Single Arm on the Tolerability of Weekly Nab-paclitaxel
Primary Purpose
Non Small Cell Lung Cancer (NSCLC)
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Nab-Paclitaxel
Sponsored by

About this trial
This is an interventional treatment trial for Non Small Cell Lung Cancer (NSCLC) focused on measuring Nab paclitaxel, Abraxane, First Line, Non small cell lung cancer, NSCLC, Phase II, Non-Randomized, Elderly, Lineberger, UNC, LCCC 1210
Eligibility Criteria
Inclusion Criteria:
- Signed written informed consent
- Male or female patient
- Greater than or equal to 70 years of age
- Diagnosis of NSCLC histologically or cytologically confirmed
- Internal Association for the Study of Lung Cancer Version 7 Stage IV disease or recurrence after prior surgery or radiotherapy
- Progression following one line of prior chemotherapy consisting of a platinum agent plus a standard cytotoxic partner agent other than a taxane, typically pemetrexed gemcitabine or vinorelbine
- A single agent non cytoxic regimen if the patient has a molecular change that the non cytotoxic regimen would be expected to be efficacious for epidermal growth factor receptor (EGFR) mutation for erlotinib and (EML4) anaplastic lymphoma kinase (ALk) or ROS1 for crizotinib
- Eastern Cooperative Oncology Group performance status 0 to 2
- Adequate organ and bone marrow function as defined by
- Absolute neutrophil count greater than or equal to 1500 cells/mm3
- Creatinine less than or equal to 1.5 mg dL
- Total bilirubin less than or equal to 1.5 mg dL
- Alkaline phosphatase less than or equal to 2.5 x upper limit of normal
- Alanine aminotransferase less than or equal to 2.5 x upper limit of normal
- Aspartate aminotransferase less than or equal to 2.5 upper limit of normal
- Recovered from all reversible toxicities related to their previous treatment to less than or equal to grade 1 or baseline
- Patients must have equal to grade 2 pre existing peripheral neuropathy
- Women of childbearing potential and sexually active men must agree to use effective contraception prior to study entry for the duration of study participation and for three months after completing treatment. Adequate contraception is defined as any medically recommended method as per standard of care
- Negative serum or urine bhCG pregnancy test at screening for patients of childbearing potential
- Patients with brain metastases may participate if they have undergone appropriate treatment for the lesions are at least two weeks post treatment without evidence for post treatment progression have no significant neurologic symptoms and no longer require steroids for the reason of brain metastases. Patients with symptoms suggestive of central nervous system (CNS) metastases should be evaluated with imaging prior to study participation
Exclusion Criteria:
- Prior taxane therapy for any indication
- Less than 3 weeks elapsed since prior exposure to chemotherapy
- Pre existing neuropathy greater than grade 1
- Other active invasive malignancy requiring ongoing therapy or expected to require systemic therapy within two years localized squamous cell carcinoma of the skin basal cell carcinoma of the skin, carcinoma in situ of teh cervix or other malignancies requiring locally ablative therapy only will not result in exclusion
- Concomitant anticancer therapy immunotherapy or radiation therapy within prior 4 weeks
- Have received treatment within the last 30 days prior to study entry with any drug that has not receive regulatory approval for an indication at the time of study entry
- Uncontrolled intercurrent illness including but not limited to ongoing or active infection requiring IV antibiotics symptomatic congestive heart failure unstable angina pectoris, cardiac arrhythmia, or psychiatric illness or social situations that would limit compliance with study requirements
- Pregnant women are excluded due to the potential for teratogenic or abortifacient effects of nab paclitaxel because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued prior to participation of the mother on study
- Known hypersensitivity to protein bound paclitaxel
- Any other concurrent condition that in the investigators opinion would jeopardize compliance with the protocol
Sites / Locations
- Highlands Oncology Group
- UNC Lineberger Comprehensive Cancer Center
- Rex Healthcare
- Cleveland Clinic
- Fox Chase Cancer Center
- University of Pittsburgh Medical Center
- Bon Secours Virginia Health System
- Swedish Cancer Institute
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
nab paclitaxel
Arm Description
Patients will receive nab-paclitaxel once weekly for 3 weeks of every 4 week cycle
Outcomes
Primary Outcome Measures
Number of Subjects Without Any Adverse Events Grade 3 or Higher
Tolerability of weekly nab-paclitaxel, as measured by occurrence of Grade 3 or worse toxicity after 6 cycles or 3 weeks after discontinuation of treatment, for those who came off treatment earlier as measured by the NCI Common Terminology Criteria for Adverse Events CTCAE, version 4. The CTCAE is a descriptive terminology utilized for Adverse Event (AE) reporting. A grading (severity) scale is provided for each AE term. Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living (ADL). Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL. Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE.
