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Randomized Phase II Study of Eicosanoid Pathway Modulators and Cytotoxic Chemotherapy in Advanced Non-Small Cell Lung Cancer


Phase 2
18 Years
N/A
Not Enrolling
Both
Lung Cancer

Thank you

Trial Information

Randomized Phase II Study of Eicosanoid Pathway Modulators and Cytotoxic Chemotherapy in Advanced Non-Small Cell Lung Cancer


OBJECTIVES:

Primary

- Compare the efficacy of carboplatin and gemcitabine with celecoxib and/or zileuton, in
terms of 7-month progression-free survival, in patients with advanced non-small cell
lung cancer.

Secondary

- Compare the response rate, distribution of survival, and failure-free survival time of
patients treated with these regimens.

- Correlate CYFRA and serum vascular endothelial growth factor levels with response and
survival of patients treated with these regimens.

- Correlate cyclo-oxygenase-2 and 5-lipoxygenase expression with survival of patients
treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 3
treatment arms.

- Arm I: Patients receive gemcitabine IV over 30 minutes on days 1 and 8, carboplatin IV
over 30 minutes on day 1, and oral zileuton 4 times daily on days 1-21.

- Arm II: Patients receive gemcitabine and carboplatin as in arm I and oral celecoxib
twice daily on days 1-21.

- Arm III: Patients receive gemcitabine and carboplatin as in arm I, oral celecoxib as in
arm II, and oral zileuton as in arm I.

In all arms, treatment repeats every 21 days for 6 courses. Patients with responding or
stable disease continue courses of zileuton and/or celecoxib in the absence of disease
progression or unacceptable toxicity.

Patients are followed monthly for 1 year, every 2 months for 2 years, and then every 4
months for 3 years or until disease progression.

PROJECTED ACCRUAL: A total of 117 patients (39 per treatment arm) will be accrued for this
study within 11-12 months.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed non-small cell lung cancer (NSCLC) of 1 of
the following cellular types:

- Adenocarcinoma

- Large cell

- Squamous cell

- Mixed

- Meets 1 of the following staging criteria:

- Stage IIIB disease with malignant pleural effusion, supraclavicular node
involvement, or contralateral hilar nodes

- Stage IIIB patients eligible for Cancer and Leukemia Group B protocols of
combined chemotherapy and chest irradiation are not allowed

- Stage IV disease

- Measurable or nonmeasurable disease

- Unidimensionally measurable lesions at least 20 mm by conventional techniques OR
at least 10 mm by spiral CT scan

- The following are considered nonmeasurable disease:

- Bone lesions

- Ascites

- Pleural/pericardial effusion

- Lymphangitis cutis/pulmonis

- Abdominal masses that are not confirmed and followed by imaging techniques

- Cystic lesions

- Small lesions

- No leptomeningeal disease

- Symptomatic CNS metastases must be treated (e.g., surgery, radiotherapy, or gamma
knife), neurologically stable, and off steroids

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- ECOG 0-2

Life expectancy

- Not specified

Hematopoietic

- Granulocyte count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

Hepatic

- Bilirubin no greater than 1.5 mg/dL

- AST no greater than 2.0 times upper limit of normal

Renal

- Creatinine no greater than 1.5 mg/dL

Cardiovascular

- None of the following within the past 6 months:

- Myocardial infarction

- Unstable angina

- Symptomatic congestive heart failure

- Serious uncontrolled cardiac arrhythmia

- Cerebrovascular accident

- Transient ischemic attack

- Symptomatic carotid artery or peripheral vascular disease

- Deep vein thrombosis

- Significant thromboembolic event

Pulmonary

- No pulmonary embolism within the past 6 months

Gastrointestinal

- No history of gastrointestinal (GI) bleeding

- No history of peptic ulcer disease

- No active GI bleeding

Other

- Not pregnant or nursing

- No known hypersensitivity to aspirin, NSAIDs, or sulfonamides

- No currently active second malignancy other than nonmelanoma skin cancer

- Patients are not considered to have a currently active malignancy if they have
completed therapy and are considered by their physician to be at less than 30%
risk of relapse

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No prior immunotherapy for NSCLC

Chemotherapy

- No prior chemotherapy for NSCLC

- No other concurrent chemotherapy

Endocrine therapy

- See Disease Characteristics

- No concurrent chronic oral steroids

- Concurrent episodic steroids for antiemetic purposes allowed

- No concurrent hormonal therapy

- Concurrent inhaled steroids allowed when medically indicated

- Concurrent megestrol for appetite stimulation is allowed

Radiotherapy

- See Disease Characteristics

- At least 2 weeks since prior radiotherapy and recovered

Surgery

- See Disease Characteristics

- At least 2 weeks since prior surgery and recovered

Other

- No prior systemic treatments for NSCLC

- No other concurrent investigational therapy

- At least 1 week since prior nonsteroidal anti-inflammatory drugs (NSAIDs), including
any of the following:

- Rofecoxib

- Choline magnesium trisalicylate

- Ibuprofen

- Naproxen

- Etodolac

- Oxaprozin

- Diflunisal

- Nabumetone

- Tolmetin

- Valdecoxib

- No concurrent NSAIDs

- No concurrent chronic aspirin

- Concurrent aspirin no greater than 325 mg/day is allowed

- No concurrent fluconazole

- No concurrent leukotriene antagonists (e.g., zafirlukast, montelukast, or pranlukast)

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Disease free survival

Outcome Time Frame:

9 months

Safety Issue:

No

Principal Investigator

Martin J. Edelman, MD

Investigator Role:

Study Chair

Investigator Affiliation:

University of Maryland Greenebaum Cancer Center

Authority:

United States: Federal Government

Study ID:

CDR0000334573

NCT ID:

NCT00070486

Start Date:

