Recurrent Non-Small Cell Lung CarcinomaPhase 2NCT00698815
Pemetrexed and/or Sunitinib as Second-Line Therapy in Treating Patients With Stage IIIB or Stage IV Non-small Cell Lung Cancer
A Phase 2 study testing Laboratory Biomarker Analysis, Pemetrexed Disodium and Sunitinib Malate in people with Recurrent Non-Small Cell Lung Carcinoma and Stage IIIB Non-Small Cell Lung Cancer AJCC v7, run by National Cancer Institute (NCI) at 129 sites in United States.
Trial summary
This randomized phase II trial studies pemetrexed disodium and sunitinib malate to compare how well they work when given alone or together as second-line therapy in treating patients with stage IIIB or stage IV non-small cell lung cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Recurrent Non-Small Cell Lung Carcinoma, Stage IIIB Non-Small Cell Lung Cancer AJCC v7, Stage IV Non-Small Cell Lung Cancer AJCC v7
- What is being tested?
- Laboratory Biomarker Analysis, Pemetrexed Disodium and Sunitinib Malate
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 130 participants
- Where
- 129 sitesUnited States
- Study dates
- 15 Apr 2008to 1 Dec 2011
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologic documentation: histologic or cytologic documentation of NSCLC
- Stage: IIIB/IV with evidence of disease progression following first-line therapy
- Tumor site: lung (non-small cell)
- No cavitary lesions
- Only one prior chemotherapy regimen in the first-line stage IIIB/IV setting is allowed; this could have been either a platinum- or non-platinum-based regimen
- First-line therapy must be completed >= 28 days before registration
Show all 43Show fewer
- Prior adjuvant therapy is allowed provided the patient had one previous regimen in the advanced stage IIIB/IV setting
- At least 28 days from prior major surgery and at least 14 days from any prior radiotherapy before registration
- No prior inhibitors of VEGF receptor (VEGFR) (e.g., SU5416, SU6668, AZ6474, SU11248, PTK787, AZD2171, AEE-788, sorafenib); prior treatment with epidermal growth factor receptor (EGFR) inhibitors and bevacizumab is allowed, provided at least 4 weeks has elapsed
- No prior pemetrexed
- Patients must have measurable or non-measurable disease
- Measurable disease
- Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 2 cm with conventional techniques or as >= 1 cm with spiral computed tomography (CT) scan
- Non-measurable disease
- All other lesions, including small lesions (longest diameter < 20 mm with conventional techniques or < 10 mm with spiral CT scan) and truly nonmeasurable lesions
- Lesions that are considered non-measurable include the following:
- Bone lesions
- Leptomeningeal disease
- Ascites
- Pleural/pericardial effusion
- Lymphangitis cutis/pulmonis
- Abdominal masses that are not confirmed and followed by imaging techniques
- Cystic lesions
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- Pregnant or nursing mothers are not eligible for this study; patients in their child bearing years must have a baseline negative pregnancy test (in the case of females); males and females must practice appropriate contraceptive measures during the period of protocol therapy and for 6 months after completion of protocol therapy; appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives (Norplant), or double barrier method (diaphragm plus condom)
- No ongoing cardiac dysrhythmias, atrial fibrillation, or history of corrected QT interval (QTc interval) > 500 msec (within 2 years prior to registration); the use of agents with proarrhythmic potential (e.g., quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide, flecainide) is not recommended while on protocol therapy
- Patients with class I New York Heart Association (NYHA) heart failure are eligible; patients with a history of class II NYHA heart failure are eligible, provided they meet at least one of the following criteria:
- Patients with a history of class II heart failure who are asymptomatic on treatment
- Patients with prior anthracycline exposure
- Patients who have received central thoracic radiation that included the heart in the radiotherapy port
- Patients with a history of symptomatic congestive heart failure within 12 months prior to entry are not eligible
- No myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft or stenting, cerebrovascular accident or transient ischemic attack within the last year
