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AzTrials

Lung CancerPhase 1NCT00424840

Phase I/II Study to Evaluate the Efficacy and Safety of a Combination Chemotherapy

A Phase 1 study testing Bortezomib 1.3 mg/m2, Bortezomib 1.6 mg/m2 and Bortezomib 1.8 mg/m2 in people with Lung Cancer, run by University of Massachusetts, Worcester at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

A pilot trial of combination of bortezomib, bevacizumab and carboplatin as first line therapy in patients with metastatic Non-Small Cell Lung Cancer (NSCLC). Phase I and II study of this combination in first line setting will be conducted in order to properly estimate the efficacy and safety of this regimen. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Lung Cancer
What is being tested?
Bortezomib 1.3 mg/m2, Bortezomib 1.6 mg/m2 and Bortezomib 1.8 mg/m2
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteUnited States
Study dates
Jun 2006to Mar 2014
Phase
Phase 1
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed SCLC (adeno- and large cell, anaplastic carcinoma and broncho-alveolar-carcinoma). Patients with squamous-cell histology are eligible with extra thoracic or peripheral lung lesions only.
  • Sputum cytology alone not acceptable evidence of cell type. Cytologic specimens obtained by brushing, washings, or needle aspiration of defined lesions will be acceptable. Mixed tumors will be categorized by the predominant cell type unless a small cell anaplastic elements are present, in which case the patient is ineligible.
  • Stage III B because of pleural effusion or Stage IV disease
  • Measurable disease.
  • Age: 18 years or older
  • No history of thrombotic, hemorrhagic, or coagulopathy disorders
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  • international normalized ratio (INR<1.5) and a prothrombin time (PTT) no greater than normal limits of normal within 1 week prior to registration. NB: subjects with lung cancer placed on anticoagulant therapy for a thrombotic event are not eligible for this study.
  • No gross hemoptysis (defined as bright red blood of ½ teaspoon or more)
  • No central nervous system (CNS) or brain metastasis
  • Laboratory Criteria (completed <2 weeks before enrollment):
  • Hematologic: white blood cell (WBC) > 3500/mm3 or absolute neutrophil count (ANC) > 1500/mm3 and platelet count > 100 000/ mm3;
  • Hepatic: Total bilirubin < 1.5 mg/dl
  • Renal: Creatinine < 1.5 mg/dl. or calculated
  • Creatinine clearance > 45 ml/min (NB: Urine protein:creatinine ratio in exclusion criteria)
  • Eastern Cooperative Oncology Group (ECOG) performance status < 2
  • Be free of active infection.
  • Be available for active follow up.
  • No prior chemotherapy for metastatic disease.
  • Be disease free for > 5 years if they had a prior second malignancy other than treated basal cell carcinoma or squamous cell skin cancer, or carcinoma in situ of the cervix.
  • Female subject post-menopausal; surgically sterilized or willing to use an acceptable method of birth control for the duration of the study. Male subject agrees to use an acceptable method for contraception for the duration of the study.

Who cannot join

  • CNS or brain metastasis
  • Patient has = or greater Grade 2 peripheral neuropathy within 14 days before enrollment.
  • Known previous sensitivity reactions with boron, or mannitol,
  • Patients with known HIV positivity
  • Myocardial infarction within 6 months prior to enrollment or has New York Hospital Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Any ECG abnormality at Screening has to be documented by the investigator as not medically relevant.
  • Blood pressure of >150/100 mmHG
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  • History of myocardial infarction or stroke within 6 months
  • Clinically significant peripheral vascular disease
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 0, anticipation of need for major surgical procedure during the course of the study.
  • Minor surgical procedure such as fine needle aspirations or core biopsies within 7 days prior to day 0
  • Urine protein: Creatinine ratio > 1.0 at screening
  • History of abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within 6 months prior to Day 0
  • Serious, non-healing wound, ulcer, or bone fracture
  • Lung carcinoma or any histology in close proximity to a major vessel or cavitation
  • Female subject is pregnant or breast-feeding. Confirmation that the subject is not pregnant. Pregnancy testing is not required for post-menopausal or surgically sterilized women.
  • Patient has received other investigational drugs with 14 days before enrollment or is expected to participate in an experiment drug study during this study treatment.
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Massachusetts Medical School

    Worcester, Massachusetts, 01655-0002

Other trials in United States

About this study

Official title: Phase I/II Study to Evaluate the Efficacy and Safety of Combination Chemotherapy With Carboplatin, Bortezomib and Bevacizumab as First Line Therapy in Patients With Advanced Non-small Cell Lung Cancer

A pilot trial of combination of bortezomib, bevacizumab and carboplatin as first line therapy in patients with metastatic Non-Small Cell Lung Cancer (NSCLC). Phase I and II study of this combination in first line setting will be conducted in order to properly estimate the efficacy and safety of this regimen. This will form the basis for future studies comparing this combination to what is now considered standard regimen for first line therapy in patients with NSCLC, carboplatin, paclitaxel and bevacizumab.

