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Gefitinib and Sirolimus in Treating Patients With Recurrent or Refractory Stage IIIB or Stage IV Non-Small Cell Lung Cancer

Primary Purpose

Lung Cancer

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
gefitinib
sirolimus
Sponsored by
Jonsson Comprehensive Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer focused on measuring recurrent non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed non-small cell lung cancer Stage IIIB or IV disease Recurrent or refractory disease Received ≥ 1 prior platinum-containing chemotherapy regimen Unidimensionally measurable disease that has not been irradiated No newly diagnosed untreated brain metastases or spinal cord compression Paraffin-embedded tumor tissue or slides available PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Adequate bone marrow function Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Adequate hepatic function No severe or uncontrolled hepatic disease Renal Adequate renal function Creatinine ≤ 3.0 times upper limit of normal No severe or uncontrolled renal disease Cardiovascular Adequate cardiac function No severe or uncontrolled cardiac disease No uncontrolled hyperlipidemia Pulmonary No unstable or uncompensated respiratory disease No clinically active interstitial lung disease Patients with chronic stable radiographic changes who are asymptomatic are eligible Gastrointestinal Able to take oral medication No gastrointestinal condition (e.g., peptic ulcer disease) that would affect absorption Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No serious infection No known severe hypersensitivity to gefitinib or any of its excipients No other malignancy within the past 5 years except treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No other severe or uncontrolled systemic disease No significant clinical disorder or laboratory finding that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy More than 14 days since prior biologic therapy No prior cetuximab, panitumumab, or bevacizumab Chemotherapy See Disease Characteristics More than 4 weeks since prior cytotoxic chemotherapy Endocrine therapy Not specified Radiotherapy See Disease Characteristics More than 3 weeks since prior radiotherapy No concurrent radiotherapy Surgery Recovered from prior oncologic or other major surgery No prior gastrointestinal surgery affecting absorption No concurrent surgery, including ophthalmic surgery, during and for 1 week after study treatment Other Recovered from all prior therapy More than 30 days since prior investigational agents No other prior HER1/epidermal growth factor receptor axis agents, including the following: Gefitinib Erlotinib CI-1033 Lapatinib No other prior vascular endothelial growth factor axis agents, including the following: ZD6474 Vatalanib No concurrent CYP3A4 inducers, including the following: Phenytoin Carbamazepine Rifampin Phenobarbital Barbiturates Hypericum perforatum (St. John's wort) No other concurrent systemic treatment for the malignancy No concurrent bisphosphonates for symptomatic bone metastases No concurrent systemic retinoids

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Maximum tolerated dose (Phase I)

    Secondary Outcome Measures

    Overall response (complete response [CR] and partial response [PR]) as measured by RECIST criteria
    Disease control rate (CR, PR, and stable disease) correlated with smoking history
    Time to tumor progression and overall survival
    Quality of life as assessed by the Functional Assessment of Cancer Therapy-Lung (FACT-L)
    Lung cancer subscale from FACT-L

    Full Information

    First Posted
    December 7, 2004
    Last Updated
    October 2, 2012
    Sponsor
    Jonsson Comprehensive Cancer Center
    Collaborators
    National Cancer Institute (NCI)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00098462
    Brief Title
    Gefitinib and Sirolimus in Treating Patients With Recurrent or Refractory Stage IIIB or Stage IV Non-Small Cell Lung Cancer
    Official Title
    A Phase I/II Trial of ZD1839 (Iressa®) and Rapamycin (Rapamune) in Patients With Advanced Non Small Cell Lung Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2012
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Withdrawn as study never opened
    Study Start Date
    October 2004 (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Jonsson Comprehensive Cancer Center
    Collaborators
    National Cancer Institute (NCI)

