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Phase II Avastin Trial for Stage IIIB/IV NSCLC
This study is currently recruiting participants.
Verified by Pharmatech, October 2008
Sponsors and Collaborators: Pharmatech
Genentech
Sanofi-Aventis
Information provided by: Pharmatech
ClinicalTrials.gov Identifier: NCT00766246
  Purpose

This is a randomized, open-label, multicenter study in 160 patients in first line treatment and 114 in second line treatment with advanced or metastatic NSCLC (Stage IIIB/IV).


Condition Intervention Phase
Stage IIIB or IV Non-Small Cell Lung Cancer
Drug: bevacizumab
Drug: pemetrexed
Drug: docetaxel
Drug: carboplatin
Phase II

MedlinePlus related topics: Cancer Lung Cancer
Drug Information available for: Carboplatin Docetaxel Pemetrexed disodium Pemetrexed Bevacizumab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study
Official Title: A Multicenter, Open-Label, Randomized, Phase II Trial of Docetaxel, Carboplatin and Bevacizumab as First-Line Treatment, Followed by Bevacizumab Plus Pemetrexed Versus Pemetrexed Alone as Second-Line Treatment of Stage IIIB or IV Non-Small Cell Lung Cancer

Further study details as provided by Pharmatech:

Primary Outcome Measures:
  • Progression-free survival (PFS) of bevacizumab and pemetrexed compared to pemetrexed monotherapy during second-line treatment of Stage IIIB or IV NSCLC [ Time Frame: Duration of study ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall Survival (OS) [ Time Frame: Duration of the study ] [ Designated as safety issue: No ]
  • Objective tumor response (objective response rate [ORR]) in second-line treatment [ Time Frame: Duration of the study ] [ Designated as safety issue: No ]
  • Progression-free survival (PFS) in first-line and maintenance treatment [ Time Frame: Duration of the study ] [ Designated as safety issue: No ]
  • Objective tumor response (objective response rate [ORR]) in first-line and maintenance treatment [ Time Frame: Duration of the study ] [ Designated as safety issue: No ]
  • Treatment safety in first-line, maintenance and second-line treatment [ Time Frame: Duration of the study ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 160
Study Start Date: October 2008
Estimated Study Completion Date: August 2013
Estimated Primary Completion Date: February 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
First-line: Experimental
  • Open-label, single arm with treatment period up to 6 cycles.
  • Patients completing a total of 2 to 6 cycles of first-line without disease progression will be eligible for maintenance.
  • Patients completing a total of 2 to 6 cycles of first-line with disease progression will be eligible for second-line randomization.
Drug: bevacizumab
15 mg/kg administered in 21 day cycles on day 1 of each cycle for first-line, maintenance, and second-line treatments
Drug: docetaxel
75 mg/m2 administered in 21-day cycles on day 1 of each cycle for first line treatment
Drug: carboplatin
AUC=6 administered in 21-day cycles on day 1 of each cycle for first-line treatment
Maintenance: Experimental
  • Open-label, single arm with treatment period up to 18 cycles.
  • Upon disease progression patients will be eligible for second-line.
Drug: bevacizumab
15 mg/kg administered in 21 day cycles on day 1 of each cycle for first-line, maintenance, and second-line treatments
Second-Line Arm A: Active Comparator
  • Open-label, randomized, double arm with treatment period until disease progression.
  • Patients will be followed until death, withdrawal of consent or lost to follow-up.
  • Pemetrexed plus bevacizumab administered in 21 day cycles on day 1 of each cycle.
Drug: bevacizumab
15 mg/kg administered in 21 day cycles on day 1 of each cycle for first-line, maintenance, and second-line treatments
Drug: pemetrexed
500 mg/m2 administered in 21-day cycles on day 1 of each cycle for second-line treatment
Second-Line Arm B: Active Comparator
  • Open-label, randomized, double arm with treatment period until disease progression.
  • Patients will be followed until death, withdrawal of consent or lost to follow-up.
  • Pemetrexed administered in 21-day cycles on day 1 of each cycle.
Drug: pemetrexed
500 mg/m2 administered in 21-day cycles on day 1 of each cycle for second-line treatment

Detailed Description:

This phase II clinical trial will address the issues of bevacizumab treatment duration and treatment safety as first-line therapy for patients with non-squamous NSCLC. Following disease progression or treatment failure, the potential benefit of continued bevacizumab therapy will be tested by randomizing patients to two treatment arms, including second-line chemotherapy with or without further bevacizumab. It is hypothesized that continuation of bevacizumab with pemetrexed as second-line treatment following progression will result in improved clinical outcomes for patients with NSCLC.

  Eligibility

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

Inclusion Criteria:

  • Age ≥ 18 years
  • Histologically or cytologically confirmed stage IIIB with malignant pleural effusion or stage IV NSCLC except squamous-cell carcinoma
  • Measurable disease defined by RECIST
  • Adequate organ function:

    1. Absolute neutrophil count ≥ 1.5 x 10(9)/L
    2. Hemoglobin ≥ 9.0 g/dL
    3. Platelets ≥ 100 x 10(9)/L
    4. Hepatic enzyme levels: AST and ALT and Alkaline Phosphatase must be within range allowing for eligibility. In determining eligibility, the more abnormal of the two values (AST or ALT) should be used according to table listed in the protocol
    5. Bilirubin ≤ ULN
    6. Serum Creatinine ≤ 1.5 mg/dL (or creatinine clearance ≥ 60mL/min)
    7. Urine protein/creatinine ratio < 1.0 OR urine dipstick for proteinuria < 2 + (patients discovered to have ≥ 2 + proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate ≤1g of protein in 24 hours to be eligible)
    8. INR ≤ 1.5
    9. PTT ≤ ULN
  • ECOG Performance Status 0-1
  • Estimated survival of ≥ 12 weeks
  • Provide written informed consent

