Sorafenib in Resected Non-small Cell Lung Carcinoma (SIRN)
Primary Purpose
Carcinoma, Non-Small-Cell Lung
Status
Terminated
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Sorafenib
Sponsored by

About this trial
This is an interventional treatment trial for Carcinoma, Non-Small-Cell Lung focused on measuring Sorafenib, NSCLC, Adjuvant Treatment, resected Non-Small Cell Lung Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Patients with histologically confirmed diagnosis of NSCLC pathological stages I, II or III A
- Patients must have completely resected disease and may not be treated with prior chemotherapy. Patients must have fully recovered from surgery prior to initiation of study treatment.
- Adjuvant radiotherapy for stage III A disease is permitted given that the patient has recovered from all radiation-induced toxicities. In those patients, a complete restaging will be performed prior to enrolment into the trial.
- Patients with completely resected NSCLC stage II or III A, who for medical reasons are not eligible for adjuvant chemotherapy consisting of a standard regimen of 4 cycles cisplatin/vinorelbine
- Patients with completely resected NSCLC stage II or III A, who are not willing to undergo adjuvant chemotherapy with 4 cycles of cisplatin/ vinorelbine, are also eligible.
- Age ≥ 18 years
- ECOG performance status ≤ 2
- Normal organ and marrow function defined as:
Hematopoetic: absolute neutrophil count >1,500/mm3, platelet count > 100,000/mm3, hemoglobin > 9 g/dL INR < 1.5 ULN and PTT within normal limits Hepatic: total bilirubin < 1.5 x ULN, AST or ALT < 2.5 x ULN Renal: creatinine < 1.5 x ULN
- Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
- Women of childbearing potential and men must agree to use adequate birth contraception prior to study entry and for the duration of study participation. Women and men should use adequate birth control for at least 3 months after the last administration of Sorafenib.
- Written informed consent
Exclusion Criteria:
- Any other histology (e.g. SCLC, carcinoid tumors) or disease stages other than I to III A
- Patients who are eligible and willing to undergo a standard adjuvant chemotherapy regimen (4 cycles of cisplatin/vinorelbine)
- Any prior systemic anticancer therapy including chemotherapy, targeted agents, experimental therapy or biological therapy for NSCLC
- Cardiac disease: congestive heart failure > class II NYHA, patients must not have unstable angina pectoris or new onset of angina pectoris or myocardial infarction within the past 6 months, or cardiac ventricular arrhythmias requiring antiarrhythmic therapy
- Uncontrolled hypertension defined as systolic blood pressure > 150 mm Hg or diastolic pressure > 90 mm Hg, despite optimal therapy
- Known brain metastasis. Patients with symptoms should undergo CT scan/MRI of the brain to exclude brain metastasis
- Active clinically serious infections > NCI-CTCAE Grade 2
- Thrombotic or embolic events including transient ischemic attacks within the past 6 months
- Hemorrhage/bleeding event ≥ NCI-CTCAE Grade 3 within 4 weeks before first dose of study drug
- Serious non-healing wound, ulcer or bone fracture
- Evidence or history of bleeding diathesis or coagulopathy
- Therapeutic anticoagulation with Vitamin K antagonists such as warfarin, phenprocoumon, or with heparins or heparinoids. Low dose warfarin/phenprocoumon is permitted if INR is < 1.5. Low dose aspirin (300 mg/d) is permitted.
- Use of St John's Wort or rifampicin
- Major surgery, open biopsy or significant traumatic injury within 4 weeks before first dose of study drug
- Known or suspected allergy to Sorafenib or any agent given in the course of this trial
- Previous cancer that is distinct in primary site or histology from NSCLC except cervical cancer in situ, treated basal cell carcinoma, superficial bladder tumors or any cancer curatively treated ≥ 3 years prior to study entry.
- Substance abuse, medical or psychological condition that may interfere with the patient´s participation in the study
Sites / Locations
- SIRN investigational trial site
- SIRN investigational trial site
- SIRN investigational trial site
- SIRN investigational trial site Johannes Gutenberg Universität
- SIRN investigational trial site Katholisches Klinikum
- SIRN investigational trial site
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
1
Arm Description
Sorafenib treatment
Outcomes
Primary Outcome Measures
Progression-free survival (PFS) clinical and radiological assessment of remission status (RECIST criteria)
Secondary Outcome Measures
Progression free survival
Overall survival
Assessment of safety and tolerability of Sorafenib when administered as adjuvant treatment following surgery for NSCLC
Assessment of biomarkers relevant to Sorafenib response and disease state, and their correlation to clinical outcome
Full Information
NCT ID
NCT00532025
First Posted
September 18, 2007
Last Updated
July 24, 2009
Sponsor
Johannes Gutenberg University Mainz
1. Study Identification
Unique Protocol Identification Number
NCT00532025
Brief Title
Sorafenib in Resected Non-small Cell Lung Carcinoma
Acronym
SIRN
Official Title
A Phase II Study to Investigate the Efficacy and Safety of Sorafenib as Adjuvant Treatment Following Resection of Non-small Cell Lung Carcinoma (NSCLC) in Patients Not Eligible for Cisplatin-based Adjuvant Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
July 2009
Overall Recruitment Status
Terminated
Study Start Date
September 2007 (undefined)
Primary Completion Date
September 2008 (Actual)
Study Completion Date
September 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Johannes Gutenberg University Mainz
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is an open-label, single-armed, multicentric, phase II study of Sorafenib treatment following surgery for NSCLC.
