Erlotinib Hydrochloride With or Without Celecoxib in Treating Patients With Stage IIIB-IV Non-Small Cell Lung Cancer
Primary Purpose
Recurrent Non-small Cell Lung Cancer, Stage IIIB Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
erlotinib hydrochloride
celecoxib
placebo
laboratory biomarker analysis
immunohistochemistry staining method
fluorescence in situ hybridization
mutation analysis
protein expression analysis
gene expression analysis
Sponsored by

About this trial
This is an interventional treatment trial for Recurrent Non-small Cell Lung Cancer
Eligibility Criteria
Inclusion
- Pathologically proven NSCLC, stage IIIB (defined as: with pleural effusion or recurrence after mediastinal radiation and chemotherapy) or IV
- Available tumor tissue for mutation screening
- Measurable stage IIIb or IV disease by RECIST guidelines
- ECOG performance status of 0 or 1
- Progressive disease despite >= 1 prior chemotherapy regimens as standard of care or subject's refusal or inability to receive standard chemotherapy
- Normal renal function (defined as serum creatinine =< 2mg/dl)
- Normal liver function (defined as serum total bilirubin =< 1.5, and serum transaminases =< 2.5X the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
- No evidence of coagulopathy (defined as PT and/or PTT =< 1.5X ULN or platelets >= 100,000)
- No evidence of leukopenia (defined as absolute neutrophil count >= 1,500 mm^3)
- Negative pregnancy test prior to initiation of treatment and adequate contraception throughout treatment
Exclusion
- Cytotoxic chemotherapy agents within 4 weeks of initiating treatment; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
- Evidence of NYHA class III or greater cardiac disease, history of myocardial infarction, cerebral vascular accident, symptomatic ventricular arrhythmia, or symptomatic conduction abnormality
- Non-cytoxic therapy within 2 weeks of initiating treatment ; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
- Prior radiotherapy to target lesions is not permitted unless completed more than 4 weeks prior to treatment within the study and that there has been documented progression at these sites (Radiotherapy to non-target lesions is permitted within 2 weeks of study entry provided all acute effects of the radiotherapy have resolved at least grade 1)
- Comorbid disease or a medical condition that would impair the ability of the subject to receive or comply with the study protocol
- Prior malignancy within the last 3 years with the exception of non-melanoma skin cancer or cervical cancer in situ
- Hypersensitivity of erlotinib or celecoxib or to any of the excipients of these products
- Hypersensitivity to sulfonamides, aspirin or other NSAIDS
- Prior history of EGFR inhibitor for the treatment of cancer
- Previous history of gastrointestinal ulceration, bleeding or perforation
- Concurrent use of COX-2 inhibitors or other NSAIDS (For subjects on NSAIDS prior to study initiation, cessation of the drug for 72 hours prior to study entry is required)
- Chronic or concurrent use of steroids (topical steroids are acceptable if medically indicated)
- Subjects who require treatment with fluconazole or lithium
- Any evidence of clinically active interstitial lung disease (patients with chronic stable radiographic changes who are asymptomatic need not be excluded)
- Renal insufficiency (defined as serum creatinine > 2 mg/dl)
- Liver insufficiency (defined as serum total bilirubin > 1.5, or serum transaminases > 2.5C the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
- Coagulopathy (defined as PT and/or PTT > 1.5X ULN or platelets < 100,000)
- Leukopenia (defined as absolute neutrophil count < 1,500/mm^3)
- Pregnancy or inadequate contraception
- Lactating females
- Active CNS metastasis (stable, treated CNS metastasis acceptable)
Sites / Locations
- City of Hope Medical Center
- South Pasadena Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Arm I
Arm II
Arm Description
Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28.
Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28.
Outcomes
Primary Outcome Measures
Progression-free Survival
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Secondary Outcome Measures
Number of Participants With Overall Response
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Progression-free Survival - Elevated PGEM
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Progression-free Survival - EGRF
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Progression-free Survival - Low PGEM
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Full Information
NCT ID
NCT00499655
First Posted
July 10, 2007
Last Updated
February 28, 2017
Sponsor
City of Hope Medical Center
Collaborators
OSI Pharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT00499655
Brief Title
Erlotinib Hydrochloride With or Without Celecoxib in Treating Patients With Stage IIIB-IV Non-Small Cell Lung Cancer
Official Title
A Randomized, Placebo-Controlled Phase II Clinical Trial of Combination Erlotinib (Tarceva) and Celecoxib (Celebrex) Versus Erlotinib (Tarceva)/Placebo in Advanced Non-Small Cell Lung Cancer Patients
Study Type
Interventional
2. Study Status
Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
December 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
City of Hope Medical Center
Collaborators
OSI Pharmaceuticals
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
RATIONALE: Erlotinib hydrochloride and celecoxib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Celecoxib may also stop the growth of lung cancer by blocking blood flow to the tumor. Giving erlotinib hydrochloride together with celecoxib may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying how well giving erlotinib hydrochloride together with celecoxib works compared with erlotinib hydrochloride alone in treating patients with stage IIIB-IV non-small cell lung cancer.
Detailed Description
PRIMARY OBJECTIVES:
I. Comparison of progression-free survival (PFS) in patients receiving erlotinib + celecoxib vs. erlotinib + placebo for advanced NSCLC.