- Patients with hypertension that cannot be controlled by medications (> 150/100 mmHg despite optimal medical therapy) are not eligible
- Patients who require use of therapeutic anticoagulation for thromboembolic disease are not eligible; Note: low doses of Coumadin (up to 2 mg daily) are permitted for prophylaxis of thrombosis
- No history of venous thrombosis, pulmonary embolism, or hypercoagulopathy syndrome
- No history of pulmonary hemorrhage, bleeding diathesis, or evidence of hemoptysis; patients with blood-tinged or blood-streaked sputum will be permitted on study if the hemoptysis amounts to less than 5 mL of blood per episode and less than 10 mL of blood per 24-hour period in the best estimate of the investigator
- Patients with a history of hypothyroidism or hyperthyroidism are eligible, provided they are currently euthyroid
- None of the following within 28 days of beginning treatment: abdominal fistula, gastrointestinal perforation, intra-abdominal abscess, serious or non-healing wound, ulcer, or bone fracture
- The use of the following specific inhibitors and inducers of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) is not permitted; the following inhibitors of CYP3A4 are prohibited within 7 days before and during treatment with sunitinib: azole antifungals (ketoconazole, itraconazole), diltiazem, clarithromycin, erythromycin, verapamil, delavirdine, and human immunodeficiency virus (HIV) protease inhibitors (indinavir, saquinavir, ritonavir, atazanavir, nelfinavir); the following inducers of CYP3A4 are prohibited within 12 days before beginning and during treatment with sunitinib: rifampin, rifabutin, carbamazepine, phenobarbital, phenytoin, St. John's Wort, efavirenz, tipranavir
- Other inhibitors and inducers of CYP3A4 may be used if necessary, but their use is discouraged
- No symptomatic or untreated central nervous system (CNS) metastases; patients with CNS metastases must be asymptomatic, must have received definitive therapy (>= 6 weeks since resection or >= 2 weeks since radiotherapy) for brain metastases, and be off steroids or on a stable dose for 2 weeks prior to registration
- No chronic daily treatment with aspirin (> 325 mg/day) or non-steroidal antiinflammatory agents known to inhibit platelet function; treatment with dipyridamole (Persantine), ticlopidine (Ticlid), clopidogrel (Plavix) and/or cilostazol (Pletal) is not allowed
- No pleural effusions or ascites that are detectable on physical exam
Who cannot join
None listed.
Trial locations and contacts
129 sites in 1 country.
129 sites in 1 country
United States129 sites
Kaiser Permanente-Anaheim
Anaheim, California, 92807
Arroyo Grande Community
Arroyo Grande, California, 93420
Randolph Hospital
Asheboro, North Carolina, 27203
Harold Alfond Center for Cancer Care
Augusta, Maine, 04330
Kaiser Permanente-Baldwin Park
Baldwin Park, California, 91706
Eastern Maine Medical Center
Bangor, Maine, 04401
Kaiser Permanente-Bellflower
Bellflower, California, 90706
Central Vermont Medical Center/National Life Cancer Treatment
Berlin Corners, Vermont, 05602
University of Iowa Healthcare Cancer Services Quad Cities
Bettendorf, Iowa, 52722
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
Brigham and Women's Hospital
Boston, Massachusetts, 02115
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
University of Vermont College of Medicine
Burlington, Vermont, 05405
Cooper Hospital University Medical Center
Camden, New Jersey, 08103
East Bay Radiation Oncology Center
Castro Valley, California, 94546
Eden Hospital Medical Center
Castro Valley, California, 94546
Valley Medical Oncology Consultants-Castro Valley
Castro Valley, California, 94546
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
Novant Health Presbyterian Medical Center
Charlotte, North Carolina, 28204
Jesse Brown Veterans Affairs Medical Center
Chicago, Illinois, 60612
University of Illinois
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
University of Missouri - Ellis Fischel
Columbia, Missouri, 65212
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Danville Regional Medical Center
Danville, Virginia, 24541
Greenville Health System Cancer Institute-Easley
Easley, South Carolina, 29640
Hematology Oncology Associates of Central New York-East Syracuse
East Syracuse, New York, 13057
Elkhart Clinic
Elkhart, Indiana, 46514-2098
