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Study of Pralatrexate vs. Erlotinib for Non-Small Cell Lung Cancer After at Least 1 Prior Platinum-based Treatment

Primary Purpose

Non-small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Pralatrexate
Erlotinib
Vitamin B12
Folic Acid
Sponsored by
Spectrum Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-small Cell Lung Cancer focused on measuring Stage IIIB/IV non-small cell lung cancer, Non-small cell lung cancer, NSCLC, Lung Cancer, Pralatrexate, Erlotinib, Tarceva, PDX, Smoking, Smoker

Eligibility Criteria

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

Inclusion Criteria:

  • Confirmed Stage IIIB/ IV non-small cell lung cancer (NSCLC).
  • Relapsed after treatment with 1 or 2 prior chemotherapy regimens, including at least 1 platinum-based treatment. Patients may have received pemetrexed as 1 of the prior therapies. Patients may not have received investigational therapy as their only prior therapy.
  • Recovered from the toxic effects of prior therapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Smoked ≥ 100 cigarettes in their lifetime, whether a former or current cigarette smoker.
  • Adequate blood, liver and kidney function as defined by laboratory values.
  • Received 1-1.25 mg daily oral folic acid for at least 7 days prior to randomization and 1 mg intramuscular injection of vitamin B12 within 10 weeks prior to randomization.
  • Women of childbearing potential must use medically acceptable birth control and have a negative serum pregnancy test within 14 days prior to randomization. Patients who are postmenopausal for at least 1 year (> 12 months since last menses) or are surgically sterilized do not require this test.
  • Men who are not surgically sterile must use medically safe and effective birth control from the time of study randomization, and agree to continue practicing until at least 90 days after the last administration of study treatment.
  • Accessible for repeat dosing and follow-up.
  • Give written informed consent.

Exclusion Criteria:

  • Active concurrent primary malignancy (except non-melanoma skin cancer or in situ carcinoma of the cervix). If there is a history of prior malignancy, the patient must be disease-free for ≥ 5 years. Patients with other prior malignancies less than 5 years before study entry may still be enrolled if they have received treatment resulting in complete resolution of the cancer and currently have no evidence of active or recurrent disease.
  • Use of investigational drugs, biologics, or devices within 4 weeks prior to randomization.
  • Previous exposure to pralatrexate or erlotinib.
  • Women who are pregnant or breastfeeding.
  • Congestive Heart Failure Class III/IV according to New York Heart Association (NYHA) Functional Classification.
  • Uncontrolled hypertension.
  • Human immunodeficiency virus (HIV)-positive diagnosis with a CD4 count of <100 mm3 or detectable viral load within the past 3 months, and is receiving combination anti-retroviral therapy.
  • Symptomatic central nervous system metastases or lesions for which treatment is required.
  • Major surgery within 2 weeks of study randomization.
  • Receipt of any conventional systemic chemotherapy within 4 weeks (6 weeks for nitrosoureas, mitomycin C), or radiation therapy (RT) within 2 weeks, prior to randomization.
  • Active infection or any serious underlying medical condition, which would impair the ability of the patient to receive protocol treatment.
  • Dementia or significantly altered mental status that would prohibit the understanding and giving of informed consent or limit study compliance.

