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Lung CancerPhase 2NCT00084409

Iloprost in Preventing Lung Cancer in Patients at High Risk for This Disease

A Phase 2 study testing iloprost in people with Lung Cancer and Precancerous Condition, run by University of Colorado, Denver at 6 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the development or recurrence of cancer. Iloprost may be effective in preventing lung cancer. PURPOSE: This randomized phase II trial is studying how well iloprost works in preventing lung cancer in patients who are at high risk for this… Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Lung Cancer, Precancerous Condition
What is being tested?
iloprost
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
152 participants
Where
6 sitesUnited States
Study dates
Nov 2001to Jan 2009
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Current or former smoker with ≥ 20 pack-year history of smoking with no tobacco use within the past 6 months
  • Mild atypia or worse on sputum cytology, or
  • Bronchial biopsy with mild or worse dysplasia within the past 12 months
  • Age 18 and over
  • SWOG (Southwest Oncology Group)0-2
  • Life expectancy at least 6 months
Show all 17Show fewer
  • Granulocyte count > 1,500/mm^3
  • Platelet count > 100,000/mm^3
  • Alkaline phosphatase ≤ 2.5 times upper limit of normal (ULN)
  • Transaminases ≤ 2.5 times ULN
  • Bilirubin ≤ 2.0 mg/dL
  • Albumin ≥ 2.5 g/dL
  • Creatinine ≤ 1.5 mg/dL
  • Well-controlled atrial fibrillation OR rare (< 2 minutes) premature ventricular contractions allowed
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able and willing to undergo bronchoscopy

Who cannot join

  • Clinically apparent bleeding diathesis
  • Ventricular tachycardia
  • Multifocal premature ventricular contractions or supraventricular tachycardias with rapid ventricular response
  • Pneumonia or acute bronchitis within the past 2 weeks
  • Hypoxemia (< 90% saturation with supplemental oxygen)
  • Pregnant or nursing
Show all 19Show fewer
  • Malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • Serious medical condition that would preclude bronchoscopy or study participation
  • Clinically active coronary artery disease
  • Myocardial infarction within the past 6 weeks
  • Chest pain
  • Congestive heart failure
  • Cardiac dysrhythmia that is potentially life-threatening
  • Biologic therapy (Not specified)
  • More than 5 years since prior chemotherapy
  • More than 6 weeks since prior inhaled steroids
  • More than 5 years since prior thoracic radiotherapy
  • Surgery (Not specified)
  • No prior prostacyclin

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United States6 sites
  • University of Colorado Cancer Center at UC Health Sciences Center

    Aurora, Colorado, 80045

  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, 21231-2410

  • Veterans Affairs Medical Center - Denver

    Denver, Colorado, 80220

  • Vanderbilt-Ingram Cancer Center

    Nashville, Tennessee, 37232-6838

  • UPMC Cancer Centers

    Pittsburgh, Pennsylvania, 15232

  • Mayo Clinic Cancer Center

    Rochester, Minnesota, 55905

Other trials in United States

About this study

Official title: A Randomized Phase II Chemoprevention Study of Iloprost Versus Placebo in Patients at High Risk for Lung Cancer

RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the development or recurrence of cancer. Iloprost may be effective in preventing lung cancer.

PURPOSE: This randomized phase II trial is studying how well iloprost works in preventing lung cancer in patients who are at high risk for this disease.

Read the detailed description

OBJECTIVES:

Primary

  • Compare the reversal of premalignant histological changes in the bronchial epithelium of patients at high risk for lung cancer (defined by > 20 pack years of smoking and sputum atypia) treated with iloprost vs placebo.
  • Determine whether this drug modulates Ki-67 proliferation index (Antigen Ki-67) in these patients.
  • Determine whether this drug affects prostaglandin metabolism in these patients.
  • Determine the toxicity profile of this drug in these patients.