Exclusion Criteria:

  • Prior chemotherapy for advanced NSCLC
  • Neoadjuvant or adjuvant treatment within six (6) months of registration
  • Prior radiation therapy within three (3) weeks of registration; all side effects must have resolved by registration
  • Prior treatment with an investigational or marketed agent that acts by antiangiogenesis mechanisms
  • Large ( > 4 cm) centrally located lesions or large lesions in close proximity to major blood vessels unless treated with palliative radiation
  • Brain metastases or leptomeningeal disease, except for patients who have had a resection and/or completed a course of cranial irradiation, have no worsening CNS symptoms, and have discontinued all corticosteroids for that indication for at least one (1) month prior to registration
  • History of gross hemoptysis (defined as bright red blood of at least ½ teaspoon or 2.5 mL per episode) within three (3) months of registration unless definitively treated with surgery, radiation, arteriographic embolization, or endobronchial interventions at least four (4) weeks prior to registration
  • Presence of cavitory lesion
  • Presence of squamous histology (mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible; sputum cytology alone is not acceptable)
  • Peripheral neuropathy > grade 1
  • Major surgery, open biopsy or significant traumatic injury within four (4) weeks of registration or anticipation of need for major surgical procedure during the course of the study
  • Minor surgical procedures, fine needle aspirations or core biopsies within one (1) week prior to registration
  • Current, ongoing therapeutic anticoagulation with full-dose warfarin or its equivalent
  • Current or recent (within ten [10] days of the first dose of study treatment) use of aspirin (at least 325 mg/day) or other NSAIDs with anti-platelet activity or treatment with dipyridamole (Persantine), ticlopidine (Ticlid), clopidogrel (Plavix), or cilostazol (Pletal)
  • History of prior malignancy within the past three (3) years except for curatively treated basal cell carcinoma of the skin, cervical intra-epithelial neoplasia, or treated localized prostate cancer with a current PSA of < 1.0 mg/dL on two successive evaluations, at least three (3) months apart, with the most recent evaluation no more than four (4) weeks prior to registration
  • History of serious systemic disease including:

    1. Unstable angina, New York Heart Association (NYHA) ≥ Grade II or congestive heart failure
    2. Inadequately controlled hypertension (blood pressure >150/100 mmHg while taking antihypertensive medications)
    3. Unstable symptomatic arrhythmia requiring medication
    4. Myocardial infarction within six (6) months prior to registration
    5. Stroke within six (6) months prior to registration
    6. Transient ischemic attack within six (6) months prior to registration
    7. Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within six (6) months prior to registration
    8. Clinically significant peripheral vascular disease or evidence of bleeding, diathesis (prone to bleeding) or coagulopathy
    9. Active systemic bacterial, fungal or viral infection, including known HCV and HIV
  • Pregnancy or women who are breast-feeding; women of child-bearing potential and non-vasectomized men must agree to use effective methods of birth control during and three (3) months following treatment period and women of child-bearing potential must have a negative pregnancy test
  • History of severe hypersensitivity reaction to docetaxel or any other drugs formulated with polysorbate 80
  • Any other medical condition, including mental illness or substance abuse, which in the judgment of the investigator, is likely to interfere with a patient's ability to provide informed consent, cooperate, and participate in the study, or to interfere with the interpretation of the results
  • Use of any investigational agent within four (4) weeks prior to registration
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00766246

Contacts
Contact: Joel Aronoff 720-917-7452 joela@pharmatech.com
Contact: Nikos Sophos 720-917-7470 nickolass@pharmatech.com

Locations
United States, Pennsylvania
Penn State Milton S. Hershey Medical Center Penn State College of Medicine Penn State Hershey Cancer Institute, H072 Recruiting
Hershey, Pennsylvania, United States, 17033
Contact: Chandra P Belani, MD     717-531-1078        
Contact: Cindy Naret     717-531-5232        
Principal Investigator: Chandra P. Belani, MD            
Sponsors and Collaborators
Pharmatech
Genentech
Sanofi-Aventis
Investigators
Principal Investigator: Chandra P Belani, MD Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Penn State Hershey Cancer Institute
  More Information

Pharmatech's Active Clinical Trials  This link exits the ClinicalTrials.gov site

Responsible Party: Penn State Hershey Cancer Institute ( Chandra P. Belani, M.D./Principal Investigator )
Study ID Numbers: PSHCI 08-009
Study First Received: October 1, 2008
Last Updated: October 2, 2008
ClinicalTrials.gov Identifier: NCT00766246  
Health Authority: United States: Institutional Review Board

Keywords provided by Pharmatech:
Non-Small Cell Lung Cancer
Advanced Non-Small Cell Lung Cancer
Lung Cancer

Study placed in the following topic categories:
Thoracic Neoplasms
Non-small cell lung cancer
Bevacizumab
Carboplatin
Carcinoma
Docetaxel
Pemetrexed
Folic Acid
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Antimetabolites
Respiratory Tract Neoplasms
Neoplasms by Histologic Type
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Folic Acid Antagonists
Angiogenesis Inhibitors
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents

ClinicalTrials.gov processed this record on January 16, 2009