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Vandetanib, Carboplatin, and Paclitaxel in Treating Patients With Stage I, Stage II, or Stage III Non-Small Cell Lung Cancer That Can Be Removed by Surgery

Primary Purpose

Lung Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
carboplatin
paclitaxel
Zactima
neoadjuvant therapy
Sponsored by
Barbara Ann Karmanos Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer focused on measuring stage I non-small cell lung cancer, stage II non-small cell lung cancer, stage IIIA 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 staging criteria:

    • Stage IB or II disease
    • T3, N0-1 disease (stage IIIA)
  • Deemed a surgical candidate
  • No prior lung cancer (NSCLC or small cell lung cancer)

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
  • WBC ≥ 3,000/mm³
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Creatinine ≤ 1.5 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No evidence of severe or uncontrolled systemic disease or any concurrent condition that, in the opinion of the investigator, would preclude study compliance
  • No peripheral neuropathy ≥ grade 2
  • No hemoptysis within the past 12 weeks
  • No spontaneous bleeding within the past 12 weeks
  • No clinically significant cardiac event (e.g., NYHA class II-IV heart disease, myocardial infarction) within the past 3 months
  • No history of asymptomatic sustained ventricular tachycardia or arrhythmia that is symptomatic or requires treatment, including any of the following:

    • Multifocal premature ventricular contractions
    • Bigeminy
    • Trigeminy
    • Ventricular tachycardia
    • Uncontrolled atrial fibrillation

      • Atrial fibrillation controlled with medication allowed
  • No history of QTc prolongation as a result from other medication that required discontinuation of that medication
  • No congenital long QT syndrome or first-degree family relative with an unexplained death before the age of 40
  • No left bundle branch block
  • No QTc with Bazett's correction that is unmeasurable or QTc ≥ 480 milliseconds on screening ECG

    • Patients with QTc ≥ 480 milliseconds on screening ECG may have ECG repeated twice

      • Average QTc from the 3 screening ECG's must be < 480 milliseconds
  • No uncontrolled hypertension (systolic BP > 160 mm Hg or diastolic BP > 100 mm Hg)
  • No active diarrhea or active gastrointestinal disease that may affect the absorption of study drugs or ability to tolerate study drugs
  • No other malignancy within the past 3 years except in situ cervical carcinoma or adequately treated basal cell or squamous cell carcinoma of the skin

PRIOR CONCURRENT THERAPY:

  • More than 4 weeks since major surgery and recovered
  • No prior carboplatin, paclitaxel, or vandetanib
  • More than 30 days since prior investigational agents
  • More than 2 weeks since prior and no concurrent drugs that induce CYP3A4 including, but not limited to, any of the following:

    • Rifampin
    • Phenytoin
    • Carbamazepine
    • Barbiturates
    • Hypericum perforatum (St. John's wort)
  • No medication that may cause QTc prolongation or induce torsades de pointes for 2 weeks prior to beginning study treatment, during, and for 2 weeks after completion of study treatment
  • No concurrent combination antiretroviral treatment for HIV-positive patients
  • No other concurrent investigational agents

Sites / Locations

  • Barbara Ann Karmanos Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Zactima, Paclitaxel, Carboplatin

Arm Description

Zactima- 100 mg orally daily, starting on day 1 of cycle 1. Paclitaxel- 200mg/m2 IV, every 3 weeks starting on day 1 of cycle 1. Carboplatin AUC6 IV, every 3 weeks starting on day 1 of cycle 1 Duration of each cycle: 21 days. The last dose of zactima will be on the first day of the last cycle. Neoadjuvant Surgery: Surgical resection of the tumor will be performed after the resolution of all the adverse effects from the last cycle of treatment but no earlier than 3 weeks after the last cycle of treatment.

Outcomes

Primary Outcome Measures

Complete Resection (R0) Rate

Secondary Outcome Measures

Post-Operative Mortality Rate
Assess Toxicity of This Regimen and the Percentage of Patients Completing All Planned Cycles of Therapy
Serum chemistry includes Albumin, alkaline phosphatase, total bilirubin, bicarbonate, BUN, calcium, chloride, creatinine, glucose, potassium, total protein, SGOT [AST], SGPT [ALT], sodium, laboratory tests should be done on a weekly basis for the first cycle. After the first cycle laboratory tests should be done within 72 hours of each dose of carboplatin/paclitaxel.
Assess the Clinical Response Rate of the Proposed Pre-operative Regimen
Patients will undergo tumor evaluation when all of the three cycles have been completed unless the treating physician has concerns regarding tumor progression. If the patient has undergone tumor evaluation prior to the last cycle the patient will require repeat tumor assessment within 4 weeks of completion of the last cycle of therapy
Assess the Complete Pathologic Complete Response (CR) Rate With This Regimen.
Evaluation of the number of patients who have no evidence of tumor in the resected tumor.

