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Bendamustine With Irinotecan Followed by Etoposide/Carboplatin for Patients With Extensive Stage Small Cell Lung Cancer

Primary Purpose

Small Cell Lung Cancer, Extensive Stage Lung Cancer, Chemonaive

Status

Completed

Phase

Phase 1

Locations

United States

Study Type

Interventional

Intervention

Novel Drug Combination

About this trial

This is an interventional treatment trial for Small Cell Lung Cancer focused on measuring Small cell lung cancer, Chemonaive, Bendamustine, Irinotecan, Etoposide, Carboplatin

Eligibility Criteria

18 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Histologic or cytologic diagnosis of extensive stage SCLC.
Measurable or assessable tumor parameters.
ECOG Performance Status 0-2.
Age between 18 and 79 years (in the State of Alabama > 18).
Adequate bone marrow, liver and renal function, defined as:
Absolute neutrophil count (ANC) ≥ 1500/µL
Hemoglobin ≥ 8g/dl
Platelet count ≥ 100,000/µL
SGOT/SGPT ≤ 2 x upper limit of normal or ≤ 5 x upper limit of normal when liver metastases are present.
Total bilirubin value ≤ 2 x upper limit of normal.
Serum creatinine value ≤ 2 x upper limit of normal.
Fully recovered from any previous surgery (at least 4 weeks since major surgery)
Must have recovered from prior radiation therapy (at least 3 weeks)
All subjects must agree to practice approved methods of birth control (if applicable). A negative pregnancy test must be documented during the screening period for women of childbearing potential.
Must provide written informed consent and authorization to use and disclose health information (HIPAA).
Extensive-stage SCLC as defined as disease not confined to one hemithorax, including ipsilateral pleural effusion or pericardial effusion.
No prior chemotherapy.

Exclusion Criteria:

Concurrent cancer chemotherapy, biologic therapy or radiotherapy.
Administration of any investigational drug within 28 days prior to administration of the current therapy.
Symptomatic brain metastases; those patients should be treated first with either whole brain radiation therapy or radiosurgery.
Concurrent serious infection.
Concomitant severe or uncontrolled underlying medical disease unrelated to the tumor, which is likely to compromise patient safety and affect the outcome of the study.
History of other malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for a minimum of 2 years.
Neuropathy at baseline ≥ Grade 2.
Any evidence or history of hypersensitivity or other contraindications for the drugs used in this trial.
History of chronic diarrhea; or diarrhea (excess of 2-3 stools/day above normal frequency) in the past 2 weeks.
History of a positive serology for human immunodeficiency virus (HIV).
Psychiatric disorder that prevents patients from providing informed consent or following protocol instructions.
Pregnant or lactating women.

Sites / Locations

University of Alabama at Birmingham
Georgia Cancer Specialists

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Novel Drug Combination

Arm Description

This novel drug combination includes: Bendamustine, Irinotecan, and Etoposide/Carboplatin. This study has only one arm but it incorporates two phases. Phase I utilizes a combination of bendamustine and irinotecan for Regimen A followed by etoposide and carboplatin for Regimen B.

Outcomes

Primary Outcome Measures

Number of Participants Experiencing Dose Limiting Toxicity Regimen A - Phase I

The determination of the dose limiting toxicity as defined by The National Cancer Institute Common Toxicity Criteria version 3 as follows: grade 4 neutropenia >5 days; grade 3/4 febrile neutropenia; grade 4 thrombocytopenia; or grade >2 non-hematologic toxicities (except for nausea/vomiting, alopecia, or fatigue).

Number of Patients With Adverse Events - Phase II

The degree of toxicity as defined by The National Cancer Institute Common Toxicity Criteria version 3.

Secondary Outcome Measures

Progression Free Survival

Using the Response Evaluation Criteria in Solid Tumors (RECIST 2000), progression is defined as 20% or greater increase from the baseline tumor parameters or new lesions.

