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Paclitaxel + Carboplatin With/Out Cediranib Maleate in Stage III or Stage IV Non-Small Cell Lung Cancer

Primary Purpose

Lung Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
carboplatin
cediranib maleate
paclitaxel
placebo
Sponsored by
NCIC Clinical Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed non-small cell lung cancer (NSCLC), 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 Measurable disease (phase II) Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by x-ray, ultrasound, physical exam, or conventional CT scan OR ≥ 10 mm by spiral CT scan Measurable lesions must be outside a previous radiotherapy field if they are the sole site of disease, unless disease progression has been documented No significant central thoracic lesion with any appreciable cavitation Measurable or nonmeasurable disease (phase III) No necrotic or hemorrhagic tumor or metastases No untreated brain or meningeal metastases CT scans are not required to rule out disease unless there is clinical suspicion of CNS disease 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: Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic 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 ≤ 2 times ULN (< 5 times ULN if liver metastases are present) Renal Creatinine clearance ≥ 50 mL/min Proteinuria ≤ grade 1 Cardiovascular Mean QTc ≤ 470 msec (with Bazett's correction) by ECG No unstable angina No congestive heart failure No myocardial infarction within the past year No cardiac ventricular arrhythmias requiring medication No history of 2nd- or 3rd-degree atrioventricular conduction defects No untreated or uncontrolled cardiovascular condition No symptomatic cardiac dysfunction No uncontrolled hypertension (i.e., resting blood pressure ≥ 150/100 mm Hg despite antihypertensive therapy) 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 Flecks of blood only in sputum allowed Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective (double method for females; barrier method for males) contraception Able and willing to participate in the quality of life assessment No peripheral neuropathy > grade 1 No prior allergic reaction to drugs containing Cremophor EL® No active or uncontrolled infection No serious illness or medical condition which would preclude study compliance No inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis) No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or in situ cancer PRIOR CONCURRENT THERAPY: Biologic therapy At least 14 days since prior epidermal growth factor receptor-inhibitor therapy (e.g., tyrosine kinase inhibitor, monoclonal antibodies, vaccines, or other agents) No prior antiangiogenesis therapy, including any of the following: Bevacizumab Cediranib maleate AZD6474 PTK787/ZK222584 (PTK/ZK) Sunitinib malate Concurrent epoetin alfa allowed Chemotherapy At least 12 months since prior adjuvant chemotherapy Combined chemotherapy and radiotherapy regimens for locally advanced stage IIIB disease is not considered adjuvant therapy and is not allowed No prior chemotherapy for metastatic or recurrent NSCLC Endocrine therapy See Disease Characteristics At least 1 week since prior steroids Radiotherapy See Disease Characteristics At least 21 days since prior radiotherapy except for low-dose non-myelosuppressive radiotherapy with approval Concurrent palliative radiotherapy allowed with approval Surgery At least 14 days since prior major surgery Other Recovered from prior therapy Prior treatment with cyclooxygenase-2 inhibitors allowed Concurrent prophylactic anticoagulation (e.g., warfarin) allowed provided requirements for INR are met No potent inhibitors of CYP3A4 and 2C8, including any of the following drugs: Amiodarone hydrochloride Clarithromycin Citalopram hydrobromide Erythromycin Omeprazole Simvastatin Atorvastatin Lovastatin Montelukast sodium Verapamil hydrochloride Ketoconazole Miconazole Indinovir and other antivrails Diltiazem No other concurrent experimental drug or anticancer therapy

Sites / Locations

  • Instituto Alexander Fleming
  • Compleso Medico de la Policia Federal Argentina
  • Hospital Universitario Austral
  • Alfred Hospital
  • Instituto Nacional de Cancer (INCA)
  • Cross Cancer Institute
  • BCCA - Vancouver Cancer Centre
  • Juravinski Cancer Centre at Hamilton Health Sciences
  • London Regional Cancer Program
  • Ottawa Health Research Institute - General Division
  • Algoma District Cancer Program
  • Niagara Health System
  • Northeast Cancer Center Health Sciences
  • Mount Sinai Hospital
  • Univ. Health Network-Princess Margaret Hospital
  • University Institute of Cardiology and
  • Oncology Institute Bucharest
  • Oncological Institute "Ion Chiricuta"
  • Clinical County Hospital of Sibiu
  • National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm I

Arm II

Arm Description

Patients receive oral cediranib maleate once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment with paclitaxel and carboplatin repeats every 21 days for 6-8 courses in the absence of disease progression or unacceptable toxicity.

Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel and carboplatin as in arm I.

