Lung Cancer Clinical Trial
Official title:
A Multicenter Phase II Trial of Carboplatin, Pemetrexed, and Bevacizumab Followed By Pemetrexed and Bevacizumab Maintenance Therapy in Patients With a Light or Never Smoking History
RATIONALE: Drugs used in chemotherapy, such as carboplatin, work in different ways to stop
the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Pemetrexed disodium may stop the growth of tumor cells by blocking some of the enzymes needed
for cell growth. Monoclonal antibodies, such as bevacizumab, can block tumor growth in
different ways. Some block the ability of tumor cells to grow and spread. Others find tumor
cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop
the growth of non-small cell lung cancer by blocking blood flow to the tumor. Giving
carboplatin and pemetrexed disodium together with bevacizumab may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving carboplatin and pemetrexed disodium
together with bevacizumab works in treating patients with stage III or stage IV non-small
cell lung cancer who are light or never smokers.
OBJECTIVES:
Primary
- To estimate the progression-free survival (PFS) of patients with advanced non-small cell
lung cancer who are never or light smokers treated with carboplatin, pemetrexed
disodium, and bevacizumab followed by pemetrexed disodium and bevacizumab maintenance
therapy.
Secondary
- To estimate the overall survival (OS) of patients treated with this regimen.
- To estimate the toxicity of treatment using the NCI CTCAE version 3.0.
- To conduct an exploratory analysis of molecular markers, e.g., Kirsten rat sarcoma
(KRAS) and epidermal growth factor receptor (EGFR) mutations, in patients with a never
or light smoking history and to analyze any potential association with response, PFS,
and OS.
- To assess response to second-line erlotinib hydrochloride therapy according to RECIST
criteria.
OUTLINE: This is a multicenter study.
- First-line therapy: Patients receive pemetrexed disodium IV over 10 minutes, carboplatin
IV over 30 minutes, and bevacizumab IV over 30-90 minutes on day 1. Treatment repeats
every 21 days for 4 courses in the absence of disease progression or unacceptable
toxicity. Patients who achieve partial or complete response or have stable disease
progress to maintenance therapy.
- Maintenance therapy: Patients receive pemetrexed disodium IV over 10 minutes and
bevacizumab IV over 30 minutes on day 1. Treatment repeats every 21 days in the absence
of disease progression or unacceptable toxicity.
Patients who experience disease progression or unacceptable toxicity may receive second-line
therapy with erlotinib hydrochloride as part of standard-of-care treatment.
Tissue samples are collected at baseline for laboratory biomarker analysis.
After completion of maintenance therapy, patients are followed every 4 weeks for 2 months.
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