December 2003

Completion Date:

May 2011

Related Keywords:

  • Lung Cancer
  • stage IV non-small cell lung cancer
  • adenocarcinoma of the lung
  • squamous cell lung cancer
  • large cell lung cancer
  • stage IIIB non-small cell lung cancer
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms

Name

Location

Memorial Sloan-Kettering Cancer Center New York, New York  10021
Walter Reed Army Medical Center Washington, District of Columbia  20307-5000
University of Chicago Cancer Research Center Chicago, Illinois  60637
University of Minnesota Cancer Center Minneapolis, Minnesota  55455
Duke Comprehensive Cancer Center Durham, North Carolina  27710
CCOP - Kansas City Kansas City, Missouri  64131
CCOP - Southern Nevada Cancer Research Foundation Las Vegas, Nevada  89106
CCOP - Christiana Care Health Services Wilmington, Delaware  19899
CCOP - Mount Sinai Medical Center Miami Beach, Florida  33140
CCOP - North Shore University Hospital Manhasset, New York  11030
CCOP - Southeast Cancer Control Consortium Winston-Salem, North Carolina  27104-4241
MBCCOP - Massey Cancer Center Richmond, Virginia  23298-0037
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
Comprehensive Cancer Center at Wake Forest University Winston-Salem, North Carolina  27157-1082
Western Pennsylvania Hospital Pittsburgh, Pennsylvania  15224
Martha Jefferson Hospital Charlottesville, Virginia  22901
MBCCOP - University of Illinois at Chicago Chicago, Illinois  60612
CCOP - Evanston Evanston, Illinois  60201
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
Ellis Fischel Cancer Center at University of Missouri - Columbia Columbia, Missouri  65203
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire  03756-0002
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Chapel Hill, North Carolina  27599-7570
North Shore University Hospital Manhasset, New York  11030
Veterans Affairs Medical Center - Chicago (Westside Hospital) Chicago, Illinois  60612
Naval Medical Center - San Diego San Diego, California  92134-3202
Veterans Affairs Medical Center - San Francisco San Francisco, California  94121
Baptist Hospital East - Louisville Louisville, Kentucky  40207
CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C. Syracuse, New York  13217
Veterans Affairs Medical Center - Minneapolis Minneapolis, Minnesota  55417
Veterans Affairs Medical Center - Columbia (Truman Memorial) Columbia, Missouri  65201
Veterans Affairs Medical Center - Buffalo Buffalo, New York  14215
Veterans Affairs Medical Center - Syracuse Syracuse, New York  13210
Veterans Affairs Medical Center - Durham Durham, North Carolina  27705
Rebecca and John Moores UCSD Cancer Center La Jolla, California  92093-0658
Broward General Medical Center Fort Lauderdale, Florida  33316
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute Boston, Massachusetts  02115
University of Massachusetts Memorial Medical Center - University Campus Worcester, Massachusetts  01655
Northeast Alabama Regional Medical Center Anniston, Alabama  36207
Veterans Affairs Medical Center - San Diego San Diego, California  92161
UCSF Comprehensive Cancer Center San Francisco, California  94115
Veterans Affairs Medical Center - Washington, DC Washington, District of Columbia  20422
Louis A. Weiss Memorial Hospital Chicago, Illinois  60640
West Suburban Center for Cancer Care River Forest, Illinois  60305
Fort Wayne Medical Oncology and Hematology, Incorporated Fort Wayne, Indiana  46885-5099
Veterans Affairs Medical Center - Las Vegas Las Vegas, Nevada  89106
Cooper University Hospital Camden, New Jersey  08103
Queens Cancer Center of Queens Hospital Jamaica, New York  11432
Veterans Affairs Medical Center - Asheville Asheville, North Carolina  28805
Cape Fear Valley Health System Fayetteville, North Carolina  28302-2000
FirstHealth Moore Regional Hospital Pinehurst, North Carolina  28374
Lifespan: The Miriam Hospital Providence, Rhode Island  02906
Veterans Affairs Medical Center - Dallas Dallas, Texas  75216
Virginia Oncology Associates - Norfolk Norfolk, Virginia  23502
St. Mary's Medical Center Huntington, West Virginia  25701
Oklahoma University Medical Center Oklahoma City, Oklahoma  73104
Mount Sinai Medical Center New York, New York  10029
Vermont Cancer Center at University of Vermont Burlington, Vermont  05405-0075
Lombardi Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
UNMC Eppley Cancer Center at the University of Nebraska Medical Center Omaha, Nebraska  68198-7680
New Hampshire Oncology-Hematology, PA - Hooksett Hooksett, New Hampshire  03106
NorthEast Oncology Associates - Concord Concord, North Carolina  28025
Arthur G. James Cancer Hospital at Ohio State University Columbus, Ohio  43210-1240
Oncology and Hematology Associates of Southwest Virginia, Incorporated - Roanoke Roanoke, Virginia  24014
Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph Saint Joseph, Michigan  49085
New York Weill Cornell Cancer Center at Cornell University New York, New York  10021
Zimmer Cancer Center at New Hanover Regional Medical Center Wilmington, North Carolina  28402-9025
Cedars-Sinai Comprehensive Cancer Center at Cedars-Sinai Medical Center Los Angeles, California  90048
University Hospital at State University of New York - Upstate Medical University Syracuse, New York  13210
Simmons Cancer Center at University of Texas Southwestern Medical Center - Dallas Dallas, Texas  75390-9063
Memorial Regional Cancer Center at Memorial Regional Hospital Hollywood, Florida  33021
Missouri Baptist Cancer Center St. Louis, Missouri  63131
Palm Beach Cancer Institute West Palm Beach, Florida  33401
Siteman Cancer Center Saint Louis, Missouri  63110