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Celecoxib and Docetaxel or Pemetrexed in Treating Patients With Advanced Recurrent Non-Small Cell Lung Cancer

2017년 2월 10일 업데이트: Leora Horn, MD, Vanderbilt-Ingram Cancer Center

A Phase II Trial of Celecoxib Plus Chemotherapy [Docetaxel or Pemetrexed] in Patients With Previously Treated, "COX Dependent" Recurrent Non-Small Cell Lung Cancer

RATIONALE: Celecoxib may stop the growth of tumor cells by blocking some of the enzymes need for cell growth. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving celecoxib together with docetaxel or pemetrexed may kill more tumor cells.

PURPOSE: This phase II trial is studying how well celecoxib given together with docetaxel or pemetrexed works in treating patients with advanced or recurrent non-small cell lung cancer.

연구 개요

상세 설명

OBJECTIVES:

Primary

  • To determine the efficacy of celecoxib when administered with standard chemotherapy comprising docetaxel or pemetrexed disodium in patients with advanced, recurrent non-small cell lung cancer (NSCLC) exhibiting cyclooxygenase (COX) dependence.

Secondary

  • To determine the overall response rate and time to progression in patients with COX-dependent recurrent NSCLC treated with celecoxib and docetaxel or pemetrexed disodium.
  • To determine the effect of celecoxib on the urinary metabolites of PGE_2 , PGI_2, and thromboxane in patients with COX-dependent recurrent NSCLC.
  • To correlate changes in urinary PGE-M and survival with intratumoral expression of COX-2, mPGES, and 15-PGDH as assessed by IHC.

OUTLINE: Patients with no prior taxane exposure receive docetaxel IV over 1 hour on day 1; patients with prior taxane exposure or for whom docetaxel treatment is contraindicated receive pemetrexed disodium IV over 10 minutes on day 1. Treatment with docetaxel or pemetrexed disodium repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity. All patients receive oral celecoxib twice daily beginning 5-7 days prior to the first docetaxel or pemetrexed disodium infusion and continuing for up to 1 year in the absence of disease progression or unacceptable toxicity.

Patients undergo blood and urine sample collection at baseline and periodically during study for biomarker correlative studies. Urine samples are assessed for PGE-M levels. Blood samples are analyzed for serum celecoxib levels, VEGF, endostatin, and cytokine assays.

After completing the last dose of celecoxib, patients are followed at 4-6 weeks and then every 3 months thereafter for up to 2 years from study entry.

연구 유형

중재적

등록 (실제)

23

단계

  • 2 단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Tennessee
      • Nashville, Tennessee, 미국, 37232-6838
        • Vanderbilt-Ingram Cancer Center
      • Nashville, Tennessee, 미국, 37064
        • Vanderbilt-Ingram Cancer Center - Cool Springs
      • Nashville, Tennessee, 미국, 37064
        • Vanderbilt-Ingram Cancer Center at Franklin

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Eligibility Criteria:

  • Cytologically or histologically confirmed "COX dependent" non-small cell lung cancer.
  • COX dependency is defined by change in urinary PGE-M levels following a "run-in" phase of celecoxib.
  • Previous treatment with ≤2 different chemotherapy regimens one of which must have been platinum-based (cisplatin or carboplatin) chemotherapy.
  • Age ≥18 years
  • ECOG PS 0, 1 or 2.
  • Measurable or evaluable disease.
  • At least 3 weeks post major surgery, chemotherapy or radiotherapy & recovered from all toxicities.
  • Expected survival of at least 2 months.
  • CNS metastases permitted provided the patient has adequately recovered from radiotherapy includes stereotactic therapy) or surgery.
  • Adequate renal function: serum creatinine ≤1.8 mg/dl &/or CrCl >50 cc/min

Eligibility According to Liver Function:

AST:

</= 1.5 ULN-Docetaxel; </= 2.5 ULN-Pemetrexed (Liver parameters to be used for pemetrexed in the absence of proven or radiographically suspected liver metastases.); </= 5.0 ULN-Pemetrexed (Liver parameters to be used for pemetrexed only in the presence of proven or radiographically suspected liver metastases.)

Alk Phosphatase:

</= 2.5 ULN-Docetaxel; </= 2.5 ULN-Pemetrexed (Liver parameters to be used for pemetrexed in the absence of proven or radiographically suspected liver metastases.); </= 5.0 ULN-Pemetrexed (Liver parameters to be used for pemetrexed only in the presence of proven or radiographically suspected liver metastases.)

