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Cisplatin + Etoposide +/- Concurrent ZD6474 in Previously Untreated Extensive Stage Small Cell Lung Cancer

7 lutego 2020 zaktualizowane przez: Hoosier Cancer Research Network

A Randomized Double Blind Phase II Trial of Cisplatin Plus Etoposide With/Without Concurrent ZD6474 in Patients With Previously Untreated Extensive Stage Small Cell Lung Cancer: Hoosier Oncology Group LUN06-113

At this point in the treatment of extensive stage SCLC, we have reached a plateau in survival with conventional chemotherapy and newer regimens are greatly needed. It has been noted that patients with increased VEGF levels have a poorer prognosis. Anti-angiogenic agents hold significant promise in the treatment of patients with extensive stage SCLC. ZD6474, a new inhibitor of the VEGFR-2, has shown favorable action in NSCLC.

Przegląd badań

Szczegółowy opis

OUTLINE: This is a multi-center study.

Arm A:

Cisplatin 60mg/m2 Day 1 + Etoposide 120mg/m2 Day 1,2,3 + Placebo oral daily given continuously for the duration of the study

Arm B:

Cisplatin 60mg/m2 Day 1 + Etoposide 120mg/m2 Day 1,2,3 + ZD6474 100mg oral daily given continuously for the duration of the study

For both arms, PE and toxicity evaluation prior to each cycle and disease assessment by imaging every 2 cycles. Patients with non-PD and acceptable toxicity will continue protocol therapy; patients with progressive disease or excessive toxicity will be taken off treatment. Cycles will be repeated every 21 days up to a total of 4 cycles.

ECOG Performance Status of 0 or 1

Life Expectancy: Not specified

Hematopoietic:

  • Platelets > 100K/mm3
  • Absolute neutrophil count (ANC) > 1.5K/mm3

Hepatic:

  • Bilirubin < 1.5 x ULN
  • Aspartate aminotransferase (AST) < 2.5 x ULN or < 5 x ULN if judged by the investigator to be related to liver metastases
  • Alkaline phosphatase < 2.5 x ULN or < 5 x ULN if judged by the investigator to be related to liver metastases

Renal:

  • Serum creatinine < 1.5 x ULN or Calculated creatinine clearance of > 45 cc/min using the Cockcroft-Gault formula

Cardiovascular:

  • No clinically significant cardiac event such as myocardial infarction; New York Heart Association (NYHA) classification of heart disease >2 (see SPM) within 3 months prior to registration for protocol therapy
  • No presence of cardiac disease that, in the opinion of the Investigator, increases the risk of ventricular arrhythmia.
  • No history of arrhythmia (multifocal premature ventricular contractions (PVCs), bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial fibrillation) which is symptomatic or requires treatment (CTCAE grade 3) or asymptomatic sustained ventricular tachycardia. Atrial fibrillation, controlled on medication is permitted.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