Michiana Hematology Oncology PC-Elkhart
Elkhart, Indiana, 46514
Elkhart General Hospital
Elkhart, Indiana, 46515
Union Hospital of Cecil County
Elkton, Maryland, 21921
Bay Area Breast Surgeons Inc
Emeryville, California, 94608
Exeter Hospital
Exeter, New Hampshire, 03833
McLeod Regional Medical Center
Florence, South Carolina, 29506
Kaiser Permanente Hospital
Fontana, California, 92335
Holy Cross Hospital
Fort Lauderdale, Florida, 33308
Valley Medical Oncology Consultants-Fremont
Fremont, California, 94538
Glens Falls Hospital
Glens Falls, New York, 12801
Wayne Memorial Hospital
Goldsboro, North Carolina, 27534
CHI Health Saint Francis
Grand Island, Nebraska, 68803
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Saint Francis Hospital
Greenville, South Carolina, 29601
Greenville Health System Cancer Institute-Andrews
Greenville, South Carolina, 29605
Greenville Health System Cancer Institute-Butternut
Greenville, South Carolina, 29605
Greenville Health System Cancer Institute-Faris
Greenville, South Carolina, 29605
Greenville Memorial Hospital
Greenville, South Carolina, 29605
Greenville Health System Cancer Institute-Eastside
Greenville, South Carolina, 29615
Self Regional Healthcare
Greenwood, South Carolina, 29646
Greenville Health System Cancer Institute-Greer
Greer, South Carolina, 29650
Kaiser Permanente - Harbor City
Harbor City, California, 90710
Hartford Hospital
Hartford, Connecticut, 06102
Saint Mary's Medical Center
Huntington, West Virginia, 25702
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
Iowa City VA Healthcare System
Iowa City, Iowa, 52246
Kaiser Permanente-Irvine
Irvine, California, 92618
Capital Region Medical Center-Goldschmidt Cancer Center
Jefferson City, Missouri, 65109
Joliet Oncology-Hematology Associates Limited
Joliet, Illinois, 60435
Jupiter Medical Center
Jupiter, Florida, 33458
Kinston Medical Specialists PA
Kinston, North Carolina, 28501
Community Howard Regional Health
Kokomo, Indiana, 46904
AMITA Health Adventist Medical Center
La Grange, Illinois, 60525
IU Health La Porte Hospital
La Porte, Indiana, 46350
LRGHealthcare-Lakes Region General Hospital
Laconia, New Hampshire, 03246
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
Nevada Cancer Research Foundation CCOP
Las Vegas, Nevada, 89106
Beebe Medical Center
Lewes, Delaware, 19958
Nebraska Cancer Research Center
Lincoln, Nebraska, 68510
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Kaiser Permanente-Cadillac
Los Angeles, California, 90034
North Shore University Hospital
Manhasset, New York, 11030
Contra Costa Regional Medical Center
Martinez, California, 94553-3156
Memorial Hospital Of Martinsville
Martinsville, Virginia, 24115
Mount Sinai Medical Center
Miami Beach, Florida, 33140
Middlesex Hospital
Middletown, Connecticut, 06457
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
Milford, Massachusetts, 01757
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545
Saint Joseph Regional Medical Center-Mishawaka
Mishawaka, Indiana, 46545
El Camino Hospital
Mountain View, California, 94040
Long Island Jewish Medical Center
New Hyde Park, New York, 11040
Northwell Health/Center for Advanced Medicine
New Hyde Park, New York, 11040
Christiana Care Health System-Christiana Hospital
Newark, Delaware, 19718
Newton-Wellesley Hospital
Newton, Massachusetts, 02462
Lakeland Community Hospital
Niles, Michigan, 49120
Great Plains Regional Medical Center
North Platte, Nebraska, 69103
Norwalk Hospital
Norwalk, Connecticut, 06856
Highland General Hospital
Oakland, California, 94602
Alta Bates Summit Medical Center - Summit Campus
Oakland, California, 94609
Bay Area Tumor Institute
Oakland, California, 94609
Hematology and Oncology Associates-Oakland
Oakland, California, 94609
Tom K Lee Inc
Oakland, California, 94609
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
Alegent Health Immanuel Medical Center
Omaha, Nebraska, 68122
Alegent Health Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Creighton University Medical Center
Omaha, Nebraska, 68131
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Kaiser Permanente - Panorama City
Panorama City, California, 91402
Memorial Hospital of Rhode Island
Pawtucket, Rhode Island, 02860
PCR Oncology
Pismo Beach, California, 93449
Valley Care Health System - Pleasanton
Pleasanton, California, 94588
Valley Medical Oncology Consultants
Pleasanton, California, 94588
