S0802 - Topotecan With or Without Aflibercept in Treating Patients With Extensive-Stage Small Cell Lung Cancer
Extensive Stage Small Cell Lung Cancer, Recurrent Small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Extensive Stage Small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed extensive stage small cell lung cancer
- Progressive or recurrent disease following one (and only one) standard first-line platinum-containing regimen (cisplatin or carboplatin)
Measurable or non-measurable disease per RECIST criteria
- Disease must be outside a previously irradiated field OR a new lesion must be inside the irradiated field
- Disease must be outside a previously resected area OR a new lesion must be present
- No known brain metastasis unless the metastasis has been treated and is stable for ≥ 3 months prior to study entry
- No leptomeningeal involvement or brain stem metastasis
- Zubrod performance status 0-1
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 10 g/dL
- Serum creatinine ≤ 1.5 times upper limit of normal OR creatinine clearance ≥ 60 mL/min
- Urine protein: creatinine ratio < 1 OR urine protein < 500 mg by 24-hour urine collection
- Not pregnant or nursing
- Fertile patients must use effective contraception
- Willing to provide smoking history
- No evidence of active infection
- No active bleeding
- No significant history of bleeding diathesis, including hemoptysis (½ teaspoon of hemoptysis within the past 3 months), or underlying coagulopathy
No history of recent arterial embolic events, including any of the following:
- Myocardial infarction
- Cerebrovascular accident
- Transient ischemic attack
- Worsening of pre-existing angina within the past 6 months
No uncontrolled hypertension (systolic BP > 150 mm Hg or diastolic BP > 100 mm Hg)
- History of hypertension allowed provided it is controlled on anti-hypertensive medications
- No history of congestive heart failure
- No history of encephalitis or encephalopathy of any cause
- No diverticulitis, gastrointestinal bleeding, or peptic ulcer within the past 3 months
- No known AIDS or HIV-1 associated complex
- No known history of immune or immunodeficiency disorders
- No unstable or pre-existing major medical conditions except for cancer-related abnormalities
No other prior malignancy except for any of the following:
- Adequately treated basal cell or squamous cell skin cancer
- In situ cervical cancer
- Adequately treated stage I or II cancer currently in complete remission
- Any other cancer from which the patient been disease-free for 5 years
- Concurrent chronic therapeutic doses of low molecular weight heparin allowed
- At least 21 days since prior and no concurrent radiotherapy and recovered
- At least 28 days since prior and no concurrent surgery (e.g., thoracic or other major surgeries) and recovered
- No prior bevacizumab or other anti-angiogenic therapies including, but not limited to, small molecule tyrosine kinase inhibitors
No concurrent enzyme-inducing anticonvulsant drugs
- Non-enzyme-inducing anticonvulsant drugs (e.g., Keppra) allowed
- Concurrent chronic oral anticoagulation therapy allowed provided INR is maintained in the therapeutic range (INR 2-3)
Sites / Locations
- Northeast Alabama Regional Medical Center
- Providence Hospital
- Arizona Cancer Center at UMC Orange Grove
- Arizona Cancer Center at University Medical Center North
- University of Arizona Health Sciences Center
- NEA Baptist Memorial Hospital
- University of Arkansas for Medical Sciences
- Highlands Oncology Group-Rogers
- East Bay Radiation Oncology Center
- Eden Hospital Medical Center
- Valley Medical Oncology Consultants-Castro Valley
- City of Hope Medical Center
- Valley Medical Oncology Consultants-Fremont
- Contra Costa Regional Medical Center
- Fremont - Rideout Cancer Center
- El Camino Hospital
- Highland General Hospital
- Alta Bates Summit Medical Center - Summit Campus
- Bay Area Breast Surgeons Inc
- Bay Area Tumor Institute CCOP
- Larry G Strieff MD Medical Corporation
- Tom K Lee Inc
- Valley Care Health System - Pleasanton
- Valley Medical Oncology Consultants
- University of California at Davis Cancer Center
- Doctors Medical Center- JC Robinson Regional Cancer Center
