LBH Phase II in Small Cell Lung Cancer (SCLC)
Primary Purpose
Small Cell Lung Carcinoma
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
LBH581
Sponsored by
About this trial
This is an interventional treatment trial for Small Cell Lung Carcinoma focused on measuring LBH581, Panobinostat, Small Cell Lung Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Histological/cytological diagnosis of SCLC, mixed small and non small cell tumours are excluded
- ≤ 2 prior chemotherapy lines
- Progression after, and not during, last previous chemotherapy treatment
- Age ≥ 18 and ≤ 75 years
- Life expectancy of at least 3 months
- ECOG Performance Status 0-1
- At least one measurable lesion according to modified RECIST criteria defined as ≥ 1 lesion with longest diameter ≥ 20 mm by conventional techniques or ≥ 10 mm with spiral CT scan. In case of solitary measurable lesion, histological confirmation is not required.
Adequate haematological function:
- haemoglobin ≥ 9 g/dl
- platelet count ≥ 100,000/mm3
- neutrophils count ≥ 1,500/mm3
Adequate liver and renal functions:
- Total serum bilirubin ≤ 1.5 x UNL
- Serum creatinine ≤ 1.5 x UNL or 24 hours creatinine clearance ≥ 50 mL/min
- AST and ALT ≤ 2.5 x UNL or ≤ 5.0 x UNL if the transaminase elevation is due to hepatic involvement
- Albumin ≥ 2.5 g/dl
- Alkaline phosphatase ≤ 2.5 x UNL
- Fertile patients must use effective contraception during and for ≥ 6 weeks after completion of study therapy
- Ability to signed informed consent
Exclusion Criteria:
- Progression while on previous chemotherapy
- Other chemotherapy treatment < 4 weeks prior to enrolment
- Presence of active infection
- A known history of HIV positivity
- Participation to any investigational drug study < 4 weeks preceding study enrolment
- Radiotherapy involving > 30% of the active bone marrow
- Thoracic and brain radiotherapy < 4 weeks prior to enrolment. Palliative radiotherapy is allowed during study treatment
- Presence of any serious neurological or psychiatric disorder
Impaired cardiac function, including any one of the following:
- Complete Left Bundle Branch Block or obligate use of a cardiac pacemaker or congenital long QT syndrome or history or presence of atrial or ventricular tachyarrhythmias or clinically significant resting bradycardia (< 50 beats per minute) or QTcF > 480 msec on screening ECG or Right Bundle Branch block + left anterior hemiblock (biphasic block)
- Acute MI ≤ 3 months prior to starting study drug
- Other clinically significant heart disease (e.g. congestive heart failure, previous history angina pectoris, uncontrolled hypertension, history of labile hypertension or arrhythmia, or history of poor compliance with an antihypertensive regimen)
- Any other case of current abnormal cardiac functionality or history of cardiac disease causing LVEF < 45% as determined by ECHO
- Known hypersensitivity/allergic reaction to the study product
- Presence of uncontrolled intercurrent illness or any condition which in the judgement of the investigator would place the subject at undue risk or interfere with the results of the study.
- Previous or current concomitant malignancy at other site, other than basal or squamous cell carcinoma of the skin and carcinoma in situ of the uterine cervix, within 3 years.
- Symptomatic or progressive brain metastases
- Patients with an active bleeding diathesis or on anticoagulants Therapeutic doses of sodium warfarin (Coumadin) are not allowed. Low doses of Coumadin (e.g., ≤ 2 mg/day) for line patency are allowed
- Pregnant or lactating women
- Concomitant use of CYP3A4/5 inhibitors or inducers, or drug that prolong the QT interval and/or induce torsades ventricular arrythmia, where the treatment can not be discontinued or switched to a different medication prior to starting study drug.
- Treatment with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GMCSF) ≤ 2 weeks prior to starting study drug.
- Unable or unwilling to comply with all study procedures
Sites / Locations
- Klinik für Onkologie und Haematologie
- Klinikum Kassel Innere Medizin
- Azienda Ospedaliera "S. G. Moscati"
- Istituto Nazionale Ricerca sul Cancro
- U.O. di Oncologia Medica
- Ospedale Maggiore di Parma
- Azienda Ospedaliera San Camillo Forlanini
- Az. San. Ospedaliera Molinette S. Giovanni Battista di Torino
Outcomes
Primary Outcome Measures
Objective response rate
Objective response rate measured according to the RECIST (Response Evaluation Criteria In Solid Tumours).