Sites / Locations

  • Comprehensive Blood and Cancer Center
  • Sharp Memorial Hospital
  • Hematology Oncology Associates of the Treasure Coast
  • Northwestern University Feinberg School of Medicine
  • University of Kansas Cancer Center
  • Donald Berdeaux
  • Summit Medical Group
  • Hematology and Oncology Associates South Jersey
  • New York Oncology Hematology-Oncology Associates, P.C.
  • Memorial Sloan-Kettering Cancer Center
  • New Bern Cancer Care
  • Signal Point Clinical Research Center
  • Baptist Regional Cancer Center
  • Cancer Therapy and Research Center
  • Providence Everett Medical Center
  • Instituto Medico Especializado Alexander Fleming
  • Policlinica Privada - Instituto de Medicina Nuclear
  • Hospital Britanico
  • Centro Oncologico Rosario
  • ISIS Clinica Especializada
  • CAIPO (Centero Para la Atencion Integral del Paciente Oncologico)
  • Associação Hospital de Caridade de Ijuí
  • Hospital de Clínicas de Porto Alegre
  • Clinionco - Clínica de Oncologia de Porto Alegre
  • Fundação Pio XII - Hospital do Câncer de Barretos
  • Biocancer S.A.
  • Instituto do Cancer - Arnaldo Vieira de Carvalho
  • Masarykuv onkologicky ustav
  • Palacký University Medical School and Teaching Hospital
  • Vitkovicka nemocnice, a. s.
  • Fakultni nemocnice na Bulovce
  • Fakultni nemocnice v Motole
  • Nemocnice Na Homolce
  • National Koranyi TBC and Pulmonology Institute
  • Jósa András Teaching Hospital
  • Vas County Markusovszky Hospital
  • Zala County Hospital
  • Matrai Allami Gyogyintezet
  • Komarom-Esztergom Megyei Onkorm. Szent Borbala Korhaza
  • MNJ Radium Hospital and Radium Institute of Oncology and Regional Cancer Centre
  • Indo American Cancer Institute and Research Center
  • Kidwai Memorial Institute of Oncology
  • Regional Cancer Center
  • Tata Memorial Hospital
  • Jehangir Clinical Development Centre Pvt Ltd
  • B.P. Poddar Cancer Institute
  • Dharmashila Cancer Hospital & Research Centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Pralatrexate

Erlotinib

Arm Description

Intravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride).

150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.

Outcomes

Primary Outcome Measures

Overall Survival (OS) of Patients Receiving Pralatrexate vs. Erlotinib
OS was defined as the length of time from randomization until death due to any cause. Patients who were alive at the time of the data cut-off date were censored at the last contact date.

Secondary Outcome Measures

Response Rate (RR) to Treatment of Patients Receiving Pralatrexate vs. Erlotinib
Number of patients whose tumors responded to Pralatrexate or Erlotinib, using the Response Criteria in Solid Tumors (RECIST).
Progression-free Survival (PFS) of Patients Receiving Pralatrexate vs. Erlotinib
PFS was calculated as the number of days from randomization to the date of radiological evidence of PD or death due to any cause.
Adverse Events of Patients Receiving Pralatrexate vs. Erlotinib

Full Information

First Posted
January 22, 2008
Last Updated
February 8, 2021
Sponsor
Spectrum Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT00606502
Brief Title
Study of Pralatrexate vs. Erlotinib for Non-Small Cell Lung Cancer After at Least 1 Prior Platinum-based Treatment
Official Title
A Randomized, Phase 2b, Multi-center Study of Pralatrexate Versus Erlotinib in Patients With Stage IIIB/IV Non-small Cell Lung Cancer After Failure of at Least 1 Prior Platinum-based Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
January 2008 (undefined)
Primary Completion Date
June 24, 2010 (Actual)
Study Completion Date
June 24, 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spectrum Pharmaceuticals, Inc

4. Oversight

5. Study Description

Brief Summary
The purpose of this clinical study is to determine the effectiveness (ability to provide beneficial treatment of the disease) and safety of pralatrexate compared to erlotinib when given to non-small cell lung cancer (NSCLC) patients who are current or former cigarette smokers and who have received at least 1 prior treatment with a platinum drug (cisplatin or carboplatin)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-small Cell Lung Cancer
Keywords
Stage IIIB/IV non-small cell lung cancer, Non-small cell lung cancer, NSCLC, Lung Cancer, Pralatrexate, Erlotinib, Tarceva, PDX, Smoking, Smoker