- San Luis Valley Regional Medical Center
- University of Colorado Cancer Center - Anschutz Cancer Pavilion
- The Shaw Regional Cancer Center
- Valley View Hospital Cancer Center
- Saint Mary's Hospital and Regional Medical Center
- Montrose Memorial Hospital
- Saint Francis Hospital and Medical Center
- Piedmont Hospital
- Atlanta Regional CCOP
- Northside Hospital
- Saint Joseph's Hospital of Atlanta
- Well Star Cobb Hospital
- John B Amos Cancer Center
- Dekalb Medical Center
- Piedmont Fayette Hospital
- Gwinnett Medical Center
- Wellstar Kennestone Hospital
- Southern Regional Medical Center
- Harbin Clinic Medical Oncology and Clinical Research
- Memorial Health University Medical Center
- South Georgia Medical Center
- Saint Alphonsus Regional Medical Center
- Saint Anthony's Health
- Cancer Care Center of Decatur
- Decatur Memorial Hospital
- Loyola University Medical Center
- Good Samaritan Regional Health Center
- Memorial Medical Center
- Saint Francis Hospital and Health Centers
- Reid Hospital and Health Care Services
- Genesis Medical Center - East Campus
- Genesis Medical Center - West Campus
- Hospital District Sixth of Harper County
- Cancer Center of Kansas - Chanute
- Cancer Center of Kansas - Dodge City
- Cancer Center of Kansas - El Dorado
- Cancer Center of Kansas - Fort Scott
- Hays Medical Center
- Promise Regional Medical Center-Hutchinson
- Cancer Center of Kansas-Independence
- Kansas City Cancer Center-West
- University of Kansas Medical Center
- Cancer Center of Kansas-Kingman
- Lawrence Memorial Hospital
- Cancer Center of Kansas-Liberal
- Cancer Center of Kansas - Newton
- Olathe Cancer Center
- Cancer Center of Kansas - Parsons
- Via Christi Hospital-Pittsburg
- Cancer Center of Kansas - Pratt
- Cancer Center of Kansas - Salina
- Salina Regional Health Center
- Stormont-Vail Regional Health Center
- Saint Francis Hospital and Medical Center - Topeka
- Cancer Center of Kansas - Wellington
- Associates In Womens Health
- Cancer Center of Kansas-Wichita Medical Arts Tower
- Cancer Center of Kansas - Main Office
- Via Christi Regional Medical Center
- Wichita CCOP
- Cancer Center of Kansas - Winfield
- University of Kentucky
- Baton Rouge General Medical Center
- Mary Bird Perkins Cancer Center
- Interim LSU Public Hospital
- Louisiana State University Health Science Center
- Sinai Hospital of Baltimore
- Boston Medical Center
- Lahey Hospital and Medical Center
- Holy Family Hospital
- Saint Joseph Mercy Hospital
- Michigan Cancer Research Consortium Community Clinical Oncology Program
- University of Michigan
- Bronson Battle Creek
- Spectrum Health Big Rapids Hospital
- Oakwood Hospital
- Wayne State University/Karmanos Cancer Institute
- Saint John Hospital and Medical Center
- Hurley Medical Center
- Genesys Regional Medical Center-West Flint Campus
- Grand Rapids Clinical Oncology Program
- Mercy Health Saint Mary's
- Spectrum Health at Butterworth Campus
- Allegiance Health
- Sparrow Hospital
- Saint Mary Mercy Hospital
- Mercy Health Mercy Campus
- Saint Joseph Mercy Oakland
- Saint Joseph Mercy Port Huron
- Saint Mary's of Michigan
- Munson Medical Center
- Saint John Macomb-Oakland Hospital
- Metro Health Hospital
- Gulfport Memorial Hospital
- University of Mississippi Medical Center
- Singing River Hospital
- Saint Francis Medical Center
- Truman Medical Center
- Kansas City Veterans Affairs Medical Center
- Saint Louis Cancer and Breast Institute-South City
- Saint Louis University Hospital
- Saint John's Mercy Medical Center
- Saint Louis-Cape Girardeau CCOP
- Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield
- Mercy Hospital Springfield
- CoxHealth South Hospital
- Montana Cancer Consortium CCOP
- Northern Rockies Radiation Oncology Center
- Saint Vincent Healthcare
- Hematology-Oncology Centers of the Northern Rockies PC
- Billings Clinic
- Bozeman Deaconess Cancer Center
- Bozeman Deaconess Hospital
- Saint James Community Hospital and Cancer Treatment Center
- Benefis Healthcare- Sletten Cancer Institute
- Berdeaux, Donald MD (UIA Investigator)
- Big Sky Oncology
- Great Falls Clinic
- Northern Montana Hospital
- Saint Peter's Community Hospital
- Glacier Oncology PLLC
- Kalispell Medical Oncology
- Kalispell Regional Medical Center
