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Gefitinib With or Without Simvastatin in NSCLC

This study is currently recruiting participants.
Verified by National Cancer Center, Korea, December 2007

Sponsored by: National Cancer Center, Korea
Information provided by: National Cancer Center, Korea
ClinicalTrials.gov Identifier: NCT00452244
  Purpose

The epidermal growth factor receptor (EGFR) is a key regulator of growth, differentiation, and survival of epithelial cancers. In a small subset of tumors, the presence of activating mutations within the ATP binding site confers increased susceptibility to gefitinib, a potent tyrosine kinase inhibitor of EGFR. Agents that can inhibit EGFR function through different mechanisms may enhance gefitinib activity in patients lacking these mutations. Mevalonate metabolites play significant roles in the function of the EGFR; therefore, mevalonate pathway inhibitors may potentiate EGFR-targeted therapies. Targeting HMG-CoA reductase, the rate-limiting enzyme of mevalonate pathway, using lovastatin induces a potent apoptosis in a variety of tumor types. In an in vitro study, combining gefitinib and lovastatin treatment showed synergistic cytotoxic activity through enhanced inhibition of AKT activation by EGF in NSCLC and head & neck cancer cell lines. Therefore, we would like to compare the combination effect of gefitinib and simvastatin, the specific and protein inhibitor of HMG-CoA reductase, with gefitinib alone in previously treated patients with NSCLC.


Condition Intervention Phase
Lung Cancer
Drug: Gefitinib+simvastatin
Drug: gefitinib only
Phase II

MedlinePlus related topics:   Cancer    Lung Cancer   

ChemIDplus related topics:   ZD1839    Simvastatin   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Open Label, Dose Comparison, Parallel Assignment, Safety/Efficacy Study
Official Title:   Randomized Phase II Trail Comparing Gefitinib Plus Simvastatin and Gefitinib Alone in Patients With Previously Treated Advanced Non-Small Cell Lung Cancer (NSCLC)

Further study details as provided by National Cancer Center, Korea:

Primary Outcome Measures:
  • Tumor response rate [ Time Frame: the ratio between the number of responders and number of patients assessable for tumor response ] [ Designated as safety issue: No ]
  • Time to progression [ Time Frame: From randomization date to disease progresssion or death date ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Time Frame: the first day of treatment to death ] [ Designated as safety issue: No ]
  • Toxicity [ Time Frame: the first day of treatment to 30 days after the last dose ] [ Designated as safety issue: Yes ]
  • Pharmacogenetic and biomarker study [ Time Frame: before the first treatment date, each response evaluation until disease progression ] [ Designated as safety issue: No ]

Estimated Enrollment:   94
Study Start Date:   May 2006
Estimated Study Completion Date:   February 2009
Estimated Primary Completion Date:   February 2009 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
1: Experimental
Iressa + simvastatin
Drug: Gefitinib+simvastatin
Gefitinib 250mg/QD po daily every 3 weeks plus Simvastatin 40mg/QD po daily every 3 weeks
2: Active Comparator
Iressa only
Drug: gefitinib only
gefitinib 250mg/QD po daily every 3 weeks

Detailed Description:

Randomization

  1. Sex (female vs. male)
  2. ECOG PS (0/1 vs. 2/3)
  3. Number of prior regimen (one vs. two).

Gefitinib (250 mg per day) + Simvastatin (40 mg per day) PO or Gefitinib (250 mg per day) alone