Outcomes

Primary Outcome Measures

Progression-free survival

Secondary Outcome Measures

Toxicity
Quality of Life
Overall survival
Correlative Studies

Full Information

First Posted
October 25, 2005
Last Updated
August 3, 2023
Sponsor
NCIC Clinical Trials Group
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1. Study Identification

Unique Protocol Identification Number
NCT00245154
Brief Title
Paclitaxel + Carboplatin With/Out Cediranib Maleate in Stage III or Stage IV Non-Small Cell Lung Cancer
Official Title
A Phase II/III Double Blind Randomized Trial of AZD2171 Versus Placebo in Patients Receiving Paclitaxel/Carboplatin Chemotherapy for the Treatment of Advanced or Metastatic Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
November 3, 2005 (Actual)
Primary Completion Date
July 4, 2008 (Actual)
Study Completion Date
January 10, 2013 (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: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Cediranib maleate 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. Giving paclitaxel and carboplatin together with AZD2171 may kill more tumor cells. It is not yet known whether giving paclitaxel and carboplatin together with AZD2171 is more effective than giving paclitaxel and carboplatin together with a placebo in treating non-small cell lung cancer. PURPOSE: This randomized phase II/III trial is studying how well giving paclitaxel and carboplatin together with cediranib maleate works and compares it to giving paclitaxel and carboplatin together with placebo in treating patients with stage III or stage IV non-small cell lung cancer.
Detailed Description
OBJECTIVES: Primary Compare the progression-free survival of patients with stage IIIB or IV non-small cell lung cancer treated with paclitaxel and carboplatin in combination with either cediranib maleate or a placebo. Determine the pharmacogenomics and pharmacodynamic aspects of these regimens in these patients. (Phase II) Compare the overall survival of patients treated with these regimens. (Phase III) Secondary Compare objective tumor response rates in patients treated with these regimens. Determine the time to response and response duration in patients treated with these regimens. (Phase III) Determine the nature, severity, and frequency of the toxic effects of these regimens, including hemorrhage and hemoptysis, in these patients. Correlate the expression of tissue markers (at diagnosis) with outcomes and response in patients treated with these regimens. (Phase III) Compare quality of life of patients treated with these regimens. (Phase III) OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to gender, participating center, disease stage (IIIB vs IV), weight loss (≥ 5% vs < 5%), and prior adjuvant chemotherapy (yes vs no). Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive oral cediranib maleate once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment with paclitaxel and carboplatin repeats every 21 days for 6-8 courses in the absence of disease progression or unacceptable toxicity. Arm II: Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel and carboplatin as in arm I. Quality of life is assessed at baseline, before each treatment course, after completion of study treatment, and every 3 months thereafter. After completion of study treatment, patients are followed every 3 months. PROJECTED ACCRUAL: A total of 750 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
Lung Cancer
Keywords
stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
296 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral cediranib maleate once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment with paclitaxel and carboplatin repeats every 21 days for 6-8 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm II
Arm Type
Active Comparator
Arm Description
Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity. Patients also receive paclitaxel and carboplatin as in arm I.
Intervention Type
Drug
Intervention Name(s)
carboplatin
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
cediranib maleate
Intervention Description
Given orally
Intervention Type
Drug
Intervention Name(s)
paclitaxel
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
placebo
Intervention Description
Given orally
Primary Outcome Measure Information:
Title
Progression-free survival
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Toxicity
Time Frame
3 years
Title
Quality of Life
Time Frame
3 years
Title
Overall survival
Time Frame
3 years
Title
Correlative Studies
Time Frame
3 years

