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AZD2171 + Chemotherapy in Advanced NSCLC, Colorectal Cancer, or Other Cancer Suitable for Treatment With Capecitabine (Non-Small Lung Cancer Patients Closed to Enrollment as 8/9/07)

Primary Purpose

Colorectal Cancer, Lung Cancer, Unspecified Adult Solid Tumor, Protocol Specific

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
capecitabine
carboplatin
cediranib maleate
paclitaxel
Sponsored by
NCIC Clinical Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring recurrent non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, stage IV colon cancer, stage IV rectal cancer, unspecified adult solid tumor, protocol specific

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed diagnosis of 1 of the following: Non-small cell lung cancer (NSCLC) (closed to accrual as of 8/9/07) meeting 1 of the following stage criteria: Stage IIIB disease Patients without pleural effusion who are not candidates for combined modality treatment OR who were treated at centers where combined modality treatment is not considered standard treatment are eligible Stage IV disease Local or metastatic failure after prior surgery and/or radiotherapy Colorectal cancer Metastatic disease Considered suitable for first-line therapy with capecitabine Other tumor types Suitable for treatment with capecitabine No more than 2 prior chemotherapy regimens for advanced or metastatic disease Incurable by radiotherapy or surgery Clinically or radiologically documented disease No tumor marker elevation as the only evidence of disease No necrotic or hemorrhagic tumor or metastases No untreated brain or meningeal metastases Patients with previously treated stable brain metastases (by radiography or clinical exam) are eligible provided they are asymptomatic and do not require corticosteroids PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 12 weeks (colorectal cancer patients) Hematopoietic Hemoglobin adequate Anemia allowed provided patient is well compensated with no evidence of recent bleeding Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 No overt bleeding (i.e., ≥ 30 mL/episode) within the past 3 months Hepatic Bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT or AST ≤ 2 times ULN (5 times ULN for documented liver metastases) Renal Creatinine ≤ 1.5 times ULN OR Creatinine clearance ≥ 50 mL/min No proteinuria > grade 1 Cardiovascular Resting systolic blood pressure ≤ 150 mm Hg AND/OR resting diastolic blood pressure ≤ 100 mm Hg (in the presence or absence of a stable dose of antihypertensive medication) Mean QTc ≤ 470 msec (with Bazetts correction) by ECG LVEF > 50% for patients with prior anthracyclines/trastuzumab or cardio-toxic agents No untreated or uncontrolled cardiovascular condition No symptomatic cardiac dysfunction No poorly controlled hypertension No history of labile hypertension No history of poor compliance with antihypertensive medication No history of familial long QT syndrome Pulmonary No clinically relevant hemoptysis (i.e., ≥ 5 mL fresh blood) within the past 4 weeks Patients with only flecks of blood in their sputum are eligible Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective (double-method for females; barrier method for males) contraception No prior allergic reaction to drugs containing Cremophor EL® (NSCLC patients [closed to accrual as of 8/9/07]) No peripheral neuropathy > grade 1 (NSCLC patients [closed to accrual as of 8/9/07]) No dihydropyrimidine dehydrogenase deficiency (colorectal cancer patients) No history of severe hand-foot syndrome after treatment with fluoropyrimidines (colorectal cancer patients) No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or other curatively treated solid tumor No active or uncontrolled infection No other serious illness or medical condition that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy No prior antiangiogenesis therapy Chemotherapy At least 4 weeks since prior single-agent non-platinum-containing chemotherapy (6 weeks for nitrosoureas or mitomycin) for metastatic disease (NSCLC patients [closed to accrual as of 8/9/07]) No more than 1 prior single-agent non-platinum-containing chemotherapy regimen for metastatic disease At least 6 months since prior adjuvant or neoadjuvant chemotherapy No prior taxane therapy (NSCLC patients [closed to accrual as of 8/9/07]) No prior chemotherapy for metastatic disease (colorectal cancer patients) No prior capecitabine (colorectal cancer patients) Endocrine therapy See Disease Characteristics At least 4 weeks since prior corticosteroids Radiotherapy See Disease Characteristics At least 21 days since prior palliative radiotherapy except for low-dose non-myelosuppressive radiotherapy with approval At least 6 months since prior adjuvant radiotherapy Surgery See Disease Characteristics At least 14 days since prior major surgery Other Recovered from prior therapy At least 14 days since prior epidermal growth factor receptor inhibitor therapy Concurrent oral anticoagulants (e.g., warfarin) allowed provided INR is strictly monitored No other concurrent investigational therapy No other concurrent anticancer therapy No concurrent prophylactic pyridoxine (vitamin B_6) for hand-foot syndrome (colorectal or other tumor type patients) Use of pyridoxine after the onset of hand-foot syndrome allowed at the discretion of the physician