Read the detailed description

Study design and methodology The study will have two phases.

The phase I will use traditional dose escalation model (3-6 patient per dose level) to determine the maximum tolerated dose (MTD).

*[In phase II, either level III or (MTD) will be used in the same every 21 day cycle to evaluate the efficacy and safety of the regimen in first line treatment of advanced NSCLC]* not conducted.

Treatments administered

In phase I, three dose levels of weekly bortezomib will be studied in conjunction with fixed dose carboplatin and bevacizumab on a 21 day cycle to define the maximum tolerated dose (MTD).

A maximum of six cycles will be administered. Patients with complete response, partial response or stable disease after six cycles will be allowed to continue on single agent bevacizumab every 3 weeks as maintenance therapy until disease progression.

If no dose limiting toxicity (DLT) is observed in 3 patients during the first cycle, the next dose level will be accrued. If 1 DLT is observed, 3 additional patients will be accrued to the dose level. If no additional DLTs are observed, the next dose level will be accrued. However, if 2 or more DLTs are observed in a given dose level, MTD will be defined. MTD will be defined as the dose below which ≥2 DLTs were observed.

The following three levels will be studied:

Level I (every 21 day cycle): D1: carboplatin AUC 6, bevacizumab 15 mg/kg, bortezomib 1.3 mg/m2 D8 : bortezomib 1.3 mg/m2

Level II (every 21 day cycle): D1: carboplatin AUC 6, bevacizumab 15 mg/kg, bortezomib 1.6 mg/m2 D8 : bortezomib 1.6 mg/m2

Level III(every 21 day cycle):D1: carboplatin AUC 6, bevacizumab 15 mg/kg, bortezomib 1.8 mg/m2 D8 : bortezomib 1.8 mg/m2

If 2 or more DLT are observed in Level 1, level -1 will be accrued.

Level -1: (every 21 day cycle): D1: carboplatin AUC 6, bevacizumab 15 mg/kg, bortezomib 1 mg/m2 D8: bortezomib 1 mg/m2

*[In phase II, either level III or the MTD dose level will be used in the same every 21 day cycle to evaluate the efficacy and safety of the regimen in first line treatment of advanced NSCLC.

Efficacy data collected

The following evaluations will be conducted to assess the efficacy of the combination:

  • response rate by Response Evaluation Criteria in Solid Tumors (RECIST) criteria
  • disease free and overall survival, time to progress (TTP) and duration of response Safety data collected

The following evaluations will be conducted to assess the safety of the combination chemotherapy:

  • toxicity based on National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 3.0]* Not conducted

Statistical procedures

In phase I portion, 9-18 patients will be enrolled. The patients treated at recommended dose level for phase II will also be eligible for response evaluation as part of phase II.

*[The primary objective of the phase II study is to estimate the efficacy and safety of the combination therapy with carboplatin, bortezomib and bevacizumab as the first line therapy in patients with advanced NSCLC. The primary endpoints are response rate and progression-free survival (PFS).

(NOT CONDUCTED) In phase II portion, the optimal two-stage design for phase II clinical trials described by Simon et al. will be utilized.

Overall survival, progression free survival and time to progression will be estimated using Kaplan-Meier methods. Time to progression, progression free survival and survival will be calculated from the date of study entry.]* (Phase II not conducted.)

