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NGR-hTNF in Combination With Standard Chemotherapy to Treat Patients With Advanced Non-small Cell Lung Cancer

Primary Purpose

Non-small Cell Lung Cancer

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
NGR-hTNF
Cisplatin
Gemcitabine
Pemetrexed
Sponsored by
AGC Biologics S.p.A.
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 NGR-hTNF, Randomized controlled trial, Gemcitabine, Cisplatin, Pemetrexed, Carcinoma, non-small cell lung

Eligibility Criteria

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

Inclusion criteria:

  1. Histologically or cytologically documented inoperable, locally advanced (stage IIIb with supraclavicular lymph node metastases or malignant pleural or pericardial effusion), metastatic (stage IV) or recurrent NSCLC. Mixed tumors should be categorized according to the predominant cell type.
  2. Age ≥18 years
  3. Life expectancy more than 3 months
  4. ECOG performance status 0-1
  5. At least one unidimensional measurable lesion (as per RECIST criteria)
  6. Adequate baseline bone marrow, hepatic and renal function, defined as follows:

    • Neutrophils >1.5 x 10^9/L and platelets > 100 x 10^9/L
    • Bilirubin <1.5 x ULN
    • AST and/or ALT <2.5 x ULN in absence of liver metastasis
    • AST and/or ALT <5 x ULN in presence of liver metastasis
    • Serum creatinine <1.5 x ULN
    • Creatinine clearance (estimated according to Cockcroft-Gault formula) ≥ 50 ml/min
  7. Patients may have had prior therapy providing the following conditions are met:

    • Radiation therapy: wash-out period of 28 days
    • Surgery: wash-out period of 14 days
  8. Patients must give written informed consent to participate in the study

Exclusion criteria:

  1. Prior chemotherapy or treatment with another systemic anti-cancer agent (for example monoclonal antibody, tyrosine kinase inhibitor).
  2. Patients must not receive any other investigational agents while on study
  3. Patients with myocardial infarction within the last six (6) months, unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, or serious cardiac arrhythmia requiring medication
  4. Uncontrolled hypertension
  5. Prolonged QTc interval (congenital or acquired)
  6. Patient with significant peripheral vascular disease
  7. History or evidence upon physical examination of CNS disease unless adequately treated (e.g., primary brain tumor, any brain metastasis, seizure not controlled with standard medical therapy, or history of stroke).
  8. Patients with active or uncontrolled systemic disease/infections or with serious illness or medical conditions, which is incompatible with the protocol
  9. Known hypersensitivity/allergic reaction or contraindications to human albumin preparations or to any of the excipients
  10. Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol
  11. Pregnancy or lactation. Patients - both males and females - with reproductive potential (i.e. menopausal for less than 1-year and not surgically sterilized) must practice effective contraceptive measures throughout the study. Women of child-bearing potential must provide a negative pregnancy test (serum or urine) within 14 days prior to registration.

Sites / Locations

  • Istituto Nazionale per la ricerca sul cancro
  • Fondazione San Raffaele del Monte Tabor
  • Istituto Nazionale dei Tumori
  • Istituto Europeo Oncologico

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

A: NGR-hTNF + cisplatin/gemcitabine or cisplatin/pemetrexed

B: cisplatin/gemcitabine or cisplatin/pemetrexed

Arm Description

NGR-hTNF with cisplatin/gemcitabine regimen in patients with squamous histology or with cisplatin/pemetrexed regimen in patients with nonsquamous histology

Cisplatin/gemcitabine regimen is administered in patients with squamous histology and cisplatin/pemetrexed regimen is administered in patients with nonsquamous histology

Outcomes

Primary Outcome Measures

Progression-free survival (PFS)
PFS evaluated according to Response evaluation criteria in solid tumors (RECIST)

Secondary Outcome Measures

Safety according to NCI-CTCAE criteria (version 3)
To evaluate safety profile related to NGR-hTNF in combination with standard chemotherapy
Objective response rate
Antitumor activity defined as response rate evaluated according to Response evaluation criteria in solid tumors (RECIST)
Duration of response (DR)
defined as the time that measurement criteria are met for complete response or partial response (whichever status is recorded first) until the progressive disease is objectively documented.
Overall survival (OS)
Defined as the time from the date of randomization until the date of death due to any cause or the last date the patient was known to be alive

Full Information

First Posted
October 13, 2009
Last Updated
September 25, 2018
Sponsor
AGC Biologics S.p.A.
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1. Study Identification

Unique Protocol Identification Number
NCT00994097
Brief Title
NGR-hTNF in Combination With Standard Chemotherapy to Treat Patients With Advanced Non-small Cell Lung Cancer
Official Title
NGR014: Randomized Phase II Study of NGR-hTNF in Combination With Standard Chemotherapy Versus Standard Chemotherapy Alone in Previously Untreated Patients With Advanced Non-small Cell Lung Cancer (NSCLC)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
July 2009 (Actual)
Primary Completion Date
March 2017 (Actual)
Study Completion Date
March 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AGC Biologics S.p.A.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main objective of this study is to demonstrate superiority in progression-free survival (PFS) when NGR-hTNF is added to standard chemotherapy regimen (cisplatin/gemcitabine or cisplatin/pemetrexed) in locally advanced (stage IIIb with supraclavicular lymph node metastases or malignant pleural or pericardial effusion), metastatic (stage IV) or recurrent non-small cell lung cancer (NSCLC).
Detailed Description
Eligible patients will be randomly assigned to a standard chemotherapy regimen plus low-dose (0.8 mcg/m^2) NGR-hTNF or standard chemotherapy alone, through a centralized randomization process using the following stratification factors: performance status (0 vs 1) and histology (squamous vs non-squamous). In both arms the choice between the two chemotherapy regimens will be based on the histologic subtype: in patients with squamous histology (including also generic diagnosis of NSCLC without further subtype classification) is recommended cisplatin/gemcitabine regimen, in patients with nonsquamous histology (including adenocarcinoma and large-cell carcinoma) is recommended cisplatin/pemetrexed regimen.