Secondary Outcome Measures
Median Overall Survival
Overall Survival is defined as the time from day 1 (D1) of treatment until death as a result of any cause
Median Progression Free Survival
Progression free survival is defined as the time from D1 of treatment until progression or death as a result of any cause. Progressive Disease (PD) is determined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. PD is at least a 20% increase in the sum of the longest diameters (LD) of the target lesions taking as reference the smallest sum LD recorded since the treatment started including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters. The appearance of one or more new lesions also constitutes PD.
Overall Response Rate
Response will be measured by Response Evaluation Criteria In Solid Tumors Criteria (RECIST) version 1.1, indicating if subject experienced a Complete Response (CR), disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions. The Overall Response rate is defined as the percentage of participants with CR or PR
Full Information
NCT ID
NCT01702844
First Posted
September 25, 2012
Last Updated
September 14, 2020
Sponsor
UNC Lineberger Comprehensive Cancer Center
Collaborators
Celgene
1. Study Identification
Unique Protocol Identification Number
NCT01702844
Brief Title
Single Arm on the Tolerability of Weekly Nab-paclitaxel
Official Title
LCCC 1210 - Phase II, Multicenter, Single Arm Study of the Tolerability of Weekly Nab-paclitaxel as Second Line Treatment for Elderly Patients With Advanced Lung Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
June 25, 2013 (Actual)
Primary Completion Date
June 23, 2017 (Actual)
Study Completion Date
July 12, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UNC Lineberger Comprehensive Cancer Center
Collaborators
Celgene
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety and efficacy of weekly nab-paclitaxel for a second-line treatment in elderly subjects, 70 years of age or greater, with non-small cell lung cancer (NSCLC)
Detailed Description
This will be a non-randomized phase II study evaluating the safety and efficacy of weekly nab-paclitaxel for second-line treatment in 42 elderly patients, who are 70 years of age or greater with non-small cell lung cancer (NSLC). Patients will be required to have progressed on a single prior regimen. Nab-paclitaxel 100mg/m2 will be administered intravenously, weekly for 3 weeks of every 4-week cycle. After every two cycles of therapy, imaging will be performed to assess for response. Patients will be eligible to continue receiving therapy until the time of disease progression.
Primary Objectives To evaluate the tolerability of weekly nab-paclitaxel in older adults with advanced lung cancer who have progressed on at least 1 prior regimen after 6 cycles or 3 weeks after discontinuation of treatment, for those who come off treatment earlier.
Secondary Objectives To estimate overall survival To estimate progression-free survival To estimate the response rate
Correlative Objectives To explore baseline components of the Geriatric Assessment (GA) as predictors of chemotherapy tolerance and overall survival To explore the use of p16 measurements in the elderly as predictors of chemotherapy tolerance and overall survival To explore the impact of weekly nab-paclitaxel treatment on quality of life, as measured by Lung Cancer Symptom Scale (LCSS) and Functional Assessment of Cancer Therapy-Lung (FACT-L).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Small Cell Lung Cancer (NSCLC)
Keywords
Nab paclitaxel, Abraxane, First Line, Non small cell lung cancer, NSCLC, Phase II, Non-Randomized, Elderly, Lineberger, UNC, LCCC 1210
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Actual)
8. Arms, Groups, and Interventions
Arm Title
nab paclitaxel
Arm Type
Experimental
Arm Description
Patients will receive nab-paclitaxel once weekly for 3 weeks of every 4 week cycle
Intervention Type
Drug
Intervention Name(s)
Nab-Paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Description
Administer 2 cycles of Nab-Paclitaxel 100 mg/m2 IV on days 1 8 and 15
Primary Outcome Measure Information:
Title
Number of Subjects Without Any Adverse Events Grade 3 or Higher
Description
Tolerability of weekly nab-paclitaxel, as measured by occurrence of Grade 3 or worse toxicity after 6 cycles or 3 weeks after discontinuation of treatment, for those who came off treatment earlier as measured by the NCI Common Terminology Criteria for Adverse Events CTCAE, version 4. The CTCAE is a descriptive terminology utilized for Adverse Event (AE) reporting. A grading (severity) scale is provided for each AE term. Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living (ADL). Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL. Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE.
Time Frame
168 days after start of treatment (6 cycles) (or 3 weeks after discontinuation of treatment, for those who come off treatment earlier)
Secondary Outcome Measure Information:
Title
Median Overall Survival
Description
Overall Survival is defined as the time from day 1 (D1) of treatment until death as a result of any cause
Time Frame
up to 2 years after end of treatment (treatment lasts up to 168 days (up to 6 cycles of 28 days each))
Title
Median Progression Free Survival
Description
Progression free survival is defined as the time from D1 of treatment until progression or death as a result of any cause. Progressive Disease (PD) is determined by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. PD is at least a 20% increase in the sum of the longest diameters (LD) of the target lesions taking as reference the smallest sum LD recorded since the treatment started including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters. The appearance of one or more new lesions also constitutes PD.
