- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT00550537
Proteomic Profiling in Predicting Response in Patients Receiving Erlotinib for Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer
A Feasibility Study Investigating Translational Science in Chemotherapy-Naive Patients With Stage IIIb or IV Non-Small Cell Lung Cancer (NSCLC) Treated With the EGFR-TKI, Erlotinib
RATIONALE: Studying samples of tumor tissue, blood, and urine in the laboratory from patients receiving erlotinib may help doctors predict how patients will respond to treatment.
PURPOSE: The phase II trial is studying proteomic profiling to see how well it predicts response in patients receiving erlotinib for stage IIIB, stage IV, or recurrent non-small cell lung cancer.
Обзор исследования
Статус
Условия
Подробное описание
OBJECTIVES:
Primary
- To define a pre-treatment tumor proteomic profile that predicts response, stable disease, or progressive disease in patients with stage IIIB, stage IV, or recurrent non-small cell lung cancer treated with erlotinib hydrochloride.
Secondary
- To test and refine a pre-treatment serum proteomic expression pattern that predicts response to erlotinib hydrochloride and/or carboplatin and paclitaxel after failing treatment with erlotinib hydrochloride.
- To test and refine tumor proteomic profiles that predict response to carboplatin and paclitaxel after failing treatment with erlotinib hydrochloride.
- To analyze individual and pattern(s) of erlotinib hydrochloride-induced genomic and proteomic biomarker changes in relation to response or non-response to treatment.
- To correlate the efficacy and toxicity of erlotinib hydrochloride with expression of EGFR, EGFR pathway, ErbB family, and other related biomarkers.
- To determine a set of biomarkers to be evaluated in tumor tissue or surrogate tissues prior to treatment with erlotinib hydrochloride to enable patient selection for therapy.
- To estimate response rate and progression-free and overall survival of patients treated with erlotinib hydrochloride as initial therapy.
- To characterize the safety profile of erlotinib hydrochloride in these patients.
OUTLINE: This is a multicenter study.
Patients receive oral erlotinib hydrochloride once daily until disease progression.
At the time of disease progression, patients receive standard chemotherapy comprising paclitaxel IV over 3 hours and carboplatin IV over 15-30 minutes on day 1. Patients with non-squamous cell non-small cell lung cancer also receive bevacizumab IV over 30-90 minutes on day 1. Treatment repeats every 21 days for up to 6 courses.
Tumor tissue, plasma, serum, and urine samples are collected at baseline for proteomics analysis.
After the completion of study treatment, patients are followed every 8 weeks.
Тип исследования
Регистрация (Действительный)
Фаза
- Фаза 2
Контакты и местонахождение
Места учебы
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Florida
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Gainesville, Florida, Соединенные Штаты, 32610-0232
- University of Florida Shands Cancer Center
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Georgia
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Atlanta, Georgia, Соединенные Штаты, 30308
- Emory University
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Michigan
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Ann Arbor, Michigan, Соединенные Штаты, 48109-0942
- University Of Michigan Comprehensive Cancer Center
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Tennessee
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Nashville, Tennessee, Соединенные Штаты, 37232-6838
- Vanderbilt-Ingram Cancer Center
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Nashville, Tennessee, Соединенные Штаты, 37064
- Vanderbilt-Ingram Cancer Center - Cool Springs
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Nashville, Tennessee, Соединенные Штаты, 37064
- Vanderbilt-Ingram Cancer Center at Franklin
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Texas
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Houston, Texas, Соединенные Штаты, 77030-4009
- M. D. Anderson Cancer Center at University of Texas
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
DISEASE CHARACTERISTICS:
Histologically confirmed non-small cell lung cancer (NSCLC), meeting 1 of the following criteria:
- Stage IIIB (with pleural effusion) or stage IV disease
- Recurrent disease after prior surgery
- Measurable or evaluable disease is desirable but not required
No untreated symptomatic brain metastases
- Patients who are neurologically unstable despite radiotherapy for the brain metastases are not eligible
- No requirement for steroids to control neurological symptoms
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- ANC ≥ 1,500/mm³
- Hemoglobin ≥ 9 g/dL
- Platelet count ≥ 100,000/mm³
- Creatinine ≤ 2.0 mg/dL
- Total bilirubin ≤ 1.5 mg/dL
- Normal hemostasis by history
- PT/PTT within 0.5 seconds of normal range
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Willing to undergo biopsy procedures
- No known severe hypersensitivity to erlotinib hydrochloride or any of the excipients of this product
- No other concurrent malignancies or malignancies diagnosed within the past 5 years, except basal cell carcinoma or cervical cancer in situ
No significant cardiac disease, including any of the following:
- NYHA class III or IV heart disease
- Uncontrolled dysrhythmia
- Myocardial infarction within the past 6 months
No evidence of clinically active interstitial lung disease
- Chronic stable radiographic changes that are asymptomatic allowed
- No evidence of any other severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease)
- No evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial
No uncontrolled hypertension
- Blood pressure must be ≤ 150/90 mmHg on a stable antihypertensive regimen
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- At least 6 months since prior adjuvant chemotherapy
- No unresolved chronic toxicity > CTC grade 2 from prior anticancer therapy (except alopecia)
- More than 30 days since prior non-approved or investigational drugs
- No prior chemotherapy for advanced NSCLC
- No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or St. John's wort
- No concurrent administration of other drugs known to inhibit EGFR
- No other concurrent anti-neoplastic or anti-tumor agents, including chemotherapy, radiotherapy, immunotherapy, or hormonal anticancer therapy
- No other concurrent investigational agents
- Concurrent cardioprotective doses of aspirin, as recommended by the physician, for cardiovascular disease allowed
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Н/Д
- Интервенционная модель: Одногрупповое задание
- Маскировка: Нет (открытая этикетка)
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
|
Экспериментальный: Treatment
Erlotinib followed by paclitaxel + carboplatin (+ bevacizumab in non-squamous) at the time disease progression.
|
Сбор крови и тканей.