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 non-small cell lung cancer (NSCLC), 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 Measurable disease (phase II) Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by x-ray, ultrasound, physical exam, or conventional CT scan OR ≥ 10 mm by spiral CT scan Measurable lesions must be outside a previous radiotherapy field if they are the sole site of disease, unless disease progression has been documented No significant central thoracic lesion with any appreciable cavitation Measurable or nonmeasurable disease (phase III) No necrotic or hemorrhagic tumor or metastases No untreated brain or meningeal metastases CT scans are not required to rule out disease unless there is clinical suspicion of CNS disease 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: Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic 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 ≤ 2 times ULN (< 5 times ULN if liver metastases are present) Renal Creatinine clearance ≥ 50 mL/min Proteinuria ≤ grade 1 Cardiovascular Mean QTc ≤ 470 msec (with Bazett's correction) by ECG No unstable angina No congestive heart failure No myocardial infarction within the past year No cardiac ventricular arrhythmias requiring medication No history of 2nd- or 3rd-degree atrioventricular conduction defects No untreated or uncontrolled cardiovascular condition No symptomatic cardiac dysfunction No uncontrolled hypertension (i.e., resting blood pressure ≥ 150/100 mm Hg despite antihypertensive therapy) 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 Flecks of blood only in sputum allowed Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective (double method for females; barrier method for males) contraception Able and willing to participate in the quality of life assessment No peripheral neuropathy > grade 1 No prior allergic reaction to drugs containing Cremophor EL® No active or uncontrolled infection No serious illness or medical condition which would preclude study compliance No inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis) No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or in situ cancer PRIOR CONCURRENT THERAPY: Biologic therapy At least 14 days since prior epidermal growth factor receptor-inhibitor therapy (e.g., tyrosine kinase inhibitor, monoclonal antibodies, vaccines, or other agents) No prior antiangiogenesis therapy, including any of the following: Bevacizumab Cediranib maleate AZD6474 PTK787/ZK222584 (PTK/ZK) Sunitinib malate Concurrent epoetin alfa allowed Chemotherapy At least 12 months since prior adjuvant chemotherapy Combined chemotherapy and radiotherapy regimens for locally advanced stage IIIB disease is not considered adjuvant therapy and is not allowed No prior chemotherapy for metastatic or recurrent NSCLC Endocrine therapy See Disease Characteristics At least 1 week since prior steroids Radiotherapy See Disease Characteristics At least 21 days since prior radiotherapy except for low-dose non-myelosuppressive radiotherapy with approval Concurrent palliative radiotherapy allowed with approval Surgery At least 14 days since prior major surgery Other Recovered from prior therapy Prior treatment with cyclooxygenase-2 inhibitors allowed Concurrent prophylactic anticoagulation (e.g., warfarin) allowed provided requirements for INR are met No potent inhibitors of CYP3A4 and 2C8, including any of the following drugs: Amiodarone hydrochloride Clarithromycin Citalopram hydrobromide Erythromycin Omeprazole Simvastatin Atorvastatin Lovastatin Montelukast sodium Verapamil hydrochloride Ketoconazole Miconazole Indinovir and other antivrails Diltiazem No other concurrent experimental drug or anticancer therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Glenwood D. Goss, MD, BCh, FCP, FRCPC
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
Instituto Alexander Fleming
City
Buenos Aires
ZIP/Postal Code
1426
Country
Argentina
Facility Name
Compleso Medico de la Policia Federal Argentina
City
Buenos Aires
ZIP/Postal Code
1437
Country
Argentina
Facility Name
Hospital Universitario Austral
City
Buenos Aires
ZIP/Postal Code
B1629AHJ
Country
Argentina
Facility Name
Alfred Hospital
City
Melbourne
ZIP/Postal Code
3004
Country
Australia
Facility Name
Instituto Nacional de Cancer (INCA)
City
Rio de Janeiro
ZIP/Postal Code
CEP20231-050
Country
Brazil
Facility Name
Cross Cancer Institute
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 1Z2
Country
Canada
Facility Name
BCCA - Vancouver Cancer Centre
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E6
Country
Canada
Facility Name
Juravinski Cancer Centre at Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8V 5C2
Country
Canada
Facility Name
London Regional Cancer Program
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4L6
Country
Canada
Facility Name
Ottawa Health Research Institute - General Division
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
Algoma District Cancer Program
City
Sault Ste. Marie
State/Province
Ontario
ZIP/Postal Code
P6B 0A8
Country
Canada
Facility Name
Niagara Health System
City
St. Catharines
State/Province
Ontario
ZIP/Postal Code
L2R 7C6
Country
Canada
Facility Name
Northeast Cancer Center Health Sciences
City
Sudbury
State/Province
Ontario
ZIP/Postal Code
P3E 5J1
Country
Canada
Facility Name
Mount Sinai Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X5
Country
Canada
Facility Name
Univ. Health Network-Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
University Institute of Cardiology and
City
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
Oncology Institute Bucharest
City
Bucharest
Country
Romania
Facility Name
Oncological Institute "Ion Chiricuta"
City
Cluj-Napoca
ZIP/Postal Code
3400
Country
Romania
Facility Name
Clinical County Hospital of Sibiu
City
Sibiu
ZIP/Postal Code
2400
Country
Romania
Facility Name
National University Hospital
City
Singapore
ZIP/Postal Code
119074
Country
Singapore

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
Citation
Bradbury PA, Twumasi-Ankrah P, Ding K, et al.: The impact of brain metastases on overall survival (OS) in National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) clinical trials (CT) in advanced non-small cell lung cancer (NSCLC). [Abstract] J Clin Oncol 27 (Suppl 15): A-8075, 2009.
Results Reference
background
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
PubMed Identifier
19917841
Citation
Goss GD, Arnold A, Shepherd FA, Dediu M, Ciuleanu TE, Fenton D, Zukin M, Walde D, Laberge F, Vincent MD, Ellis PM, Laurie SA, Ding K, Frymire E, Gauthier I, Leighl NB, Ho C, Noble J, Lee CW, Seymour L. Randomized, double-blind trial of carboplatin and paclitaxel with either daily oral cediranib or placebo in advanced non-small-cell lung cancer: NCIC clinical trials group BR24 study. J Clin Oncol. 2010 Jan 1;28(1):49-55. doi: 10.1200/JCO.2009.22.9427. Epub 2009 Nov 16.
Results Reference
result

Learn more about this trial

Paclitaxel + Carboplatin With/Out Cediranib Maleate in Stage III or Stage IV Non-Small Cell Lung Cancer

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