- Community Medical Hospital
- Montana Cancer Specialists
- Saint Patrick Hospital - Community Hospital
- Guardian Oncology and Center for Wellness
- University Medical Center of Southern Nevada
- Nevada Cancer Research Foundation CCOP
- Arnot Ogden Medical Center
- Adirondack Cancer Center
- Winthrop University Hospital
- Columbia University Medical Center
- Highland Hospital
- Interlakes Foundation Inc-Rochester
- University of Rochester
- Randolph Hospital
- Carolinas Medical Center
- Novant Health Presbyterian Medical Center
- Carolinas Medical Center - Northeast
- Gaston Memorial Hospital
- Wayne Memorial Hospital
- Cone Health Cancer Center
- Margaret R Pardee Memorial Hospital
- High Point Regional Hospital
- Annie Penn Memorial Hospital
- Rutherford Hospital
- Iredell Memorial Hospital
- Akron General Medical Center
- Mary Rutan Hospital
- Adena Regional Medical Center
- University of Cincinnati
- Riverside Methodist Hospital
- Columbus CCOP
- Grant Medical Center
- Mount Carmel Health Center West
- Doctors Hospital
- Grandview Hospital
- Good Samaritan Hospital - Dayton
- Miami Valley Hospital
- Samaritan North Health Center
- Dayton CCOP
- Grady Memorial Hospital
- Blanchard Valley Hospital
- Atrium Medical Center-Middletown Regional Hospital
- Wayne Hospital
- Kettering Medical Center
- Fairfield Medical Center
- Marietta Memorial Hospital
- Knox Community Hospital
- Licking Memorial Hospital
- Southern Ohio Medical Center
- Springfield Regional Medical Center
- Upper Valley Medical Center
- Saint Ann's Hospital
- Clinton Memorial Hospital
- Wright-Patterson Medical Center
- Greene Memorial Hospital
- Genesis HealthCare System
- Clackamas Radiation Oncology Center
- Providence Milwaukie Hospital
- Providence Newberg Medical Center
- Providence Willamette Falls Medical Center
- Providence Portland Medical Center
- Western Oncology Research Consortium
- Adventist Medical Center
- Providence Saint Vincent Medical Center
- Oregon Health and Science University
- Salem Hospital
- AnMed Health Hospital
- McLeod Regional Medical Center
- Spartanburg Regional Medical Center
- Upstate Carolina CCOP
- University of Tennessee - Knoxville
- Veterans Affairs Medical Center - Memphis
- University of Tennessee - Memphis
- University of Texas Medical Branch at Galveston
- Baylor College of Medicine
- Ben Taub General Hospital
- Methodist Hospital
- Saint Luke's Episcopal Hospital
- Veterans Administration Medical Center
- Texas Tech University Health Sciences Center
- Southwest Oncology Group
- Scott and White Memorial Hospital
- Huntsman Cancer Institute/University of Utah
- Danville Regional Medical Center
- Memorial Hospital Of Martinsville
- Cancer Care Center at Island Hospital
- PeaceHealth Saint Joseph Medical Center
- Harrison HealthPartners Hematology and Oncology-Bremerton
- Highline Medical Center-Main Campus
- Columbia Basin Hematology and Oncology PLLC
- Skagit Valley Hospital
- Harrison HealthPartners Hematology and Oncology-Poulsbo
- Harborview Medical Center
- Minor and James Medical PLLC
- Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
- Group Health Cooperative-Seattle
- Swedish Medical Center-First Hill
- The Polyclinic
- University of Washington Medical Center
- United General Hospital
- Cancer Care Northwest - Spokane South
- Evergreen Hematology and Oncology PS
- Rockwood Clinic
- PeaceHealth Southwest Medical Center
- Compass Oncology Vancouver
- Wenatchee Valley Medical Center
- Rocky Mountain Oncology
- Welch Cancer Center
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm I (ziv-aflibercept, topotecan hydrochloride)
Arm II (topotecan hydrochloride)
Patients receive ziv-aflibercept IV over 1 hour on day 1 and topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity. Patients with responsive or stable disease after 4 courses may then receive ziv-aflibercept IV on day 1 and topotecan hydrochloride IV on days 1 and 8. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.
Patients receive topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity. Patients with responsive or stable disease after 4 courses may then receive topotecan hydrochloride IV on days 1 and 8. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.