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Safety and Efficacy of Belinostat When Used With Standard of Care Chemotherapy for Untreated Non-small Cell Lung Cancer (HCH003)

Primary Purpose

Non-Small-Cell Lung Carcinoma

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Belinostat, carboplatin, paclitaxel and bevacizumab
Sponsored by
Holy Cross Hospital, Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Non-Small-Cell Lung Carcinoma focused on measuring Non small cell lung cancer, Belinostat, carboplatin, Paclitaxel, Bevacizumab, chemotherapy, Maximum Tolerated Dose, Neoplasms, Pulmonary, Lung Cancer, Event Free Survival, Disease free survival, Progression Free Survival, Histone Deacetylase Inhibitors, Treatment Efficacy

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically documented NSCLC confirmed.
  • Has advanced NSCLC (Stage IV), not previously treated with any chemotherapy regiment (prior adjuvant chemotherapy and/or chemotherapy/radiation for Stage III allowed).
  • Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan.
  • Life expectancy of > 3 months
  • Must have returned to baseline or grade 1 adverse event from any acute toxicity related to prior therapy
  • Adequate immune and multisystem organ function (as evidenced by urine and blood values within specified parameters).

Exclusion Criteria:

  • Brain or meningeal metastases. Note, patients with adequately treated brain metastases, e.g. surgically resected, or adequately controlled by radiotherapy, with no residual neurological symptoms due to metastases and no steroid treatment required, can be enrolled. If clinical suspicion, adequate investigations should be performed to rule out brain metastases or meningeal involvement.
  • History of a previous malignancy within 5 years with the exception of non-metastatic non-melanoma skin cancer or cervical carcinoma in situ. Prior systemic therapy for other malignancy must be completed at least 5 years before treatment is allowed.
  • Lung carcinoma of squamous cell histology (mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible; sputum cytology alone is not acceptable).
  • History of hemoptysis within 3 months prior to enrollment
  • Current or recent (within 10 days of enrollment) use of aspirin (>325 mg/day) or chronic use of other non-steroidal anti-inflammatory medications.
  • Prior systemic anti-tumor therapy for Stage IV lung cancer. Note, prior radiotherapy is allowed provided treatment was completed at least 2 weeks before enrollment. Prior surgery is allowed if completed at least 4 weeks before enrollment.
  • Treatment with investigational agents within the 2 weeks prior to enrollment.
  • Significant vascular disease (e.g., aortic aneurysm, history of aortic dissection) or clinically significant peripheral vascular disease.
  • Hypertension not controlled by medical therapy.
  • Significant cardiovascular disease, myocardial infarction within the past 6 months, unstable angina, unstable arrhythmia or a need for anti-arrhythmic therapy (use of medication to control heart rate in patients with atrial fibrillation is allowed, if stable medication for at least last month prior to enrollment, or evidence of acute ischemia on electrocardiogram).
  • Marked baseline prolongation of QT/QTc interval that required use of concomitant medication that may cause Torsade de Pointes
  • Significant, non-healing wounds, acute or non-healing ulcers, or bone fractures within 3 months of fracture.
  • Undergone major surgery within 4 weeks of planned initiation of cycle 1.
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days of enrollment.
  • History of any gastrointestinal bleeding within the 3 months prior to enrollment.
  • Known hypersensitivity to either platinum compounds or paclitaxel, or any components of the study medications, and inability for desensitization.
  • Peripheral neuropathy NCI ≥ Grade 2.
  • Co-existing active severe infection or any co-existing medical condition likely to interfere with trial procedures.
  • Known infection with HIV, or known active Hepatitis B or C infection.
  • Pregnant or lactating.
  • not willing to use effective contraception during the study and until 6 months post-completion of last cycle administered

Sites / Locations

  • Holy Cross Hospital, Inc

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Belinostat

Arm Description

This is a one arm, open label study of the investigational medication Belinostat.

Outcomes

Primary Outcome Measures

The recommended phase II dose of Belinostat when used in combination with carboplatin, paclitaxel and bevacizumab.
The aim of the initial phase Ib component is to establish the maximum tolerated dose (MTD) of Belinostat when used with a standard of care carboplatin, paclitaxel and bevacizumab course of therapy ("BelCap-B") regimen. The MTD will be determined through the process of dose-limiting-toxicity evaluation.