SECONDARY OBJECTIVES:
I. Objective tumor response rate as defined by RECIST Criteria for subjects receiving erlotinib/celecoxib treatment arms.
II. Categorize the change in e-cadherin expression from baseline to week 8 in a subset of subjects.
III. Evaluation of overall survival (OS). IV. Measurement of COX-2, EGFR by immunohistochemistry and EGFR amplification by FISH, and EGFR mutation status to correlate with clinical response.
V. Measurement of change in urinary PGE-M and correlation with response.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28.
ARM II: Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28.
In both arms, treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity.
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
Recurrent Non-small Cell Lung Cancer, Stage IIIB Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
107 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm I
Arm Type
Active Comparator
Arm Description
Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28.
Arm Title
Arm II
Arm Type
Experimental
Arm Description
Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28.
Intervention Type
Drug
Intervention Name(s)
erlotinib hydrochloride
Other Intervention Name(s)
CP-358,774, erlotinib, OSI-774, Tarceva
Intervention Description
Given orally
Intervention Type
Drug
Intervention Name(s)
celecoxib
Other Intervention Name(s)
Celebrex, SC-58635, YM 177
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
PLCB
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
immunohistochemistry staining method
Other Intervention Name(s)
immunohistochemistry
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
fluorescence in situ hybridization
Other Intervention Name(s)
fluorescence in situ hybridization (FISH)
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
mutation analysis
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
protein expression analysis
Intervention Description
Correlative studies
Intervention Type
Genetic
Intervention Name(s)
gene expression analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Progression-free Survival
Description
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time Frame
Until disease progression, up to 5 years.
Secondary Outcome Measure Information:
Title
Number of Participants With Overall Response
Description
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Time Frame
16 weeks post start of treatment
Title
Progression-free Survival - Elevated PGEM
Description
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time Frame
Until disease progression, up to 5 years.
Title
Progression-free Survival - EGRF
Description
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time Frame
Until disease progression, up to 5 years.
Title
Progression-free Survival - Low PGEM
Description
Estimated using the product-limit method of Kaplan and Meier.Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), as a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time Frame
Until disease progression, up to 5 years.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion
Pathologically proven NSCLC, stage IIIB (defined as: with pleural effusion or recurrence after mediastinal radiation and chemotherapy) or IV
Available tumor tissue for mutation screening
Measurable stage IIIb or IV disease by RECIST guidelines
ECOG performance status of 0 or 1
Progressive disease despite >= 1 prior chemotherapy regimens as standard of care or subject's refusal or inability to receive standard chemotherapy
Normal renal function (defined as serum creatinine =< 2mg/dl)
Normal liver function (defined as serum total bilirubin =< 1.5, and serum transaminases =< 2.5X the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
No evidence of coagulopathy (defined as PT and/or PTT =< 1.5X ULN or platelets >= 100,000)
No evidence of leukopenia (defined as absolute neutrophil count >= 1,500 mm^3)
Negative pregnancy test prior to initiation of treatment and adequate contraception throughout treatment
Exclusion
Cytotoxic chemotherapy agents within 4 weeks of initiating treatment; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
Evidence of NYHA class III or greater cardiac disease, history of myocardial infarction, cerebral vascular accident, symptomatic ventricular arrhythmia, or symptomatic conduction abnormality
Non-cytoxic therapy within 2 weeks of initiating treatment ; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
Prior radiotherapy to target lesions is not permitted unless completed more than 4 weeks prior to treatment within the study and that there has been documented progression at these sites (Radiotherapy to non-target lesions is permitted within 2 weeks of study entry provided all acute effects of the radiotherapy have resolved at least grade 1)
Comorbid disease or a medical condition that would impair the ability of the subject to receive or comply with the study protocol
Prior malignancy within the last 3 years with the exception of non-melanoma skin cancer or cervical cancer in situ
Hypersensitivity of erlotinib or celecoxib or to any of the excipients of these products
Hypersensitivity to sulfonamides, aspirin or other NSAIDS
Prior history of EGFR inhibitor for the treatment of cancer
Previous history of gastrointestinal ulceration, bleeding or perforation
Concurrent use of COX-2 inhibitors or other NSAIDS (For subjects on NSAIDS prior to study initiation, cessation of the drug for 72 hours prior to study entry is required)
Chronic or concurrent use of steroids (topical steroids are acceptable if medically indicated)
Subjects who require treatment with fluconazole or lithium
Any evidence of clinically active interstitial lung disease (patients with chronic stable radiographic changes who are asymptomatic need not be excluded)
Renal insufficiency (defined as serum creatinine > 2 mg/dl)
Liver insufficiency (defined as serum total bilirubin > 1.5, or serum transaminases > 2.5C the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
Coagulopathy (defined as PT and/or PTT > 1.5X ULN or platelets < 100,000)
Leukopenia (defined as absolute neutrophil count < 1,500/mm^3)
Pregnancy or inadequate contraception
Lactating females
Active CNS metastasis (stable, treated CNS metastasis acceptable)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Karen Reckamp
Organizational Affiliation
City of Hope Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
City of Hope Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
South Pasadena Cancer Center
City
South Pasadena
State/Province
California
ZIP/Postal Code
91030
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Erlotinib Hydrochloride With or Without Celecoxib in Treating Patients With Stage IIIB-IV Non-Small Cell Lung Cancer
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