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Certolizumab in Combination With Chemotherapy for Patients With Stage IV Lung Adenocarcinomas

Primary Purpose

Stage IV Lung Adenocarcinoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Certolizumab
cisplatin
pemetrexed
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stage IV Lung Adenocarcinoma focused on measuring Certolizumab, Cisplatin, Pemetrexed, thoracic, 13-063

Eligibility Criteria

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

Inclusion Criteria:

  • Previously untreated stage IV lung adenocarcinoma confirmed at MSKCC
  • Age 18 years or older
  • Karnofsky Performance Status ≥ 70
  • Patients with locally treated, stable, and/or asymptomatic brain metastases are eligible.
  • Adequate bone marrow, liver and renal function, as specified below:
  • Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L
  • Hemoglobin ≥ 8 g/dL
  • Platelets ≥ 100 x 109/L
  • Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN) (except for patients with documented Gilbert's Syndrome)
  • AST and ALT ≤ 2.5 x ULN or ≤ 5 x ULN if liver metastases are present
  • Serum creatinine ≤ 1.5 x upper limit of normal or creatinine clearance ≥ 60ml/min for patients with creatinine levels above institutional normal.
  • Negative PPD test
  • For women of child-bearing potential, negative pregnancy test within 14 days prior to starting treatment
  • Men and women of childbearing age must be willing to use effective contraception while on treatment and for at least 3 months thereafter
  • Presence of at least one site of measurable disease as defined by the Response Evaluation Criteria in Solid Tumors
  • Archival tissue (10 Unstained Slides - 5 micron sections) from a core biopsy performed and received within 30 days before signing consent or ability to have a fresh core biopsy performed
  • Biopsy cannot be from any cytology or bone specimen
  • Biopsy site must be amenable to re-biopsy at the end of the study
  • Ability to provide written, informed consent

Exclusion Criteria:

  • Hypersensitivity to platinum agents
  • Ongoing use of investigational agents or use of investigational agents within the last four weeks
  • Prior use of agents for TNF-alpha blockade
  • History of rheumatoid arthritis, inflammatory bowel disease, or psoriatic arthritis
  • Baseline hearing deficit (CTCAE version 4.0 grade 2 or higher)
  • Ongoing bacterial, viral, or antifungal infection requiring antimicrobial treatment with the exception of thrush
  • Active tuberculosis or untreated, latent tuberculosis

    o If a patient has signs, symptoms, or a history suggestive of active tuberculosis, evaluation by an infectious disease physician will be required and active tuberculosis ruled-out prior to enrollment.

  • Acute or chronic Hepatitis B or C infection
  • Known HIV infection requiring antiretroviral medications and those with AIDS
  • Active herpes zoster infection
  • Non-healed infected skin ulcers
  • History of myocardial infarction or unstable angina within the past 12 months
  • Ongoing use of other immunosuppressive medications, including oral steroids and excluding topical steroids
  • Women who are breastfeeding Prior history of other malignancy with the exclusion of localized prostate cancer, non-melanomatous skin cancer, ductal carcinoma or lobular carcinoma in situ of the breast

Sites / Locations

  • Memorial Sloan Kettering at Basking Ridge
  • Memorial Sloan Kettering Cancer Center @ Suffolk
  • Memorial Sloan Kettering West Harrison
  • Memorial Sloan Kettering Cancer Center
  • Memorial Sloan Kettering at Mercy Medical Center
  • Memorial Sloan Kettering Cancer Center at Phelps Memorial Hospital Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

certolizumab, cisplatin and pemetrexed

Arm Description

Patients will receive certolizumab with 6 cycles of cisplatin & pemetrexed. Cycle of chemo will be 3 weeks. Certolizumab will be adm in the following fashion: first dose administered at the time of treatment initiation, second dose will be given after 2 weeks of treatment, third dose after four weeks of treatment, & subsequent doses given every 4 weeks thereafter. Patients will be monitored for progression of disease using RECIST 1.1 with scans to be performed every 6 weeks. Posttreatment biopsies will be performed at the time of treatment discontinuation. Two dose levels of certolizumab will be tested, 200mg & 400mg. A non-therapeutic cohort of 10 patients with adenocarcinomas who will be undergoing standard of care treatment with platinum based chemotherapy + pemetrexed +/- bevacizumab will be consented for blood draws before each cycle of treatment. This blood will be analyzed for cytokines and will serve as a reference for the experimental arm.

