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Phase II Study of Combination of Paclitaxel Poliglumex and Alimta for Advanced Non-small Cell Lung Cancer (NSCLC)

Primary Purpose

Advanced Non-small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
paclitaxel poliglumex, pemetrexed
Sponsored by
Dartmouth-Hitchcock Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Non-small Cell Lung Cancer focused on measuring paclitaxel poliglumex, xyotax, alimta, advanced non-small cell lung cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of locally advanced and/or metastatic NSCLC (Stage IIIB or IV).
  • Bidimensionally measurable lesions or unidimensionally evaluable lesions.
  • Age ≥ 18 years.
  • At least one measurable target lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST), which has not been previously treated with local therapy (e.g. radiation therapy, chemoembolization, surgery, etc.).
  • May have received prior chemotherapy (including taxanes) for advanced NSCLC.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • Life expectancy > 12 weeks.
  • No active infections.
  • Adequate liver and bone marrow function.
  • AST<2.5 x ULN, bilirubin <1.5x ULN, alkaline phosphatase<2.5 x ULN (unless bone origin and no liver metastases are documented).
  • ANC ≥ 1,500/uL, platelet count ≥ 100,000/uL.
  • Normal PT and PTT.
  • Bisphosphates initiated prior to study entry will be permitted. However, initiation of bisphosphonates following study entry is not permitted.
  • Patients with treated brain metastases must be neurologically stable.
  • At least 3 weeks since last chemotherapy and recovered from treatment-related adverse events ≤ grade 1.
  • At least 3 weeks since prior radiation and recovered from treatment-related adverse events ≤ grade 1.
  • Women of childbearing potential are eligible for the study, provided they have a negative serum or urine pregnancy test within three days of study entry, and an adequate method of contraception is used. Acceptable methods of birth control include barrier methods (condoms, diaphragms with spermicide) or intrauterine devices (IUD). Women whose sole sexual partner is infertile, or who are not sexually active, are also eligible.
  • Able to provide written informed consent.

Exclusion Criteria:

  • Grade 2 or greater peripheral neuropathy, according to the National Cancer Institute-Common Toxicity Criteria.
  • Clinically significant pleural, pericardial or abdominal effusions.
  • Untreated brain metastases.
  • Patients with previously diagnosed brain metastases will be eligible if they are neurologically stable and have recovered from the effects of radiotherapy or surgery (≤ grade 2).
  • Patients with brain metastases must have at least one other site of measurable disease.
  • Concurrent radiotherapy.
  • Other concurrent cancer treatment-related investigational agent. Investigational supportive care medications are permitted.
  • Concurrent treatment with unfractionated heparin or warfarin.
  • History of radiotherapy encompassing greater than 50% of the marrow-bearing skeleton.
  • Prior bone marrow or stem cell transplant.
  • History of other active malignancy within the last year requiring chemotherapy, not including curatively-treated carcinoma in situ of the cervix, or non-melanoma skin cancer (basal cell carcinoma or squamous cell carcinoma).
  • Uncontrolled infection.
  • Active bleeding, or history of bleeding requiring transfusion within 2 weeks of study entry.
  • Active cardiac disease, as defined as:
  • Current history of uncontrolled or symptomatic angina.
  • History of arrhythmias requiring medications or clinically significant arrhythmias, with the exception of uncomplicated atrial fibrillation.
  • Myocardial infarction < 6 months from study entry.
  • Any other cardiac conditions, which in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient.

Sites / Locations

  • Dartmouth-Hitchcock Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Paclitaxel Poliglumex with Pemetrexed

Arm Description

The first 6 eligible patients will be enrolled at a dose of 135 mg/m2 paclitaxel poliglumex in combination with 500 mg/m2 of pemetrexed. Patients who experience disease progression without dose-limiting adverse events after the initial cycle will be replaced. Dose escalation to the next dose level can occur provided that no more than 1 of 6 patients experience in initial dose limiting toxicity (IDLT) following 2 cycles of therapy. If ≥ 2 of 6 patients experience IDLTs at the 135 mg/m2 dose, the maximally tolerated dose (MTD) was surpassed and the study will be discontinued.

Outcomes

Primary Outcome Measures

To Evaluate the Overall Response Rate (Complete Plus Partial Responses by RECIST Criteria) to the Combination of Paclitaxel Poliglumex and Pemetrexed as Therapy in Patients With Advanced NSCLC.

Secondary Outcome Measures

Time to Progression
Overall Survival

Full Information

First Posted
June 14, 2007
Last Updated
November 21, 2013
Sponsor
Dartmouth-Hitchcock Medical Center
Collaborators
CTI BioPharma
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1. Study Identification

Unique Protocol Identification Number
NCT00487669
Brief Title
Phase II Study of Combination of Paclitaxel Poliglumex and Alimta for Advanced Non-small Cell Lung Cancer (NSCLC)
Official Title
Phase II Study of the Combination of Paclitaxel Poliglumex (CT-2103, Xyotax) and Pemetrexed (Alimta) for the Treatment of Patients With Advanced Non-small Cell Lung Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Completed
Study Start Date
October 2006 (undefined)
Primary Completion Date
November 2009 (Actual)
Study Completion Date
November 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dartmouth-Hitchcock Medical Center
Collaborators
CTI BioPharma

