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GTI-2040 and Docetaxel in Treating Patients With Recurrent, Metastatic, or Unresectable Locally Advanced Non-Small Cell Lung Cancer, Prostate Cancer, or Other Solid Tumors

Primary Purpose

Recurrent Non-small Cell Lung Cancer, Recurrent Prostate Cancer, Stage III Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
GTI-2040
docetaxel
laboratory biomarker analysis
pharmacological study
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Non-small Cell Lung Cancer

Eligibility Criteria

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

Inclusion Criteria: Histologically or cytologically confirmed diagnosis of 1 of the following: Solid tumor malignancy (phase I only)* Prostate cancer (phase I only)* Non-small cell lung cancer (phase I and II)* Recurrent, metastatic, locally advanced unresectable, or treatment-refractory disease Measurable disease At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan Previously irradiated lesions are considered measurable provided they have demonstrated progression before study entry No bone-only disease Must have measurable disease other than bone lesions No stage IIIA or IIIB non-small cell lung cancer without a malignant pleural or pericardial effusion that is eligible for first-line radical combined chemotherapy and radiotherapy No known progressive or symptomatic brain metastases Asymptomatic brain metastases allowed Performance status - ECOG 0-2 Performance status - Karnofsky 60-100% More than 3 months WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of coagulopathy Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST/ALT no greater than 2 times ULN (3.5 times ULN if liver metastases are present) INR no greater than 1.3 APTT no greater than 1.25 times ULN Creatinine no greater than 1.5 times ULN Creatinine clearance at least 50 mL/min No symptomatic congestive heart failure No evidence of cardiac dysfunction No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active peptic ulcer disease No poorly controlled diabetes mellitus No pre-existing grade 2 or greater neuropathy No ongoing or active infection No contraindication to corticosteroids No psychiatric illness or social situation that would limit compliance with study requirements No prior allergic reaction attributed to compounds of similar chemical or biological composition to study drugs No other concurrent uncontrolled illness One, and only one, prior chemotherapy regimen for advanced disease (not including adjuvant therapy) allowed Neoadjuvant/adjuvant chemotherapy allowed More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas and mitomycin) and recovered Prior multiple lines of endocrine therapy for advanced solid tumors allowed More than 4 weeks since prior endocrine therapy and recovered Concurrent steroids allowed See Disease Characteristics More than 4 weeks since prior radiotherapy and recovered No concurrent radiotherapy to sole site of measurable disease Prior surgery allowed No concurrent anticoagulant therapy Concurrent low-dose warfarin for central line thrombosis prophylaxis allowed No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents or therapies intended to treat the malignancy Concurrent bisphosphonates allowed

Sites / Locations

  • Princess Margaret Hospital Phase 2 Consortium

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (GTI-2040, docetaxel)

Arm Description

Phase I (closed to accrual as of 8/5/2004): Patients receive GTI-2040 IV continuously on days 1-14. Patients also receive docetaxel IV over 1 hour on day 3 during course 1 and on day 1 for all subsequent courses. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of GTI-2040 and docetaxel until the MTD is determined. The MTD is defined as the dose at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. The RP2D is defined as the dose preceding the MTD. Phase II: Patients receive GTI-2040 and docetaxel at the RP2D as in phase I.

Outcomes

Primary Outcome Measures

Number of patients experiencing dose limiting toxicities (DLTs), graded according to the National Cancer Institute Common Toxicity Criteria (NCI CTC) v2.0 (Phase I)
Objective tumor response as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) (Phase II)
The 95% confidence intervals will be provided.

Secondary Outcome Measures

Stable disease rate
Response duration
The 95% confidence intervals will be provided.
Toxicities of GTI-2040 combined with docetaxel, graded according to the NCI CTC v2.0
Time to disease progression
Duration of stable disease
Level of ribonucleotide reductase (RNR) activity
Logistic regression and descriptive statistics will be used.
Tumoral expression in terms of c-myc, R2 subunit protein levels and markers of proliferation (cyclin B1) and apoptosis (activated caspase 3)
Logistic regression and descriptive statistics will be used.

Full Information

First Posted
December 10, 2003
Last Updated
January 23, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00074022
Brief Title
GTI-2040 and Docetaxel in Treating Patients With Recurrent, Metastatic, or Unresectable Locally Advanced Non-Small Cell Lung Cancer, Prostate Cancer, or Other Solid Tumors
Official Title
A Phase I/2 Study of GTI-2040 Combined With Docetaxel In Metastatic Or Unresectable Locally Advanced Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
October 2003 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase I/II trial to study the effectiveness of combining GTI-2040 with docetaxel in treating patients who have recurrent, metastatic, or unresectable locally advanced non-small cell lung cancer, prostate cancer, or other solid tumors. GTI-2040 may stop the growth of cancer cells by blocking the enzymes necessary for their growth. It may also increase the effectiveness of docetaxel by making the tumor cells more sensitive to the drug. Combining GTI-2040 with docetaxel may kill more tumor cells
Detailed Description
OBJECTIVES: I. Determine the recommended phase II dose of GTI-2040 and docetaxel in patients with recurrent, metastatic, or unresectable locally advanced non-small cell lung cancer, prostate cancer, or other solid tumors (phase I study closed to accrual as of 8/5/2004). II. Determine the toxicity of this regimen in these patients. III. Determine the objective tumor response rate in patients treated with this regimen. IV. Determine the stable disease rate, time to disease progression, objective response duration, and duration of stable disease in patients treated with this regimen. V. Determine the pharmacokinetics of GTI-2040 when administered in combination with docetaxel in these patients. VI. Correlate the pharmacokinetics of GTI-2040 with the biological and toxic effects of this regimen in these patients. VII. Correlate baseline and post-treatment levels of ribonucleotide reductase activity in tumor biopsies and peripheral blood mononuclear cells and tumoral expression of c-myc, ras, pRAF1, pMAPK, and markers of apoptosis with clinical outcome in patients treated with this regimen. OUTLINE: This is an open-label, dose-escalation, multicenter study. Phase I (closed to accrual as of 8/5/2004): Patients receive GTI-2040 IV continuously on days 1-14. Patients also receive docetaxel IV over 1 hour on day 3 during course 1 and on day 1 for all subsequent courses. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of GTI-2040 and docetaxel until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. The recommended phase II dose (RP2D) is defined as the dose preceding the MTD. Phase II: Patients receive GTI-2040 and docetaxel at the RP2D as in phase I. Patients are followed every 3 months. PROJECTED ACCRUAL: A total of 12-48 patients (12-18 for phase I [closed to accrual as of 8/5/2004] and 15-30 for phase II) will be accrued for this study within 4-16 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Non-small Cell Lung Cancer, Recurrent Prostate Cancer, Stage III Prostate Cancer, Stage IIIA Non-small Cell Lung Cancer, Stage IIIB Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer, Stage IV Prostate Cancer, Unspecified Adult Solid Tumor, Protocol Specific