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
201 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pralatrexate
Arm Type
Experimental
Arm Description
Intravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride).
Arm Title
Erlotinib
Arm Type
Active Comparator
Arm Description
150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.
Intervention Type
Drug
Intervention Name(s)
Pralatrexate
Other Intervention Name(s)
FOLOTYN, PDX, (RS)-10-propargyl-10-deazaaminopterin
Intervention Description
Intravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride). Initial dose: 230 mg/m2, increased to 270 mg/m2 if patient does not have specific adverse events (AEs) as per the protocol after receipt of 2 consecutive doses 2 weeks apart. Reductions allowed in 40 mg/m2 decrements to 190 mg/m2 per the protocol defined dose modifications. Protocol amended dose: 190 mg/m2, then 230 mg/m2 if patient does not have specific AEs per the protocol after receipt of 2 consecutive doses 2 weeks apart. Reductions allowed in 40 mg/2 decrements to 150 mg/m2 per the protocol defined dose modifications. Administered on days 1 and 15 of a 4-week cycle (every 2 weeks) until criteria for discontinuation per the protocol are met.
Intervention Type
Drug
Intervention Name(s)
Erlotinib
Other Intervention Name(s)
Tarceva®, Erlotinib hydrochloride
Intervention Description
150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.
Intervention Type
Dietary Supplement
Intervention Name(s)
Vitamin B12
Other Intervention Name(s)
Cyanocobalamin
Intervention Description
1 mg intramuscular injection Administered within 10 weeks of randomization, every 8-10 weeks throughout the study and for at least 30 days after last dose of study treatment.
Intervention Type
Dietary Supplement
Intervention Name(s)
Folic Acid
Other Intervention Name(s)
Vitamin B9, Folate, Folacin
Intervention Description
1-1.25 mg orally Administered daily for at least 7 days prior to randomization, throughout the study and for at least 30 days after last dose of study treatment.
Primary Outcome Measure Information:
Title
Overall Survival (OS) of Patients Receiving Pralatrexate vs. Erlotinib
Description
OS was defined as the length of time from randomization until death due to any cause. Patients who were alive at the time of the data cut-off date were censored at the last contact date.
Time Frame
Assessed from date of randomization no less frequently than every 16 weeks for up to 2 years after randomization.
Secondary Outcome Measure Information:
Title
Response Rate (RR) to Treatment of Patients Receiving Pralatrexate vs. Erlotinib
Description
Number of patients whose tumors responded to Pralatrexate or Erlotinib, using the Response Criteria in Solid Tumors (RECIST).
Time Frame
Assessed every 8 weeks for the first 24 weeks, then every 16 weeks for up to 2 years or until PD or start of subsequent treatment.
Title
Progression-free Survival (PFS) of Patients Receiving Pralatrexate vs. Erlotinib
Description
PFS was calculated as the number of days from randomization to the date of radiological evidence of PD or death due to any cause.
Time Frame
Assessed every 8 weeks for the first 24 weeks, then every 16 weeks for up to 2 years or until PD or start of subsequent treatment.
Title
Adverse Events of Patients Receiving Pralatrexate vs. Erlotinib
Time Frame
Assessed every 2 weeks while on treatment through safety follow-up visit (35 +/-5 days post-last dose) or early termination visit (at time of withdrawal).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed Stage IIIB/ IV non-small cell lung cancer (NSCLC). Relapsed after treatment with 1 or 2 prior chemotherapy regimens, including at least 1 platinum-based treatment. Patients may have received pemetrexed as 1 of the prior therapies. Patients may not have received investigational therapy as their only prior therapy. Recovered from the toxic effects of prior therapy. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Smoked ≥ 100 cigarettes in their lifetime, whether a former or current cigarette smoker. Adequate blood, liver and kidney function as defined by laboratory values. Received 1-1.25 mg daily oral folic acid for at least 7 days prior to randomization and 1 mg intramuscular injection of vitamin B12 within 10 weeks prior to randomization. Women of childbearing potential must use medically acceptable birth control and have a negative serum pregnancy test within 14 days prior to randomization. Patients who are postmenopausal for at least 1 year (> 12 months since last menses) or are surgically sterilized do not require this test. Men who are not surgically sterile must use medically safe and effective birth control from the time of study randomization, and agree to continue practicing until at least 90 days after the last administration of study treatment. Accessible for repeat dosing and follow-up. Give written informed consent. Exclusion Criteria: Active concurrent primary malignancy (except non-melanoma skin cancer or in situ carcinoma of the cervix). If there is a history of prior malignancy, the patient must be disease-free for ≥ 5 years. Patients with other prior malignancies less than 5 years before study entry may still be enrolled if they have received treatment resulting in complete resolution of the cancer and currently have no evidence of active or recurrent disease. Use of investigational drugs, biologics, or devices within 4 weeks prior to randomization. Previous exposure to pralatrexate or erlotinib. Women who are pregnant or breastfeeding. Congestive Heart Failure Class III/IV according to New York Heart Association (NYHA) Functional Classification. Uncontrolled hypertension. Human immunodeficiency virus (HIV)-positive diagnosis with a CD4 count of <100 mm3 or detectable viral load within the past 3 months, and is receiving combination anti-retroviral therapy. Symptomatic central nervous system metastases or lesions for which treatment is required. Major surgery within 2 weeks of study randomization. Receipt of any conventional systemic chemotherapy within 4 weeks (6 weeks for nitrosoureas, mitomycin C), or radiation therapy (RT) within 2 weeks, prior to randomization. Active infection or any serious underlying medical condition, which would impair the ability of the patient to receive protocol treatment. Dementia or significantly altered mental status that would prohibit the understanding and giving of informed consent or limit study compliance.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Garry Weems, PharmD
Organizational Affiliation
Spectrum Pharmaceuticals, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Comprehensive Blood and Cancer Center
City
Bakersfield
State/Province
California
ZIP/Postal Code
93309
Country
United States
Facility Name
Sharp Memorial Hospital
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Hematology Oncology Associates of the Treasure Coast
City
Port Saint Lucie
State/Province
Florida
ZIP/Postal Code
34952
Country
United States
Facility Name
Northwestern University Feinberg School of Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Kansas Cancer Center
City
Westwood
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Facility Name
Donald Berdeaux
City
Great Falls
State/Province
Montana
ZIP/Postal Code
59405
Country
United States
Facility Name
Summit Medical Group
City
Berkeley Heights
State/Province
New Jersey
ZIP/Postal Code
07922
Country
United States
Facility Name
Hematology and Oncology Associates South Jersey
City
Mount Holly
State/Province
New Jersey
ZIP/Postal Code
08060
Country
United States
Facility Name
New York Oncology Hematology-Oncology Associates, P.C.
City
Latham
State/Province
New York
ZIP/Postal Code
12110
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
New Bern Cancer Care
City
New Bern
State/Province
North Carolina
ZIP/Postal Code
28562
Country
United States
Facility Name
Signal Point Clinical Research Center
City
Middletown
State/Province
Ohio
ZIP/Postal Code
45042
Country
United States
Facility Name
Baptist Regional Cancer Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37920
Country
United States
Facility Name
Cancer Therapy and Research Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Providence Everett Medical Center