Full Information

NCT ID

NCT00856830

First Posted

March 5, 2009

Last Updated

June 19, 2017

Sponsor

University of Alabama at Birmingham

Collaborators

National Comprehensive Cancer Network

1. Study Identification

Unique Protocol Identification Number

NCT00856830

Brief Title

Bendamustine With Irinotecan Followed by Etoposide/Carboplatin for Patients With Extensive Stage Small Cell Lung Cancer

Official Title

Phase I/IIa Study of the Novel Combination of Bendamustine With Irinotecan Followed by Etoposide/Carboplatin in Chemonaive Patients With Extensive Stage Small Cell Lung Cancer

Study Type

Interventional

2. Study Status

Record Verification Date

June 2017

Overall Recruitment Status

Completed

Study Start Date

April 2009 (undefined)

Primary Completion Date

May 2015 (Actual)

Study Completion Date

May 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title

Principal Investigator

Name of the Sponsor

University of Alabama at Birmingham

Collaborators

National Comprehensive Cancer Network

4. Oversight

Data Monitoring Committee

Yes

5. Study Description

Brief Summary

Small cell lung cancer, or SCLC, constitutes approximately 15% of the 170,000 new cases of lung cancer diagnosed annually in the United States. Extensive-stage SCLC comprises two thirds of new cases and is generally considered sensitive to chemotherapy, despite a median time to progression of 4 months. SCLC is one of the most aggressive and lethal types of cancer, with a median survival of 9 months (range 7-11 months) in patients diagnosed with extensive disease. Overall, the majority of patients with SCLC die in less than 2 years (2-year survival rates generally less than 10%), and the 5-year survival rate is 2.3% for patients with extensive disease. The regimen of etoposide in combination with a platinum (cisplatin or carboplatin) is generally considered the "standard of care" although a recent Phase III trial suggests improved survival with the combination of cisplatin/irinotecan. Further evaluation of new agents in combination regimens attempting to overcome the intrinsic drug resistance seen in extensive-stage SCLC is warranted attempting to improve survival and achieve palliation of disease-related symptoms.

Detailed Description

We are proposing a novel combination of bendamustine plus irinotecan followed by the standard regimen of etoposide with carboplatin. This will allow the investigation of response to the novel combination as well as any improvement in outcomes compared to historical controls.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study

Small Cell Lung Cancer, Extensive Stage Lung Cancer, Chemonaive

Keywords

Small cell lung cancer, Chemonaive, Bendamustine, Irinotecan, Etoposide, Carboplatin

7. Study Design

Primary Purpose

Treatment

Study Phase

Phase 1, Phase 2

Interventional Study Model

Single Group Assignment

Model Description

This is a single arm, open-label, Phase I - II trial with an initial dose escalation component and an expansion cohort of patients treated at the recommended Phase II dose.

Masking

None (Open Label)

Allocation

N/A

Enrollment

30 (Actual)

8. Arms, Groups, and Interventions

Arm Title

Novel Drug Combination

Arm Type

Experimental

Arm Description

Intervention Type

Drug

Intervention Name(s)

Novel Drug Combination

Other Intervention Name(s)

Irinotecan (Camptosar), Carboplatin (Paraplatin), Etoposide (VdPesid), Bendamustine (Treanda)

Intervention Description

This novel drug combination includes: Bendamustine, Irinotecan, and Etoposide/Carboplatin. Subjects will be treated with irinotecan (150 mg/m2) infusion on Day 1 followed by infusion of bendamustine on Days 1 and 2 at increasing dose levels using a 3+3 design (starting dose of 80-mg/m2/d with 20 mg/mg/d incremental increase to max 120 mg/m2/d) (Regimen A). This will be repeated every 3 weeks for a total of 3 cycles. Restaging for response will be performed prior to the next regimen. All subjects will then be given carboplatin (AUC 6) on day 1 and etoposide (100 mg/m2) on days 1, 2 and 3 (Regimen B). They will receive 3 cycles of this regimen every 3 weeks prior to restaging. At the end (3 weeks after) of the sixth total round of chemotherapy, subjects will be re-evaluated for response, and will be followed-up for recurrent disease every 8 weeks.