Secondary Outcome Measures

To evaluate overall survival with this investigational treatment.
The percentage of participants who are alive at 2 years post initiation of investigational treatment.
Long-term safety (late-effects up to 2 years)
Long-term (up to 2 years) safety evaluation of the investigational treatment will be evaluated by ongoing evaluation of adverse events/late-effects using the NCI Common Toxicity Criteria.
Evaluate disease response of participants who receive this investigational medication regimen
Response to therapy will be measured by the RECIST criteria. The investigators will assess the percentage of research participants whose disease status indicates a response to investigational treatment according to the RECIST criteria.
To evaluate progression-free survival
The number (%) of participants who do not show evidence of disease progression (according to RECIST criteria)at 2 years post initial administration of the investigational product.

Full Information

First Posted
March 22, 2010
Last Updated
February 21, 2018
Sponsor
Holy Cross Hospital, Florida
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1. Study Identification

Unique Protocol Identification Number
NCT01090830
Brief Title
Safety and Efficacy of Belinostat When Used With Standard of Care Chemotherapy for Untreated Non-small Cell Lung Cancer
Acronym
HCH003
Official Title
Phase Ib/II Study to Determine the Recommended Dose, Safety, and Preliminary Efficacy of Belinostat When Used in Combination With Carboplatin, Paclitaxel, and Bevacizumab in Patients With Untreated Non-small Cell Lung Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Terminated
Why Stopped
Principal Investigator has left institution. IND withdrawn.
Study Start Date
April 2010 (undefined)
Primary Completion Date
February 2012 (Actual)
Study Completion Date
February 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Holy Cross Hospital, Florida

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to establish the safest dose of the investigational medication Belinostat that can be administered with a standard of care chemotherapy regimen of bevacizumab, carboplatin, and paclitaxel. Further study will examine the short and long-term effect (up to 2 years) of this medication on participant's disease status and overall survival.
Detailed Description
This is a Phase Ib/II, single center, open label, dose-finding study to evaluate the use of Belinostat when given with standard of care chemotherapy in patients with untreated, non-small cell lung cancer (NSCLC). In the Phase Ib portion, dose limiting toxicity evaluation will be used to determine the maximum tolerated dose (MTD) of Belinostat when given with fixed doses of bevacizumab, carboplatin, and paclitaxel(a BelCap-B regimen). Three dose levels of Belinostat are proposed (600mg/kg, 800mg/kg, 1000mg/kg). Determination of MTD will be the basis for establishing set dosing for the phase II component of the study. The phase II portion of the study includes further drug safety evaluation and a preliminary assessment of efficacy of Belinostat when used with specified induction and maintenance regimens. Response will be evaluated through the RECIST criteria. Additional analysis will be done to estimate the time to response, progression free survival, median survival, and overall survival (OS) in study participants to 2 years post-initiation of cycle 1. Based on a standard 3 x 3 statistical design, the phase Ib portion may accrue between 3 to 12 participants. Phase II will have a minimum sample size of 10 and a maximum of 16 patients. Participants who complete the Phase I portion and are able to advance to Phase II, will be evaluable for the Phase II objectives.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small-Cell Lung Carcinoma
Keywords
Non small cell lung cancer, Belinostat, carboplatin, Paclitaxel, Bevacizumab, chemotherapy, Maximum Tolerated Dose, Neoplasms, Pulmonary, Lung Cancer, Event Free Survival, Disease free survival, Progression Free Survival, Histone Deacetylase Inhibitors, Treatment Efficacy