Outcomes

Primary Outcome Measures

Maximum tolerated does (MTD)
A standard 3+3 dose-escalation scheme will be used to test two doses of certolizumab: dose level A (200mg) and dose level B (400mg), in combination with the standard dose of chemotherapy. In addition, two de-escalation doses are planned, if dose level A proves too toxic: dose level C (chemotherapy at 75% of the standard dose + certolizumab 200mg) and dose level D (chemotherapy at 75% of the standard dose + certolizumab 400mg)..The MTD is the highest dose at which ≤ 1/6 patients experiences a DLT. Please see the dose escalation schema for exact dose level details.

Secondary Outcome Measures

Progression-free survival (PFS)
Patients will be followed from the first drug administration until disease progression (by RECIST 1.1) or death, whichever comes first. Patients alive who have not progressed by the end of the study time will be censored at the time of the last available follow-up. PFS probability will be estimated using Kaplan-Meier methods.
Immunohistochemical staining
Biopsies will be performed pre- and post-treatment in all patients and will undergo immunohistochemical staining of TNF-alpha, CXCL1/2, and S100A8/9. Staining will be scored from 0-4. The difference in IHC score from post-treatment to baseline will be compared between patients who have, at minimum, evidence of stable disease during treatment (CR+PR+SD) and the remaining patients, using non-parametric Wilcoxon signed rank test.

Full Information

First Posted
April 21, 2014
Last Updated
January 25, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02120807
Brief Title
Certolizumab in Combination With Chemotherapy for Patients With Stage IV Lung Adenocarcinomas
Official Title
A Phase I Trial of Certolizumab in Combination With Chemotherapy for Patients With Stage IV Lung Adenocarcinomas
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
April 15, 2014 (Actual)
Primary Completion Date
January 24, 2023 (Actual)
Study Completion Date
January 24, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to test the safety of certolizumab when it is given with the chemotherapy drugs cisplatin and pemetrexed. Cisplatin and pemetrexed are two chemotherapy drugs used in the treatment of lung cancer. The investigators want to find out what effects, good and/or bad, certolizumab has on the patient and lung cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage IV Lung Adenocarcinoma
Keywords
Certolizumab, Cisplatin, Pemetrexed, thoracic, 13-063