Sites / Locations

  • Ottawa Hospital Regional Cancer Centre - General Campus
  • Princess Margaret Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AZD2171 + Standard chemotherpay regimens

Arm Description

Outcomes

Primary Outcome Measures

Dose limiting toxicity
To recommend phase II dose of AZD2171 when given orally daily in combination with standard chemotherapy in patients with advanced NSCLC or colon cancer or other tumour types suitable for treatment with capecitabine.

Secondary Outcome Measures

Safety
safety, tolerability, toxicity profile, dose limiting toxicities and pharmacokinetic profile of AZD2171 and standard chemotherapy given in these combinations. The correlation, if any,between the toxicity profile and the pharmacokinetics will be determined.
Anti-tumour activity
Assessing the anti-tumour activity of AZD2171 in combination with standard chemotherapy regimens in patients with measurable disease.
Tumour Response
To correlate patient outcomes (response) with baseline (tumour) and serial (urine and plasma) biomarkers

Full Information

First Posted
April 5, 2005
Last Updated
August 3, 2023
Sponsor
NCIC Clinical Trials Group
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1. Study Identification

Unique Protocol Identification Number
NCT00107250
Brief Title
AZD2171 + Chemotherapy in Advanced NSCLC, Colorectal Cancer, or Other Cancer Suitable for Treatment With Capecitabine (Non-Small Lung Cancer Patients Closed to Enrollment as 8/9/07)
Official Title
A Phase I, Open-Label, Dose-Seeking Study of AZD2171 Given Daily Orally in Combination With Standard Chemotherapy Regimens (CT) in Patients With Advanced Incurable Non-Small Cell Lung Cancer (NSCLC) or Colorectal Cancer or Other Tumor Types Suitable for Treatment With Capecitabine
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
January 21, 2005 (Actual)
Primary Completion Date
October 23, 2009 (Actual)
Study Completion Date
January 18, 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NCIC Clinical Trials Group

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: AZD2171 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as paclitaxel, carboplatin, or capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving AZD2171 together with chemotherapy may kill more tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of AZD2171 when given together with chemotherapy in treating patients with advanced non-small cell lung cancer (closed to enrollment as of 8/9/07), colorectal cancer, or other cancer suitable to capecitabine treatment.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose and recommended phase II dose of AZD2171 when administered in combination with standard chemotherapy comprising either paclitaxel and carboplatin OR capecitabine in patients with advanced incurable non-small cell lung cancer (closed to accrual as of 8/9/07), colorectal cancer, or other tumor types suitable for treatment with capecitabine. Determine the safety and tolerability of these regimens in these patients. Determine the toxicity profile and dose-limiting toxic effects of these regimens in these patients. Determine the pharmacokinetic profile of these regimens in these patients. Correlate the toxicity profile with the pharmacokinetic profile of these regimens in these patients. Determine the antitumor activity of these regimens in patients with measurable disease. Correlate patient outcome (response) with baseline (using tumor samples) and serial (using urine and plasma samples) biomarkers in patients treated with these regimens. OUTLINE: This is an open-label, multicenter, dose-escalation study of AZD2171. Patients are assigned to 1 of 2 treatment groups according to diagnosis. Group 1 (non-small cell lung cancer) (closed to accrual as of 8/9/07): Patients receive paclitaxel IV and carboplatin IV on day 1. Patients also receive oral AZD2171 once daily on days 2-21 of course 1 and on days 1-21 of all subsequent courses. Treatment with paclitaxel and carboplatin repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Treatment with AZD2171 repeats every 21 days in the absence of disease progression or unacceptable toxicity. Group 2 (colorectal or other tumor types): Patients receive oral capecitabine twice daily on days 1-14. Patients also receive oral AZD2171 once daily on days 8-21 of course 1 and on days 1-21 of all subsequent courses. Treatment with capecitabine repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Treatment with AZD2171 repeats every 21 days in the absence of disease progression or unacceptable toxicity. In both groups, patients achieving a complete response (CR) OR a stable partial response (SPR) receive 2 additional courses beyond CR or SPR. Cohorts of 3-6 patients per group receive escalating doses of AZD2171 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Up to 30 additional patients (20 in group 1 and 10 in group 2) will be treated at the MTD. After completion of study treatment, patients are followed at 4 weeks and then every 3 months until disease relapse. PROJECTED ACCRUAL: A total of 3-35 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Lung Cancer, Unspecified Adult Solid Tumor, Protocol Specific
Keywords
recurrent non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, stage IV colon cancer, stage IV rectal cancer, unspecified adult solid tumor, protocol specific

