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A Randomized, Phase II ECOG Trial of Two Dose Levels of CCI-779 in Patients With Extensive-Stage Small Cell Lung Cancer Who Have Responding or Stable Disease After Induction Chemotherapy


Phase 2
18 Years
N/A
Not Enrolling
Both
Extensive Stage Small Cell Lung Cancer

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Trial Information

A Randomized, Phase II ECOG Trial of Two Dose Levels of CCI-779 in Patients With Extensive-Stage Small Cell Lung Cancer Who Have Responding or Stable Disease After Induction Chemotherapy


PRIMARY OBJECTIVES:

I. To study the progression-free survival in patients who receive a lower or a higher dose
of CCI-779, a cytostatic agent following cytoreductive chemotherapy in extensive SCLC.

II. To determine the toxicity of two treatment regimens involving a lower or a higher dose
of CCI-779.

SECONDARY OBJECTIVES:

I. To quantify the effects of CCI-779 treatment on p70S6 phosphorylation in peripheral blood
mononuclear cells of patients with small cell lung cancer who are treated with CCI-779.

II. To measure the effects on mTOR activation and signaling of plasma from patients treated
with CCI-779.

III. To determine the relationship between CCI-779 dose and its pharmacodynamic parameters.

IV. To correlate the inhibition of p70S6 with indices of patient outcome.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to brain
metastases (yes vs no), prior induction chemotherapy regimen (platinum and etoposide vs
platinum and irinotecan), and response to prior induction chemotherapy (complete or partial
response vs stable disease). Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive low-dose CCI-779 IV over 30 minutes once weekly. Treatment continues
in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive high-dose CCI-779 as in arm I.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then
annually thereafter.


Inclusion Criteria:



- Patients must have histologically-confirmed small cell carcinoma of the lung or
unequivocally positive cytological evidence (sputum [at least 2] or aspirate biopsy),
with extensive disease (disease beyond the hemithorax and adjacent nodes,
supraclavicular node involvement or pleural effusion with positive cytology), who
have required induction chemotherapy, who have responding or stable disease, and who
meet the following criteria:

- Induction chemotherapy including platinum (cisplatin or carboplatin) plus either
etoposide (VP-16) or irinotecan (CPT-11)

- A minimum of 3 and a maximum of 6 cycles of induction chemotherapy have been
administered

- Recovered from all toxicity related to prior chemotherapy (except alopecia
and/or neuropathy)

- No less than 4 and no more than 8 weeks have elapsed between the last treatment
of induction chemotherapy and randomization

- No more than 32 weeks have elapsed between the first dose of induction
chemotherapy and date of randomization

- The patient has responding or stable disease using RECIST criteria since the
initiation of systemic chemotherapy (i.e., patients who have exhibited disease
progression are NOT ELIGIBLE)

- Patients must be disease-free for >= 5 years if they have had a prior second
malignancy other than treated basal cell or squamous cell skin cancer, or carcinoma
in situ of the cervix

- Baseline measurements/evaluations of disease must be obtained =< 4 weeks prior to
randomization

- WBC >= 4000/mm³ or

- ANC >= 1500/mm³

- Platelet count >= 100,000/mm³

- Total bilirubin =< 1.5 mg/dl

- Creatinine =< 1.5 mg/dl

- Patient's cholesterol level must be < 350mg/dl; (note; if non-fasting levels are high
repeat in a fasting state)

- Patient's triglycerides must be < 400mg/dl; (note; if non-fasting levels are high
repeat in a fasting state)

- ECOG performance status 0, 1, or 2

- Prior radiation to any symptomatic site is permitted so long as the site(s) of
measurable disease are NOT irradiated, and radiation is completed at least 4 weeks
before randomization

- Patients must not have had prior treatment with biological response modifiers

- Patients with brain metastases are eligible provided they have received treatment,
are asymptomatic and are no longer taking corticosteroids; patients who develop brain
metastases after completion of induction chemotherapy are ineligible

- Patients must not be on anticonvulsant therapy

- Patients must not have limited disease

- Patients must not become pregnant and must practice adequate contraception; women of
child-bearing potential and men must agree to use adequate contraception (hormonal or
barrier method of birth control) prior to study entry, for the duration of study
participation and continue approximately 12 weeks after the study is completed;
should a woman become pregnant or suspect she is pregnant while participating in this
study, she should inform her treating physician immediately; female patients who are
breastfeeding are also excluded from this study

- Patients must not have history of allergic reactions attributed to compounds of
similar chemical or biologic composition to CCI-779, or to any of the components of
the CCI-779 formulation; patients must also not be allergic to or for medical reasons
are unable to receive antihistamines

- Patients must not be immunocompromised, have an active infection or serious
intercurrent infection, or have received known immunosuppressive therapies within 3
weeks randomization

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Progression-free survival (PFS)

Outcome Description:

A log-rank test will compare the PFS curves of both arms.

Outcome Time Frame:

Time to death or relapse, assessed up to 6 years

Safety Issue:

No

Principal Investigator

Kishan Pandya

Investigator Role:

Principal Investigator

Investigator Affiliation:

Eastern Cooperative Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2012-03146

NCT ID:

NCT00028028

Start Date:

February 2002

Completion Date:

Related Keywords:

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

Name

Location

Eastern Cooperative Oncology Group Boston, Massachusetts  02215