Secondary

  • Determine whether this drug modulates a panel of biomarkers, including MCM-2(Minichromosome maintenance protein: forms DNA helicase), EGFR (Epidermal growth factor receptor: cell surface receptor for the epidermal growth factor family of proteins. Mutations in EGFR expression or activity can result in cancer.) , HER2/neu (Human epidermal growth factor receptor 2 HER2 is a member of the EGFR family), RARβ (Retinoic Acic Receptor Beta is a nuclear transcription regulator and a member of the thyroid-steroid hormone receptor superfamily), p53, FHIT (Fragile histidine triad protein is an enzyme involved in purine metabolism and had been demonstrated to be a tumor suppressor), apoptotic index, and microvessel density, in these patients.
  • Determine the genes whose expression is altered by this drug in these patients.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to smoking status (current vs former) and participating center. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral iloprost twice daily.
  • Arm II: Patients receive oral placebo twice daily. In both arms, treatment continues for 6 months in the absence of unacceptable toxicity.

Patients are followed at 1 month and then annually thereafter.

PROJECTED ACCRUAL: A total of 152 patients (76 [38 current smokers and 38 former smokers] per treatment arm) will be accrued for this study within 2 years.

Being tested
iloprost, placebo
Keywords
non-small cell lung cancer, squamous lung dysplasia
Medical subject headings
Lung Neoplasms, Precancerous Conditions, Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • iloprostDrug

    Given orally

  • placeboOther

    Given orally

Study groups in NCT00084409
Study groupRoleWhat they receive
Arm IExperimentalPatients receive oral iloprost twice daily for 6 months in the absence of unacceptable toxicity.
Receives: Drug: iloprost
Arm IIPlacebo comparatorPatients receive oral placebo twice daily for 6 months in the absence of unacceptable toxicity.
Receives: Other: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Average (Follow-up - Baseline) From All Biopsies

    This outcome measure is created for each subject as follows:

    From all biopsies scored at the baseline bronchoscopy, the mean WHO score is calculated.

    From all biopsies scored at the follow-up bronchoscopy, the mean WHO score is calculated.Histology on bronchial biopsies pre-treatment and post-treatment will be compared. All biopsies will be graded according to the WHO classification for bronchial epithelium for this outcome, and all the following outcomes.

    WHO Classification Grade Normal 1.0 Reserve Cell Hyperplasia 2.0 Metaplasia 3.0 Mild Dysplasia 4.0 Moderate Dysplasia 5.0 Severe Dysplasia 6.0 Carcinoma in Situ 7.0 Carcinoma 8.0

    The difference (follow-up mean - baseline mean) is used as the outcome measure for each subject.

    Measured: Nine years

Secondary outcomes (10)
  1. Change in Dysplasia Index (Follow-up - Baseline) Using All Biopsies

    This outcome measure is created for each subject as follows:

    From all biopsies scored at the baseline bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated (this is the definition of Dysplasia Index (DI)).

    From all biopsies scored at the follow-up bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated.

    The difference (follow-up DI - baseline DI) is used as the outcome measure for each subject.

    Measured: 9 Years

  2. Change in Average (Follow-up - Baseline) Using Reference Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are those from the following 6 anatomical sites pre-specified in the protocol to be biopsied: RUL (Right upper lobe: the superior region of the right lung), RML (Right middle lobe: an anatomic portion of the right lung), RB6 (The carina in the right lower lobe at the entrance to the superior segment), LUL (Left upper lobe: the superior portion of the lung), LUDB (Left upper division bronchus: the carina between the lingular orifice and the left upper lobe), and LB6 (The carina in the left lower lobe at the entrance to the superior segment).

    From these biopsies scored at the baseline bronchoscopy, the mean WHO score is calculated.

    From these biopsies scored at the follow-up bronchoscopy, the mean WHO score is calculated.

    The difference (follow-up mean - baseline mean) is used as the outcome measure for each subject.

    Measured: 9 Years

  3. Change in Maximum (Follow-up - Baseline) Using Reference Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are those from the following 6 anatomical sites pre-specified in the protocol to be biopsied: RUL, RML, RB6, LUL, LUDB, and LB6.

    From these biopsies scored at the baseline bronchoscopy, the maximum WHO score is used.

    From these biopsies scored at the follow-up bronchoscopy, the maximum WHO score is used.

    The difference (follow-up maximum - baseline maximum) is used as the outcome measure for each subject.

    Measured: 9 Years

  4. Change in Dysplasia Index (Follow-up - Baseline) Using Reference Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are those from the following 6 anatomical sites pre-specified in the protocol to be biopsied: RUL, RML, RB6, LUL, LUDB, and LB6.

    From these biopsies scored at the baseline bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated (this is the definition of Dysplasia Index (DI)).

