healthcare System Cancer Care Center · Zanesville, United StatesSuspended→Recruiting
    Site contacts Changed at 2 sites. See the sites
    Show 2 sites
    • Upper Valley Medical Center · Troy, United StatesContact added c•••@daytonncorp.org · •••2900Contact added (no phone or email listed)
    • Genesis Healthcare System Cancer Care Center · Zanesville, United StatesContact added J•••@columbusccop.org · •••2745Contact added (no phone or email listed)
  11. Oct 6, 2026
    3 sites changed recruiting status (3 now suspended)
    Show 3 sites
    • Genesis Healthcare System Cancer Care Center · Zanesville, United StatesRecruiting→Suspended
    • Providence Portland Medical Center · Portland, United StatesRecruiting→Suspended
    • Providence Saint Vincent Medical Center · Portland, United StatesRecruiting→Suspended
    Site contacts Changed at 3 sites. See the sites
    Show 3 sites
    • Genesis Healthcare System Cancer Care Center · Zanesville, United StatesContact removed J•••@columbusccop.org · •••2745Contact removed (no phone or email listed)
    • Providence Portland Medical Center · Portland, United StatesContact removed C•••@providence.org · •••2614Contact removed (no phone or email listed)
    • Providence Saint Vincent Medical Center · Portland, United StatesContact removed C•••@providence.org · •••2614Contact removed (no phone or email listed)
  12. Oct 5, 2026
    2 sites changed recruiting status (2 now suspended)
    Show 2 sites
    • Smilow Cancer Hospital Care Center at Glastonbury · Glastonbury, United StatesRecruiting→Suspended
    • Smilow Cancer Hospital Care Center at Saint Francis · Hartford, United StatesRecruiting→Suspended
    Site contacts Changed at 2 sites. See the sites
    Show 2 sites
    • Smilow Cancer Hospital Care Center at Glastonbury · Glastonbury, United StatesContact removed c•••@yale.edu · •••5702Contact removed (no phone or email listed)
    • Smilow Cancer Hospital Care Center at Saint Francis · Hartford, United StatesContact removed c•••@yale.edu · •••5702Contact removed (no phone or email listed)
  13. Oct 1, 2026
    1 site added, 1 site removed
    Show site
    • Vandalia Health/CAMC Institute for Academic Medicine · Charleston, United States
    Show 1 removed
    • West Virginia University Charleston Division · Charleston, United States
  14. Sep 29, 2026
    Primary completion Dec 31, 2026→Jun 30, 2029
    Study completion Dec 31, 2026→Jun 30, 2029
    Site contacts Changed at 1 site. See the sites
    Show the site
    • West Virginia University Charleston Division · Charleston, United StatesContact none listed→C•••@vandaliahealth.org
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT04181060
Responsible party
Sponsor
First posted
Nov 29, 2019
Start date
Dec 28, 2020
Primary completion
Jun 30, 2029 (estimated)
Completion
Jun 30, 2029 (estimated)
Last update
Nov 4, 2026

Study contacts

Helena A Yu
principal investigator · ECOG-ACRIN Cancer Research Group

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Bevacizumab

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