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Feasibility Study to Estimate Number of Patients With Precancerous Areas in Their Airways and the Response to Gefitinib (TIDAL1)

Primary Purpose

Lung Cancer, Head and Neck Cancer

Status
Terminated
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Gefitinib
Sponsored by
Papworth Hospital NHS Foundation Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers
  • Age 18 years or above
  • Resected NSCLC or Squamous cell Head & Neck cancer treated curatively
  • All treatment, including any adjuvant treatment with radiotherapy and/or chemotherapy completed at least 3 months prior to study entry
  • ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1
  • Suitable for flexible bronchoscopy
  • Able to give signed informed consent
  • Adequate haematological, kidney and liver function:

    • Serum alanine transaminase (ALT) ≤2.5 x upper limit of normal (ULN)
    • Total serum bilirubin ≤1.5 x ULN
    • Absolute neutrophil count (ANC) ≥1500/μL
    • Platelets ≥100,000/μL
    • Haemoglobin ≥9.0 g/dL
    • Sufficient renal function to allow administration of contrast medium (in line with Royal College of Radiologists guidelines).

In addition, the following inclusion criteria must be met during the screening period in order to confirm eligibility for the study treatment

  • No evidence of malignant disease activity on screening
  • High grade dysplasia on autofluorescence bronchoscopy analysis
  • No evidence of pulmonary fibrosis or interstitial lung disease on screening CT

Exclusion Criteria:

  • Diagnosis of any second malignancy within the 5 years from date of enrolment, except basal cell carcinoma, squamous cell skin cancer, or in situ carcinoma of the cervix uteri that has been adequately treated with no evidence of recurrent disease for 12 months
  • Evidence of severe or uncontrolled systemic disease or psychiatric disorder that would interfere with the patient's safety
  • Known severe hypersensitivity to Gefitinib or any of the excipients of the product
  • Past medical history of interstitial lung disease, drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease
  • Pre-existing idiopathic pulmonary fibrosis
  • History of allergy to contrast medium
  • Insufficient lung function as determined by either clinical examination or an arterial oxygen tension (PaO2) of < 9.3kpa
  • Inability to swallow oral medications
  • Presence of active inflammatory bowel disease, partial or complete bowel obstruction or chronic diarrhoea or any condition which would interfere with absorption of an oral drug.
  • Past medical history of keratitis
  • Past medical history of Sjogren's syndrome
  • Pregnant or breast-feeding
  • Male and female patients (of childbearing age) not using, or not willing to use, protocol mandated contraception
  • Prior EGFR inhibitor use.
  • Concurrent medication with known potent CYP3A4 inhibitors and inducers and/or dosing within 7 days of date of enrolment (e.g.. ketoconazole, rifampin, phenytoin, carbamazepine, barbiturates or herbal preparations containing St John's wort/Hypericum perforatum etc.) or use of other concomitant medication incompatible with study drug (see SmPC)
  • Current treatment on another therapeutic clinical trial or previous investigational agent in the last 12 weeks (supportive care trials or non-treatment trials are allowed)
  • Previous enrolment or treatment in the present study.

Sites / Locations

  • Papworth Hospital NHS Trust

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Gefitinib

Arm Description

Single arm study

Outcomes

Primary Outcome Measures

Incidence of high grade dysplasia of the bronchial epithelium in patients at high risk of lung dysplasia
Patients will have white/blue light bronchoscopy with biopsy of identified lesions. The incidence of high grade lung epithelial dysplasia will be recorded.

Secondary Outcome Measures

Acceptability of screening patients as measured by success of trial recruitment
Response of high grade dysplasia to treatment (complete / partial / stable / progression)
To be estimated by photography & biopsy of the lesions & comparison with previous findings: Complete response: Complete resolution of a dysplastic lesion Partial response: Reduction of a dysplastic lesion by >=50% OR Reduction in grade of a high grade dysplastic lesion Progressive disease: Development of a new area of high grade dysplasia or invasive malignancy in an area of previous low grade dysplasia or normal epithelium OR Development of a higher grade lesion in an area of previous high grade dysplasia OR Increase in surface area of >=50%. Stable disease: None of the above.
Toxicity and acceptability of treatment (proportion of patients refusing study entry).
Successful biobanking of samples

Full Information

First Posted
July 28, 2011
Last Updated
August 18, 2016
Sponsor
Papworth Hospital NHS Foundation Trust
Collaborators
AstraZeneca, Noble Organisation
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1. Study Identification