    From these biopsies scored at the follow-up bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated.

    The difference (follow-up DI - baseline DI) is used as the outcome measure for each subject.

    Measured: 9 Years

  5. Change in Average (Follow-up - Baseline) Using Matched Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies, thus creating "pairs" of biopsies.

    From these biopsies scored at the baseline bronchoscopy, the mean WHO score is calculated.

    From these biopsies scored at the follow-up bronchoscopy, the mean WHO score is calculated.

    The difference (follow-up mean - baseline mean) is used as the outcome measure for each subject.

    Measured: 9 Years

  6. Change in Maximum (Follow-up - Baseline) Using Matched Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies.

    From these biopsies scored at the baseline bronchoscopy, the maximum WHO score is used.

    From these biopsies scored at the follow-up bronchoscopy, the maximum WHO score is used.

    The difference (follow-up maximum - baseline maximum) is used as the outcome measure for each subject.

    Measured: 9 Years

  7. Change in Dysplasia Index (Follow-up - Baseline) Using Matched Sites

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies.

    From these biopsies scored at the baseline bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated (this is the definition of Dysplasia Index (DI)).

    From these biopsies scored at the follow-up bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated.

    The difference (follow-up DI - baseline DI) is used as the outcome measure for each subject.

    Measured: 9 Years

  8. Change in Average (Follow-up - Baseline) Using Baseline Non-Normal Pairs

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies, thus creating "pairs" of biopsies. Any "pair" for which the baseline WHO score was 1 (i.e. normal tissue) was excluded from the analysis.

    From these biopsies scored at the baseline bronchoscopy, the mean WHO score is calculated.

    From these biopsies scored at the follow-up bronchoscopy, the mean WHO score is calculated.

    The difference (follow-up mean - baseline mean) is used as the outcome measure for each subject.

    Measured: 9 Years

  9. Change in Maximum (Follow-up - Baseline) Using Baseline Non-Normal Pairs

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies, thus creating "pairs" of biopsies. Any "pair" for which the baseline WHO score was 1 (i.e. normal tissue) was excluded from the analysis.

    From these biopsies scored at the baseline bronchoscopy, the maximum WHO score is used.

    From these biopsies scored at the follow-up bronchoscopy, the maximum WHO score is used.

    The difference (follow-up maximum - baseline maximum) is used as the outcome measure for each subject.

    Measured: 9 Years

  10. Change in Dysplasia Index (Follow-up - Baseline) Using Baseline Non-Normal Pairs

    This outcome measure is created for each subject as follows:

    The biopsies used in this analysis are restricted to biopsies from anatomical sites that were biopsies during both the baseline and follow-up bronchoscopies, thus creating "pairs" of biopsies. Any "pair" for which the baseline WHO score was 1 (i.e. normal tissue) was excluded from the analysis.

    From these biopsies scored at the baseline bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated (this is the definition of Dysplasia Index (DI)).

    From these biopsies scored at the follow-up bronchoscopy, the percentage with a WHO score greater than or equal to 4 is calculated.

    The difference (follow-up DI - baseline DI) is used as the outcome measure for each subject.

    Measured: 9 Years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2004 (estimated)
  2. Study startNov 2001
  3. Primary completionJan 2009
  4. Study completionJan 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
152 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00084409
Sponsor's protocol ID
01-279.cc
Other IDs
National Cancer Institute, 01-279
Status last verified
May 2020
First submitted
10 Jun 2004
Last updated
14 May 2020
Data monitoring committee
Yes

Publications

  • Keith RL, Blatchford PJ, Kittelson J, Minna JD, Kelly K, Massion PP, Franklin WA, Mao J, Wilson DO, Merrick DT, Hirsch FR, Kennedy TC, Bunn PA Jr, Geraci MW, Miller YE. Oral iloprost improves endobronchial dysplasia in former smokers. Cancer Prev Res (Phila). 2011 Jun;4(6):793-802. doi: 10.1158/1940-6207.CAPR-11-0057.

    PubMed 21636546

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing iloprost in people with Lung Cancer and Precancerous Condition, run by University of Colorado, Denver at 6 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 May 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 Feb 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Average (Follow-up - Baseline) From All Biopsies (time frame: Nine years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00084409, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2020.

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