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Phase 2b Study of Cetuximab With Platinum-Based Chemo as First Line Treatment of Recurrent or Advanced NSCLC

Primary Purpose

Non-Small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cetuximab
Paclitaxel
Carboplatin
Gemcitabine
Cisplatin
Sponsored by
Accelerated Community Oncology Research Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Written informed consent before study-related activities
  • Histologically or cytologically confirmed Stage IIIb with cytologically documented malignant pleural or pericardial effusion, Stage IV, or recurrent non-smal cell lung cancer (NSCLC) after resection or radiation for earlier stage disease
  • Measurable or evaluable disease (per modified Response Evaluation Criteria in Solid Tumors [RECIST] guidelines)
  • Male or female ≥ 18 years of age
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • White blood count ≥ 3 x 10(9)/L with neutrophils ≥ 1.5 x 10(9)/L, platelet count ≥ 100 x 10(9)/L, and hemoglobin ≥ 9.5 g/dL
  • Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN or ≤ 5 x ULN in patients with liver mets
  • Serum creatinine ≤ 1.25 x ULN
  • Recovery from prior surgery or radiation to Grade 1 or better toxicity
  • Women of childbearing potential (WOCBP) and fertile men with partners of childbearing potential must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 wks after the study in such a manner that the risk of pregnancy is minimized
  • WOCBP must have a negative serum or urine pregnancy test within 72 hrs prior to the start of study medication or in accordance with local regulations, whichever is of shorter duration

Exclusion Criteria:

  • WOCBP who are unwilling or unable to use an acceptable method of birth control to avoid pregnancy for the entire study period and for up to 4 weeks after the study
  • Women who are pregnant or breastfeeding
  • Women with a positive pregnancy test during screening or prior to study drug administration
  • Sexually active fertile men not using effective birth control if their partners are women of child-bearing potential
  • Prior chemo for advanced NSCLC; neoadjuvant or post-operative adjuvant chemo is allowed if completed at least 12 months before study entry
  • Previous exposure to epidermal growth factor receptor (EGFR)-targeted therapy. Prior treatment with monoclonal antibodies targeting receptors other than the EGFR, such as bevacizumab, is allowed if completed > 30 days prior to randomization
  • Treatment with any investigational agent(s) within 4 weeks prior to study entry
  • Concurrent anti-cancer therapy (chemotherapy, hormonal therapy, biologic or targeted therapy) other than protocol therapy
  • Carcinoid, atypical carcinoid or small cell lung cancer
  • Symptomatic or uncontrolled mets in the central nervous system
  • Prior invasive malignancy requiring ongoing therapy within the past year
  • Active infection (infection requiring intravenous [IV] antibiotics), including active tuberculosis, known and declared HIV
  • Myocardial infarction within 6 months prior to study entry, uncontrolled congestive heart failure; or any current Grade 3 or 4 cardiovascular disorder despite treatment
  • Known allergic/hypersensitivity reaction to any of the components of study treatments
  • Peripheral neuropathy ≥ Grade 2, as assessed by Common Terminology Criteria for Adverse Events, version 3.0
  • History of significant neurologic or psychiatric disorders including but not limited to dementia, seizures, and bipolar disorder
  • Medical or psychological condition that would not permit the patient to complete the study or sign informed consent
  • Known drug abuse

Patients of all races and ethnic groups are eligible for this trial.

Sites / Locations

  • Family Medicine of Vincennes

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

Paclitaxel, Carboplatin, Cetuximab (Arm A)

Platinum, Gemcitabine, Cetuximab (Arm B)

Platinum, Pemetrexed, Cetuximab (Arm C)

Arm Description

Patients with squamous or non-squamous histologies will receive carboplatin and paclitaxel for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion.

Patients with squamous or non-squamous histologies will receive gemcitabine with either carboplatin or cisplatin for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion. The choice of platinum-based chemotherapy is also at the investigator's discretion.

Patients with squamous histology will receive pemetrexed and either carboplatin or cisplatin for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion. The choice of platinum-based chemotherapy is also at the investigator's discretion. Patients with non-squamous histology are not eligible for this arm.