Unique Protocol Identification Number
NCT01405846
Brief Title
Feasibility Study to Estimate Number of Patients With Precancerous Areas in Their Airways and the Response to Gefitinib
Acronym
TIDAL1
Official Title
Tyrosine Kinase Inhibitors in DyplAsia of Lung Epithelium
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Terminated
Why Stopped
Futility
Study Start Date
December 2011 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Papworth Hospital NHS Foundation Trust
Collaborators
AstraZeneca, Noble Organisation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
We are going to use a special type of bronchoscopy test to examine patients who have had previous surgical treatment for lung cancer or head and neck cancer. The aim is to determine a) whether we can identify precancerous changes in their airways b) whether this type of testing is acceptable and c) get an initial idea of whether a new drug called gefitinib has any effect on precancerous areas in the airway.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer, Head and Neck Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gefitinib
Arm Type
Other
Arm Description
Single arm study
Intervention Type
Drug
Intervention Name(s)
Gefitinib
Other Intervention Name(s)
IRESSA
Intervention Description
250mg od for 6 months
Primary Outcome Measure Information:
Title
Incidence of high grade dysplasia of the bronchial epithelium in patients at high risk of lung dysplasia
Description
Patients will have white/blue light bronchoscopy with biopsy of identified lesions. The incidence of high grade lung epithelial dysplasia will be recorded.
Time Frame
during the screening broncoscopy - carried out within the first month post consent
Secondary Outcome Measure Information:
Title
Acceptability of screening patients as measured by success of trial recruitment
Time Frame
12 months
Title
Response of high grade dysplasia to treatment (complete / partial / stable / progression)
Description
To be estimated by photography & biopsy of the lesions & comparison with previous findings: Complete response: Complete resolution of a dysplastic lesion Partial response: Reduction of a dysplastic lesion by >=50% OR Reduction in grade of a high grade dysplastic lesion Progressive disease: Development of a new area of high grade dysplasia or invasive malignancy in an area of previous low grade dysplasia or normal epithelium OR Development of a higher grade lesion in an area of previous high grade dysplasia OR Increase in surface area of >=50%. Stable disease: None of the above.
Time Frame
6 & 12 months
Title
Toxicity and acceptability of treatment (proportion of patients refusing study entry).
Time Frame
2 weeks, 4 weeks, 3 & 6 months
Title
Successful biobanking of samples
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Age 18 years or above Resected NSCLC or Squamous cell Head & Neck cancer treated curatively All treatment, including any adjuvant treatment with radiotherapy and/or chemotherapy completed at least 3 months prior to study entry ECOG (Eastern Cooperative Oncology Group) performance status of 0 or 1 Suitable for flexible bronchoscopy Able to give signed informed consent Adequate haematological, kidney and liver function: Serum alanine transaminase (ALT) ≤2.5 x upper limit of normal (ULN) Total serum bilirubin ≤1.5 x ULN Absolute neutrophil count (ANC) ≥1500/μL Platelets ≥100,000/μL Haemoglobin ≥9.0 g/dL Sufficient renal function to allow administration of contrast medium (in line with Royal College of Radiologists guidelines). In addition, the following inclusion criteria must be met during the screening period in order to confirm eligibility for the study treatment No evidence of malignant disease activity on screening High grade dysplasia on autofluorescence bronchoscopy analysis No evidence of pulmonary fibrosis or interstitial lung disease on screening CT Exclusion Criteria: Diagnosis of any second malignancy within the 5 years from date of enrolment, except basal cell carcinoma, squamous cell skin cancer, or in situ carcinoma of the cervix uteri that has been adequately treated with no evidence of recurrent disease for 12 months Evidence of severe or uncontrolled systemic disease or psychiatric disorder that would interfere with the patient's safety Known severe hypersensitivity to Gefitinib or any of the excipients of the product Past medical history of interstitial lung disease, drug-induced interstitial disease, radiation pneumonitis which required steroid treatment or any evidence of clinically active interstitial lung disease Pre-existing idiopathic pulmonary fibrosis History of allergy to contrast medium Insufficient lung function as determined by either clinical examination or an arterial oxygen tension (PaO2) of < 9.3kpa Inability to swallow oral medications Presence of active inflammatory bowel disease, partial or complete bowel obstruction or chronic diarrhoea or any condition which would interfere with absorption of an oral drug. Past medical history of keratitis Past medical history of Sjogren's syndrome Pregnant or breast-feeding Male and female patients (of childbearing age) not using, or not willing to use, protocol mandated contraception Prior EGFR inhibitor use. Concurrent medication with known potent CYP3A4 inhibitors and inducers and/or dosing within 7 days of date of enrolment (e.g.. ketoconazole, rifampin, phenytoin, carbamazepine, barbiturates or herbal preparations containing St John's wort/Hypericum perforatum etc.) or use of other concomitant medication incompatible with study drug (see SmPC) Current treatment on another therapeutic clinical trial or previous investigational agent in the last 12 weeks (supportive care trials or non-treatment trials are allowed) Previous enrolment or treatment in the present study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tim Eisen, Professor
Organizational Affiliation
Papworth Hospital NHS Trust
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Robert Rintoul, Dr
Organizational Affiliation
Papworth Hospital NHS Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
Papworth Hospital NHS Trust
City
Papworth Everard
State/Province
Cambs
ZIP/Postal Code
CB23 3RE
Country
United Kingdom

12. IPD Sharing Statement

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Feasibility Study to Estimate Number of Patients With Precancerous Areas in Their Airways and the Response to Gefitinib

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