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment (GTI-2040, docetaxel)
Arm Type
Experimental
Arm Description
Phase I (closed to accrual as of 8/5/2004): Patients receive GTI-2040 IV continuously on days 1-14. Patients also receive docetaxel IV over 1 hour on day 3 during course 1 and on day 1 for all subsequent courses. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of GTI-2040 and docetaxel until the MTD is determined. The MTD is defined as the dose at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. The RP2D is defined as the dose preceding the MTD. Phase II: Patients receive GTI-2040 and docetaxel at the RP2D as in phase I.
Intervention Type
Biological
Intervention Name(s)
GTI-2040
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
docetaxel
Other Intervention Name(s)
RP 56976, Taxotere, TXT
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Number of patients experiencing dose limiting toxicities (DLTs), graded according to the National Cancer Institute Common Toxicity Criteria (NCI CTC) v2.0 (Phase I)
Time Frame
Up to day 21
Title
Objective tumor response as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) (Phase II)
Description
The 95% confidence intervals will be provided.
Time Frame
Up to day 42
Secondary Outcome Measure Information:
Title
Stable disease rate
Time Frame
Up to 6 weeks
Title
Response duration
Description
The 95% confidence intervals will be provided.
Time Frame
Up to 4 years
Title
Toxicities of GTI-2040 combined with docetaxel, graded according to the NCI CTC v2.0
Time Frame
Up to 4 years
Title
Time to disease progression
Time Frame
Up to 4 years
Title
Duration of stable disease
Time Frame
Up to 6 weeks
Title
Level of ribonucleotide reductase (RNR) activity
Description
Logistic regression and descriptive statistics will be used.
Time Frame
Up to week 10
Title
Tumoral expression in terms of c-myc, R2 subunit protein levels and markers of proliferation (cyclin B1) and apoptosis (activated caspase 3)
Description
Logistic regression and descriptive statistics will be used.
Time Frame
Up to week 10

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed diagnosis of 1 of the following: Solid tumor malignancy (phase I only)* Prostate cancer (phase I only)* Non-small cell lung cancer (phase I and II)* Recurrent, metastatic, locally advanced unresectable, or treatment-refractory disease Measurable disease At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan Previously irradiated lesions are considered measurable provided they have demonstrated progression before study entry No bone-only disease Must have measurable disease other than bone lesions No stage IIIA or IIIB non-small cell lung cancer without a malignant pleural or pericardial effusion that is eligible for first-line radical combined chemotherapy and radiotherapy No known progressive or symptomatic brain metastases Asymptomatic brain metastases allowed Performance status - ECOG 0-2 Performance status - Karnofsky 60-100% More than 3 months WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of coagulopathy Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST/ALT no greater than 2 times ULN (3.5 times ULN if liver metastases are present) INR no greater than 1.3 APTT no greater than 1.25 times ULN Creatinine no greater than 1.5 times ULN Creatinine clearance at least 50 mL/min No symptomatic congestive heart failure No evidence of cardiac dysfunction No unstable angina pectoris No cardiac arrhythmia Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active peptic ulcer disease No poorly controlled diabetes mellitus No pre-existing grade 2 or greater neuropathy No ongoing or active infection No contraindication to corticosteroids No psychiatric illness or social situation that would limit compliance with study requirements No prior allergic reaction attributed to compounds of similar chemical or biological composition to study drugs No other concurrent uncontrolled illness One, and only one, prior chemotherapy regimen for advanced disease (not including adjuvant therapy) allowed Neoadjuvant/adjuvant chemotherapy allowed More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas and mitomycin) and recovered Prior multiple lines of endocrine therapy for advanced solid tumors allowed More than 4 weeks since prior endocrine therapy and recovered Concurrent steroids allowed See Disease Characteristics More than 4 weeks since prior radiotherapy and recovered No concurrent radiotherapy to sole site of measurable disease Prior surgery allowed No concurrent anticoagulant therapy Concurrent low-dose warfarin for central line thrombosis prophylaxis allowed No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent investigational or commercial agents or therapies intended to treat the malignancy Concurrent bisphosphonates allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Natasha Leighl
Organizational Affiliation
Princess Margaret Hospital Phase 2 Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Hospital Phase 2 Consortium
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

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GTI-2040 and Docetaxel in Treating Patients With Recurrent, Metastatic, or Unresectable Locally Advanced Non-Small Cell Lung Cancer, Prostate Cancer, or Other Solid Tumors

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