Primary Outcome Measure Information:

Title

Number of Participants Experiencing Dose Limiting Toxicity Regimen A - Phase I

Description

Time Frame

9 weeks

Title

Number of Patients With Adverse Events - Phase II

Description

The degree of toxicity as defined by The National Cancer Institute Common Toxicity Criteria version 3.

Time Frame

9 weeks

Secondary Outcome Measure Information:

Title

Progression Free Survival

Description

Using the Response Evaluation Criteria in Solid Tumors (RECIST 2000), progression is defined as 20% or greater increase from the baseline tumor parameters or new lesions.

Time Frame

7 months

10. Eligibility

Sex

All

Minimum Age & Unit of Time

18 Years

Maximum Age & Unit of Time

79 Years

Accepts Healthy Volunteers

Eligibility Criteria

Inclusion Criteria: Histologic or cytologic diagnosis of extensive stage SCLC. Measurable or assessable tumor parameters. ECOG Performance Status 0-2. Age between 18 and 79 years (in the State of Alabama > 18). Adequate bone marrow, liver and renal function, defined as: Absolute neutrophil count (ANC) ≥ 1500/µL Hemoglobin ≥ 8g/dl Platelet count ≥ 100,000/µL SGOT/SGPT ≤ 2 x upper limit of normal or ≤ 5 x upper limit of normal when liver metastases are present. Total bilirubin value ≤ 2 x upper limit of normal. Serum creatinine value ≤ 2 x upper limit of normal. Fully recovered from any previous surgery (at least 4 weeks since major surgery) Must have recovered from prior radiation therapy (at least 3 weeks) All subjects must agree to practice approved methods of birth control (if applicable). A negative pregnancy test must be documented during the screening period for women of childbearing potential. Must provide written informed consent and authorization to use and disclose health information (HIPAA). Extensive-stage SCLC as defined as disease not confined to one hemithorax, including ipsilateral pleural effusion or pericardial effusion. No prior chemotherapy. Exclusion Criteria: Concurrent cancer chemotherapy, biologic therapy or radiotherapy. Administration of any investigational drug within 28 days prior to administration of the current therapy. Symptomatic brain metastases; those patients should be treated first with either whole brain radiation therapy or radiosurgery. Concurrent serious infection. Concomitant severe or uncontrolled underlying medical disease unrelated to the tumor, which is likely to compromise patient safety and affect the outcome of the study. History of other malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for a minimum of 2 years. Neuropathy at baseline ≥ Grade 2. Any evidence or history of hypersensitivity or other contraindications for the drugs used in this trial. History of chronic diarrhea; or diarrhea (excess of 2-3 stools/day above normal frequency) in the past 2 weeks. History of a positive serology for human immunodeficiency virus (HIV). Psychiatric disorder that prevents patients from providing informed consent or following protocol instructions. Pregnant or lactating women.

Overall Study Officials:

First Name & Middle Initial & Last Name & Degree

Francisco Robert, M.D.

Organizational Affiliation

University of Alabama at Birmingham

Official's Role

Principal Investigator

Facility Information:

Facility Name

University of Alabama at Birmingham

City

Birmingham

State/Province

Alabama

ZIP/Postal Code

35294 - 0104

Country

United States

Facility Name

Georgia Cancer Specialists

City

Marietta

State/Province

Georgia

ZIP/Postal Code

30060

Country

United States

12. IPD Sharing Statement

Plan to Share IPD

Learn more about this trial

Bendamustine With Irinotecan Followed by Etoposide/Carboplatin for Patients With Extensive Stage Small Cell Lung Cancer

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