Secondary Outcome Measures
Duration of antitumor activity
Time-to-progression, duration of response and disease stabilization
Drug safety profile
Evaluation of adverse events, physical examination, vital signs, concomitant medications, laboratory (hematology and chemistry) and instrumental data (i.e. ECG) considered for safety analyses
Full Information
NCT ID
NCT01222936
First Posted
October 11, 2010
Last Updated
October 14, 2010
Sponsor
Southern Europe New Drug Organization
Collaborators
Novartis Pharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT01222936
Brief Title
LBH Phase II in Small Cell Lung Cancer (SCLC)
Official Title
A Phase II Study of the Histone Deacetylase Inhibitor Panobinostat (LBH589) in Patients With Advanced Small Cell Lung Cancer (SCLC)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2010
Overall Recruitment Status
Completed
Study Start Date
May 2008 (undefined)
Primary Completion Date
June 2009 (Actual)
Study Completion Date
August 2010 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Southern Europe New Drug Organization
Collaborators
Novartis Pharmaceuticals
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
SCLC is the most aggressive and lethal form of lung cancer, typically very sensitive to cytotoxic therapy when first diagnosed, but associated with a high incidence of tumour relapse and a very poor life expectancy. Combination chemotherapy based on cisplatin or carboplatin and etoposide represents the most widely used regimen. Despite of the high response rate, approximately 80% of patients with limited disease and nearly all patients with extended disease develop disease relapse or progression. Topotecan is, at present, the only approved second line treatment in Europe.
The search of a new therapeutic agent that could alter the natural history of SCLC would be an important goal to be reached. LBH589 (Panobinostat) is a histone deacetylase (HDAC) inhibitor available for intravenous and oral administration. LBH589 could be classified as PAN-DAC inhibitor targeting both histone and non histone proteins and as such it could be suitable for combination with cytotoxics. Three phase I dose escalation studies with both the intravenous and the oral formulation of LBH589, examining various dose schedules of administration have been conducted in advanced solid tumours and haematological malignancies.
Single agent activity was observed in phase I in patients with haematological cancer. In solid tumours one response (Hormone-refractory Prostatic Cancer) and some prolonged stabilizations have been observed with intravenous formulation. Phase II studies are now in progress.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Small Cell Lung Carcinoma
Keywords
LBH581, Panobinostat, Small Cell Lung Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Actual)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
LBH581
Other Intervention Name(s)
Panobinostat
Intervention Description
25 mg/5 ml solution packaged in 6 ml type I glass vials and given as a 30 minutes infusion at the dose of 20 mg/m2 i.v., on day 1 and 8, every 21 days.
Primary Outcome Measure Information:
Title
Objective response rate
Description
Objective response rate measured according to the RECIST (Response Evaluation Criteria In Solid Tumours).
Time Frame
12-18 weeks (foreseen participation of the patient in the study)
Secondary Outcome Measure Information:
Title
Duration of antitumor activity
Description
Time-to-progression, duration of response and disease stabilization
Time Frame
12-18 weeks (foreseen participation of the patient in the study)
Title
Drug safety profile
Description
Evaluation of adverse events, physical examination, vital signs, concomitant medications, laboratory (hematology and chemistry) and instrumental data (i.e. ECG) considered for safety analyses
Time Frame
28 days following the last dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histological/cytological diagnosis of SCLC, mixed small and non small cell tumours are excluded
≤ 2 prior chemotherapy lines
Progression after, and not during, last previous chemotherapy treatment
Age ≥ 18 and ≤ 75 years
Life expectancy of at least 3 months
ECOG Performance Status 0-1
At least one measurable lesion according to modified RECIST criteria defined as ≥ 1 lesion with longest diameter ≥ 20 mm by conventional techniques or ≥ 10 mm with spiral CT scan. In case of solitary measurable lesion, histological confirmation is not required.
