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Trial of ZD6474 and Faslodex in Non-Small Cell Lung Cancer

Primary Purpose

Carcinoma, Non Small Cell Lung

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
ZD6474 (vandetanib)
Faslodex (Fulvestrant)
Sponsored by
University of Wisconsin, Madison
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Non Small Cell Lung focused on measuring non small cell lung cancer, vandetanib, ZD6474, fulvestrant, faslodex, phase 1

Eligibility Criteria

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

Inclusion Criteria:

  • Pathologically/histologically confirmed non-small cell lung cancer (NSCLC), advanced (stage IIIB w/ effusion or IV).
  • Performance status of 0, 1, or 2
  • Brain metastases must be clinically stable after treatment with surgery and/or radiotherapy
  • Must have received two prior systemic anti-cancer regimens for recurrent/ metastatic disease, including one platinum-containing regimen
  • Prior radiotherapy, chemotherapy and/or treatment with investigational agents is allowed provided that the patient has recovered from the treatment-related side effects to grade ≤1, and that at least 3 weeks has passed since the last dose
  • Required laboratory values demonstrating adequate bone marrow, kidney, liver, and blood clotting function.
  • Negative pregnancy test for women of childbearing potential within 7 days prior to study entry
  • Life expectancy of 3 months or more
  • Must tolerate intramuscular injections
  • No prior or concurrent use of estrogen replacement therapy
  • No concurrent use of cytotoxic, immunologic, hormonal, or investigational agent intended for the antitumor treatment of NSCLC

Exclusion Criteria:

  • Prior therapy with any anti-EGFR therapy such as gefitinib (IRESSA), erlotinib (TARCEVA), vandetanib (ZD6474, ZACTIMA), or fulvestrant (FASLODEX), or an aromatase inhibitor
  • Clinically significant cardiac event such as myocardial infarction, superior vena cava syndrome, New York Heart Association (NYHA) classification of heart disease ≥ 2 within 3 months before entry
  • History of arrhythmia (multifocal premature ventricular contractions (PVCs), bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial fibrillation), which is symptomatic or requires treatment (CTCAE grade 3) or asymptomatic sustained ventricular tachycardia
  • Presence of left bundle branch block
  • Congenital long QT syndrome, or 1st degree relative with unexplained sudden death under 40 years of age
  • History of QTc prolongation as a result from other medications that required discontinuation of that medication
  • QTc with Bazett's correction that is unmeasurable, or ≥ 480 msec on screening ECG
  • Potassium <4.0 mmol/L despite supplementation, or potassium above the CTCAE grade 1 upper limit
  • Serum calcium above the CTCAE grade 1 upper limit
  • Magnesium below the normal range despite supplementation, or above the CTCAE grade 1 upper limit
  • Hypertension not controlled by medical therapy (systolic blood pressure greater than 160 mm Hg or diastolic blood pressure greater than 100 mm Hg)
  • Diagnosis of active interstitial lung disease
  • Currently active diarrhea that may affect drug absorption
  • Previous or current malignancies of other histologies within the last 5 years, with the exception of cervical carcinoma in situ and basal cell or squamous cell carcinoma of the skin
  • Concomitant use of medications that are potent inducers of CYP3A4 are not allowed within 2 weeks of study or during the study
  • Any unresolved toxicity greater than CTC grade 1 from previous anti-cancer therapy
  • Major surgery within 4 weeks, or incompletely healed surgical incision
  • Women who are currently pregnant or breast feeding
  • History of bleeding diathesis (ie, disseminated intravascular coagulation [DIC], clotting factor deficiency)
  • History of hypersensitivity to active or inactive excipients of fulvestrant (ie castor oil or Mannitol)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Vandetanib plus fulvestrant

    Arm Description

    vandetanib by mouth once daily for 28 days plus fulvestrant intra-muscular injection each cycle

    Outcomes

    Primary Outcome Measures

    Toleration of combination of fulvestrant/vandetanib

    Secondary Outcome Measures

    Response rate to combination of fulvestrant/vandetanib
    Safety of combination of fulvestrant/vandetanib

    Full Information

    First Posted
    October 28, 2009
    Last Updated
    September 30, 2015
    Sponsor
    University of Wisconsin, Madison
    Collaborators
    AstraZeneca, University of Pittsburgh
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01004419
    Brief Title
    Trial of ZD6474 and Faslodex in Non-Small Cell Lung Cancer
    Official Title
    Phase I Trial of Vandetanib (ZD6474, Zactima) and Fulvestrant (Faslodex) as Third-Line Treatment of Advanced Non-Small Cell Lung Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2015
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Support for investigational products has been withdrawn.
    Study Start Date
    November 2009 (undefined)
    Primary Completion Date
    November 2010 (Anticipated)
    Study Completion Date
    May 2011 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    University of Wisconsin, Madison
    Collaborators
    AstraZeneca, University of Pittsburgh

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to evaluate the safety and tolerability of vandetanib and fulvestrant; to find the maximum tolerated dose of these two drugs; and to evaluate response rate and assess toxicity of this combination.
    Detailed Description
    Current treatment for metastatic non-small cell lung cancer (NSCLC) is inadequate, with a median survival of 8-12 months. Second-line therapy options include cytotoxic agents or molecularly-targeted agents such as erlotinib. Nevertheless, only 7-9% of patients will respond to standard second-line treatment. Treatment-related side effects from cytotoxic drugs and declining performance status in patients with progressing disease are significant issues in this patient population. Novel approaches with molecularly-targeted agents are clearly needed. The combination of vandetanib and fulvestrant addresses the potential to interfere with multiple interdependent growth-stimulatory pathways simultaneously. Recent work has revealed cross-talk between epidermal growth factor receptor (EGFR) and estrogen receptor (ER) pathways. This clinical trial will evaluate the clinical interaction of the EGFR inhibitor, vandetanib, in combination with the ER down-regulator, fulvestrant.

