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

7 de fevereiro de 2020 atualizado por: 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.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

74

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador de 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.
Medicamento: Cisplatin
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Medicamento: Etoposide
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
Medicamento: Placebo
Matched placebo oral daily
Comparador Ativo: 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.
Medicamento: Cisplatin
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Medicamento: Etoposide
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
Medicamento: ZD6474
ZD6474 100mg oral daily to be continued for the duration of the study.
Experimental: 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.
Medicamento: Cisplatin
Cisplatin 60 mg/m2 IV day 1 every 21 days for a total of 4 cycles
Medicamento: Etoposide
Etoposide 120 mg/m2 IV days 1, 2, and 3 every 21 days for a total of 4 cycles
Medicamento: ZD6474
ZD6474 100mg oral daily to be continued for the duration of the study.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Time to Disease Progression - Median Time to Progression and Log-Rank Test
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Percentage of Participants With Grade 3/4 Hematologic and Non-Hematologic Toxicities
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 24 months
24 months
Assess VEGF Polymorphisms and Correlate Subject Response
Prazo: 24 months
24 months

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Hoosier Cancer Research Network

Colaboradores

AstraZeneca

Investigadores

  • Cadeira de estudo: Nasser Hanna, M.D., Hoosier Oncology Group, Inc.

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

Publicações Gerais

Links úteis

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de janeiro de 2008

Conclusão Primária (Real)

1 de agosto de 2015

Conclusão do estudo (Real)

1 de agosto de 2015

Datas de inscrição no estudo

Enviado pela primeira vez

31 de janeiro de 2008

Enviado pela primeira vez que atendeu aos critérios de CQ

31 de janeiro de 2008

Primeira postagem (Estimativa)

13 de fevereiro de 2008

Atualizações de registro de estudo

Última Atualização Postada (Real)

11 de fevereiro de 2020

Última atualização enviada que atendeu aos critérios de controle de qualidade

7 de fevereiro de 2020

Última verificação

1 de fevereiro de 2020

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • LUN06-113

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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