74

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Delaware
      • Newark, Delaware, Stany Zjednoczone, 19713
        • Helen F. Graham Cancer Center
    • Illinois
      • Chicago, Illinois, Stany Zjednoczone, 60611
        • Northwestern University Feinberg School of Medicine
      • Galesburg, Illinois, Stany Zjednoczone, 61401
        • Medical & Surgical Specialists, LLC
    • Indiana
      • Bloomington, Indiana, Stany Zjednoczone, 47403
        • Cancer Care Center of Southern Indiana
      • Evansville, Indiana, Stany Zjednoczone, 47714
        • Oncology Hematology Associates of SW Indiana
      • Fort Wayne, Indiana, Stany Zjednoczone, 46815
        • Fort Wayne Oncology & Hematology, Inc
      • Indianapolis, Indiana, Stany Zjednoczone, 46202
        • Indiana University Simon Cancer Center
      • Indianapolis, Indiana, Stany Zjednoczone, 46202
        • IN Onc/Hem Associates
      • Indianapolis, Indiana, Stany Zjednoczone, 46206
        • St. Vincent Hospital & Health Centers
      • Lafayette, Indiana, Stany Zjednoczone, 47904
        • IU Health Arnett Cancer Center
      • Lafayette, Indiana, Stany Zjednoczone, 47905
        • Horizon Oncology Researcg
      • Muncie, Indiana, Stany Zjednoczone, 47303
        • IU Health at Ball Memorial Hospital
      • Munster, Indiana, Stany Zjednoczone, 46321
        • Monroe Medical Associates
      • South Bend, Indiana, Stany Zjednoczone, 46601
        • Northern Indiana Cancer Research Consortium
      • Terre Haute, Indiana, Stany Zjednoczone, 47802
        • Providence Medical Group
    • Nebraska
      • Omaha, Nebraska, Stany Zjednoczone, 68114
        • Methodist Cancer Center
    • New Jersey
      • Mount Holly, New Jersey, Stany Zjednoczone, 08060
        • Hematology Oncology Associates S.J., P.A.
    • Oregon
      • Portland, Oregon, Stany Zjednoczone, 97213
        • Providence Portland Medical Center
    • Pennsylvania
      • Philadelphia, Pennsylvania, Stany Zjednoczone, 19106
        • Pennsylvania Oncology-Hematology Associates

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • Histological or cytological proof of chemotherapy-naïve, extensive, small cell lung cancer.
  • Measurable disease according to RECIST and obtained by imaging within 28 days prior to being registered for protocol therapy.
  • Written informed consent and HIPAA authorization for release of personal health information.
  • Age 18 years or older at the time of consent.
  • Potassium ≥4.0 mmol/L and <5.5mmol/L (supplementation is allowed).
  • Calcium within normal range (supplementation is allowed).
  • Magnesium within normal range (supplementation is allowed).

Exclusion Criteria:

  • No prior EGFR inhibitor or antiangiogenic agent allowed.
  • No prior hormonal therapy.
  • No symptomatic brain metastasis.
  • No clinically significant infections as judged by the treating investigator.
  • No evidence of severe or uncontrolled other systemic disease or any concurrent condition which in the Investigator's opinion makes it undesirable for the subject to participate in the trial or which would jeopardize compliance with the protocol.
  • No previous history of QTc prolongation as a result of medication that required discontinuation of that medication.
  • No congenital long QT syndrome or known 1st degree relative with unexplained sudden death under 40 years of age.
  • No presence of left bundle branch block (LBBB.)
  • No QTc with Bazett's correction that is unmeasurable, or ≥480 msec on screening ECG obtained within 7 days prior to registration for protocol therapy. If a subject has QTc ≥480 msec on screening ECG, the screen ECG may be repeated twice (at least 24 hours apart). The average QTc from the three screening ECGs must be <480 msec in order for the subject to be eligible for the study.
  • No concomitant (within 14 days prior to registration for and during protocol therapy) medication associated with Torsades de Pointes or cause QTc prolongation, is allowed. Medications that prolong QT, but are not strictly associated with Torsades, are allowed if medically necessary and will require increased ECG and electrolyte monitoring.
  • No uncontrolled hypertension (systolic blood pressure greater than 160 mm Hg or diastolic blood pressure greater than 100 mm Hg).
  • No currently active diarrhea that may affect the ability to absorb ZD6474.
  • No prior malignancy is allowed except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, Gleason < grade 7 prostate cancers, or other cancer for which the subject has been disease-free for at least 5 years.
  • Major surgery must be completed greater than 28 days prior to registration for protocol therapy and healed surgical incision is required.
  • No concomitant (within 14 days prior to registration for and during protocol therapy) medications that are potent inducers (rifampicin, rifabutin, phenytoin, carbamazepine, phenobarbital and St. John's Wort) of CYP3A4 function.
  • Females of childbearing potential and males must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 8 weeks after treatment discontinuation.
  • Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for protocol therapy.
  • Females must not be breastfeeding.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Podwójnie