Full Information

First Posted
April 9, 2007
Last Updated
March 13, 2019
Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00459121
Brief Title
Vandetanib, Carboplatin, and Paclitaxel in Treating Patients With Stage I, Stage II, or Stage III Non-Small Cell Lung Cancer That Can Be Removed by Surgery
Official Title
Assessment of Feasibility and Safety of the Addition of ZD6474 (Zactima) to Carboplatin and Paclitaxel Administered Neo-Adjuvantly in Stage IB, II and T3, N1 Non-Small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Terminated
Study Start Date
July 2007 (undefined)
Primary Completion Date
January 2008 (Actual)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Vandetanib 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 carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving vandetanib together with chemotherapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. PURPOSE: This phase II trial is studying how well giving vandetanib together with carboplatin and paclitaxel works in treating patients with stage I, stage II, or stage III non-small cell lung cancer that can be removed by surgery.
Detailed Description
OBJECTIVES: Primary Determine the feasibility of neoadjuvant vandetanib in combination with carboplatin and paclitaxel in patients with resectable stage IB, II, or IIIA non-small cell lung cancer. Secondary Assess the 30-day postoperative mortality rate in these patients. Assess the toxicity of this regimen in these patients. Determine the percentage of patients who complete all planned courses of therapy. Assess the clinical response rate in patients treated with this regimen. Assess the pathologic complete response rate in patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive oral vandetanib once daily on days 1-21. Patients also receive paclitaxel IV over 3 hours and carboplatin IV over 1 hour on day 1. Treatment repeats every 3 weeks for up to 3 courses. Patients undergo surgery at least 3 weeks after the last course of chemotherapy. PROJECTED ACCRUAL: A total of 15 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 I non-small cell lung cancer, stage II non-small cell lung cancer, stage IIIA non-small cell lung cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Zactima, Paclitaxel, Carboplatin
Arm Type
Experimental
Arm Description
Zactima- 100 mg orally daily, starting on day 1 of cycle 1. Paclitaxel- 200mg/m2 IV, every 3 weeks starting on day 1 of cycle 1. Carboplatin AUC6 IV, every 3 weeks starting on day 1 of cycle 1 Duration of each cycle: 21 days. The last dose of zactima will be on the first day of the last cycle. Neoadjuvant Surgery: Surgical resection of the tumor will be performed after the resolution of all the adverse effects from the last cycle of treatment but no earlier than 3 weeks after the last cycle of treatment.
Intervention Type
Drug
Intervention Name(s)
carboplatin
Other Intervention Name(s)
Paraplatin ®
Intervention Description
Carboplatin AUC6 IV, every 3 weeks starting on day 1 of cycle 1
Intervention Type
Drug
Intervention Name(s)
paclitaxel
Other Intervention Name(s)
Taxol ®, Onxal TM
Intervention Description
Paclitaxel- 200mg/m2 IV, every 3 weeks starting on day 1 of cycle 1.
Intervention Type
Drug
Intervention Name(s)
Zactima
Other Intervention Name(s)
Caprelsa, ZD6474, Vandetanib
Intervention Description
Zactima- 100 mg orally daily, starting on day 1 of cycle 1.
Intervention Type
Procedure
Intervention Name(s)
neoadjuvant therapy
Other Intervention Name(s)
R0 Resection
Intervention Description
Neoadjuvant surgery: Surgical resection of the tumor will be performed after the resolution of all the adverse effects from the last cycle of treatment but no earlier than 3 weeks after the last cycle of treatment.
Primary Outcome Measure Information:
Title
Complete Resection (R0) Rate
Time Frame
Following three cycles of pre-operative zactima and carboplatin/paclitaxel
Secondary Outcome Measure Information:
Title
Post-Operative Mortality Rate
Time Frame
at 30 days
Title
Assess Toxicity of This Regimen and the Percentage of Patients Completing All Planned Cycles of Therapy
Description
Serum chemistry includes Albumin, alkaline phosphatase, total bilirubin, bicarbonate, BUN, calcium, chloride, creatinine, glucose, potassium, total protein, SGOT [AST], SGPT [ALT], sodium, laboratory tests should be done on a weekly basis for the first cycle. After the first cycle laboratory tests should be done within 72 hours of each dose of carboplatin/paclitaxel.
Time Frame
Weekly for the first cycle; Thereafter within 72 hours of each dose of carboplatin/paclitaxel
Title
Assess the Clinical Response Rate of the Proposed Pre-operative Regimen
Description
Patients will undergo tumor evaluation when all of the three cycles have been completed unless the treating physician has concerns regarding tumor progression. If the patient has undergone tumor evaluation prior to the last cycle the patient will require repeat tumor assessment within 4 weeks of completion of the last cycle of therapy
Time Frame
End of three cycles of treatment
Title
Assess the Complete Pathologic Complete Response (CR) Rate With This Regimen.
Description
Evaluation of the number of patients who have no evidence of tumor in the resected tumor.
Time Frame
30 days post surgery