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
NGR-hTNF, Randomized controlled trial, Gemcitabine, Cisplatin, Pemetrexed, Carcinoma, non-small cell lung

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
A: NGR-hTNF + cisplatin/gemcitabine or cisplatin/pemetrexed
Arm Type
Experimental
Arm Description
NGR-hTNF with cisplatin/gemcitabine regimen in patients with squamous histology or with cisplatin/pemetrexed regimen in patients with nonsquamous histology
Arm Title
B: cisplatin/gemcitabine or cisplatin/pemetrexed
Arm Type
Active Comparator
Arm Description
Cisplatin/gemcitabine regimen is administered in patients with squamous histology and cisplatin/pemetrexed regimen is administered in patients with nonsquamous histology
Intervention Type
Drug
Intervention Name(s)
NGR-hTNF
Intervention Description
NGR-hTNF: 0.8 mcg/m² as 60-minute intravenous infusion every 3 weeks until confirmed evidence of disease progression or unacceptable toxicity occurs
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
Cisplatin: 80 mg/m² intravenous infusion on day 1 every 3 weeks for a maximum of 6 cycles
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine: 1,250 mg/m² intravenous infusion on days 1 and 8 every 3 weeks for a maximum of 6 cycles
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Intervention Description
Pemetrexed: 500 mg/m² intravenous infusion on day 1 every 3 weeks for a maximum of 6 cycles
Primary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS evaluated according to Response evaluation criteria in solid tumors (RECIST)
Time Frame
Every 6 weeks during study treatment and every 6 weeks during the follow-up before PD
Secondary Outcome Measure Information:
Title
Safety according to NCI-CTCAE criteria (version 3)
Description
To evaluate safety profile related to NGR-hTNF in combination with standard chemotherapy
Time Frame
from the date of randomization until 28 days after last treatment
Title
Objective response rate
Description
Antitumor activity defined as response rate evaluated according to Response evaluation criteria in solid tumors (RECIST)
Time Frame
Every 6 weeks during study treatment and every 6 weeks during the follow-up before PD
Title
Duration of response (DR)
Description
defined as the time that measurement criteria are met for complete response or partial response (whichever status is recorded first) until the progressive disease is objectively documented.
Time Frame
from the time of first recorded evidence of complete response or partial response until the progressive disease objectively documented
Title
Overall survival (OS)
Description
Defined as the time from the date of randomization until the date of death due to any cause or the last date the patient was known to be alive
Time Frame
from the randomization until to the date of patient death or discontinuation from the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Histologically or cytologically documented inoperable, locally advanced (stage IIIb with supraclavicular lymph node metastases or malignant pleural or pericardial effusion), metastatic (stage IV) or recurrent NSCLC. Mixed tumors should be categorized according to the predominant cell type. Age ≥18 years Life expectancy more than 3 months ECOG performance status 0-1 At least one unidimensional measurable lesion (as per RECIST criteria) Adequate baseline bone marrow, hepatic and renal function, defined as follows: Neutrophils >1.5 x 10^9/L and platelets > 100 x 10^9/L Bilirubin <1.5 x ULN AST and/or ALT <2.5 x ULN in absence of liver metastasis AST and/or ALT <5 x ULN in presence of liver metastasis Serum creatinine <1.5 x ULN Creatinine clearance (estimated according to Cockcroft-Gault formula) ≥ 50 ml/min Patients may have had prior therapy providing the following conditions are met: Radiation therapy: wash-out period of 28 days Surgery: wash-out period of 14 days Patients must give written informed consent to participate in the study Exclusion criteria: Prior chemotherapy or treatment with another systemic anti-cancer agent (for example monoclonal antibody, tyrosine kinase inhibitor). Patients must not receive any other investigational agents while on study Patients with myocardial infarction within the last six (6) months, unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, or serious cardiac arrhythmia requiring medication Uncontrolled hypertension Prolonged QTc interval (congenital or acquired) Patient with significant peripheral vascular disease History or evidence upon physical examination of CNS disease unless adequately treated (e.g., primary brain tumor, any brain metastasis, seizure not controlled with standard medical therapy, or history of stroke). Patients with active or uncontrolled systemic disease/infections or with serious illness or medical conditions, which is incompatible with the protocol Known hypersensitivity/allergic reaction or contraindications to human albumin preparations or to any of the excipients Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol Pregnancy or lactation. Patients - both males and females - with reproductive potential (i.e. menopausal for less than 1-year and not surgically sterilized) must practice effective contraceptive measures throughout the study. Women of child-bearing potential must provide a negative pregnancy test (serum or urine) within 14 days prior to registration.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antonio Lambiase, MD
Organizational Affiliation
AGC Biologics S.p.A.
Official's Role
Study Director
Facility Information:
Facility Name
Istituto Nazionale per la ricerca sul cancro
City
Genoa
ZIP/Postal Code
16132
Country
Italy
Facility Name
Fondazione San Raffaele del Monte Tabor
City
Milan
ZIP/Postal Code
20132
Country
Italy
Facility Name
Istituto Nazionale dei Tumori
City
Milan
ZIP/Postal Code
20133
Country
Italy
Facility Name
Istituto Europeo Oncologico
City
Milan
Country
Italy

12. IPD Sharing Statement

Learn more about this trial

NGR-hTNF in Combination With Standard Chemotherapy to Treat Patients With Advanced Non-small Cell Lung Cancer

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