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AZD2171 + Standard chemotherpay regimens
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
capecitabine
Intervention Description
1000 mg/m2 orally twice daily (total of 2000 mg/m2 per day) for the first 14 days of a 21 day cycle for a maximum of 6-8 cycles.
Intervention Type
Drug
Intervention Name(s)
carboplatin
Intervention Description
AUC 6; IV; 30 minutes; Every 21 days for a maximum of 6-8 cycles
Intervention Type
Drug
Intervention Name(s)
cediranib maleate
Intervention Description
Given daily; orally with approximately 240 ml of water whilst in an upright position
Intervention Type
Drug
Intervention Name(s)
paclitaxel
Intervention Description
200mg/m2; IV; 3 hours; Every 21 days for a maximum of 6-8 cycles
Primary Outcome Measure Information:
Title
Dose limiting toxicity
Description
To recommend phase II dose of AZD2171 when given orally daily in combination with standard chemotherapy in patients with advanced NSCLC or colon cancer or other tumour types suitable for treatment with capecitabine.
Time Frame
Each dose level
Secondary Outcome Measure Information:
Title
Safety
Description
safety, tolerability, toxicity profile, dose limiting toxicities and pharmacokinetic profile of AZD2171 and standard chemotherapy given in these combinations. The correlation, if any,between the toxicity profile and the pharmacokinetics will be determined.
Time Frame
Each dose level
Title
Anti-tumour activity
Description
Assessing the anti-tumour activity of AZD2171 in combination with standard chemotherapy regimens in patients with measurable disease.
Time Frame
Each dose level
Title
Tumour Response
Description
To correlate patient outcomes (response) with baseline (tumour) and serial (urine and plasma) biomarkers
Time Frame
Each dose level

