Bendamustine With Irinotecan Followed by Etoposide/Carboplatin for Patients With Extensive Stage Small Cell Lung Cancer

Small Cell Lung Cancer Clinical Trial

Official title:

Phase I/IIa Study of the Novel Combination of Bendamustine With Irinotecan Followed by Etoposide/Carboplatin in Chemonaive Patients With Extensive Stage Small Cell Lung Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00856830
• Other study ID #: F080929010
• Secondary ID: UAB 0818
• Status: Completed
• Phase: Phase 1/Phase 2
• First received: March 5, 2009
• Last updated: July 7, 2016
• Start date: March 2009
• Est. completion date: May 2016

Study information

• Verified date: July 2016
• Source: University of Alabama at Birmingham
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

SCLC constitutes approximately 15% of the 170,000 new cases of lung cancer diagnosed annually in the United States(1). Extensive-Stage SCLC comprises two thirds of new cases and is generally considered sensitive to chemotherapy, despite a median time to progression of 4 months(2). SCLC is one of the most aggressive and lethal types of cancer, with a median survival of 9 months (range 7-11 months) in patients diagnosed with extensive disease(3). Overall, the majority of patients with SCLC die in less than 2 years (2-year survival rates generally less than 10%), and the 5-year survival rate is 2.3% for patients with extensive disease(4). The regimen of etoposide in combination with a platinum (cisplatin or carboplatin) is generally considered the "standard of care" although a recent Phase III trial suggests improved survival with the combination of cisplatin/irinotecan(5). Further evaluation of new agents in combination regimens attempting to overcome the intrinsic drug resistance seen in extensive-stage SCLC is warranted attempting to improve survival and achieve palliation of disease-related symptoms.

Description:

We are proposing a novel combination of bendamustine plus irinotecan followed by the standard regimen of etoposide with carboplatin. This will allow the investigation of response to the novel combination as well as any improvement in outcomes compared to historical controls.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: May 2016
• Est. primary completion date: May 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 79 Years

Eligibility

Inclusion Criteria:

• Histologic or cytologic diagnosis of extensive stage SCLC.

• Measurable or assessable tumor parameters.

• ECOG Performance Status 0-2.

• Age between 18 and 79 years (in the State of Alabama > 18).

• Adequate bone marrow, liver and renal function, defined as:

• Absolute neutrophil count (ANC) = 1500/µL

• Hemoglobin = 8g/dl

• Platelet count = 100,000/µL

• SGOT/SGPT = 2 x upper limit of normal or = 5 x upper limit of normal when liver metastases are present.

• Total bilirubin value = 2 x upper limit of normal.

• Serum creatinine value = 2 x upper limit of normal.

• Fully recovered from any previous surgery (at least 4 weeks since major surgery)

• Must have recovered from prior radiation therapy (at least 3 weeks)

• All subjects must agree to practice approved methods of birth control (if applicable). A negative pregnancy test must be documented during the screening period for women of childbearing potential.

• Must provide written informed consent and authorization to use and disclose health information (HIPAA).

• Extensive-stage SCLC as defined as disease not confined to one hemithorax, including ipsilateral pleural effusion or pericardial effusion.

• No prior chemotherapy.

Exclusion Criteria:

• Concurrent cancer chemotherapy, biologic therapy or radiotherapy.

• Administration of any investigational drug within 28 days prior to administration of the current therapy.

• Symptomatic brain metastases; those patients should be treated first with either whole brain radiation therapy or radiosurgery.

• Concurrent serious infection.

• Concomitant severe or uncontrolled underlying medical disease unrelated to the tumor, which is likely to compromise patient safety and affect the outcome of the study.

• History of other malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for a minimum of 2 years.

• Neuropathy at baseline = Grade 2.

• Any evidence or history of hypersensitivity or other contraindications for the drugs used in this trial.

• History of chronic diarrhea; or diarrhea (excess of 2-3 stools/day above normal frequency) in the past 2 weeks.

• History of a positive serology for human immunodeficiency virus (HIV).

• Psychiatric disorder that prevents patients from providing informed consent or following protocol instructions.

• Pregnant or lactating women.

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Chemonaive
• Extensive Stage Lung Cancer
• Lung Neoplasms
• Small Cell Lung Cancer
• Small Cell Lung Carcinoma

Intervention

Drug:
• Bendamustine, Irinotecan, Etoposide/Carboplatin (Novel drug combination)
Subjects will be treated with irinotecan (150 mg/m2) infusion on Day 1 followed by infusion of bendamustine on Days 1 and 2 at increasing dose levels using a 3+3 design (starting dose of 80-mg/m2/d with 20 mg/mg/d incremental increase to max 120 mg/m2/d) (Regimen A). This will be repeated every 3 weeks for a total of 3 cycles. Restaging for response will be performed prior to the next regimen. All subjects will then be given carboplatin (AUC 6) on day 1 and etoposide (100 mg/m2) on days 1, 2 and 3 (Regimen B). They will receive 3 cycles of this regimen every 3 weeks prior to restaging. At the end (3 weeks after) of the sixth total round of chemotherapy, subjects will be re-evaluated for response, and will be followed-up for recurrent disease every 8 weeks.

Locations

Country	Name	City	State
United States	University of Alabama at Birmingham	Birmingham	Alabama
United States	Georgia Cancer Specialists	Marietta	Georgia

Sponsors (2)

Lead Sponsor	Collaborator
University of Alabama at Birmingham	National Comprehensive Cancer Network

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum tolerated dose (MTD) and safety of the combination bendamustine and irinotecan in chemotherapy-naive patients with extensive SCLC		9 weeks - regimen given every 3 weeks for 3 cycles	Yes
Secondary	To investigate the time to progression of bendamustine/irinotecan in sequence with etoposide/carboplatin in chemonaive extensive stage SCLC patients.		9 weeks	Yes