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Belinostat
Arm Type
Experimental
Arm Description
This is a one arm, open label study of the investigational medication Belinostat.
Intervention Type
Drug
Intervention Name(s)
Belinostat, carboplatin, paclitaxel and bevacizumab
Other Intervention Name(s)
Belionostat, PDX101, Bevacizumab, Carboplatin, Paraplatin, Paclitaxel, Taxol
Intervention Description
Induction therapy will include 6 cycles of 5-days of medication administration followed by a 16 day rest period. Belinostat will be given once a day for 5 days total. Three dose levels will be evaluated (600mg/kg, 800 mg/kg, and 1000 mg/kg). In addition, participants will receive fixed doses of intravenous carboplatin (AUC 6), Paclitaxel (200 mg/m2), and bevacizumab (15 mg/kg) once on day 3 of each cycle. Serial disease status evaluations will be done throughout the study. In the absence of significant toxicity or disease progression, participants may continue with a maintenance regimen of bevacizumab and Belinostat for an additional 6 cycles. The dose of Belinostat received during maintenance will be that tolerated in the initial 6 cycles.
Primary Outcome Measure Information:
Title
The recommended phase II dose of Belinostat when used in combination with carboplatin, paclitaxel and bevacizumab.
Description
The aim of the initial phase Ib component is to establish the maximum tolerated dose (MTD) of Belinostat when used with a standard of care carboplatin, paclitaxel and bevacizumab course of therapy ("BelCap-B") regimen. The MTD will be determined through the process of dose-limiting-toxicity evaluation.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
To evaluate overall survival with this investigational treatment.
Description
The percentage of participants who are alive at 2 years post initiation of investigational treatment.
Time Frame
2 years
Title
Long-term safety (late-effects up to 2 years)
Description
Long-term (up to 2 years) safety evaluation of the investigational treatment will be evaluated by ongoing evaluation of adverse events/late-effects using the NCI Common Toxicity Criteria.
Time Frame
2 years
Title
Evaluate disease response of participants who receive this investigational medication regimen
Description
Response to therapy will be measured by the RECIST criteria. The investigators will assess the percentage of research participants whose disease status indicates a response to investigational treatment according to the RECIST criteria.
Time Frame
2 years
Title
To evaluate progression-free survival
Description
The number (%) of participants who do not show evidence of disease progression (according to RECIST criteria)at 2 years post initial administration of the investigational product.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically documented NSCLC confirmed. Has advanced NSCLC (Stage IV), not previously treated with any chemotherapy regiment (prior adjuvant chemotherapy and/or chemotherapy/radiation for Stage III allowed). Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >20 mm with conventional techniques or as >10 mm with spiral CT scan. Life expectancy of > 3 months Must have returned to baseline or grade 1 adverse event from any acute toxicity related to prior therapy Adequate immune and multisystem organ function (as evidenced by urine and blood values within specified parameters). Exclusion Criteria: Brain or meningeal metastases. Note, patients with adequately treated brain metastases, e.g. surgically resected, or adequately controlled by radiotherapy, with no residual neurological symptoms due to metastases and no steroid treatment required, can be enrolled. If clinical suspicion, adequate investigations should be performed to rule out brain metastases or meningeal involvement. History of a previous malignancy within 5 years with the exception of non-metastatic non-melanoma skin cancer or cervical carcinoma in situ. Prior systemic therapy for other malignancy must be completed at least 5 years before treatment is allowed. Lung carcinoma of squamous cell histology (mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible; sputum cytology alone is not acceptable). History of hemoptysis within 3 months prior to enrollment Current or recent (within 10 days of enrollment) use of aspirin (>325 mg/day) or chronic use of other non-steroidal anti-inflammatory medications. Prior systemic anti-tumor therapy for Stage IV lung cancer. Note, prior radiotherapy is allowed provided treatment was completed at least 2 weeks before enrollment. Prior surgery is allowed if completed at least 4 weeks before enrollment. Treatment with investigational agents within the 2 weeks prior to enrollment. Significant vascular disease (e.g., aortic aneurysm, history of aortic dissection) or clinically significant peripheral vascular disease. Hypertension not controlled by medical therapy. Significant cardiovascular disease, myocardial infarction within the past 6 months, unstable angina, unstable arrhythmia or a need for anti-arrhythmic therapy (use of medication to control heart rate in patients with atrial fibrillation is allowed, if stable medication for at least last month prior to enrollment, or evidence of acute ischemia on electrocardiogram). Marked baseline prolongation of QT/QTc interval that required use of concomitant medication that may cause Torsade de Pointes Significant, non-healing wounds, acute or non-healing ulcers, or bone fractures within 3 months of fracture. Undergone major surgery within 4 weeks of planned initiation of cycle 1. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days of enrollment. History of any gastrointestinal bleeding within the 3 months prior to enrollment. Known hypersensitivity to either platinum compounds or paclitaxel, or any components of the study medications, and inability for desensitization. Peripheral neuropathy NCI ≥ Grade 2. Co-existing active severe infection or any co-existing medical condition likely to interfere with trial procedures. Known infection with HIV, or known active Hepatitis B or C infection. Pregnant or lactating. not willing to use effective contraception during the study and until 6 months post-completion of last cycle administered
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin E Guiterrez, MD
Organizational Affiliation
Holy Cross Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Holy Cross Hospital, Inc
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.holy-cross.com/
Description
Holy Cross Hospital

Learn more about this trial

Safety and Efficacy of Belinostat When Used With Standard of Care Chemotherapy for Untreated Non-small Cell Lung Cancer

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