A Randomized, Double-Blind, Placebo-controlled Phase 2 Study of Maintenance OSI-906 Plus Erlotinib (Tarceva®), or Erlotinib Plus Placebo in Patients With Nonprogression Following Four Cycles of 1st-line Platinum-based Chemotherapy for Advanced NSCLC

Inclusion Criteria:

- Histologically confirmed locally advanced or metastatic stage IIIB or IV NSCLC

- Have experienced Complete Response (CR), Partial Response (PR) or Stable Disease (SD)
following completion of 4 cycles of first-line platinum-based chemotherapy and are
not progressing at time of entry into study (prior completed first-line combination
bevacizumab therapy is permitted; however, current use of maintenance bevacizumab is
not permitted. A maximum interval of 28 days between the last day of the treatment
cycle and randomization

- Patient has recovered from prior chemotherapy-related toxicity to ≤ grade 2

- EGFR mutation status must be confirmed for participation in the study. EGFR analysis
can be performed either by central or local laboratory. If analysis is done locally,
verifiable documentation confirming the EGFR mutation status must be submitted for
review and approval by APGD prior to randomization. If no local result is available,
formalin-fixed, paraffin-embedded archival tissue representative of the tumor or in
the absence of archival tissue, a fresh tumor tissue sample of sufficient size to
perform EGFR mutation analysis must be submitted centrally. Results of the central
analysis must be available prior to randomization. Additionally, subjects should
provide tissue blocks centrally for biomarker analysis whenever possible. Ideal
tissue requirement: block with ≥5 mm2 tumor area sufficient to provide four 4-micron,
and five 10-micron sections)

- Measurable disease (for those patients with PR or SD after first-line platinum-based
chemotherapy) according to Response Evaluation Criteria in Solid Tumors (RECIST)
(version 1.1)

- Eastern Cooperative Oncology Group (ECOG) Performance Status(PS) 0 - 1

- Previous adjuvant or neo-adjuvant treatment is permitted

- Must be able to take oral medication

- Fasting glucose ≤ 150 mg/dL (8.3 mmol/L). Concurrent use of non-insulinotropic
antihyperglycemic therapy is permitted if the dose has been stable for ≥ 4 weeks at
the time of randomization

- Adequate hematopoietic, hepatic, and renal function defined as follows:

- Neutrophil count ≥ 1.5 x 109/L

- Platelet count ≥ 100 x 109/L

- Bilirubin ≤ 1.5 x Upper Limit of Normal (ULN)

- AST and ALT ≤ 2.5 x ULN, or ≤ 5 x ULN if patient has documented liver metastases

- Serum creatinine ≤ 1.5 x ULN

- Potassium, magnesium and calcium within normal limits (supplementation and retesting
is permitted)

Female patient must be either:

- Of non child bearing potential:

- post-menopausal (defined as at least 1 year without any menses) prior to
Screening, or

- documented surgically sterile or status post hysterectomy (at least 1 month
prior to Screening)

- Or, if of childbearing potential:

- must have a negative urine pregnancy test at Screening, and

- must use two forms of birth control (one of which must be a barrier method)
starting at Screening and throughout the study period and for 30 days after
final study drug administration

- Female patient must not be breastfeeding at Screening or during the study period and
for 30 days after final study drug administration

- Female patient must not donate ova starting at Screening and throughout the study
period and for 30 days after final study drug administration

- Male patient and their female spouse/partners who are of childbearing potential must
be using highly effective contraception consisting of two forms of birth control (one
of which must be a barrier method) starting at Screening and continue throughout the
study period and for 30 days after final study drug administration

- Male patient must not donate sperm starting at Screening and throughout the study
period and for at least 30 days after final study drug administration

- Prior radiation therapy is permitted provided patients have recovered from acute
toxic effects of radiotherapy prior to randomization. A minimum of 28 days must have
elapsed between the end of radiotherapy and randomization

- Prior surgery is permitted provided that the surgery was performed 21 days prior to
randomization and adequate wound healing has occurred prior to randomization

- Patients must provide written (signed) informed consent to participate in the study
and for use of tumor tissues

Exclusion Criteria:

- Prior exposure to agents directed at the Human Epidermal Receptor (HER) axis (eg,
erlotinib, gefitinib, cetuximab, and trastuzumab)

- Malignancies other than NSCLC within past 3 years (exceptions if curatively treated:
basal or squamous cell carcinoma of skin; locally advanced prostate cancer; ductal
carcinoma in situ of breast; in situ cervical carcinoma; and superficial bladder
cancer)

- Type 1 diabetes mellitus or Type 2 diabetes mellitus currently requiring
insulinotropic or insulin therapy

- Prior insulin-like growth factor receptor (IGF-1R)

- Prior investigational agent within 21 days prior to randomization

- Concurrent use of maintenance bevacizumab

- History of poorly controlled gastrointestinal disorders that could affect the
absorption of study drug (eg, Crohn's disease, ulcerative colitis, etc)

- History (within last 180 days) of significant cardiovascular disease unless the
disease is well-controlled. Significant cardiac disease includes second/third degree
heart block; clinically significant ischemic heart disease; superior vena cava (SVC)
syndrome; poorly controlled hypertension; congestive heart failure of New York Heart
Association (NYHA) Class II or worse (slight limitation of physical activity;
comfortable at rest, but ordinary physical activity results in fatigue, palpitation,
or dyspnea)

- History of arrhythmia (multifocal premature ventricular contractions [PVCs],
bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial fibrillation)
that is symptomatic or requires treatment (≥ grade 3), left bundle branch block
(LBBB), or asymptomatic sustained ventricular tachycardia are not allowed. Patients
with atrial fibrillation controlled by medication are not excluded

- Mean QTcF interval > 450 msec based on independent central reviewer analysis of
screening visit ECGs

- Use of drugs that have a known risk of causing Torsades de Pointes (TdP) are
prohibited within 14 days prior to randomization

- Use of the potent CYP1A2 inhibitors ciprofloxacin and fluvoxamine. Other less potent
CYP1A2 inhibitors/inducers are not excluded

- Use of potent CYP3A4 inhibitor such as ketoconazole, clarithromycin, atazanavir,
indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir,
telithromycin, troleandomycin (TAO), or voriconazole

- Use of proton pump inhibitors such as omeprazole. Use of H2-receptor antagonists
such as ranitidine are not excluded

- History of cerebrovascular accident (CVA) within 180 days prior to randomization or
that resulted in ongoing neurologic instability

- Active infection, serious underlying medical condition (including any type of active
seizure disorder within 12 months prior to randomization), or serious chronic illness
that would impair the ability of the patient to receive study drug

- History of any psychiatric or neurologic condition that might impair the patient's
ability to understand or to comply with the requirements of the study or to provide
informed consent

- Pregnant or breast-feeding females

- Symptomatic brain metastases that are not stable, require steroids, or that have
required radiation and/or other related treatment (e.g., anti-epileptic medication)
within 21 days prior to randomization

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to study drug

- Participated in any interventional clinical study or has been treated with any
investigational drugs within 30 days or 5 half lies whichever is longer, prior to the
initiation of Screening or during the course of the study