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Abraxane and Alimta in Advanced Solid Tumors

Primary Purpose

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

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Abraxane
Alimta
Sponsored by
University of California, Davis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring male breast cancer, recurrent breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage IV breast cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent non-small cell lung cancer, unspecified adult solid tumor, protocol specific

Eligibility Criteria

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

Inclusion Criteria

  1. For the phase II portion patients must have cytologically or histologically proven selected stage IIIB (pleural effusion) or IV NSCLC.
  2. For the phase II portion patients must have NSCLC that has progressed or recurred after treatment with platinum-based therapy.
  3. No prior pemetrexed. Prior Taxol is allowed. Prior ABI 007 is not allowed.
  4. Patients must have measurable disease by RECIST criteria for the phase II portion.
  5. Patients must be 18 years of age or older.
  6. Patients must have a performance status of 0 -2
  7. Patients must have an estimated survival of at least 3 months.
  8. Any prior chemotherapy must have been completed at least 4 weeks prior to start of treatment.
  9. Patients must have adequate renal function as documented by a calculated creatinine clearance of > 45 ml/min
  10. Patients must have adequate liver functions: AST and ALT < 2.5 X upper limit of normal, and bilirubin < upper limit of normal.
  11. Patients must have adequate bone marrow function: Platelets >100,000 cells/mm3 and ANC > 1,500 cells/mm3.
  12. For patients who have baseline clinically significant pleural or peritoneal effusions (on the basis of symptoms or clinical examination) before initiation of pemetrexed therapy, consideration should be given to draining the effusion prior to dosing.
  13. Patients with asymptomatic treated brain metastasis (surgical resection or radiotherapy) may be included if they are neurologically stable and have been off steroids and anticonvulsants for at least 4 weeks.
  14. Patients must be able to take and retain oral medication.
  15. Ability to take folic acid, vitamin B12 and dexamethasone according to protocol.
  16. Ability to interrupt NSAIDS 2 days before, the day of, and 2 days following administration of pemetrexed.
  17. Patients of reproductive potential must agree to use effective contraceptive method while on treatment and for 3 months afterwards as the effects of these drugs on the unborn fetus are unknown.
  18. No other current active malignancy.
  19. Patient or his/her legally authorized representative or guardian signed the Informed Consent form prior to participation in any study-related activities.

Exclusion Criteria

  1. Pregnant or breastfeeding women.
  2. Patient with pre-existing peripheral neuropathy of NCI CTCAE Version 3.0 of grade 2.
  3. Patient has a clinically significant concurrent illness.
  4. Patient is currently enrolled in a different clinical study in which investigational procedures are performed or investigational therapies are administered.
  5. Patient has a history of allergy or hypersensitivity to the study drugs or a taxane.
  6. Patient has serious medical risk factors involving any of the major organ systems such that the investigator considers it unsafe for the patient to receive an experimental research drug.
  7. Prior therapy with pemetrexed, or ABI-007.
  8. Patient is receiving treatment with any excluded concomitant medication.
  9. Presence of third space fluid which cannot be controlled by drainage.

Sites / Locations

  • University of California Davis Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Phase I: Abraxane and Alimta

Phase II: Abraxane and Alimta

Arm Description

Three dose levels were tested. Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 180, 220, and 260 mg/m2 every 21 days.

Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 260 mg/m2 every 21 days.

Outcomes

Primary Outcome Measures

Number of Participants With Dose Limiting Toxicities
Dose limiting toxicity (DLT) was defined as any of the following occurring during the first cycle: Grade 4 thrombocytopenia, or grade 3 thrombocytopenia associated with bleeding, requirement for transfusion, febrile neutropenia, neutropenia with documented infection. Non-hematologic DLT included any other ≥ grade 3 non-hematologic toxicity that was clinically significant and considered by the investigator to be related to study drug. Alopecia and grade 3 allergic reaction/hypersensitivity with infusion were not considered DLTs.
Number of Patients With Toxicities
Toxicities was evaluated based on the standard NCI CTCAE Version 3.0 grading criteria. Attributable grade ≥ 3 hematologic and non-hematologic toxicities are presented here.