Michiana Hematology Oncology PC-Plymouth
Plymouth, Indiana, 46563
Annie Penn Memorial Hospital
Reidsville, North Carolina, 27320
Kaiser Permanente-Riverside
Riverside, California, 92505
Lakeland Hospital
Saint Joseph, Michigan, 49085
Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
University of California San Diego
San Diego, California, 92103
Kaiser Permanente-San Diego Mission
San Diego, California, 92108
Kaiser Permanente-San Diego Zion
San Diego, California, 92120
Kaiser Permanente-San Marcos
San Marcos, California, 92069
Doctors Medical Center- JC Robinson Regional Cancer Center
San Pablo, California, 94806
Greenville Health System Cancer Institute-Seneca
Seneca, South Carolina, 29672
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Michiana Hematology Oncology PC-South Bend
South Bend, Indiana, 46601
Northern Indiana Cancer Research Consortium
South Bend, Indiana, 46628
Greenville Health System Cancer Institute-Spartanburg
Spartanburg, South Carolina, 29307
Missouri Baptist Medical Center
St Louis, Missouri, 63131
Center for Cancer Care and Research
St Louis, Missouri, 63141
Comprehensive Cancer Care PC
St Louis, Missouri, 63141
Iredell Memorial Hospital
Statesville, North Carolina, 28677
State University of New York Upstate Medical University
Syracuse, New York, 13210
Syracuse Veterans Administration Medical Center
Syracuse, New York, 13210
Marion L Shepard Cancer Center at Vidant Beaufort Hospital
Washington, North Carolina, 27889
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
MedStar Washington Hospital Center
Washington D.C., District of Columbia, 20010
Michiana Hematology Oncology PC-Westville
Westville, Indiana, 46391
New Hanover Regional Medical Center/Zimmer Cancer Center
Wilmington, North Carolina, 28401
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Kaiser Permanente
Woodland Hills, California, 91367
About this study
Official title: A Randomized Phase II Study to Assess the Efficacy of Pemetrexed or Sunitinib (NSC # 736511) or Pemetrexed Plus Sunitinib in the Second-Line Treatment of Advanced Non-small Cell Lung Cancer
This randomized phase II trial studies pemetrexed disodium and sunitinib malate to compare how well they work when given alone or together as second-line therapy in treating patients with stage IIIB or stage IV non-small cell lung cancer. Drugs used in chemotherapy, such as pemetrexed disodium, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. It is not yet known whether pemetrexed disodium and sunitinib malate are more effective when given alone or together in treating non-small cell lung cancer.
Read the detailed description
PRIMARY OBJECTIVES:
- To estimate the 18 week progression-free survival rate of pemetrexed (pemetrexed disodium) alone (Arm I), sunitinib (sunitinib malate) alone (Arm II) and pemetrexed plus sunitinib (Arm III) in the second-line setting of advanced non-small cell lung cancer (NSCLC).
SECONDARY OBJECTIVES:
- To compare the progression-free survival of the three arms. II. To estimate the response rate, duration of response, rate of stable disease, overall survival and to characterize the toxicity profiles of the three arms.
III. To estimate the response rate, duration of response, rate of stable disease, overall survival and toxicity of sunitinib in those patients on Arm I that receive this regimen in the third line setting.
IV. To assess vascular endothelial growth factor (VEGF) haplotypes in advanced non-small cell lung cancer.
- To test change in tumor size at 6 weeks (after 2 cycles of therapy, typically the first evaluation point in this type of study) as an early predictor of therapeutic activity in second-line treatment of non-small cell lung cancer.
OUTLINE: Patients are randomized to 1 of 3 treatment arms.
ARM I: Patients receive pemetrexed disodium intravenously (IV) over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in Arm II as third-line therapy.
ARM II: Patients receive sunitinib malate orally (PO) once daily (QD) on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in Arm I as third-line therapy.
ARM III: Patients receive pemetrexed disodium IV over 10 minutes on day 1 and sunitinib malate PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician.
After completion of study treatment, patients are followed up every 6 weeks until disease progression and then every 6 months for 2 years.
