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Bortezomib in Treating Patients With Malignant Pleural Mesothelioma

Primary Purpose

Malignant Mesothelioma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
bortezomib
quality-of-life assessment
Sponsored by
Cancer Trials Ireland
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignant Mesothelioma focused on measuring recurrent malignant mesothelioma, stage IA malignant mesothelioma, stage IB malignant mesothelioma, stage II malignant mesothelioma, stage III malignant mesothelioma, stage IV malignant mesothelioma

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

Inclusion criteria:

  • Histologically confirmed malignant pleural mesothelioma
  • Meets 1 of the following criteria for first-line or second-line chemotherapy:

    • Patients in the first-line setting must be unsuitable for, cannot access locally, or refuse combination chemotherapy
    • Patients in the second-line setting must be unsuitable for, cannot access locally, or refuse cytotoxic chemotherapy after failure of a first-line regimen

      • Second-line patients may not have received more than 1 prior line of antineoplastic treatment for this cancer
  • Pleural effusions should be drained before treatment whenever possible

    • Talc or tetracycline pleurodesis may be used per standard practice for uncontrollable pleural effusions (recurrent despite regular drainage)

Exclusion criteria:

  • Symptomatic or known brain or leptomeningeal metastases

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status 0-2
  • Hemoglobin ≥ 10 g/dL
  • Neutrophil count ≥ 1,500 mm^3
  • Platelet count ≥ 100,000/mm^3
  • Creatinine clearance ≥ 30 mL/min
  • AST and ALT < 3 times upper limit of normal
  • Fertile patients must use effective contraception during study therapy

Exclusion criteria:

  • Pregnant or breastfeeding
  • History of prior malignant tumor within the past 3 years except for nonmelanoma skin tumor or carcinoma in situ of the cervix
  • Patients suitably fit to receive a platinum doublet based chemotherapy (first-line only)
  • Uncontrolled or severe cardiovascular disease including any of the following:

    • Myocardial infarction within the past 6 months
    • New York Heart Association class III or IV heart failure
    • Uncontrolled angina
    • Clinically significant pericardial disease
    • Cardiac amyloidosis
  • Neuropathy ≥ grade 2 OR grade 1 with pain
  • Serious medical (e.g., uncontrolled diabetes, hepatic disease, or infection) or psychiatric illness that would interfere with study participation
  • Patients with known HIV or hepatitis B or C infection

PRIOR CONCURRENT THERAPY:

  • No prior bortezomib
  • No prior extensive radiation therapy, systemic chemotherapy, or other antineoplastic therapy within 4 weeks before enrollment
  • No preplanned surgery or procedures that would interfere with the study
  • More than 4 weeks since enrollment in another therapeutic clinical trial (i.e., received an experimental drug or used an experimental medical device)

    • Concurrent participation in non-treatment studies is allowed provided they do not interfere with participation in this study
  • No concurrent experimental or antineoplastic agent other than bortezomib

    • Medications that may have antineoplastic activity, but are taken for other reasons than specific antineoplastic effect (e.g., megestrol [Megace®], cyclo-oxygenase-2 [COX-2] inhibitors, or bisphosphonates) are allowed

Sites / Locations

  • Universitair Ziekenhuis Gent
  • Cork University Hospital
  • Adelaide and Meath Hospital, Dublin Incorporating the National Children's Hospital
  • St. Vincent's University Hospital
  • Mater Misericordiae University Hospital
  • St. James's Hospital
  • Beaumont Hospital
  • Galway University Hospital
  • Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
  • Saint Bartholomew's Hospital
  • Royal Marsden - Surrey
  • Centre for Cancer Research and Cell Biology at Queen's University Belfast
  • Beatson West of Scotland Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bortezomib 1.6mg/m2

Arm Description

Outcomes

Primary Outcome Measures

Objective tumor response rate (complete response or partial response) as assessed by modified RECIST criteria
The objective tumour response rate is a primary endpoint of the study. This will be a proportion of evaluable subjects who achieve a confirmed CR or PR per modified RECIST guidelines within four cycles (20 weeks) of treatment.