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed diagnosis of 1 of the following: Non-small cell lung cancer (NSCLC) (closed to accrual as of 8/9/07) meeting 1 of the following stage criteria: Stage IIIB disease Patients without pleural effusion who are not candidates for combined modality treatment OR who were treated at centers where combined modality treatment is not considered standard treatment are eligible Stage IV disease Local or metastatic failure after prior surgery and/or radiotherapy Colorectal cancer Metastatic disease Considered suitable for first-line therapy with capecitabine Other tumor types Suitable for treatment with capecitabine No more than 2 prior chemotherapy regimens for advanced or metastatic disease Incurable by radiotherapy or surgery Clinically or radiologically documented disease No tumor marker elevation as the only evidence of disease No necrotic or hemorrhagic tumor or metastases No untreated brain or meningeal metastases Patients with previously treated stable brain metastases (by radiography or clinical exam) are eligible provided they are asymptomatic and do not require corticosteroids PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 12 weeks (colorectal cancer patients) Hematopoietic Hemoglobin adequate Anemia allowed provided patient is well compensated with no evidence of recent bleeding Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 No overt bleeding (i.e., ≥ 30 mL/episode) within the past 3 months Hepatic Bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT or AST ≤ 2 times ULN (5 times ULN for documented liver metastases) Renal Creatinine ≤ 1.5 times ULN OR Creatinine clearance ≥ 50 mL/min No proteinuria > grade 1 Cardiovascular Resting systolic blood pressure ≤ 150 mm Hg AND/OR resting diastolic blood pressure ≤ 100 mm Hg (in the presence or absence of a stable dose of antihypertensive medication) Mean QTc ≤ 470 msec (with Bazetts correction) by ECG LVEF > 50% for patients with prior anthracyclines/trastuzumab or cardio-toxic agents No untreated or uncontrolled cardiovascular condition No symptomatic cardiac dysfunction No poorly controlled hypertension No history of labile hypertension No history of poor compliance with antihypertensive medication No history of familial long QT syndrome Pulmonary No clinically relevant hemoptysis (i.e., ≥ 5 mL fresh blood) within the past 4 weeks Patients with only flecks of blood in their sputum are eligible Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective (double-method for females; barrier method for males) contraception No prior allergic reaction to drugs containing Cremophor EL® (NSCLC patients [closed to accrual as of 8/9/07]) No peripheral neuropathy > grade 1 (NSCLC patients [closed to accrual as of 8/9/07]) No dihydropyrimidine dehydrogenase deficiency (colorectal cancer patients) No history of severe hand-foot syndrome after treatment with fluoropyrimidines (colorectal cancer patients) No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or other curatively treated solid tumor No active or uncontrolled infection No other serious illness or medical condition that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy No prior antiangiogenesis therapy Chemotherapy At least 4 weeks since prior single-agent non-platinum-containing chemotherapy (6 weeks for nitrosoureas or mitomycin) for metastatic disease (NSCLC patients [closed to accrual as of 8/9/07]) No more than 1 prior single-agent non-platinum-containing chemotherapy regimen for metastatic disease At least 6 months since prior adjuvant or neoadjuvant chemotherapy No prior taxane therapy (NSCLC patients [closed to accrual as of 8/9/07]) No prior chemotherapy for metastatic disease (colorectal cancer patients) No prior capecitabine (colorectal cancer patients) Endocrine therapy See Disease Characteristics At least 4 weeks since prior corticosteroids Radiotherapy See Disease Characteristics At least 21 days since prior palliative radiotherapy except for low-dose non-myelosuppressive radiotherapy with approval At least 6 months since prior adjuvant radiotherapy Surgery See Disease Characteristics At least 14 days since prior major surgery Other Recovered from prior therapy At least 14 days since prior epidermal growth factor receptor inhibitor therapy Concurrent oral anticoagulants (e.g., warfarin) allowed provided INR is strictly monitored No other concurrent investigational therapy No other concurrent anticancer therapy No concurrent prophylactic pyridoxine (vitamin B_6) for hand-foot syndrome (colorectal or other tumor type patients) Use of pyridoxine after the onset of hand-foot syndrome allowed at the discretion of the physician
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Derek Jonker, MD
Organizational Affiliation
Ottawa Regional Cancer Centre
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Scott A. Laurie, MD, FRCPC
Organizational Affiliation
Ottawa Regional Cancer Centre
Official's Role
Study Chair
Facility Information:
Facility Name
Ottawa Hospital Regional Cancer Centre - General Campus
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
18398152
Citation
Laurie SA, Gauthier I, Arnold A, Shepherd FA, Ellis PM, Chen E, Goss G, Powers J, Walsh W, Tu D, Robertson J, Puchalski TA, Seymour L. Phase I and pharmacokinetic study of daily oral AZD2171, an inhibitor of vascular endothelial growth factor tyrosine kinases, in combination with carboplatin and paclitaxel in patients with advanced non-small-cell lung cancer: the National Cancer Institute of Canada clinical trials group. J Clin Oncol. 2008 Apr 10;26(11):1871-8. doi: 10.1200/JCO.2007.14.4741.
Results Reference
result

Learn more about this trial

AZD2171 + Chemotherapy in Advanced NSCLC, Colorectal Cancer, or Other Cancer Suitable for Treatment With Capecitabine (Non-Small Lung Cancer Patients Closed to Enrollment as 8/9/07)

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