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 staging criteria: Stage IB or II disease T3, N0-1 disease (stage IIIA) Deemed a surgical candidate No prior lung cancer (NSCLC or small cell lung cancer) PATIENT CHARACTERISTICS: ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100% WBC ≥ 3,000/mm³ Absolute neutrophil count ≥ 1,500/mm³ Platelet count ≥ 100,000/mm³ Bilirubin normal AST and ALT ≤ 2.5 times upper limit of normal (ULN) Creatinine ≤ 1.5 times ULN Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No evidence of severe or uncontrolled systemic disease or any concurrent condition that, in the opinion of the investigator, would preclude study compliance No peripheral neuropathy ≥ grade 2 No hemoptysis within the past 12 weeks No spontaneous bleeding within the past 12 weeks No clinically significant cardiac event (e.g., NYHA class II-IV heart disease, myocardial infarction) within the past 3 months No history of asymptomatic sustained ventricular tachycardia or arrhythmia that is symptomatic or requires treatment, including any of the following: Multifocal premature ventricular contractions Bigeminy Trigeminy Ventricular tachycardia Uncontrolled atrial fibrillation Atrial fibrillation controlled with medication allowed No history of QTc prolongation as a result from other medication that required discontinuation of that medication No congenital long QT syndrome or first-degree family relative with an unexplained death before the age of 40 No left bundle branch block No QTc with Bazett's correction that is unmeasurable or QTc ≥ 480 milliseconds on screening ECG Patients with QTc ≥ 480 milliseconds on screening ECG may have ECG repeated twice Average QTc from the 3 screening ECG's must be < 480 milliseconds No uncontrolled hypertension (systolic BP > 160 mm Hg or diastolic BP > 100 mm Hg) No active diarrhea or active gastrointestinal disease that may affect the absorption of study drugs or ability to tolerate study drugs No other malignancy within the past 3 years except in situ cervical carcinoma or adequately treated basal cell or squamous cell carcinoma of the skin PRIOR CONCURRENT THERAPY: More than 4 weeks since major surgery and recovered No prior carboplatin, paclitaxel, or vandetanib More than 30 days since prior investigational agents More than 2 weeks since prior and no concurrent drugs that induce CYP3A4 including, but not limited to, any of the following: Rifampin Phenytoin Carbamazepine Barbiturates Hypericum perforatum (St. John's wort) No medication that may cause QTc prolongation or induce torsades de pointes for 2 weeks prior to beginning study treatment, during, and for 2 weeks after completion of study treatment No concurrent combination antiretroviral treatment for HIV-positive patients No other concurrent investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shirish M. Gadgeel, MD
Organizational Affiliation
Barbara Ann Karmanos Cancer Institute
Official's Role
Study Chair
Facility Information:
Facility Name
Barbara Ann Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201-1379
Country
United States

12. IPD Sharing Statement

Links:
URL
http://cancer.gov/clinicaltrials
Description
Clinical trial summary from the National Cancer Institute's PDQ® database

Learn more about this trial

Vandetanib, Carboplatin, and Paclitaxel in Treating Patients With Stage I, Stage II, or Stage III Non-Small Cell Lung Cancer That Can Be Removed by Surgery

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