Secondary Outcome Measures

Time to disease progression
Overall survival
Safety
Quality of life
Quality of life will be assessed using the Lung Cancer Symptom Score

Full Information

First Posted
August 8, 2007
Last Updated
December 30, 2014
Sponsor
Cancer Trials Ireland
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1. Study Identification

Unique Protocol Identification Number
NCT00513877
Brief Title
Bortezomib in Treating Patients With Malignant Pleural Mesothelioma
Official Title
An Open Label Phase II Multicentre Clinical Trial of Single Agent Bortezomib in Patients With Malignant Pleural Mesothelioma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
May 2006 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cancer Trials Ireland

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying the side effects of bortezomib and how well it works in treating patients with malignant pleural mesothelioma.
Detailed Description
OBJECTIVES: Primary Assess the clinical efficacy of bortezomib based on the evaluation of objective tumor response rate. Secondary Assess additional clinical efficacy of bortezomib based on the evaluation of time to early disease progression and median overall 2-year survival rate. Assess safety and toxicity in these patients. Assess quality of life using the Lung Cancer Symptom Score. OUTLINE: This is a multicenter study. Patients are stratified according to current treatment (first-line vs second-line) Patients receive bortezomib IV on days 1, 8, 15, and 22. Treatment repeats every 5 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients exhibiting objective response or stable disease by week 20, may continue treatment at the discretion of the investigator until evidence of disease progression. Quality of life is assessed periodically. After completion of study treatment, patients are followed for up to 2 years. PROJECTED ACCRUAL: 57 first-line setting and 54 second-line setting patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Mesothelioma
Keywords
recurrent malignant mesothelioma, stage IA malignant mesothelioma, stage IB malignant mesothelioma, stage II malignant mesothelioma, stage III malignant mesothelioma, stage IV malignant mesothelioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bortezomib 1.6mg/m2
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
bortezomib
Intervention Type
Procedure
Intervention Name(s)
quality-of-life assessment
Primary Outcome Measure Information:
Title
Objective tumor response rate (complete response or partial response) as assessed by modified RECIST criteria
Description
The objective tumour response rate is a primary endpoint of the study. This will be a proportion of evaluable subjects who achieve a confirmed CR or PR per modified RECIST guidelines within four cycles (20 weeks) of treatment.
Time Frame
28 days prior to baseline, at 10 weeks and at end of treatment
Secondary Outcome Measure Information:
Title
Time to disease progression
Time Frame
Time to disease progression is measured from first treatment until the date of PD or death whichever is first reported. Subjects who did not progress or die will be censored at the day of their last tumour assessment.
Title
Overall survival
Time Frame
Overall Survival is measured from the date of first treatment to the date of the subject's death. If the subject is alive or the vital status is unknown, the date of death will be censored at the date that the subject is last known to be alive.
Title
Safety
Time Frame
The assessment of safety will be based mainly on the frequency of adverse events and on the number of laboratory values that fall outside of the pre-determined normal ranges.
Title
Quality of life
Description
Quality of life will be assessed using the Lung Cancer Symptom Score
Time Frame