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Komparator placebo: Arm A: ZD6474 Matched Placebo
Subjects will receive cisplatin 60 mg/m2 IV day 1 plus etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles plus ZD6474 matched placebo oral daily to be continued for the duration of the study. Prophylactic antiemetics will be given at the discretion of the treating investigator.
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
Matched placebo oral daily
Aktywny komparator: Arm B: ZD6474
Subjects will receive cisplatin 60 mg/m2 IV day 1 plus etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles plus ZD6474 100mg oral daily to be continued for the duration of the study. Prophylactic antiemetics will be given at the discretion of the treating investigator.
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
ZD6474 100mg oral daily to be continued for the duration of the study.
Eksperymentalny: Safety Lead-In
Subjects will receive cisplatin 60 mg/m2 IV day 1 plus etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles plus ZD6474 100mg oral daily to be continued for the duration of the study. Prophylactic antiemetics will be given at the discretion of the treating investigator. The safety lead-in will be conducted to determine the safety of the combination of ZD6474 and cisplation + etopiside. If this combination is found to be unsafe, no patients will be randomized in the Phase II portion of the trial. If the combination is deemed safe according to the protocol, participants from the safety lead-in cohort will not be included in the efficacy analysis.
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
ZD6474 100mg oral daily to be continued for the duration of the study.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Time to Disease Progression - Median Time to Progression and Log-Rank Test
Ramy czasowe: 24 months
Kaplan-Meier analysis comparing arm A to arm B. Median time to progression and log-rank test. Safety lead-in participants are not included in this analysis per protocol.
24 months

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Percentage of Participants With Grade 3/4 Hematologic and Non-Hematologic Toxicities
Ramy czasowe: 6 weeks (2 Cycles)
Percentage of participants who experienced grade 3/4 hematologic and non-hematologic toxicities. Participants from Arm A were compared to subjects from Arm B + Safety Lead-In.
6 weeks (2 Cycles)
Measure the Response Rate (CR + PR) in Each Arm
Ramy czasowe: 24 months
Response assessments completed per Response Evaluation Criteria In Solid Tumors Criteria (RECIST Therasse et al., 2000). Complete Response (CR) is defined as: Disappearance of all target lesions. Partial Response (PR) is defined as: >=30% decrease in the sum of the longest diameter of target lesions.
24 months
Measure Disease Control Rate (CR + PR+ SD) in Each Arm
Ramy czasowe: 24 months
Response assessments completed per Response Evaluation Criteria In Solid Tumors Criteria (RECIST Therasse et al., 2000). Complete Response (CR) is defined as: Disappearance of all target lesions. Partial Response (PR) is defined as: >=30% decrease in the sum of the longest diameter of target lesions. Stable Disease (SD) is defined as: neither a partial response or progressive disease ( >=20% increase in the sum of the longest diameter of the target lesions).
24 months
Measure Overall Survival for Each Arm
Ramy czasowe: 24 months
24 months
Assess VEGF Polymorphisms and Correlate Subject Response
Ramy czasowe: 24 months
24 months

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Współpracownicy

Śledczy

  • Krzesło do nauki: Nasser Hanna, M.D., Hoosier Oncology Group, Inc.

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów

1 stycznia 2008

Zakończenie podstawowe (Rzeczywisty)

1 sierpnia 2015

Ukończenie studiów (Rzeczywisty)

1 sierpnia 2015

Daty rejestracji na studia

Pierwszy przesłany

31 stycznia 2008

Pierwszy przesłany, który spełnia kryteria kontroli jakości

31 stycznia 2008

Pierwszy wysłany (Oszacować)

13 lutego 2008

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

11 lutego 2020

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

7 lutego 2020

Ostatnia weryfikacja

1 lutego 2020

Więcej informacji

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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