Time Frame
up to 2 years after end of treatment (treatment lasts up to 168 days (up to 6 cycles of 28 days each))
Title
Overall Response Rate
Description
Response will be measured by Response Evaluation Criteria In Solid Tumors Criteria (RECIST) version 1.1, indicating if subject experienced a Complete Response (CR), disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions. The Overall Response rate is defined as the percentage of participants with CR or PR
Time Frame
168 days after start of treatment (6 cycles) (or 3 weeks after discontinuation of treatment, for those who come off treatment earlier)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed written informed consent
Male or female patient
Greater than or equal to 70 years of age
Diagnosis of NSCLC histologically or cytologically confirmed
Internal Association for the Study of Lung Cancer Version 7 Stage IV disease or recurrence after prior surgery or radiotherapy
Progression following one line of prior chemotherapy consisting of a platinum agent plus a standard cytotoxic partner agent other than a taxane, typically pemetrexed gemcitabine or vinorelbine
A single agent non cytoxic regimen if the patient has a molecular change that the non cytotoxic regimen would be expected to be efficacious for epidermal growth factor receptor (EGFR) mutation for erlotinib and (EML4) anaplastic lymphoma kinase (ALk) or ROS1 for crizotinib
Eastern Cooperative Oncology Group performance status 0 to 2
Adequate organ and bone marrow function as defined by
Absolute neutrophil count greater than or equal to 1500 cells/mm3
Creatinine less than or equal to 1.5 mg dL
Total bilirubin less than or equal to 1.5 mg dL
Alkaline phosphatase less than or equal to 2.5 x upper limit of normal
Alanine aminotransferase less than or equal to 2.5 x upper limit of normal
Aspartate aminotransferase less than or equal to 2.5 upper limit of normal
Recovered from all reversible toxicities related to their previous treatment to less than or equal to grade 1 or baseline
Patients must have equal to grade 2 pre existing peripheral neuropathy
Women of childbearing potential and sexually active men must agree to use effective contraception prior to study entry for the duration of study participation and for three months after completing treatment. Adequate contraception is defined as any medically recommended method as per standard of care
Negative serum or urine bhCG pregnancy test at screening for patients of childbearing potential
Patients with brain metastases may participate if they have undergone appropriate treatment for the lesions are at least two weeks post treatment without evidence for post treatment progression have no significant neurologic symptoms and no longer require steroids for the reason of brain metastases. Patients with symptoms suggestive of central nervous system (CNS) metastases should be evaluated with imaging prior to study participation
Exclusion Criteria:
Prior taxane therapy for any indication
Less than 3 weeks elapsed since prior exposure to chemotherapy
Pre existing neuropathy greater than grade 1
Other active invasive malignancy requiring ongoing therapy or expected to require systemic therapy within two years localized squamous cell carcinoma of the skin basal cell carcinoma of the skin, carcinoma in situ of teh cervix or other malignancies requiring locally ablative therapy only will not result in exclusion
Concomitant anticancer therapy immunotherapy or radiation therapy within prior 4 weeks
Have received treatment within the last 30 days prior to study entry with any drug that has not receive regulatory approval for an indication at the time of study entry
Uncontrolled intercurrent illness including but not limited to ongoing or active infection requiring IV antibiotics symptomatic congestive heart failure unstable angina pectoris, cardiac arrhythmia, or psychiatric illness or social situations that would limit compliance with study requirements
Pregnant women are excluded due to the potential for teratogenic or abortifacient effects of nab paclitaxel because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued prior to participation of the mother on study
Known hypersensitivity to protein bound paclitaxel
Any other concurrent condition that in the investigators opinion would jeopardize compliance with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jared Weiss, MD
Organizational Affiliation
UNC Lineberger Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Highlands Oncology Group
City
Fayetteville
State/Province
Arkansas
ZIP/Postal Code
72703
Country
United States
Facility Name
UNC Lineberger Comprehensive Cancer Center
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Rex Healthcare
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Fox Chase Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19111
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
Facility Name
Bon Secours Virginia Health System
City
Midlothian
State/Province
Virginia
ZIP/Postal Code
23114
Country
United States
Facility Name
Swedish Cancer Institute
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
12. IPD Sharing Statement
Links:
URL
http://unclineberger.org/
Description
Lineberger Comprehensive Cancer Center homepage
URL
http://www.cancer.gov/
Description
National Cancer Institute (NCI) homepage
Learn more about this trial
Single Arm on the Tolerability of Weekly Nab-paclitaxel
We'll reach out to this number within 24 hrs