First-Line Treatment of A Comparison of 2 Treatments in Elderly Patients With Advanced NSCLC

Lung Cancer Clinical Trial

Official title:

A Randomized Phase II Trial of Pemetrexed/Gemcitabine/Bevacizumab or Pemetrexed/Carboplatin/Bevacizumab in the First-Line Treatment of Elderly Patients With Advanced Non-Small Cell Lung Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00456261
• Other study ID #: SCRI LUN 139
• Status: Completed
• Phase: Phase 2
• Start date: March 2007
• Est. completion date: September 2012

Study information

• Verified date: April 2022
• Source: SCRI Development Innovations, LLC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This trial will look at 2 different drug combinations that have well known safety profiles and are known to be active against non small cell lung cancer and combine them with bevacizumab, an experimental drug that has shown effectiveness when added to other drug combinations for advanced non-small cell lung cancer. The primary objective in this study is to see how well this combination of drugs keeps the cancer from getting worse in this elderly population of non-small cell lung cancer patients.

Description:

Patients in this study will be assigned to one of 2 treatment groups. The selection of the treatment groups will be done randomly by a computer.

The first group, Cohort A, will receive bevacizumab 10mg/kg by vein over 30-90 minutes followed by pemetrexed 500 mg/m2 by vein over 10 minutes followed by gemcitabine 1500 mg/m2 by vein over 30-60 minutes. This regimen will be given on day 1 and day 15 of each treatment cycle. Each cycle is 28 days long. As long as their disease does not worsen patients can receive up to a maximum of 6 cycles of this combination chemotherapy. Following that they can receive bevacizumab alone once every 2 weeks as long as their disease does not worsen.

The second group, Cohort B, will receive bevacizumab 15mg/kg by vein over 30-90 minutes followed by pemetrexed 500 mg/m2 by vein over approximately 10 minutes followed by carboplatin AUC=5 by vein over 30-60 minutes. This regimen will be given on day 1 of each treatment cycle. Each cycle is 21 days long. As long as their disease does not worsen patients can receive up to a maximum of 6 cycles of this combination chemotherapy. Following that they can receive bevacizumab alone once every 3 weeks as long as their disease does not worsen.

In both regimens vitamin B12 injections and Folic Acid pills will be given to reduce the occurrence of side effects from the treatment.

Each patient's disease will be evaluated at intervals by the proper scans or X-rays to see how well the cancer is responding to the treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 110
• Est. completion date: September 2012
• Est. primary completion date: February 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 70 Years and older

Eligibility

Inclusion Criteria:

• Histologically confirmed non-small cell bronchogenic carcinoma, (adenocarcinoma, or large cell carcinoma)

• Patients who have newly diagnosed unresectable stage III or stage IV disease are eligible.

• Must be at least 70 years of age

• Must have measurable disease by CT scan

• Must be able to be up and about and care for themselves

• May not have received prior treatment for stage III or IV disease

• Must have adequate white and red blood cells and platelets.

• Must be able to take Vitamin B12, Folic Acid and dexamethasone as stated in the study

• Must be able to understand the nature of this study and give written informed consent

• Adequate liver and kidney function

Exclusion Criteria:

• Past or current history of cancer with the exception of treated non- melanoma skin cancer or carcinoma in-situ of the cervix, or other cancers cured by local therapy alone and have been disease free for five years

• Female patients who are pregnant or are lactating are ineligible

• History of unstable angina or myocardial infarction within 6 months prior to beginning bevacizumab

• Brain metastasis - cancer that has spread to the brain

• Major surgical procedure, open biopsy, or significant traumatic injury within 6 weeks of beginning bevacizumab or anticipation of need for major surgical procedure during the course of the study

• Full-dose oral or by vein anticoagulation or receiving anti-clotting therapy within 10 days of starting treatment

• Serious nonhealing wound, ulcer, or bone fracture

• Bleeding or clotting disorders

• Uncontrolled high blood pressure or serious heart arrhythmia requiring medication

• History of abdominal fistula, gastrointestinal perforation, or intra- abdominal abscess within 6 months prior to beginning bevacizumab

• Chronic non-steroidal anti-inflammatory use is not allowed on study

• History of stroke or TIAs within the last 6 months

Please Note: There are additional inclusion/exclusion criteria. The study center will determine if you meet all of the criteria. If you do not qualify for the trial, study personnel will explain the reasons. If you do qualify, study personnel will explain the trial in detail and answer any questions you may have.