    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
    non small cell lung cancer, vandetanib, ZD6474, fulvestrant, faslodex, phase 1

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Vandetanib plus fulvestrant
    Arm Type
    Experimental
    Arm Description
    vandetanib by mouth once daily for 28 days plus fulvestrant intra-muscular injection each cycle
    Intervention Type
    Drug
    Intervention Name(s)
    ZD6474 (vandetanib)
    Other Intervention Name(s)
    ZD6474, Zactima
    Intervention Description
    vandetanib (100 mg or 200 mg or 300 mg) by mouth once daily for 28 days
    Intervention Type
    Drug
    Intervention Name(s)
    Faslodex (Fulvestrant)
    Other Intervention Name(s)
    Faslodex
    Intervention Description
    Fulvestrant 500 mg intra-muscular injection on Day 1 and 250 mg Day 15 of cycle 1 Cycles 2 and beyond: Fulvestrant 500 mg intra-muscular injection on Day 1, every 28 days.
    Primary Outcome Measure Information:
    Title
    Toleration of combination of fulvestrant/vandetanib
    Time Frame
    Monthly
    Secondary Outcome Measure Information:
    Title
    Response rate to combination of fulvestrant/vandetanib
    Time Frame
    End of trial
    Title
    Safety of combination of fulvestrant/vandetanib
    Time Frame
    Monthly

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Pathologically/histologically confirmed non-small cell lung cancer (NSCLC), advanced (stage IIIB w/ effusion or IV). Performance status of 0, 1, or 2 Brain metastases must be clinically stable after treatment with surgery and/or radiotherapy Must have received two prior systemic anti-cancer regimens for recurrent/ metastatic disease, including one platinum-containing regimen Prior radiotherapy, chemotherapy and/or treatment with investigational agents is allowed provided that the patient has recovered from the treatment-related side effects to grade ≤1, and that at least 3 weeks has passed since the last dose Required laboratory values demonstrating adequate bone marrow, kidney, liver, and blood clotting function. Negative pregnancy test for women of childbearing potential within 7 days prior to study entry Life expectancy of 3 months or more Must tolerate intramuscular injections No prior or concurrent use of estrogen replacement therapy No concurrent use of cytotoxic, immunologic, hormonal, or investigational agent intended for the antitumor treatment of NSCLC Exclusion Criteria: Prior therapy with any anti-EGFR therapy such as gefitinib (IRESSA), erlotinib (TARCEVA), vandetanib (ZD6474, ZACTIMA), or fulvestrant (FASLODEX), or an aromatase inhibitor Clinically significant cardiac event such as myocardial infarction, superior vena cava syndrome, New York Heart Association (NYHA) classification of heart disease ≥ 2 within 3 months before entry History of arrhythmia (multifocal premature ventricular contractions (PVCs), bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial fibrillation), which is symptomatic or requires treatment (CTCAE grade 3) or asymptomatic sustained ventricular tachycardia Presence of left bundle branch block Congenital long QT syndrome, or 1st degree relative with unexplained sudden death under 40 years of age History of QTc prolongation as a result from other medications that required discontinuation of that medication QTc with Bazett's correction that is unmeasurable, or ≥ 480 msec on screening ECG Potassium <4.0 mmol/L despite supplementation, or potassium above the CTCAE grade 1 upper limit Serum calcium above the CTCAE grade 1 upper limit Magnesium below the normal range despite supplementation, or above the CTCAE grade 1 upper limit Hypertension not controlled by medical therapy (systolic blood pressure greater than 160 mm Hg or diastolic blood pressure greater than 100 mm Hg) Diagnosis of active interstitial lung disease Currently active diarrhea that may affect drug absorption Previous or current malignancies of other histologies within the last 5 years, with the exception of cervical carcinoma in situ and basal cell or squamous cell carcinoma of the skin Concomitant use of medications that are potent inducers of CYP3A4 are not allowed within 2 weeks of study or during the study Any unresolved toxicity greater than CTC grade 1 from previous anti-cancer therapy Major surgery within 4 weeks, or incompletely healed surgical incision Women who are currently pregnant or breast feeding History of bleeding diathesis (ie, disseminated intravascular coagulation [DIC], clotting factor deficiency) History of hypersensitivity to active or inactive excipients of fulvestrant (ie castor oil or Mannitol)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Tien Hoang, M.D.
    Organizational Affiliation
    University of Wisconsin, Madison
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Trial of ZD6474 and Faslodex in Non-Small Cell Lung Cancer

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