Outcomes

Primary Outcome Measures

Overall Survival by Treatment Arm

Secondary Outcome Measures

1-year Survival by Treatment Arm
Overall Survival by Histology

Full Information

First Posted
January 23, 2009
Last Updated
October 11, 2013
Sponsor
Accelerated Community Oncology Research Network
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1. Study Identification

Unique Protocol Identification Number
NCT00828841
Brief Title
Phase 2b Study of Cetuximab With Platinum-Based Chemo as First Line Treatment of Recurrent or Advanced NSCLC
Official Title
A Multi-Center Randomized Phase 2b Study of Cetuximab (Erbitux) in Combination With Platinum-Based Chemotherapy as First Line Treatment of Patients With Recurrent or Advanced Non-Small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Accelerated Community Oncology Research Network

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is testing the investigational drug, cetuximab, in combination with different chemotherapy drugs for lung cancer. The aim of the study is to determine which of the drug combinations looks most promising and should be tested further. The study will also look at what side effects may occur.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small Cell Lung Cancer

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Paclitaxel, Carboplatin, Cetuximab (Arm A)
Arm Type
Active Comparator
Arm Description
Patients with squamous or non-squamous histologies will receive carboplatin and paclitaxel for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion.
Arm Title
Platinum, Gemcitabine, Cetuximab (Arm B)
Arm Type
Active Comparator
Arm Description
Patients with squamous or non-squamous histologies will receive gemcitabine with either carboplatin or cisplatin for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion. The choice of platinum-based chemotherapy is also at the investigator's discretion.
Arm Title
Platinum, Pemetrexed, Cetuximab (Arm C)
Arm Type
Active Comparator
Arm Description
Patients with squamous histology will receive pemetrexed and either carboplatin or cisplatin for a minimum of four and a maximum of six 21-day cycles, plus cetuximab, and then enter a maintenance phase with single-agent cetuximab. Cetuximab will be given on Day 1, and weekly during chemotherapy, followed by biweekly administration during the maintenance period. The choice of delivering four, five or six cycles of chemotherapy is at the investigator's discretion. The choice of platinum-based chemotherapy is also at the investigator's discretion. Patients with non-squamous histology are not eligible for this arm.
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux
Intervention Description
Cetuximab will be administered at a loading dose of 400 mg/m2 on Day 1, Cycle 1 and at a dose of 250 mg/m2 weekly during chemotherapy. During the maintenance period, cetuximab will be dosed at 500 mg/m2 every two weeks.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Taxol
Intervention Description
Paclitaxel 200 mg/m2 Day 1 every 21 days
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Paraplatin
Intervention Description
Carboplatin AUC 6 Day 1 every 21 days
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Other Intervention Name(s)
Gemzar
Intervention Description
Gemcitabine 1,000 mg/m2 Days 1 and 8 every 21 days
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinol
Intervention Description
Cisplatin 75 mg/m2 Day I every 21 days
Primary Outcome Measure Information:
Title
Overall Survival by Treatment Arm
Time Frame
Survival was measured from the date of randomization to date of death due to any cause, assessed up to 36 months. Subjects who were alive at the date of last contact were censored at the date of last contact.
Secondary Outcome Measure Information:
Title
1-year Survival by Treatment Arm
Time Frame
Survival was measured from the date of randomization to date of death due to any cause, assessed up to 36 months. Subjects who were alive at the date of last contact were censored at the date of last contact.
Title
Overall Survival by Histology
Time Frame
Survival was measured from the date of randomization to date of death due to any cause, assessed up to 36 months. Subjects who were alive at the date of last contact were censored at the date of last contact.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent before study-related activities Histologically or cytologically confirmed Stage IIIb with cytologically documented malignant pleural or pericardial effusion, Stage IV, or recurrent non-smal cell lung cancer (NSCLC) after resection or radiation for earlier stage disease Measurable or evaluable disease (per modified Response Evaluation Criteria in Solid Tumors [RECIST] guidelines) Male or female ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 White blood count ≥ 3 x 10(9)/L with neutrophils ≥ 1.5 x 10(9)/L, platelet count ≥ 100 x 10(9)/L, and hemoglobin ≥ 9.5 g/dL Total bilirubin ≤ 1.5 x upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN or ≤ 5 x ULN in patients with liver mets Serum creatinine ≤ 1.25 x ULN Recovery from prior surgery or radiation to Grade 1 or better toxicity Women of childbearing potential (WOCBP) and fertile men with partners of childbearing potential must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 wks after the study in such a manner that the risk of pregnancy is minimized WOCBP must have a negative serum or urine pregnancy test within 72 hrs prior to the start of study medication or in accordance with local regulations, whichever is of shorter duration Exclusion Criteria: WOCBP who are unwilling or unable to use an acceptable method of birth control to avoid pregnancy for the entire study period and for up to 4 weeks after the study Women who are pregnant or breastfeeding Women with a positive pregnancy test during screening or prior to study drug administration Sexually active fertile men not using effective birth control if their partners are women of child-bearing potential Prior chemo for advanced NSCLC; neoadjuvant or post-operative adjuvant chemo is allowed if completed at least 12 months before study entry Previous exposure to epidermal growth factor receptor (EGFR)-targeted therapy. Prior treatment with monoclonal antibodies targeting receptors other than the EGFR, such as bevacizumab, is allowed if completed > 30 days prior to randomization Treatment with any investigational agent(s) within 4 weeks prior to study entry Concurrent anti-cancer therapy (chemotherapy, hormonal therapy, biologic or targeted therapy) other than protocol therapy Carcinoid, atypical carcinoid or small cell lung cancer Symptomatic or uncontrolled mets in the central nervous system Prior invasive malignancy requiring ongoing therapy within the past year Active infection (infection requiring intravenous [IV] antibiotics), including active tuberculosis, known and declared HIV Myocardial infarction within 6 months prior to study entry, uncontrolled congestive heart failure; or any current Grade 3 or 4 cardiovascular disorder despite treatment Known allergic/hypersensitivity reaction to any of the components of study treatments Peripheral neuropathy ≥ Grade 2, as assessed by Common Terminology Criteria for Adverse Events, version 3.0 History of significant neurologic or psychiatric disorders including but not limited to dementia, seizures, and bipolar disorder Medical or psychological condition that would not permit the patient to complete the study or sign informed consent Known drug abuse Patients of all races and ethnic groups are eligible for this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lee Schwartzberg, MD, FACP
Organizational Affiliation
Accelerated Community Oncology Research Network
Official's Role
Study Chair
Facility Information:
City
Anniston
State/Province
Alabama
Country
United States
City
Jonesboro
State/Province
Arkansas
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United States
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Anaheim
State/Province
California
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Azusa
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California
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Burbank
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California
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Campbell
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Greenbrae
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Hawthorne
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Mission Hills
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Orange
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Oxnard