Related Conditions & MeSH terms

• Lung Cancer
• Lung Neoplasms

Intervention

Drug:
• Pemetrexed
pemetrexed 500 mg/m2
• Gemcitabine
gemcitabine 1500 mg/m2
• Bevacizumab
bevacizumab 10mg/kg bevacizumab 15mg/kg
• Carboplatin
carboplatin AUC=5

Locations

Country	Name	City	State
United States	Northeast Alabama Regional Medical Center	Anniston	Alabama
United States	Cancer Care of Western North Carolina	Asheville	North Carolina
United States	Graves-Gilbert Clinic	Bowling Green	Kentucky
United States	Associates in Hematology Oncology	Chattanooga	Tennessee
United States	Chattanooga Oncology Hematology Associates	Chattanooga	Tennessee
United States	Oncology Hematology Care	Cincinnati	Ohio
United States	Florida Cancer Specialists	Fort Myers	Florida
United States	Northeast Georgia Medical Center	Gainesville	Georgia
United States	Grand Rapids Clinical Oncology Program	Grand Rapids	Michigan
United States	NEA Baptist Clinic	Jonesboro	Arkansas
United States	Watson Clinic Center for Cancer Care and Research	Lakeland	Florida
United States	Consultants in Blood Disorders and Cancer	Louisville	Kentucky
United States	Wellstar Cancer Research	Marietta	Georgia
United States	Tennessee Oncology, PLLC	Nashville	Tennessee
United States	Methodist Cancer Center	Omaha	Nebraska
United States	Mercy Hospital	Portland	Maine
United States	Spartanburg Regional Medical Center	Spartanburg	South Carolina
United States	Providence Medical Group	Terre Haute	Indiana

Sponsors (3)

Lead Sponsor	Collaborator
SCRI Development Innovations, LLC	Eli Lilly and Company, Genentech, Inc.

Country where clinical trial is conducted

United States, 

References & Publications (1)

Spigel DR, Hainsworth JD, Shipley DL, Ervin TJ, Kohler PC, Lubiner ET, Peyton JD, Waterhouse DM, Burris HA 3rd, Greco FA. A randomized phase II trial of pemetrexed/gemcitabine/bevacizumab or pemetrexed/carboplatin/bevacizumab in the first-line treatment of elderly patients with advanced non-small cell lung cancer. J Thorac Oncol. 2012 Jan;7(1):196-202. doi: 10.1097/JTO.0b013e3182307efe. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time to Progression (TTP), the Length of Time, in Months, That Patients Were Alive From Their First Date of Protocol Treatment Until Worsening of Their Disease	Time to Progression (TTP) is defined as the interval between the date of treatment initiation and the date of progressive disease. Progression is defined using the Response Evaluation Criteria in Solid Tumors (RECIST v1.0). Progressive Disease (PD): At least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or unequivocal progression of non-target lesions or the appearance of one or more new lesions.	From the date of treatment initiation until the date of first documented PD or date of last study contact or date of other therapy begins up to 18 months
Secondary	Overall Response Rate (ORR), the Percentage of Patients Who Experience an Objective Benefit From Treatment	Overall response rate (ORR) is defined as the percentage of patients who have a partial or complete response to therapy. Responses were assessed by the Response Evaluation Criteria in Solid Tumors (RECIST; version 1.0). Complete Response: Disappearance of all target lesions, and disappearance of all non-target lesions. Partial Response: At least a 30% decrease in the sum of the longest diameter of target lesions (taking as reference the baseline sum of longest diameters)	From date of treatment initiation to end of study treatment up to 18 months
Secondary	Overall Survival (OS), the Length of Time, in Months, That Patients Were Alive From Their First Date of Protocol Treatment Until Death	OS is defined as the time from the date of study entry until the date of death due to any cause. In the absence of confirmation of death or lack of data beyond follow-up period, the survival time was censored to the last date the participant was known to be alive.	From date of study entry until the date of death from any cause or the date the patient was last known alive, up to 18 months