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a non-randomized, single-arm, single-institution, open label, two-stage phase II and dose-ranging study designed to evaluate the efficacy and safety of paclitaxel poliglumex in combination with pemetrexed in patients with advanced stage IIIB or stage IV NSCLC.
Detailed Description
Primary objective To evaluate the overall response rate (complete plus partial responses by RECIST criteria) to the combination of paclitaxel poliglumex and pemetrexed as therapy in patients with advanced NSCLC. Secondary Objectives To evaluate the safety and adverse event profile of the combination of paclitaxel poliglumex and pemetrexed as therapy in patients with advanced NSCLC. To evaluate the duration of response, time to progression, and overall survival of advanced NSCLC treated with the combination of paclitaxel poliglumex and pemetrexed. To compare the overall response rate using three-dimensional reconstruction of target lesions by Medical Metrx Solutions (MMS) and RECIST criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Non-small Cell Lung Cancer
Keywords
paclitaxel poliglumex, xyotax, alimta, advanced 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
Non-Randomized
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Paclitaxel Poliglumex with Pemetrexed
Arm Type
Experimental
Arm Description
The first 6 eligible patients will be enrolled at a dose of 135 mg/m2 paclitaxel poliglumex in combination with 500 mg/m2 of pemetrexed. Patients who experience disease progression without dose-limiting adverse events after the initial cycle will be replaced. Dose escalation to the next dose level can occur provided that no more than 1 of 6 patients experience in initial dose limiting toxicity (IDLT) following 2 cycles of therapy. If ≥ 2 of 6 patients experience IDLTs at the 135 mg/m2 dose, the maximally tolerated dose (MTD) was surpassed and the study will be discontinued.
Intervention Type
Drug
Intervention Name(s)
paclitaxel poliglumex, pemetrexed
Other Intervention Name(s)
Xyotax, Alimta
Intervention Description
The first 6 eligible patients will be enrolled at a dose of 135 mg/m2 paclitaxel poliglumex in combination with 500 mg/m2 of pemetrexed. Patients who experience disease progression without dose-limiting adverse events after the initial cycle will be replaced. Dose escalation to the next dose level can occur provided that no more than 1 of 6 patients experience in initial dose limiting toxicity (IDLT) following 2 cycles of therapy. If ≥ 2 of 6 patients experience IDLTs at the 135 mg/m2 dose, the maximally tolerated dose (MTD) was surpassed and the study will be discontinued
Primary Outcome Measure Information:
Title
To Evaluate the Overall Response Rate (Complete Plus Partial Responses by RECIST Criteria) to the Combination of Paclitaxel Poliglumex and Pemetrexed as Therapy in Patients With Advanced NSCLC.
Time Frame
CT or MRI scans of the chest will be obtained after every 2 cycles (6-week intervals +/- 7 days)
Secondary Outcome Measure Information:
Title
Time to Progression
Time Frame
time from study entry until the first documented sign of progression
Title
Overall Survival
Time Frame
time from study entry until death

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed diagnosis of locally advanced and/or metastatic NSCLC (Stage IIIB or IV). Bidimensionally measurable lesions or unidimensionally evaluable lesions. Age ≥ 18 years. At least one measurable target lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST), which has not been previously treated with local therapy (e.g. radiation therapy, chemoembolization, surgery, etc.). May have received prior chemotherapy (including taxanes) for advanced NSCLC. Eastern Cooperative Oncology Group (ECOG) performance status 0-2. Life expectancy > 12 weeks. No active infections. Adequate liver and bone marrow function. AST<2.5 x ULN, bilirubin <1.5x ULN, alkaline phosphatase<2.5 x ULN (unless bone origin and no liver metastases are documented). ANC ≥ 1,500/uL, platelet count ≥ 100,000/uL. Normal PT and PTT. Bisphosphates initiated prior to study entry will be permitted. However, initiation of bisphosphonates following study entry is not permitted. Patients with treated brain metastases must be neurologically stable. At least 3 weeks since last chemotherapy and recovered from treatment-related adverse events ≤ grade 1. At least 3 weeks since prior radiation and recovered from treatment-related adverse events ≤ grade 1. Women of childbearing potential are eligible for the study, provided they have a negative serum or urine pregnancy test within three days of study entry, and an adequate method of contraception is used. Acceptable methods of birth control include barrier methods (condoms, diaphragms with spermicide) or intrauterine devices (IUD). Women whose sole sexual partner is infertile, or who are not sexually active, are also eligible. Able to provide written informed consent. Exclusion Criteria: Grade 2 or greater peripheral neuropathy, according to the National Cancer Institute-Common Toxicity Criteria. Clinically significant pleural, pericardial or abdominal effusions. Untreated brain metastases. Patients with previously diagnosed brain metastases will be eligible if they are neurologically stable and have recovered from the effects of radiotherapy or surgery (≤ grade 2). Patients with brain metastases must have at least one other site of measurable disease. Concurrent radiotherapy. Other concurrent cancer treatment-related investigational agent. Investigational supportive care medications are permitted. Concurrent treatment with unfractionated heparin or warfarin. History of radiotherapy encompassing greater than 50% of the marrow-bearing skeleton. Prior bone marrow or stem cell transplant. History of other active malignancy within the last year requiring chemotherapy, not including curatively-treated carcinoma in situ of the cervix, or non-melanoma skin cancer (basal cell carcinoma or squamous cell carcinoma). Uncontrolled infection. Active bleeding, or history of bleeding requiring transfusion within 2 weeks of study entry. Active cardiac disease, as defined as: Current history of uncontrolled or symptomatic angina. History of arrhythmias requiring medications or clinically significant arrhythmias, with the exception of uncomplicated atrial fibrillation. Myocardial infarction < 6 months from study entry. Any other cardiac conditions, which in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James R Rigas, MD
Organizational Affiliation
Norriss Cotten Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase II Study of Combination of Paclitaxel Poliglumex and Alimta for Advanced Non-small Cell Lung Cancer (NSCLC)

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