Secondary Outcome Measures

Duration of Overall Survival
From time of enrollment to the first observation of disease progression or death.
Number of Participants With Complete Response
Per RECIST criteria, complete response (CR) is defined as the disappearance of all target lesions.
Number of Participants With Stable Disease
Stable Disease is measured from the start of the treatment until the criteria for disease progression are met. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Number of Participants With Partial Response
At least a 30% decrease in the sum of the longest diameter of target lesions
Number of Participants With Disease Control
Disease control is complete response plus partial response plus stable disease from the start of treatment to death or disease progression.

Full Information

First Posted
May 3, 2007
Last Updated
January 5, 2018
Sponsor
University of California, Davis
Collaborators
Celgene, Eli Lilly and Company
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1. Study Identification

Unique Protocol Identification Number
NCT00470548
Brief Title
Abraxane and Alimta in Advanced Solid Tumors
Official Title
Phase I/II Trial of Abraxane® (ABI-007) and Alimta® (Pemetrexed) in Advanced Solid Tumors With Emphasis on Non-Small Cell Lung Cancer (NSCLC) and Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
Practice patterns with pemetrexed have evolved.
Study Start Date
April 2007 (undefined)
Primary Completion Date
October 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, Davis
Collaborators
Celgene, Eli Lilly and Company