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
certolizumab, cisplatin and pemetrexed
Arm Type
Experimental
Arm Description
Patients will receive certolizumab with 6 cycles of cisplatin & pemetrexed. Cycle of chemo will be 3 weeks. Certolizumab will be adm in the following fashion: first dose administered at the time of treatment initiation, second dose will be given after 2 weeks of treatment, third dose after four weeks of treatment, & subsequent doses given every 4 weeks thereafter. Patients will be monitored for progression of disease using RECIST 1.1 with scans to be performed every 6 weeks. Posttreatment biopsies will be performed at the time of treatment discontinuation. Two dose levels of certolizumab will be tested, 200mg & 400mg. A non-therapeutic cohort of 10 patients with adenocarcinomas who will be undergoing standard of care treatment with platinum based chemotherapy + pemetrexed +/- bevacizumab will be consented for blood draws before each cycle of treatment. This blood will be analyzed for cytokines and will serve as a reference for the experimental arm.
Intervention Type
Drug
Intervention Name(s)
Certolizumab
Intervention Type
Drug
Intervention Name(s)
cisplatin
Intervention Type
Drug
Intervention Name(s)
pemetrexed
Primary Outcome Measure Information:
Title
Maximum tolerated does (MTD)
Description
A standard 3+3 dose-escalation scheme will be used to test two doses of certolizumab: dose level A (200mg) and dose level B (400mg), in combination with the standard dose of chemotherapy. In addition, two de-escalation doses are planned, if dose level A proves too toxic: dose level C (chemotherapy at 75% of the standard dose + certolizumab 200mg) and dose level D (chemotherapy at 75% of the standard dose + certolizumab 400mg)..The MTD is the highest dose at which ≤ 1/6 patients experiences a DLT. Please see the dose escalation schema for exact dose level details.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
Patients will be followed from the first drug administration until disease progression (by RECIST 1.1) or death, whichever comes first. Patients alive who have not progressed by the end of the study time will be censored at the time of the last available follow-up. PFS probability will be estimated using Kaplan-Meier methods.
Time Frame
2 years
Title
Immunohistochemical staining
Description
Biopsies will be performed pre- and post-treatment in all patients and will undergo immunohistochemical staining of TNF-alpha, CXCL1/2, and S100A8/9. Staining will be scored from 0-4. The difference in IHC score from post-treatment to baseline will be compared between patients who have, at minimum, evidence of stable disease during treatment (CR+PR+SD) and the remaining patients, using non-parametric Wilcoxon signed rank test.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Previously untreated stage IV lung adenocarcinoma confirmed at MSKCC Age 18 years or older Karnofsky Performance Status ≥ 70 Patients with locally treated, stable, and/or asymptomatic brain metastases are eligible. Adequate bone marrow, liver and renal function, as specified below: Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L Hemoglobin ≥ 8 g/dL Platelets ≥ 100 x 109/L Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN) (except for patients with documented Gilbert's Syndrome) AST and ALT ≤ 2.5 x ULN or ≤ 5 x ULN if liver metastases are present Serum creatinine ≤ 1.5 x upper limit of normal or creatinine clearance ≥ 60ml/min for patients with creatinine levels above institutional normal. Negative PPD test For women of child-bearing potential, negative pregnancy test within 14 days prior to starting treatment Men and women of childbearing age must be willing to use effective contraception while on treatment and for at least 3 months thereafter Presence of at least one site of measurable disease as defined by the Response Evaluation Criteria in Solid Tumors Archival tissue (10 Unstained Slides - 5 micron sections) from a core biopsy performed and received within 30 days before signing consent or ability to have a fresh core biopsy performed Biopsy cannot be from any cytology or bone specimen Biopsy site must be amenable to re-biopsy at the end of the study Ability to provide written, informed consent Exclusion Criteria: Hypersensitivity to platinum agents Ongoing use of investigational agents or use of investigational agents within the last four weeks Prior use of agents for TNF-alpha blockade History of rheumatoid arthritis, inflammatory bowel disease, or psoriatic arthritis Baseline hearing deficit (CTCAE version 4.0 grade 2 or higher) Ongoing bacterial, viral, or antifungal infection requiring antimicrobial treatment with the exception of thrush Active tuberculosis or untreated, latent tuberculosis o If a patient has signs, symptoms, or a history suggestive of active tuberculosis, evaluation by an infectious disease physician will be required and active tuberculosis ruled-out prior to enrollment. Acute or chronic Hepatitis B or C infection Known HIV infection requiring antiretroviral medications and those with AIDS Active herpes zoster infection Non-healed infected skin ulcers History of myocardial infarction or unstable angina within the past 12 months Ongoing use of other immunosuppressive medications, including oral steroids and excluding topical steroids Women who are breastfeeding Prior history of other malignancy with the exclusion of localized prostate cancer, non-melanomatous skin cancer, ductal carcinoma or lobular carcinoma in situ of the breast
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Paik
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering at Basking Ridge
City
Basking Ridge
State/Province
New Jersey
ZIP/Postal Code
07920
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center @ Suffolk
City
Commack
State/Province
New York
ZIP/Postal Code
11725
Country
United States
Facility Name
Memorial Sloan Kettering West Harrison
City
Harrison
State/Province
New York
ZIP/Postal Code
10604
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Memorial Sloan Kettering at Mercy Medical Center
City
Rockville Centre
State/Province
New York
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center at Phelps Memorial Hospital Center
City
Sleepy Hollow
State/Province
New York
ZIP/Postal Code
10591
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mskcc.org/
Description
Memorial Sloan Kettering Cancer Center

Learn more about this trial

Certolizumab in Combination With Chemotherapy for Patients With Stage IV Lung Adenocarcinomas

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