The primary hypothesis is to increase the progression-free survival (PFS) of the experimental group in comparison to a historical control group. For sample size calculation a 2 year PFS of 50% was calculated for the historical control group, and a 2 year PFS of 67% was estimated for the intervention group. These estimates are based on the actual PFS and overall survival (OS) of a defined population of 120 NSCLC patients treated at a single institution with surgery alone or surgery followed by adjuvant radiotherapy, which compares favorably to published international results, and the improvement of PFS achieved by 4 cycles of cisplatin/vinorelbine-based cytotoxic chemotherapy in published randomized trials.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Non-Small-Cell Lung
Keywords
Sorafenib, NSCLC, Adjuvant Treatment, resected Non-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
Non-Randomized
Enrollment
134 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Experimental
Arm Description
Sorafenib treatment
Intervention Type
Drug
Intervention Name(s)
Sorafenib
Other Intervention Name(s)
Nexavar
Intervention Description
Sorafenib will be administered as oral formulation (200 mg tablets) at a dose of 400 mg twice daily starting 28 to 42 days after surgery or surgery plus adjuvant radiotherapy. The dose may be adjusted based on individual toxicities following a predetermined dose reduction schedule. Sorafenib therapy will be continued for 48 months, or until disease progression, patient refusal or intolerable toxicity, whichever comes first. Patients in remission after 48 months will be offered continued Sorafenib treatment in a roll-over study.
Primary Outcome Measure Information:
Title
Progression-free survival (PFS) clinical and radiological assessment of remission status (RECIST criteria)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression free survival
Time Frame
3 and 4 years
Title
Overall survival
Time Frame
3 and 4 years
Title
Assessment of safety and tolerability of Sorafenib when administered as adjuvant treatment following surgery for NSCLC
Time Frame
2, 3 and 4 years
Title
Assessment of biomarkers relevant to Sorafenib response and disease state, and their correlation to clinical outcome
Time Frame
4 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with histologically confirmed diagnosis of NSCLC pathological stages I, II or III A
Patients must have completely resected disease and may not be treated with prior chemotherapy. Patients must have fully recovered from surgery prior to initiation of study treatment.
Adjuvant radiotherapy for stage III A disease is permitted given that the patient has recovered from all radiation-induced toxicities. In those patients, a complete restaging will be performed prior to enrolment into the trial.
Patients with completely resected NSCLC stage II or III A, who for medical reasons are not eligible for adjuvant chemotherapy consisting of a standard regimen of 4 cycles cisplatin/vinorelbine
Patients with completely resected NSCLC stage II or III A, who are not willing to undergo adjuvant chemotherapy with 4 cycles of cisplatin/ vinorelbine, are also eligible.
Age ≥ 18 years
ECOG performance status ≤ 2
Normal organ and marrow function defined as:
Hematopoetic: absolute neutrophil count >1,500/mm3, platelet count > 100,000/mm3, hemoglobin > 9 g/dL INR < 1.5 ULN and PTT within normal limits Hepatic: total bilirubin < 1.5 x ULN, AST or ALT < 2.5 x ULN Renal: creatinine < 1.5 x ULN
Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
Women of childbearing potential and men must agree to use adequate birth contraception prior to study entry and for the duration of study participation. Women and men should use adequate birth control for at least 3 months after the last administration of Sorafenib.
Written informed consent
Exclusion Criteria:
Any other histology (e.g. SCLC, carcinoid tumors) or disease stages other than I to III A
Patients who are eligible and willing to undergo a standard adjuvant chemotherapy regimen (4 cycles of cisplatin/vinorelbine)
Any prior systemic anticancer therapy including chemotherapy, targeted agents, experimental therapy or biological therapy for NSCLC
Cardiac disease: congestive heart failure > class II NYHA, patients must not have unstable angina pectoris or new onset of angina pectoris or myocardial infarction within the past 6 months, or cardiac ventricular arrhythmias requiring antiarrhythmic therapy
Uncontrolled hypertension defined as systolic blood pressure > 150 mm Hg or diastolic pressure > 90 mm Hg, despite optimal therapy
Known brain metastasis. Patients with symptoms should undergo CT scan/MRI of the brain to exclude brain metastasis
Active clinically serious infections > NCI-CTCAE Grade 2
Thrombotic or embolic events including transient ischemic attacks within the past 6 months
Hemorrhage/bleeding event ≥ NCI-CTCAE Grade 3 within 4 weeks before first dose of study drug
Serious non-healing wound, ulcer or bone fracture
Evidence or history of bleeding diathesis or coagulopathy
Therapeutic anticoagulation with Vitamin K antagonists such as warfarin, phenprocoumon, or with heparins or heparinoids. Low dose warfarin/phenprocoumon is permitted if INR is < 1.5. Low dose aspirin (300 mg/d) is permitted.
Use of St John's Wort or rifampicin
Major surgery, open biopsy or significant traumatic injury within 4 weeks before first dose of study drug
Known or suspected allergy to Sorafenib or any agent given in the course of this trial
Previous cancer that is distinct in primary site or histology from NSCLC except cervical cancer in situ, treated basal cell carcinoma, superficial bladder tumors or any cancer curatively treated ≥ 3 years prior to study entry.
Substance abuse, medical or psychological condition that may interfere with the patient´s participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Schuler, MD
Organizational Affiliation
Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen
Official's Role
Principal Investigator
Facility Information:
Facility Name
SIRN investigational trial site
City
Essen
Country
Germany
Facility Name
SIRN investigational trial site
City
Halle (Saale)
Country
Germany
Facility Name
SIRN investigational trial site
City
Loewenstein
Country
Germany
Facility Name
SIRN investigational trial site Johannes Gutenberg Universität
City
Mainz
Country
Germany
Facility Name
SIRN investigational trial site Katholisches Klinikum
City
Mainz
Country
Germany
Facility Name
SIRN investigational trial site
City
Rotenburg (Wuemme)
Country
Germany
12. IPD Sharing Statement
Learn more about this trial
Sorafenib in Resected Non-small Cell Lung Carcinoma
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