15 mg/m2 given through a vein for every 3 weeks
AUC = 6 given through a vein on day 1 of each cycle.
150 mg taken by mouth daily
200 mg/m2 given through a vein on day 1 of each cycle.
Blood and tissue collection.
Blood and tissue collection.
Blood and tissue collection.
|
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Временное ограничение |
|---|---|
|
Pre-treatment Tumor Proteomic Profile as a Predictor of Response, Stable Disease, or Progressive Disease
Временное ограничение: End of treatment date
|
End of treatment date
|
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Pre-treatment Serum Proteomic Expression Pattern as a Predictor of Response to Erlotinib Hydrochloride and/or Carboplatin and Paclitaxel After Failing Treatment With Erlotinib Hydrochloride
Временное ограничение: End of treatment date
|
End of treatment date
|
|
|
Tumor Proteomic Profiles as Predictors of Response to Carboplatin and Paclitaxel After Failing Treatment With Erlotinib Hydrochloride
Временное ограничение: End of treatment date
|
End of treatment date
|
|
|
Analysis of Individual and Pattern(s) of Erlotinib Hydrochloride-induced Genomic and Proteomic Biomarker Changes in Relation to Response or Non-response to Treatment
Временное ограничение: End of treatment date
|
End of treatment date
|
End of treatment date
|
|
Correlation of the Efficacy and Toxicity of Erlotinib Hydrochloride With Expression of EGFR, EGFR Pathway, ErbB Family, and Other Related Biomarkers
Временное ограничение: End of treatment date
|
End of treatment date
|
|
|
Determination of a Set of Biomarkers to be Evaluated in Tumor Tissue or Surrogate Tissues Prior to Treatment With Erlotinib Hydrochloride to Enable Patient Selection for Therapy
Временное ограничение: End of treatment date
|
End of treatment date
|
|
|
Response Rate for Erlotinib Initial Therapy in Chemotherapy-naïve Patients With Advanced NSCLC
Временное ограничение: Through study completion, an average of 1 year
|
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.
The response rate is calculated as the percentage of PR+CR among patients assessed for response.
|
Through study completion, an average of 1 year
|
|
Progression-free Survival (PFS) for Erlotinib Initial Therapy in Chemotherapy-naïve Patients With Advanced NSCLC
Временное ограничение: Through study completion, an average of 1 year
|
PFS is defined as the time from on erlotinib treatment date to progression or death (whichever comes first) before cross-over to PC or PC+B.
For those did not progressed nor died, they were censored at the last follow up (either the off erlotinib treatment date or lost follow up date).
The median survival time and 95% confidence interval were estimated using Kaplan-meier method.
|
Through study completion, an average of 1 year
|
|
Number of Patients With Worst-grade Toxicities Per Grade
Временное ограничение: Through study completion, an average of 1 year
|
The intensity of the AE will be graded according to the Common Toxicity Criteria (CTC) of the (US) National Cancer Institute (NCI) - Cancer Therapy Evaluation Program (CTEP) [version 3.0 of December 2003] (Appendix B). Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE |
Through study completion, an average of 1 year
|
|
Overall Survival for Erlotinib Initial Therapy in Chemotherapy-naïve Patients With Advanced NSCLC
Временное ограничение: Through study completion, an average of 1 year
|
The overall survival time is defined as the time from on treatment to death.
Patients were censored of they were alive at the last follow up date.
The median survival time and its confidence interval were estimated using Kaplan-meier method.
|
Through study completion, an average of 1 year
|
Соавторы и исследователи
Спонсор
Соавторы
Следователи
- Учебный стул: David Carbone, M.D., Ph.D., Vanderbilt-Ingram Cancer Center
Даты записи исследования
Изучение основных дат
Начало исследования
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Оценивать)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Заболевания дыхательных путей
- Новообразования
- Легочные заболевания
- Новообразования по локализации
- Новообразования дыхательных путей
- Грудные новообразования
- Рак, Бронхогенный
- Бронхиальные новообразования
- Новообразования легких
- Карцинома немелкоклеточного легкого
- Физиологические эффекты лекарств
- Молекулярные механизмы фармакологического действия
- Ингибиторы ферментов
- Противоопухолевые агенты
- Модуляторы тубулина
- Антимитотические агенты
- Модуляторы митоза
- Противоопухолевые агенты растительного происхождения
- Противоопухолевые агенты, иммунологические
- Ингибиторы ангиогенеза
- Агенты, модулирующие ангиогенез
- Вещества роста
- Ингибиторы роста
- Ингибиторы протеинкиназы
- Карбоплатин
- Паклитаксел
- Эрлотиниб гидрохлорид
- Бевацизумаб
Другие идентификационные номера исследования
- VICC-THO-0640
- P30CA068485 (Грант/контракт NIH США)
- VU-VICC-THO-0640
- VU-VICC-070494
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