Stage IV Non-small Cell Lung Cancer Clinical Trial
Official title:
A Phase I, and Biologic Correlative Study of Erlotinib, in Combination With Cetuximab and Bevacizumab in Patients With Metastatic Renal Cell Carcinoma
This randomized phase I/II trial studies the side effects, best way to give, and best dose of erlotinib and bevacizumab when given with cetuximab and how well giving erlotinib and cetuximab together with or without bevacizumab works in treating patients with metastatic or unresectable kidney, colorectal, head and neck, pancreatic, or non-small cell lung cancer. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as cetuximab and 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. Cetuximab and bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving erlotinib together with cetuximab and/or bevacizumab may kill more tumor cells.
Status | Completed |
Enrollment | 66 |
Est. completion date | May 2008 |
Est. primary completion date | October 2007 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - One of the following histologically confirmed diagnoses: - Renal cell cancer - Clear cell histology - Metastatic or unresectable disease AND meets 1 of the following criteria: - Recurrent disease - Refractory to interleukin-2 (IL-2)- or interferon-based therapy - Previously untreated AND not a candidate for IL-2-based therapy - Colorectal, head and neck, pancreatic, or non-small cell lung cancer - Metastatic or unresectable disease - Progression after prior standard treatment - No evidence of CNS disease, including the following (part 2 only): - Primary brain tumor - Brain metastases - Paraffin embedded tumor blocks available - Performance status - ECOG 0-2 - Performance status - Karnofsky 60-100% - More than 12 weeks - Absolute neutrophil count = 1,500 mm^3 - Platelet count = 100,000 mm^3 - Bilirubin = 1.5 mg/dL - AST and ALT = 2.5 times upper limit of normal (ULN) (5 times ULN if liver metastasis is present) - PTT and INR = 1.5, unless receiving full-dose warfarin (part 2 only) - Creatinine = 1.5 times ULN - Creatinine clearance = 60 mL/min - Calcium < 10 mg/dL (hypocalcemic agents allowed) - No proteinuria* - Protein < 1 g on 24-hour urine collection* - No unstable angina pectoris - No cardiac arrhythmia - No symptomatic congestive heart failure - None of the following are allowed for part 2: - Myocardial infarction within the past 6 months - New York Heart Association class II-IV heart disease - Serious cardiac arrhythmia requiring medication - Peripheral vascular disease = grade II - Recent history of cerebrovascular accident - Uncontrolled hypertension (blood pressure = 150/85 mm Hg despite medication) - Other clinically significant cardiovascular disease - No gastrointestinal (GI) tract disease resulting in an inability to take oral medication - No GI tract disease resulting in a requirement for IV alimentation - No active peptic ulcer disease - No history of allergic reaction attributed to compounds of similar chemical or biologic composition to study drugs - No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies (part 2 only) - No ongoing or active infection - No active infection requiring parenteral antibiotics (part 2 only) - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception during and for 2 months after study treatment - No significant traumatic injury within the past 28 days (part 2 only) - No history of abnormalities of the cornea (e.g., dry eye syndrome, Sjögren's syndrome, or congenital abnormality [e.g., Fuch's dystrophy]) - No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the breast or cervix - No psychiatric illness or social situation that would preclude study compliance - No serious or non-healing wound ulcer or bone fracture (part 2 only) - No other uncontrolled illness - See Disease Characteristics - More than 4 weeks since prior immunotherapy - No prior cetuximab - No prior bevacizumab - Concurrent epoetin alfa or darbepoetin alfa allowed - More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) - More than 4 weeks since prior radiotherapy - No prior surgical procedures affecting absorption - Prior nephrectomy or resection of metastatic lesions allowed provided patient has fully recovered - More than 7 days since prior core biopsy* - More than 28 days since prior major surgery or open biopsy* - No concurrent major surgery* - Recovered from all prior therapy - No prior erlotinib - Concurrent bisphosphonates allowed - Concurrent full-dose anticoagulants allowed provided the following criteria are met (part 2 only): - In-range INR (usually between 2 and 3) AND on a stable dose of warfarin or low molecular weight heparin - No active bleeding - No pathological conditions that carry a high risk of bleeding (e.g., tumor involving major vessels or varices) - No other concurrent investigational agents - No concurrent combination antiretroviral therapy for HIV-positive patients - No other concurrent anticancer therapy |
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Cancer Therapy and Research Center at The UT Health Science Center at San Antonio | San Antonio | Texas |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Maximum tolerated dose (MTD) of erlotinib hydrochloride combined with cetuximab determined by dose-limiting toxicities (DLT) graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 3 (Part I) | The occurrence and maximal grade of toxicity for the whole duration of treatment will be listed and tabulated by type. | 28 days | Yes |
Primary | MTD of bevacizumab combined with cetuximab and erlotinib hydrochloride determined by DLT graded according to the CTCAE version 3 (Part II) | The occurrence and maximal grade of toxicity for the whole duration of treatment will be listed and tabulated by type. | 28 days | Yes |
Secondary | Antitumor activity defined as the number and extent (complete or partial) objective responses as well as objective stable disease as measured by RECIST criteria | The estimated rate and their 95% confidence interval, will be reported. | 6 months | No |
Secondary | Median time to progression | Up to 1 month | No | |
Secondary | Progression-free survival | From the start of the treatment until the date the criteria for progression are met or the date the patient is taken off study for any reason, assessed up to 1 month | No |
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