Week 1, Week 10 and end of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Inclusion criteria: Histologically confirmed malignant pleural mesothelioma Meets 1 of the following criteria for first-line or second-line chemotherapy: Patients in the first-line setting must be unsuitable for, cannot access locally, or refuse combination chemotherapy Patients in the second-line setting must be unsuitable for, cannot access locally, or refuse cytotoxic chemotherapy after failure of a first-line regimen Second-line patients may not have received more than 1 prior line of antineoplastic treatment for this cancer Pleural effusions should be drained before treatment whenever possible Talc or tetracycline pleurodesis may be used per standard practice for uncontrollable pleural effusions (recurrent despite regular drainage) Exclusion criteria: Symptomatic or known brain or leptomeningeal metastases PATIENT CHARACTERISTICS: Inclusion criteria: ECOG performance status 0-2 Hemoglobin ≥ 10 g/dL Neutrophil count ≥ 1,500 mm^3 Platelet count ≥ 100,000/mm^3 Creatinine clearance ≥ 30 mL/min AST and ALT < 3 times upper limit of normal Fertile patients must use effective contraception during study therapy Exclusion criteria: Pregnant or breastfeeding History of prior malignant tumor within the past 3 years except for nonmelanoma skin tumor or carcinoma in situ of the cervix Patients suitably fit to receive a platinum doublet based chemotherapy (first-line only) Uncontrolled or severe cardiovascular disease including any of the following: Myocardial infarction within the past 6 months New York Heart Association class III or IV heart failure Uncontrolled angina Clinically significant pericardial disease Cardiac amyloidosis Neuropathy ≥ grade 2 OR grade 1 with pain Serious medical (e.g., uncontrolled diabetes, hepatic disease, or infection) or psychiatric illness that would interfere with study participation Patients with known HIV or hepatitis B or C infection PRIOR CONCURRENT THERAPY: No prior bortezomib No prior extensive radiation therapy, systemic chemotherapy, or other antineoplastic therapy within 4 weeks before enrollment No preplanned surgery or procedures that would interfere with the study More than 4 weeks since enrollment in another therapeutic clinical trial (i.e., received an experimental drug or used an experimental medical device) Concurrent participation in non-treatment studies is allowed provided they do not interfere with participation in this study No concurrent experimental or antineoplastic agent other than bortezomib Medications that may have antineoplastic activity, but are taken for other reasons than specific antineoplastic effect (e.g., megestrol [Megace®], cyclo-oxygenase-2 [COX-2] inhibitors, or bisphosphonates) are allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dean A. Fennell, MD, PhD
Organizational Affiliation
Centre for Cancer Research and Cell Biology at Queen's University Belfast
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitair Ziekenhuis Gent
City
Ghent
ZIP/Postal Code
B-9000
Country
Belgium
Facility Name
Cork University Hospital
City
Cork
Country
Ireland
Facility Name
Adelaide and Meath Hospital, Dublin Incorporating the National Children's Hospital
City
Dublin
ZIP/Postal Code
24
Country
Ireland
Facility Name
St. Vincent's University Hospital
City
Dublin
ZIP/Postal Code
4
Country
Ireland
Facility Name
Mater Misericordiae University Hospital
City
Dublin
ZIP/Postal Code
7
Country
Ireland
Facility Name
St. James's Hospital
City
Dublin
ZIP/Postal Code
8
Country
Ireland
Facility Name
Beaumont Hospital
City
Dublin
ZIP/Postal Code
9
Country
Ireland
Facility Name
Galway University Hospital
City
Galway
Country
Ireland
Facility Name
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
City
Amsterdam
ZIP/Postal Code
1066 BE
Country
Netherlands
Facility Name
Saint Bartholomew's Hospital
City
London
State/Province
England
ZIP/Postal Code
EC1A 7BE
Country
United Kingdom
Facility Name
Royal Marsden - Surrey
City
Sutton
State/Province
England
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
Facility Name
Centre for Cancer Research and Cell Biology at Queen's University Belfast
City
Belfast
State/Province
Northern Ireland
ZIP/Postal Code
BT9 7BL
Country
United Kingdom
Facility Name
Beatson West of Scotland Cancer Centre
City
Glasgow
State/Province
Scotland
ZIP/Postal Code
G11 6NT
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
31576173
Citation
Walter RFH, Sydow SR, Berg E, Kollmeier J, Christoph DC, Christoph S, Eberhardt WEE, Mairinger T, Wohlschlaeger J, Schmid KW, Mairinger FD. Bortezomib sensitivity is tissue dependent and high expression of the 20S proteasome precludes good response in malignant pleural mesothelioma. Cancer Manag Res. 2019 Sep 24;11:8711-8720. doi: 10.2147/CMAR.S194337. eCollection 2019.
Results Reference
derived

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Bortezomib in Treating Patients With Malignant Pleural Mesothelioma

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