- Conditions
- Recurrent Non-Small Cell Lung Carcinoma, Stage IIIB Non-Small Cell Lung Cancer AJCC v7, Stage IV Non-Small Cell Lung Cancer AJCC v7
- Being tested
- Laboratory Biomarker Analysis, Pemetrexed Disodium, Sunitinib Malate
- Medical subject headings
- Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Laboratory Biomarker AnalysisOther
Correlative studies
Pemetrexed DisodiumDrug
Also called Alimta, LY231514, N-[4-[2-(2-Amino-4,7-dihydro-4-oxo-1H-pyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]-L-glutamic Acid Disodium Salt
Given IV
Sunitinib MalateDrug
Also called SU011248, SU11248, sunitinib, Sutent
Given PO
| Study group | Role | What they receive |
|---|---|---|
| Arm I (pemetrexed) | Experimental | Patients receive pemetrexed disodium 500 mg/m^2 IV over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in Arm II as third-line therapy. Receives: Other: Laboratory Biomarker Analysis; Drug: Pemetrexed Disodium |
| Arm II (sunitinib) | Experimental | Patients receive sunitinib malate at 37.5 mg PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in Arm I as third-line therapy. Receives: Other: Laboratory Biomarker Analysis; Drug: Sunitinib Malate |
| Arm III (pemetrexed and sunitinib) | Experimental | Patients receive pemetrexed disodium 500 mg/m^2 IV over 10 minutes on day 1 and sunitinib malate at 37.5 mg PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician. Receives: Other: Laboratory Biomarker Analysis; Drug: Pemetrexed Disodium; Drug: Sunitinib Malate |
What is being measured
The primary outcome is the main question the study is designed to answer.
18 Week Progression-free Survival (PFS) Rate
The 18 week progression-free survival rate was defined as the proportion of patients that were alive and progression-free 18 weeks after registration into the study. Disease progression was assessed per modified RECIST criteria, and defined as at least a 20% increase in the sum of the longest diameters of target lesions, in either primary or nodal lesions, taking as reference the smallest sum longest diameter recorded since the baseline measurements, or the appearance of new lesions. Kaplan-Meier estimate of 18-week progression-free survival was calculated.
Measured: At 18 weeks
Secondary outcomes (3)
PFS
PFS was defined as the time from randomization until disease progression or death, whichever occurs first. The median PFS with 95% CI was estimated using the Kaplan-Meier method. Progression is defined as in the primary outcome measure.
Measured: Time from randomization to disease progression and death of any cause, whichever comes first (up to 3 years)
Overall Response Rate
The proportion of patients who respond (completely or partially) to each combination regimen will be estimated. An exact binomial confidence interval will be computed for these estimates.
Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST) criteria: Complete Response (CR): disappearance of all target lesions; Partial Response (PR) 30% decrease in sum of longest diameter of target lesions.
Measured: Duration of treatment (up to 3 years)
Overall Survival (OS)
OS is defined as the time from patient randomization to death from any cause. The median OS with 95% CI was estimated using the Kaplan-Meier method.
Measured: Time from randomization to death (up to 3 years)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2008 (estimated)
- Study start15 Apr 2008
- Primary completion1 Dec 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Recurrent Non-Small Cell Lung CarcinomaStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 130 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Rebecca Heist, Principal investigator, Alliance for Clinical Trials in Oncology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00698815
- Sponsor's protocol ID
- NCI-2009-00471
- Other IDs
- NCI-2009-00471, CDR0000589102, CALGB 30704, CALGB-30704, U10CA180821, U10CA031946
- Status last verified
- Jan 2022
- First submitted
- 14 Jun 2008
- Last updated
- 8 Feb 2022
- Results posted
- Yes, on ClinicalTrials.gov
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase II Study to Assess the Efficacy of Pemetrexed or Sunitinib (NSC # 736511) or Pemetrexed Plus Sunitinib in the Second-Line Treatment of Advanced Non-small Cell Lung Cancer
- ClinicalTrials.gov ID
- NCT00698815
- Acronym / sponsor ID
- NCI-2009-00471
- Conditions
- Recurrent Non-Small Cell Lung Carcinoma, Stage IIIB Non-Small Cell Lung Cancer AJCC v7, Stage IV Non-Small Cell Lung Cancer AJCC v7
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 130 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 15 Apr 2008 (actual)
- Primary completion
- 1 Dec 2011 (actual)
- First posted
- 17 Jun 2008 (estimated)
- Results
- Posted 19 Mar 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized phase II trial studies pemetrexed disodium and sunitinib malate to compare how well they work when given alone or together as second-line therapy in treating patients with stage IIIB or stage IV non-small cell lung cancer. Drugs used in chemotherapy, such as pemetrexed disodium, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. It is not yet known whether pemetrexed disodium and sunitinib malate are more effective when given alone or together in treating non-small cell lung cancer.
Detailed description
PRIMARY OBJECTIVES:
- To estimate the 18 week progression-free survival rate of pemetrexed (pemetrexed disodium) alone (Arm I), sunitinib (sunitinib malate) alone (Arm II) and pemetrexed plus sunitinib (Arm III) in the second-line setting of advanced non-small cell lung cancer (NSCLC).
