A Phase II, Randomized, Double-Blind, Placebo-Controlled Study of Oral E7080 in Addition to Best Supportive Care (BSC) Versus BSC Alone in Patients With Locally Advanced or Metastatic Non-Squamous Non-Small Cell Lung Cancer Who Have Failed at Least Two Systemic Anticancer Regimens

Inclusion Criteria

Inclusion Criteria

1. Age ≥18 years;

2. Patients with histologically or cytologically confirmed non-squamous NSCLC with
locally advanced or metastatic disease, who have failed at least 2 lines of systemic
anticancer therapy for advanced or metastatic NSCLC (does not include adjuvant
chemotherapy)In countries where erlotinib is approved and marketed for the treatment
of NSCLC, patients must have received erlotinib treatment for their NSCLC. In
countries where crizotinib is approved and marketed, patients must have received
crizotinib treatment for NSCLC that is anaplastic lymphoma kinase (ALK)-positive;

3. Patients must have at least 1 site of measurable disease by the Response Evaluation
Criteria in Solid Tumors version 1.1 (RECIST v.1.1);

4. ECOG PS of 0 to 2;

5. Patients must have adequate renal function as evidenced by serum creatinine ≤1.5 X
upper limit of normal (ULN) or calculated creatinine clearance ≥30 mL/min per the
Cockcroft and Gault formula;

6. Blood pressure must be well-controlled (≤140/90 mm Hg at Screening) with or without
antihypertensive medication. Patients must have no history of hypertensive crisis or
hypertensive encephalopathy;

7. Patients must have adequate bone marrow function as evidenced by absolute neutrophil
count (ANC) ≥1.5 X 109/L, hemoglobin ≥9.0 g/dL, and platelet count ≥100 X 109/L;

8. Patients must have adequate liver function as evidenced by bilirubin ≤1.5 times the
ULN, and alkaline phosphatase, alanine aminotransferase (ALT), and aspartate
aminotransferase (AST) ≤3 X ULN (in the case of liver metastases, ≤5 X ULN).

9. Patients must have adequate coagulation system function as defined by prothrombin
time/International normalized ratio (INR) ≤1.5 X ULN.

10. Male or female patients of child-producing potential must agree to use double barrier
contraception, oral contraceptives, or avoidance of pregnancy measures during the
study and for 90 days after the last day of treatment;

11. Females of childbearing potential must have a negative serum pregnancy test;

12. Females may not be breastfeeding;

13. Ability to understand and willingness to sign a written informed consent.

Exclusion Criteria

1. Prior therapy with E7080 or other small molecule vascular endothelial growth factor
inhibitors;

2. Presence of brain metastases, unless the patient has received adequate treatment at
least 4 weeks prior to randomization, and is stable, asymptomatic, and off steroids
for at least 4 weeks prior to randomization;

3. Meningeal carcinomatosis;

4. Received chemotherapy, targeted therapy, radiotherapy, surgery, or immunotherapy
within the 21 days prior to commencing study treatment or have not recovered from all
treatment-related toxicities to Grade ≤2, except for alopecia;

5. Received treatment with another investigational agent within the 30 days prior to
commencing study treatment or patients who have not recovered from side effects of an
investigational drug to Grade ≤2, except for alopecia;

6. Patients with proteinuria >1+ on urine dipstick testing will undergo 24-hour urine
collection for quantitative assessment of proteinuria. Patients with 24-hour urine
protein ≥1 g/24 hours will be ineligible;

7. Serious non-healing wound, ulcer, bone fracture, or have undergone a major surgical
procedure, open biopsy, or significant traumatic injury within the 28 days prior to
commencing study treatment.

8. Major surgery scheduled during the projected course of the study;

9. History of bleeding diathesis or coagulopathy;

10. Active hemoptysis (defined as bright red blood of ½ teaspoon or more) within the 30
days prior to study entry;

11. Refractory nausea and vomiting, malabsorption, significant bowel resection, or any
other medical condition that would preclude adequate absorption or result in the
inability to take oral medication;

12. Other malignancy within 3 years of randomization, with the exception of adequately
treated carcinoma in situ of the cervix or non-melanoma skin cancer, with no
subsequent evidence of recurrence and/or malignancies diagnosed at a stage where
definitive therapy results in near certain cures.

13. Significant cardiovascular impairment (history of congestive heart failure New York
Heart Association [NYHA] Class >II, unstable angina or myocardial infarction within
the past 6 months, or serious cardiac arrhythmia);

14. Any history of cerebral vascular accident (CVA), transient ischemic attack (TIA), or
Grade ≥2 peripheral vascular disease unless they have had no evidence of active
disease for at least 6 months prior to randomization;

15. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within the 6 months prior to enrollment;

16. Patients with organ allografts requiring immunosuppression;

17. Known positive human immunodeficiency virus (HIV), known hepatitis B surface antigen,
or hepatitis C positive;

18. Hypersensitivity to E7080 or any of the excipients;

19. Any history of or concomitant medical condition that, in the opinion of the
Investigator, would compromise the patient's ability to safely complete the study.