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Study in Patients With Advanced Non-Small Cell Lung Cancer Treated With Pemetrexed and Carboplatin Plus or Minus Sorafenib

Information source: University Hospital Muenster
ClinicalTrials.gov processed this data on August 20, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Carcinoma, Non-Small-Cell Lung

Intervention: pemetrexed, carboplatin, sorafenib (Drug); pemetrexed, carboplatin, placebo (Drug)

Phase: Phase 1/Phase 2

Status: Terminated

Sponsored by: University Hospital Muenster

Official(s) and/or principal investigator(s):
Christian Brandts, MD, Principal Investigator, Affiliation: Universitätsklinikum Münster, Med. Klinik und Poliklinik A, Hämatologie, Onkologie und Pneumologie and Uniklinik Frankfurt Innere Medizin, Hämatologie/Onkologie, 60590 Frankfurt

Summary

The majority of patients with advanced NSCLC treated with standard platinum based chemotherapy regimens ultimately develop disease progression. Active therapies with improved toxicity profiles are clearly needed in this setting. The primary objective of this trial is to assess the toxicity profile and to determine the effect on progression free survival and time to progression in patients with advanced NSCLC treated with sorafenib in addition to carboplatin and pemetrexed.

Clinical Details

Official title: A Randomized (PhaseII), Double-blind, Multicenter Phase I/II Trial of Pemetrexed, Carboplatin Plus or Minus Sorafenib in the First-line Treatment of Patients With Stage IIIb or IV Non-Small Cell Lung Cancer

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment

Primary outcome:

Ph.1: Identify the recommended phase II dose of sorafenib for combination therapy with carboplatin and pemetrexed

Ph.2: Compare the PFS of carboplatin/pemetrexed + sorafenib or carboplatin/pemetrexed + placebo in patients with stage IIIb or IV non-small cell lung cancer

Secondary outcome:

Ph.1: Determine dose limiting toxicity

Ph 1: Determine the safety profile of the combination treatment

Ph 1: descriptive analysis of efficacy

Ph.2: Compare PFS of carboplatin/pemetrexed + sorafenib or carboplatin/pemetrexed + placebo in patients with stage IIIb or IV NSCLC

Ph 2: Assess time to progression in patients treated with either regimen

Ph 2: Determine the overall survival in patients treated with either regimen

Ph 2: Determine the objective response rate (CR, PR), disease control rate (CR,PR,SD), time to response and duration of response

Ph 2: Identify surrogate markers from the tumor biopsy or resection specimen from the time of diagnosis that predict response

Ph 2: Assess Quality of Life of patients treated with either regimen

Ph 2: Assess feasibility and toxicity profile of this regimen

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Histologically or cytologically confirmed NSCLC

- Locally advanced (stage IIIB with malignant pleural or pericardial effusion) or

metastatic (stage IV) NSCLC

- No prior systemic chemotherapy

- Prior local radiotherapy is allowed if it is completed at least 3 weeks prior to the

first dose of study medication; also concomitant palliative radiotherapy to an existing bone lesion for pain control is allowed

- Prior surgery is allowed if it is performed at least 4 weeks prior to the first dose

of study medication and patient should be fully recovered.

- Must have measurable disease with at least one lesion with a longest diameter

measured as ≥ 2 cm with conventional techniques or as ≥ 1 cm with spiral CT

- Age ≥18 years old

- ECOG performance score (PS) 0-1

- Life expectancy of at least 12 weeks

- Adequate bone marrow, renal and hepatic function

- hemoglobin ≥ 9. 0 g/dl

- absolute neutrophil count ≥1,500/mm3

- platelet count ≥ 100,000/mm3

- total bilirubin ≤ 1. 5 times the upper limit of normal

- ALT and AST ≤ 2. 5 times the upper limit of normal (≤ 5 x upper limit of normal

for patients with liver involvement)

- INR ≤ 1. 5 and aPTT within normal limits

- serum creatinine ≤ 1. 5 the upper limit of normal

- Patients with creatinine clearance ≥ 45 mL/min

- Not pregnant or nursing patients

- Women of childbearing potential must have a negative serum pregnancy test performed

within 7 days prior to the start of treatment

- Women of childbearing potential and men must agree to use adequate contraception

(barrier method of birth control) prior to study entry and for the duration of study participation. Men should use adequate birth control for at least six months after the last administration of sorafenib

- Signed informed consent prior to any study specific procedures

- Compliance and geographic proximity that allow adequate follow-up

Exclusion Criteria:

- Any prior systemic anticancer therapy including cytotoxic therapy, targeted agents,

experimental therapy (treatment within the last 30 days with a drug that has not received regulatory approval for any indication at the time of study enrollment), adjuvant, or neo-adjuvant therapy for NSCLC

- Any participation in a clinical trial 30 days prior to study entry and concomitantly

to the study

- Cardiac disease: Congestive heart failure > class II NYHA. Patients must not have

unstable angina (angina symptoms at rest) or new-onset angina (began within the last 3 months) or myocardial infarction within the past 6 months

- Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy

- Uncontrolled hypertension defined as systolic blood pressure > 150 mm Hg or diastolic

pressure > 90 mm Hg, despite optimal medical management

- Documented brain metastases (unless the patient is > 6 months from definitive therapy

for brain metastases, has a negative imaging study within 4 weeks of study entry and has been off corticosteroids for at least 4 weeks before study enrolment). Brain imaging (CT scan/MRI) is required in symptomatic patients to rule out brain metastases, but is not required in asymptomatic patients.

- Patients with seizure disorder requiring medication (such as steroids or

antiepileptics)

- Known HIV infection or chronic hepatitis B or C

- Active clinically serious infections > CTCAE Grade 2

- Presence of clinically significant third-space fluid collections, for example,

ascites or pleural effusions that cannot be controlled by drainage or other procedures prior to study enrolment

- Pulmonary hemorrhage/bleeding event >= CTCAE Grade 2 within 4 weeks of first dose of

study drug

- Any other hemorrhage/bleeding event > =Grade 3 within 4 weeks of first dose of study

drug

- Evidence or history of bleeding diathesis or coagulopathy

- Therapeutic anticoagulation with vitamin K antagonists such as phenprocoumon,

warfarin, or with heparins or heparinoids. Low dose anticoagulation is permitted

- Serious, non-healing wound, ulcer, or bone fracture

- Major surgery, open biopsy or significant traumatic injury within 4 weeks of first

dose of study drug

- Known or suspected allergy to sorafenib, carboplatin or pemetrexed

- Previous or current cancer that is distinct in primary site or histology from NSCLC

except cervical cancer in-situ, treated basal cell carcinoma, superficial bladder tumors (Ta and Tis) or any cancer curatively treated > 3 years prior to study entry

- Substance abuse, medical, psychological or social conditions that may interfere with

the patients participation in the study

- Significant weight loss (> or equal 10% body weight during preceeding 6 weeks)

- Inability to interrupt aspirin or other nonsteroidal anti-inflammatory agents, other

than an aspirin dose ≤ 1. 3 grams per day, for a 5-day period (8-day period for long-acting agents, such as piroxicam)

- Inability or unwillingness to take folic acid, vitamin B12 supplementation or

corticosteroids

- Recent (within 30 days of enrolment) or concurrent yellow fever vaccination

- Serious concomitant systemic disorder that, in the opinion of the investigator, would

compromise the patient's ability to adhere to the protocol.

Locations and Contacts

University of Muenster, Dept. of Medicine, Hematology / Oncology, Muenster 48145, Germany
Additional Information

Starting date: May 2007
Last updated: January 26, 2010

Page last updated: August 20, 2015

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