City
Everett
State/Province
Washington
ZIP/Postal Code
98201
Country
United States
Facility Name
Instituto Medico Especializado Alexander Fleming
City
Buenos Aires
State/Province
Cuidad De Buenos Aires
ZIP/Postal Code
C1426ANZ
Country
Argentina
Facility Name
Policlinica Privada - Instituto de Medicina Nuclear
City
Bahia Blanca
State/Province
Provincia De Buenos Aires
ZIP/Postal Code
B8000FJI
Country
Argentina
Facility Name
Hospital Britanico
City
Capital Federal
ZIP/Postal Code
C1280AEB
Country
Argentina
Facility Name
Centro Oncologico Rosario
City
Rosario
ZIP/Postal Code
S2000DSK
Country
Argentina
Facility Name
ISIS Clinica Especializada
City
Santa Fe
ZIP/Postal Code
S3000FFU
Country
Argentina
Facility Name
CAIPO (Centero Para la Atencion Integral del Paciente Oncologico)
City
Tucuman
ZIP/Postal Code
4000
Country
Argentina
Facility Name
Associação Hospital de Caridade de Ijuí
City
Ijui
State/Province
RS
ZIP/Postal Code
98700-000
Country
Brazil
Facility Name
Hospital de Clínicas de Porto Alegre
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90035-903
Country
Brazil
Facility Name
Clinionco - Clínica de Oncologia de Porto Alegre
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90430-090
Country
Brazil
Facility Name
Fundação Pio XII - Hospital do Câncer de Barretos
City
Barretos
State/Province
SP
ZIP/Postal Code
14780-400
Country
Brazil
Facility Name
Biocancer S.A.
City
Belo Horizonte
ZIP/Postal Code
30150-270
Country
Brazil
Facility Name
Instituto do Cancer - Arnaldo Vieira de Carvalho
City
Sao Paulo
ZIP/Postal Code
01224-010
Country
Brazil
Facility Name
Masarykuv onkologicky ustav
City
Brno
ZIP/Postal Code
656 53
Country
Czechia
Facility Name
Palacký University Medical School and Teaching Hospital
City
Olomouc
ZIP/Postal Code
775 20
Country
Czechia
Facility Name
Vitkovicka nemocnice, a. s.
City
Ostrava
ZIP/Postal Code
703 84
Country
Czechia
Facility Name
Fakultni nemocnice na Bulovce
City
Praha 8
ZIP/Postal Code
180 00
Country
Czechia
Facility Name
Fakultni nemocnice v Motole
City
Praha
ZIP/Postal Code
150 06
Country
Czechia
Facility Name
Nemocnice Na Homolce
City
Praha
ZIP/Postal Code
15003
Country
Czechia
Facility Name
National Koranyi TBC and Pulmonology Institute
City
Budapest
State/Province
Pest
ZIP/Postal Code
1525
Country
Hungary
Facility Name
Jósa András Teaching Hospital
City
Nyiregyhaza
State/Province
Szabolcs-Szatmár-Bereg
ZIP/Postal Code
4412
Country
Hungary
Facility Name
Vas County Markusovszky Hospital
City
Szombathely
State/Province
Vas
ZIP/Postal Code
9700
Country
Hungary
Facility Name
Zala County Hospital
City
Zalaegerszeg
State/Province
Zala
ZIP/Postal Code
8900
Country
Hungary
Facility Name
Matrai Allami Gyogyintezet
City
Matrahaza
ZIP/Postal Code
3233
Country
Hungary
Facility Name
Komarom-Esztergom Megyei Onkorm. Szent Borbala Korhaza
City
Tatabánya
ZIP/Postal Code
2800
Country
Hungary
Facility Name
MNJ Radium Hospital and Radium Institute of Oncology and Regional Cancer Centre
City
Hyderabaad
State/Province
Andhra Pradesh
ZIP/Postal Code
500004
Country
India
Facility Name
Indo American Cancer Institute and Research Center
City
Hyderabad
State/Province
Andhra Pradesh
ZIP/Postal Code
500034
Country
India
Facility Name
Kidwai Memorial Institute of Oncology
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560029
Country
India
Facility Name
Regional Cancer Center
City
Trivandrum
State/Province
Kerala
ZIP/Postal Code
695011
Country
India
Facility Name
Tata Memorial Hospital
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400012
Country
India
Facility Name
Jehangir Clinical Development Centre Pvt Ltd
City
Pune
State/Province
Mahara
ZIP/Postal Code
411001
Country
India
Facility Name
B.P. Poddar Cancer Institute
City
Kolkata
State/Province
West Bengal
ZIP/Postal Code
700053
Country
India
Facility Name
Dharmashila Cancer Hospital & Research Centre
City
New Delhi
ZIP/Postal Code
110096
Country
India

12. IPD Sharing Statement

Learn more about this trial

Study of Pralatrexate vs. Erlotinib for Non-Small Cell Lung Cancer After at Least 1 Prior Platinum-based Treatment

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