SECONDARY OBJECTIVES:
- To compare the progression-free survival of the three arms. II. To estimate the response rate, duration of response, rate of stable disease, overall survival and to characterize the toxicity profiles of the three arms.
III. To estimate the response rate, duration of response, rate of stable disease, overall survival and toxicity of sunitinib in those patients on Arm I that receive this regimen in the third line setting.
IV. To assess vascular endothelial growth factor (VEGF) haplotypes in advanced non-small cell lung cancer.
- To test change in tumor size at 6 weeks (after 2 cycles of therapy, typically the first evaluation point in this type of study) as an early predictor of therapeutic activity in second-line treatment of non-small cell lung cancer.
OUTLINE: Patients are randomized to 1 of 3 treatment arms.
ARM I: Patients receive pemetrexed disodium intravenously (IV) over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in Arm II as third-line therapy.
ARM II: Patients receive sunitinib malate orally (PO) once daily (QD) on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in Arm I as third-line therapy.
ARM III: Patients receive pemetrexed disodium IV over 10 minutes on day 1 and sunitinib malate PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician.
After completion of study treatment, patients are followed up every 6 weeks until disease progression and then every 6 months for 2 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm I (pemetrexed) | Experimental | Other: Laboratory Biomarker Analysis, Drug: Pemetrexed DisodiumPatients receive pemetrexed disodium 500 mg/m^2 IV over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in Arm II as third-line therapy. |
| Arm II (sunitinib) | Experimental | Other: Laboratory Biomarker Analysis, Drug: Sunitinib MalatePatients receive sunitinib malate at 37.5 mg PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in Arm I as third-line therapy. |
| Arm III (pemetrexed and sunitinib) | Experimental | Other: Laboratory Biomarker Analysis, Drug: Pemetrexed Disodium, Drug: Sunitinib MalatePatients receive pemetrexed disodium 500 mg/m^2 IV over 10 minutes on day 1 and sunitinib malate at 37.5 mg PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (43 listed)
- Histologic documentation: histologic or cytologic documentation of NSCLC
- Stage: IIIB/IV with evidence of disease progression following first-line therapy
- Tumor site: lung (non-small cell)
- No cavitary lesions
- Only one prior chemotherapy regimen in the first-line stage IIIB/IV setting is allowed; this could have been either a platinum- or non-platinum-based regimen
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Laboratory Biomarker AnalysisCorrelative studies | Other | Arm I (pemetrexed), Arm II (sunitinib), Arm III (pemetrexed and sunitinib) |
| Pemetrexed DisodiumAlso: Alimta, LY231514, N-[4-[2-(2-Amino-4,7-dihydro-4-oxo-1H-pyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]-L-glutamic Acid Disodium SaltGiven IV | Drug | Arm I (pemetrexed), Arm III (pemetrexed and sunitinib) |
| Sunitinib MalateAlso: SU011248, SU11248, sunitinib, SutentGiven PO | Drug | Arm II (sunitinib), Arm III (pemetrexed and sunitinib) |
Primary outcome
18 Week Progression-free Survival (PFS) Rate
Time frame: At 18 weeks
The 18 week progression-free survival rate was defined as the proportion of patients that were alive and progression-free 18 weeks after registration into the study. Disease progression was assessed per modified RECIST criteria, and defined as at least a 20% increase in the sum of the longest diameters of target lesions, in either primary or nodal lesions, taking as reference the smallest sum longest diameter recorded since the baseline measurements, or the appearance of new lesions. Kaplan-Meier estimate of 18-week progression-free survival was calculated.
3 secondary outcomes
PFS
Time frame: Time from randomization to disease progression and death of any cause, whichever comes first (up to 3 years)
Overall Response Rate
Time frame: Duration of treatment (up to 3 years)
Overall Survival (OS)
Time frame: Time from randomization to death (up to 3 years)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Rebecca Heist principal investigator
Alliance for Clinical Trials in Oncology
129 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Laboratory Biomarker Analysis, Pemetrexed Disodium and Sunitinib Malate in people with Recurrent Non-Small Cell Lung Carcinoma and Stage IIIB Non-Small Cell Lung Cancer AJCC v7, run by National Cancer Institute (NCI) at 129 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 43 inclusion and 0 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 8 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 129 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. 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 19 Mar 2015). 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?
18 Week Progression-free Survival (PFS) Rate (time frame: At 18 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 8 Feb 2022; AzTrials last refreshed its copy on 6 Nov 2026.