Adequate haematological function:
haemoglobin ≥ 9 g/dl
platelet count ≥ 100,000/mm3
neutrophils count ≥ 1,500/mm3
Adequate liver and renal functions:
Total serum bilirubin ≤ 1.5 x UNL
Serum creatinine ≤ 1.5 x UNL or 24 hours creatinine clearance ≥ 50 mL/min
AST and ALT ≤ 2.5 x UNL or ≤ 5.0 x UNL if the transaminase elevation is due to hepatic involvement
Albumin ≥ 2.5 g/dl
Alkaline phosphatase ≤ 2.5 x UNL
Fertile patients must use effective contraception during and for ≥ 6 weeks after completion of study therapy
Ability to signed informed consent
Exclusion Criteria:
Progression while on previous chemotherapy
Other chemotherapy treatment < 4 weeks prior to enrolment
Presence of active infection
A known history of HIV positivity
Participation to any investigational drug study < 4 weeks preceding study enrolment
Radiotherapy involving > 30% of the active bone marrow
Thoracic and brain radiotherapy < 4 weeks prior to enrolment. Palliative radiotherapy is allowed during study treatment
Presence of any serious neurological or psychiatric disorder
Impaired cardiac function, including any one of the following:
Complete Left Bundle Branch Block or obligate use of a cardiac pacemaker or congenital long QT syndrome or history or presence of atrial or ventricular tachyarrhythmias or clinically significant resting bradycardia (< 50 beats per minute) or QTcF > 480 msec on screening ECG or Right Bundle Branch block + left anterior hemiblock (biphasic block)
Acute MI ≤ 3 months prior to starting study drug
Other clinically significant heart disease (e.g. congestive heart failure, previous history angina pectoris, uncontrolled hypertension, history of labile hypertension or arrhythmia, or history of poor compliance with an antihypertensive regimen)
Any other case of current abnormal cardiac functionality or history of cardiac disease causing LVEF < 45% as determined by ECHO
Known hypersensitivity/allergic reaction to the study product
Presence of uncontrolled intercurrent illness or any condition which in the judgement of the investigator would place the subject at undue risk or interfere with the results of the study.
Previous or current concomitant malignancy at other site, other than basal or squamous cell carcinoma of the skin and carcinoma in situ of the uterine cervix, within 3 years.
Symptomatic or progressive brain metastases
Patients with an active bleeding diathesis or on anticoagulants Therapeutic doses of sodium warfarin (Coumadin) are not allowed. Low doses of Coumadin (e.g., ≤ 2 mg/day) for line patency are allowed
Pregnant or lactating women
Concomitant use of CYP3A4/5 inhibitors or inducers, or drug that prolong the QT interval and/or induce torsades ventricular arrythmia, where the treatment can not be discontinued or switched to a different medication prior to starting study drug.
Treatment with any hematopoietic colony-stimulating growth factors (e.g., G-CSF, GMCSF) ≤ 2 weeks prior to starting study drug.
Unable or unwilling to comply with all study procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Filippo De Marinis, MD
Organizational Affiliation
Azienda Ospedaliera San Camillo Forlanini
Official's Role
Study Chair
Facility Information:
Facility Name
Klinik für Onkologie und Haematologie
City
Frankfurt am Main
ZIP/Postal Code
60488
Country
Germany
Facility Name
Klinikum Kassel Innere Medizin
City
Kassel
ZIP/Postal Code
34125
Country
Germany
Facility Name
Azienda Ospedaliera "S. G. Moscati"
City
Avellino
State/Province
AV
ZIP/Postal Code
83100
Country
Italy
Facility Name
Istituto Nazionale Ricerca sul Cancro
City
Genova
State/Province
GE
ZIP/Postal Code
16132
Country
Italy
Facility Name
U.O. di Oncologia Medica
City
Palermo
State/Province
PA
ZIP/Postal Code
90141
Country
Italy
Facility Name
Ospedale Maggiore di Parma
City
Parma
State/Province
PR
ZIP/Postal Code
43100
Country
Italy
Facility Name
Azienda Ospedaliera San Camillo Forlanini
City
Rome
State/Province
RM
ZIP/Postal Code
00151
Country
Italy
Facility Name
Az. San. Ospedaliera Molinette S. Giovanni Battista di Torino
City
Torino
State/Province
TO
ZIP/Postal Code
10126
Country
Italy
12. IPD Sharing Statement
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LBH Phase II in Small Cell Lung Cancer (SCLC)
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