Conditions
Lung Cancer
Being tested
Bortezomib 1.3 mg/m2, Bortezomib 1.6 mg/m2, Bortezomib 1.8 mg/m2, Carboplatin AUC 6, Bevacizumab
Keywords
lung cancer, Carboplatin, bortezomib, Bevacizumab
Medical subject headings
Lung Neoplasms

What participants receive

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

  • Bortezomib 1.3 mg/m2Drug

    Also called Velcade

    Level I (every 21 day cycle, D8), 1.3 mg/m2:

    Day 1: bevacizumab 15 mg/kg ,carboplatin Area Under the Curve (AUC 6) 900mg, bortezomib 1.3 mg/m2 Day 8 : bortezomib 1.3 mg/m2

    Level II (every 21 day cycle):

    Day 1: bevacizumab 15 mg/kg, carboplatin Area Under the Curve (AUC 6) 900mg, bortezomib 1.6 mg/m2 Day 8 : bortezomib 1.6 mg/m2

    Level III(every 21 day cycle):

    Day 1: bevacizumab 15 mg/kg, carboplatin Area Under the Curve (AUC 6) 900mg, bortezomib 1.8 mg/m2 Day 8 : bortezomib 1.8 mg/m2

  • Bortezomib 1.6 mg/m2Drug

    Also called Velcade

    Level II (every 21 day cycle, D8), 1.6 mg/m2

  • Bortezomib 1.8 mg/m2Drug

    Also called Velcade

    Level III (every 21 day cycle, D8) 1.8 mg/m2

  • Carboplatin AUC 6Drug

    Also called Carboplatin

    Carboplatin AUC6

  • BevacizumabDrug

    Bevacizumab 15 mg/kg

  • TaxotereDrug

    Taxotere 70 + G-CSF

Study groups in NCT00424840
Study groupRoleWhat they receive
Bortezomib 1.3 mg/m2ExperimentalLevel 1 of Bortezomib Dose Escalation in combination with Carboplatin AUC6, Bevacizumab 15 mg/kg and Taxotere 70 + G-CSF
Receives: Drug: Bortezomib 1.3 mg/m2; Drug: Carboplatin AUC 6; Drug: Bevacizumab; Drug: Taxotere
Bortezomib 1.6 mg/m2ExperimentalLevel 2 of Bortezomib Dose Escalation in combination with Carboplatin AUC6, Bevacizumab 15 mg/kg and Taxotere 70 + G-CSF
Receives: Drug: Bortezomib 1.6 mg/m2; Drug: Carboplatin AUC 6; Drug: Bevacizumab; Drug: Taxotere
Bortezomib 1.8 mg/m2ExperimentalLevel 3 of Bortezomib Dose Escalation in combination with Carboplatin AUC6, Bevacizumab 15 mg/kg and Taxotere 70 + G-CSF
Receives: Drug: Bortezomib 1.8 mg/m2; Drug: Carboplatin AUC 6; Drug: Bevacizumab; Drug: Taxotere

What is being measured

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

  1. Number of Subjects Who Require Dose Delay/Reduction in Dose of Bortezomibin the First Cycle

    Dose limiting toxicity at Level 1,2 and 3: Number of subjects who required dose delay/reduction in dose of bortezomib in the first cycle of treatment. DLT defined by any of the following during first cycle: (1) GR4 neutropenia or thrombocytopenia, (2) Greater than GR3 non-hematological toxicity except alopecia or inadequately treated nausea or vomiting or (3) neurosensory toxicity of GR2 with pain or any neurotoxicity greater than GR2.

    Measured: up to 21 days for each dosing cycle

Timeline

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

  1. First posted22 Jan 2007 (estimated)
  2. Study startJun 2006
  3. Primary completionMar 2014
  4. Study completionMar 2014

Why it stopped: Poor accrual

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 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00424840
Sponsor's protocol ID
UM200601
Status last verified
Jan 2019
First submitted
18 Jan 2007
Last updated
1 Feb 2019
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Simon R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989 Mar;10(1):1-10. doi: 10.1016/0197-2456(89)90015-9.

    PubMed 2702835
  • Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006 Dec 14;355(24):2542-50. doi: 10.1056/NEJMoa061884.

    PubMed 17167137

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Bortezomib 1.3 mg/m2, Bortezomib 1.6 mg/m2 and Bortezomib 1.8 mg/m2 in people with Lung Cancer, run by University of Massachusetts, Worcester at 1 site 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 20 inclusion and 17 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: stopped early, as of the sponsor's last update on 1 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 1 Feb 2019). 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?

Number of Subjects Who Require Dose Delay/Reduction in Dose of Bortezomibin the First Cycle (time frame: up to 21 days for each dosing cycle). 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 NCT00424840, which also lists 2 linked publications.

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 1 Feb 2019.

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