until progression or unacceptable toxicity

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  1. Histologic or cytologic diagnosis of NSCLC
  2. Stage IV or selected stage IIIB (with positive pleural effusion or multiple ipsilateral lung nodules) according to the American Joint Committee on Cancer (AJCC).
  3. Previously treated with at least one platinum-based chemotherapy.
  4. Before study entry, a minimum of 21 days must have elapsed since any prior chemotherapy.
  5. Prior radiation therapy is allowed as long as the irradiated area is not the only source of measurable disease.
  6. No other forms of cancer therapy, such as radiation, immunotherapy for at least 2 weeks before the enrollment in study.
  7. Performance status of 0-3 on the ECOG criteria.
  8. At least one unidimensional measurable lesion meeting Response Evaluation Criteria in Solid Tumors (RECIST. 2000).- Estimated life expectancy of at least 8 weeks.
  9. Patient compliance that allow adequate follow-up.
  10. Adequate hematologic (ANC count ≥ 1,000/uL, platelet count ≥ 150,000/mm3), hepatic (bilirubin level≤1.5 mg/dL, AST/ALT ≤ 80 IU/L), and renal (creatinine concentration ≤ 1.5 mg/dL) function.
  11. Informed consent from patient or patient's relative.
  12. Males or females at least 18 years of age.
  13. If female: childbearing potential either terminated by surgery, radiation, or menopause, or attenuated by use of an approved contraceptive method (intrauterine device [IUD], birth control pills, or barrier device) during and for 3 months after trial. If male, use of an approved contraceptive method during the study and 3 months afterwards. Females with childbearing potential must have a urine negative hCG test within 7 days prior to the study enrollment.
  14. No concomitant prescriptions including cyclosporin A, valproic acid, phenobarbital, phenytoin, ketoconazole.
  15. Patients with brain metastasis are allowed unless there were clinically significant neurological symptoms or signs

Exclusion Criteria:

  1. Presence of small-cell lung cancer alone or with NSCLC- Unresolved chronic toxic effects from previous anticancer therapy
  2. Known severe hypersensitivity to gefitinib or any of the tablet excipients
  3. Inability to swallow tablets
  4. Other coexisting malignant disease (apart from basal-cell carcinoma)
  5. More than three previous chemotherapy regimens for NSCLC
  6. Previous treatment with an experimental agent of which the main mechanism of action is inhibition of epidermal growth factor receptor or its associated tyrosine kinase
  7. Concomitant use of phenytoin, carbamazepine, rifampicin, barbiturates, or St John's wort; severe or uncontrolled systemic disease; clinically active interstitial lung disease (except uncomplicated lymphangitic carcinomatosis) pregnancy; and breastfeeding.
  8. MI within preceding 6 months or symptomatic heart disease, including unstable angina, congestive heart failure or uncontrolled arrhythmia
  9. Serious concomitant infection including post obstructive pneumonia
  10. Major surgery other than biopsy within the past two weeks.
  11. Pregnant or breast-feeding.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00452244

Contacts
Contact: Ji-Youn Han, M.D.,Ph.D.     +82-31-920-1154     jymama@ncc.re.kr    

Locations
Korea, Republic of, Gyeonggi-do
National Cancer Center, Korea     Recruiting
      Goyang-si, Gyeonggi-do, Korea, Republic of
      Sub-Investigator: Jin Soo Lee, M.D.            
      Sub-Investigator: Heung Tae Kim, M.D.            
      Sub-Investigator: Soo-Hyun Lee, M.D.            
      Principal Investigator: Ji-Youn Han, M.D.            
      Sub-Investigator: Tak Yun, M.D.            

Sponsors and Collaborators
National Cancer Center, Korea

Investigators
Principal Investigator:     Ji-Youn Han, M.D.,Ph.D.     National Cancer Center, Korea    
  More Information


Responsible Party:   National Cancer Center, Korea ( Ji-Youn Han )
Study ID Numbers:   NCCCTS-06-177
First Received:   March 26, 2007
Last Updated:   January 25, 2008
ClinicalTrials.gov Identifier:   NCT00452244
Health Authority:   South Korea: Korea Food and Drug Administration (KFDA)

Keywords provided by National Cancer Center, Korea:
Gefitinib  
Simvastatin  
NSCLC  
Advanced NSCLC  

Study placed in the following topic categories:
Thoracic Neoplasms
Non-small cell lung cancer
Respiratory Tract Diseases
Simvastatin
Lung Neoplasms
Lung Diseases
Gefitinib
Carcinoma, Non-Small-Cell Lung

Additional relevant MeSH terms:
Antimetabolites
Respiratory Tract Neoplasms
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antilipemic Agents
Enzyme Inhibitors
Anticholesteremic Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses

ClinicalTrials.gov processed this record on October 20, 2008




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