    4. Oversight

    5. Study Description

    Brief Summary
    RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as sirolimus, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Sometimes when chemotherapy is given, it does not stop the growth of tumor cells. The tumor is said to be resistant to chemotherapy. Giving gefitinib together with sirolimus may reduce drug resistance and allow the tumor cells to be killed. PURPOSE: This phase I/II trial is studying the side effects and best dose of sirolimus when given with gefitinib and to see how well they work in treating patients with recurrent or refractory stage IIIB or stage IV non-small cell lung cancer.
    Detailed Description
    OBJECTIVES: Primary Determine the maximum tolerated dose of sirolimus when combined with gefitinib in patients with recurrent or refractory stage IIIB or IV non-small cell lung cancer. Secondary Determine the overall response rate (complete response [CR] and partial response [PR]) in patients treated with this regimen. Determine the disease control rate (CR, PR, and stable disease) in patients treated with this regimen. Determine the time to progression and overall survival of patients treated with this regimen. Determine the quality of life of patients treated with this regimen. OUTLINE: This is an open-label, phase I, dose-escalation study of sirolimus followed by a phase II study. Phase I: Patients receive oral gefitinib once daily and oral sirolimus once daily on days 1-28. Courses repeat every 28 days in the absence of unacceptable toxicity or disease progression. Cohorts of 3-6 patients receive escalating doses of sirolimus until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients receive gefitinib and sirolimus as in phase I at the MTD. Quality of life is assessed at baseline, day 1 of each course, and then at 1 month post-progression. Patients are followed every 9 weeks. Patients withdrawn from study treatment without evidence of disease progression are followed every 6 weeks until disease progression. PROJECTED ACCRUAL: A total of 25 patients (11 for phase I and 14 for phase II) will be accrued for this study within 8.3 months.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Lung Cancer
    Keywords
    recurrent non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Masking
    None (Open Label)
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Intervention Type
    Drug
    Intervention Name(s)
    gefitinib
    Intervention Type
    Drug
    Intervention Name(s)
    sirolimus
    Primary Outcome Measure Information:
    Title
    Maximum tolerated dose (Phase I)
    Secondary Outcome Measure Information:
    Title
    Overall response (complete response [CR] and partial response [PR]) as measured by RECIST criteria
    Title
    Disease control rate (CR, PR, and stable disease) correlated with smoking history
    Title
    Time to tumor progression and overall survival
    Title
    Quality of life as assessed by the Functional Assessment of Cancer Therapy-Lung (FACT-L)
    Title
    Lung cancer subscale from FACT-L

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    DISEASE CHARACTERISTICS: Histologically confirmed non-small cell lung cancer Stage IIIB or IV disease Recurrent or refractory disease Received ≥ 1 prior platinum-containing chemotherapy regimen Unidimensionally measurable disease that has not been irradiated No newly diagnosed untreated brain metastases or spinal cord compression Paraffin-embedded tumor tissue or slides available PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Adequate bone marrow function Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Adequate hepatic function No severe or uncontrolled hepatic disease Renal Adequate renal function Creatinine ≤ 3.0 times upper limit of normal No severe or uncontrolled renal disease Cardiovascular Adequate cardiac function No severe or uncontrolled cardiac disease No uncontrolled hyperlipidemia Pulmonary No unstable or uncompensated respiratory disease No clinically active interstitial lung disease Patients with chronic stable radiographic changes who are asymptomatic are eligible Gastrointestinal Able to take oral medication No gastrointestinal condition (e.g., peptic ulcer disease) that would affect absorption Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No serious infection No known severe hypersensitivity to gefitinib or any of its excipients No other malignancy within the past 5 years except treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No other severe or uncontrolled systemic disease No significant clinical disorder or laboratory finding that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy More than 14 days since prior biologic therapy No prior cetuximab, panitumumab, or bevacizumab Chemotherapy See Disease Characteristics More than 4 weeks since prior cytotoxic chemotherapy Endocrine therapy Not specified Radiotherapy See Disease Characteristics More than 3 weeks since prior radiotherapy No concurrent radiotherapy Surgery Recovered from prior oncologic or other major surgery No prior gastrointestinal surgery affecting absorption No concurrent surgery, including ophthalmic surgery, during and for 1 week after study treatment Other Recovered from all prior therapy More than 30 days since prior investigational agents No other prior HER1/epidermal growth factor receptor axis agents, including the following: Gefitinib Erlotinib CI-1033 Lapatinib No other prior vascular endothelial growth factor axis agents, including the following: ZD6474 Vatalanib No concurrent CYP3A4 inducers, including the following: Phenytoin Carbamazepine Rifampin Phenobarbital Barbiturates Hypericum perforatum (St. John's wort) No other concurrent systemic treatment for the malignancy No concurrent bisphosphonates for symptomatic bone metastases No concurrent systemic retinoids
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Fairooz F. Kabbinavar, MD
    Organizational Affiliation
    Jonsson Comprehensive Cancer Center
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Learn more about this trial

    Gefitinib and Sirolimus in Treating Patients With Recurrent or Refractory Stage IIIB or Stage IV Non-Small Cell Lung Cancer

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