Phase II Open-Label Study of Volociximab (M200) in Combination With Erlotinib (Tarceva™) in Previously Treated Patients With Locally Advanced (Stage IIIb) or Metastatic (Stage IV) Non-Small Cell Lung Cancer
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed locally advanced (stage IIIB) or metastatic
(stage IV) non-small cell lung cancer (NSCLC)
- Failed ≥ 1 prior chemotherapy regimen OR refused first-line therapy
- Measurable disease
- No active and untreated CNS tumor or metastasis
- Previously treated CNS tumor(s) allowed if CT scan or MRI shows clear-cut
response or resolution of the original lesion(s)
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
- Hemoglobin ≥ 9.0 g/dL
- WBC ≥ 2,500/mm^3
- Absolute neutrophil count ≥ 1,000/mm^3 (growth factor independent)
- Platelet count ≥ 100,000/mm^3
- Total bilirubin ≤ 1.5 mg/dL
- AST and ALT ≤ 3 times upper limit of normal (ULN) (5 times ULN if patient has liver
metastases)
- Alkaline phosphatase ≤ 5 times ULN
- Serum creatinine ≤ 2.0 mg/dL
- PT/PTT normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective (double barrier or abstinence) contraception
- No uncontrolled seizure disorder or active neurological disease
- No thromboembolic events (i.e., stroke or deep vein thrombosis) within the past year
- No clinically significant medical condition that would complicate compliance with
study treatment or be exacerbated by bleeding, including but not limited to:
- Known bleeding disorders, such as coagulation defects and thrombasthenias
- Active gastric or duodenal ulcer
- History of gastrointestinal (GI) bleeding requiring transfusion within the past
year
- History of tumor bleeding
- History of significant hemoptysis requiring intervention (i.e., transfusion,
laser therapy, surgical treatment, or radiation) within the past year
- No known active infections requiring IV antibiotics, antivirals, or antifungals
(e.g., HIV, hepatitis B, or hepatitis C infection)
- No unstable cardiac disease, including any of the following:
- Poorly controlled angina
- Congestive heart failure
- Arrhythmias
- Myocardial infarction within the past year
- Acute ischemia by ECG
- Untreated significant conduction abnormality
- Bifascicular block (defined as left anterior hemiblock in the presence of
right bundle branch block)
- Second- or third-degree atrioventricular block
- No asthma or oxygen-dependent chronic pulmonary disease
- No cerebrovascular event (e.g., stroke or transient ischemic attack) within the past
year
- No peripheral vascular disease requiring surgery within the past year
- No clinically significant or unstable medical condition, including, but not limited
to, any of the following:
- Diabetes mellitus requiring insulin
- Uncontrolled hypertension
- Uncontrolled or symptomatic orthostatic hypertension
- No serious psychiatric illness, active alcoholism, or drug addiction that may
preclude study treatment
- No condition that, in the investigator's opinion, would make the patient unsuitable
for study treatment
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Prior immunotherapy, including monoclonal antibodies, or vaccine therapy allowed
- No systemic biologic, immunotherapy, or radiation therapy within the past 4 weeks
- Local radiotherapy to a single site of bone metastasis within the past 2 weeks
allowed provided patient has recovered from any side effects
- No prior volociximab, epidermal growth factor receptor (EGFR) tyrosine kinase
inhibitors, or inhibitors of α5β1 integrin (antibodies or small molecules)
- No known hypersensitivity to murine proteins or chimeric antibodies or other
components of study drugs
- No other investigational drug within the past 4 weeks or 5 half-lives (whichever is
longer)
- No monoclonal antibody therapy within the past 4 weeks or 5 half-lives (whichever is
longer)
- No major surgery (e.g., thoracotomy) within 4 weeks prior to study entry
- No minor surgery (e.g., central venous line placement) within 1 week prior to study
entry
- No sargramostim (GM-CSF) or filgrastim (G-CSF) within the past 7 days
- No prior bone marrow or stem cell transplantation
- No concurrent chronic medications that would interfere with study drug assessment
including, but not limited to:
- High-dose glucocorticoids (prednisone ≥ 20 mg/day or equivalent)
- Chronic nonsteroidal anti-inflammatory drugs (NSAIDs)
- Infrequent or as occasion requires use of NSAIDs allowed
- No concurrent high-dose aspirin (> 81 mg/day), high-dose warfarin, or heparin
- Aspirin ≤ 81 mg/day, low-dose warfarin (1 mg/day), or low-dose heparin for
IV-catheter patency allowed
- No concurrent chemotherapy, therapeutic radiation, or anticancer hormonal therapy
- No other concurrent immunotherapy
- No other concurrent potentially antiangiogenic therapy (e.g., cyclo-oxygenase-2
inhibitors, thalidomide, or tretinoin)