Total Bilirubin:

</= 1.5 ULN-Docetaxel; </= 1.5 ULN-Pemetrexed (Liver parameters to be used for pemetrexed in the absence of proven or radiographically suspected liver metastases.); </= 2.5 ULN-Pemetrexed (Liver parameters to be used for pemetrexed only in the presence of proven or radiographically suspected liver metastases.)

  • Adequate hematologic function: ANC≥1500/mm3 & platelets ≥100,000/mm3
  • Female patients cannot be pregnant and must use contraception if of childbearing age
  • Lactating women are excluded.
  • Peripheral neuropathy must be CTC grade ≤2
  • Patients must not currently be on non-steroidal anti-inflammatory agents or other COX-2 inhibitors (Must be off for at least ≤7 days)
  • Written informed consent.

Exclusion Criteria:

  • More than two prior chemotherapy regimens for recurrent or relapsed NSCLC.
  • COX Independent as defined by change in urinary PGE-M levels following a "run-in" phase of celecoxib.
  • Previous treatment with both docetaxel and pemetrexed
  • History of greater than grade 2 allergic reaction to celecoxib or any other non-steroid anti-inflammatory agent including aspirin, ibuprofen, or indomethacin.
  • History of allergy to compounds containing boron or mannitol.
  • History of allergy to sulfonamides.
  • Concomitant use of Warfarin, but low dose Coumadin allowed for port prophylaxis
  • Recent (past 4 weeks) coronary artery bypass graft (CABG) surgery.
  • Inadequate organ function:
  • Serum creatinine ≥1.8 mg/dl or a calculated CrCl <45 cc/min.
  • AST >1.5 upper limits of normal (ULN); alkaline phosphatase >2.5 ULN; & bilirubin >1.5 ULN
  • ANC<1500/mm3 & platelets <100,000/mm3
  • Active pregnancy or inability or unwillingness to employ appropriate contraception.
  • Small cell carcinoma histology.
  • Prior malignancy within 5 years of diagnosis of NSCLC. Exceptions include basal cell or non-metastatic squamous cell carcinomas of the skin, cervical carcinoma in situ or FIGO stage I cervical carcinoma, or other cancer history considered not clinically significant by the principal investigator.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Treatment Arm
Either docetaxel or pemetrexed given with celecoxib
채혈
600 mg will be taken by mouth twice a day for 6 weeks then 400 mg twice a day for up to a year after chemotherapy is discontinued in the absence of progression.
75mg/m2 given through a vein over 90 minutes on day 1 of a 3-week cycle
500 mg/m2 through a vein over 90 minutes on day 1 of a 3 week cycle.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Median Survival
기간: 2 years from date of registration
Estimated probable duration of life from on-study date to date of death from any cause, using the Kaplan-Meier method with censoring (see analysis population description for additional details)
2 years from date of registration

2차 결과 측정

결과 측정
측정값 설명
기간
Overall Response Rate
기간: On-treatment date to date of disease progression (assessed at 6 weeks up to 2 years)
Overall response rate is measured by complete response + partial response. Number of patients in each response category, per RECIST v1.1, summarized as follows for target lesion criteria (see RECIST v1.1 for additional details): complete response (CR),disappearance of target lesions; partial response (PR), >=30% decrease in sum of longest diameter of target lesions; progressive disease (PD), >=20% increase in sum of LD of target lesions or appearance of new lesions; stable disease (SD), insufficient change in target lesions or new lesions to qualify as either PD or SD. Patients are categorized according to the best response achieved prior to occurrence of progressive disease, where best response hierarchy is CR>PR>SD>PD.
On-treatment date to date of disease progression (assessed at 6 weeks up to 2 years)
Time to Progression
기간: 2 years from date of registration
Estimated probable duration from on-study date to date of disease progression, using the Kaplan-Meier method with censoring (see analysis population description for additional details). Disease progression is defined under RECIST v1.1 as >=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.
2 years from date of registration

기타 결과 측정

결과 측정
기간
Effect of Celecoxib on Urinary Metabolites of PGE2, PG12 and Thromboxane
기간: At 1 year
At 1 year
Changes in Urinary PGE-M and Survival as Assessed by Immunohistochemistry
기간: At 1 year
At 1 year

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 연구 의자: Leora Horn, MD, Vanderbilt-Ingram Cancer Center

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2007년 10월 1일

기본 완료 (실제)

2013년 12월 1일

연구 완료 (실제)

2014년 1월 1일

연구 등록 날짜

최초 제출

2007년 8월 24일

QC 기준을 충족하는 최초 제출

2007년 8월 24일

처음 게시됨 (추정)

2007년 8월 27일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2017년 3월 20일

QC 기준을 충족하는 마지막 업데이트 제출

2017년 2월 10일

마지막으로 확인됨

2017년 2월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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