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
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 albumin-stabilized nanoparticle formulation, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Pemetrexed may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving paclitaxel albumin-stabilized nanoparticle formulation together with pemetrexed may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of paclitaxel albumin-stabilized nanoparticle formulation when given together with pemetrexed and to see how well they work in treating patients with advanced non-small cell lung cancer, breast cancer, or other solid tumors.
Detailed Description
OBJECTIVES: Primary Determine the safety of paclitaxel albumin-stabilized nanoparticle formulation when administered with pemetrexed disodium in patients with advanced non-small cell lung cancer, breast cancer, or other solid tumors. (Phase I) Determine the efficacy of this regimen, as measured by objective tumor response rate (RECIST criteria), in these patients. (Phase II) Secondary Determine the preliminary efficacy of paclitaxel albumin-stabilized nanoparticle formulation and pemetrexed disodium in these patients. (Phase I) Determine the overall survival of patients treated with this regimen. (Phase II) Evaluate the frequency and severity of toxicities associated with this regimen. (Phase II) OUTLINE: This is a phase I, dose-escalation study of paclitaxel albumin-stabilized nanoparticle formulation followed by an open-label, phase II study. Phase I: Patients receive pemetrexed disodium IV over 10 minutes and paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of paclitaxel albumin-stabilized nanoparticle formulation 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 pemetrexed disodium and paclitaxel albumin-stabilized nanoparticle formulation at the MTD as in phase I. After completion of study treatment, patients are followed periodically.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase I: Abraxane and Alimta
Arm Type
Experimental
Arm Description
Three dose levels were tested. Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 180, 220, and 260 mg/m2 every 21 days.
Arm Title
Phase II: Abraxane and Alimta
Arm Type
Experimental
Arm Description
Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 260 mg/m2 every 21 days.
Intervention Type
Drug
Intervention Name(s)
Abraxane
Other Intervention Name(s)
paclitaxel albumin-stabilized nanoparticle formulation, ABI-007
Intervention Description
ABI-007 IV administration following pemetrexed on Day 1 of each cycle (infused over 30 minutes)
Intervention Type
Drug
Intervention Name(s)
Alimta
Other Intervention Name(s)
pemetrexed disodium
Intervention Description
Pemetrexed IV administration on Day 1 of each cycle (infused over 10 minutes)
Primary Outcome Measure Information:
Title
Number of Participants With Dose Limiting Toxicities
Description
Dose limiting toxicity (DLT) was defined as any of the following occurring during the first cycle: Grade 4 thrombocytopenia, or grade 3 thrombocytopenia associated with bleeding, requirement for transfusion, febrile neutropenia, neutropenia with documented infection. Non-hematologic DLT included any other ≥ grade 3 non-hematologic toxicity that was clinically significant and considered by the investigator to be related to study drug. Alopecia and grade 3 allergic reaction/hypersensitivity with infusion were not considered DLTs.
Time Frame
Up to21 days
Title
Number of Patients With Toxicities
Description
Toxicities was evaluated based on the standard NCI CTCAE Version 3.0 grading criteria. Attributable grade ≥ 3 hematologic and non-hematologic toxicities are presented here.
Time Frame
Up to 1 year
Secondary Outcome Measure Information:
Title
Duration of Overall Survival
Description
From time of enrollment to the first observation of disease progression or death.
Time Frame
Up to 2 years
Title
Number of Participants With Complete Response
Description
Per RECIST criteria, complete response (CR) is defined as the disappearance of all target lesions.
Time Frame
Up to 2 years
Title
Number of Participants With Stable Disease
Description
Stable Disease is measured from the start of the treatment until the criteria for disease progression are met. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Time Frame
Up to 2 years
Title
Number of Participants With Partial Response
Description
At least a 30% decrease in the sum of the longest diameter of target lesions
Time Frame
Up to 2 years
Title
Number of Participants With Disease Control
Description
Disease control is complete response plus partial response plus stable disease from the start of treatment to death or disease progression.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria For the phase II portion patients must have cytologically or histologically proven selected stage IIIB (pleural effusion) or IV NSCLC. For the phase II portion patients must have NSCLC that has progressed or recurred after treatment with platinum-based therapy. No prior pemetrexed. Prior Taxol is allowed. Prior ABI 007 is not allowed. Patients must have measurable disease by RECIST criteria for the phase II portion. Patients must be 18 years of age or older. Patients must have a performance status of 0 -2 Patients must have an estimated survival of at least 3 months. Any prior chemotherapy must have been completed at least 4 weeks prior to start of treatment. Patients must have adequate renal function as documented by a calculated creatinine clearance of > 45 ml/min Patients must have adequate liver functions: AST and ALT < 2.5 X upper limit of normal, and bilirubin < upper limit of normal. Patients must have adequate bone marrow function: Platelets >100,000 cells/mm3 and ANC > 1,500 cells/mm3. For patients who have baseline clinically significant pleural or peritoneal effusions (on the basis of symptoms or clinical examination) before initiation of pemetrexed therapy, consideration should be given to draining the effusion prior to dosing. Patients with asymptomatic treated brain metastasis (surgical resection or radiotherapy) may be included if they are neurologically stable and have been off steroids and anticonvulsants for at least 4 weeks. Patients must be able to take and retain oral medication. Ability to take folic acid, vitamin B12 and dexamethasone according to protocol. Ability to interrupt NSAIDS 2 days before, the day of, and 2 days following administration of pemetrexed. Patients of reproductive potential must agree to use effective contraceptive method while on treatment and for 3 months afterwards as the effects of these drugs on the unborn fetus are unknown. No other current active malignancy. Patient or his/her legally authorized representative or guardian signed the Informed Consent form prior to participation in any study-related activities. Exclusion Criteria Pregnant or breastfeeding women. Patient with pre-existing peripheral neuropathy of NCI CTCAE Version 3.0 of grade 2. Patient has a clinically significant concurrent illness. Patient is currently enrolled in a different clinical study in which investigational procedures are performed or investigational therapies are administered. Patient has a history of allergy or hypersensitivity to the study drugs or a taxane. Patient has serious medical risk factors involving any of the major organ systems such that the investigator considers it unsafe for the patient to receive an experimental research drug. Prior therapy with pemetrexed, or ABI-007. Patient is receiving treatment with any excluded concomitant medication. Presence of third space fluid which cannot be controlled by drainage.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David R. Gandara, MD
Organizational Affiliation
University of California, Davis
Official's Role
Study Chair
Facility Information:
Facility Name
University of California Davis Cancer Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24013936
Citation
Ho C, Davies AM, Sangha RS, Lau D, Lara P Jr, Chew HK, Beckett L, Mack PC, Riess JW, Gandara DR. Phase I/II trial of pemetrexed plus nab-paclitaxel in advanced solid tumor patients with emphasis on non-small cell lung cancer. Invest New Drugs. 2013 Dec;31(6):1587-91. doi: 10.1007/s10637-013-0024-y. Epub 2013 Sep 8.
Results Reference
result

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Abraxane and Alimta in Advanced Solid Tumors

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