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St. Helena
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Fort Collins
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Colorado
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Norwich
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Connecticut
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Torrington
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Connecticut
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Trumbull
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Connecticut
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Fort Lauderdale
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Florida
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Lake Worth
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Florida
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Orange City
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Florida
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Pembroke Pines
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Florida
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St. Petersburg
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Titusville
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Florida
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Weston
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Florida
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Augusta
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Georgia
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Columbus
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Georgia
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Lawrenceville
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Georgia
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Marietta
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Georgia
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Valdosta
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Georgia
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Elmhurst
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Illinois
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Harvey
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Illinois
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Joliet
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Illinois
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Quincy
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Illinois
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Skokie
State/Province
Illinois
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South Bend
State/Province
Indiana
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United States
Facility Name
Family Medicine of Vincennes
City
Vincennes
State/Province
Indiana
Country
United States
City
Arnes
State/Province
Iowa
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United States
City
Bettendorf
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Iowa
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Mason City
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Iowa
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Waterloo
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Hazard
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Kentucky
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Louisville
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Kentucky
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Lafayette
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Louisiana
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Shreveport
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Louisiana
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Baltimore
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Towson
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Springfield
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Massachusetts
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Worchester
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Massachusetts
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Jefferson City
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Missouri
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St. Joseph
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Missouri
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St. Louis
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Billings
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Montana
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Grand Island
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Nebraska
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Omaha
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Nebraska
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Portsmouth
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New Hampshire
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Bellville
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New Jersey
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Cherry Hill
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New Jersey
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Elizabeth
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New Jersey
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Hackensack
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New Jersey
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Bronx
State/Province
New York
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East Setauket
State/Province
New York
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Fresh Meadows
State/Province
New York
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Fayetteville
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North Carolina
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Gastonia
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North Carolina
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Goldsboro
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North Carolina
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Columbus
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Ohio
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Dayton
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Ohio
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Middletown
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Ohio
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Sandusky
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Ohio
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Bend
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Oregon
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Bethlehem
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Pennsylvania
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Reading
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Pennsylvania
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Sumter
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South Carolina
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Sioux Falls
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South Dakota
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Bristol
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Tennessee
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Chattanooga
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Tennessee
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Memphis
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Tennessee
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Beaumont
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Texas
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Corpus Christi
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Texas
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Lubbock
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Texas
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Bennington
State/Province
Vermont
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United States
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Kirkland
State/Province
Washington
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Tacoma
State/Province
Washington
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City
Huntington
State/Province
West Virginia
Country
United States
City
Wauwatosa
State/Province
Wisconsin
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase 2b Study of Cetuximab With Platinum-Based Chemo as First Line Treatment of Recurrent or Advanced NSCLC

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