ZD6474 in Treating Patients With Small Cell Lung Cancer

This study has been completed.
Sponsor:
Information provided by:
AstraZeneca
ClinicalTrials.gov Identifier:
NCT00066313
First received: August 6, 2003
Last updated: April 7, 2011
Last verified: April 2011
  Purpose

RATIONALE: ZD6474 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. ZD6474 may also stop the growth of small cell lung cancer by blocking blood flow to the tumor.

PURPOSE: This randomized phase II trial is studying how well ZD6474 works compared to placebo in treating patients with small cell lung cancer that has responded to previous chemotherapy with or without radiation therapy.


Condition Intervention Phase
Lung Cancer
Drug: vandetanib
Procedure: adjuvant therapy
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Double-Blind
Primary Purpose: Treatment
Official Title: A Phase II Study Of ZD6474 Or Placebo In Small Cell Lung Cancer Patients Who Have Complete Or Partial Response To Induction Chemotherapy +/- Radiation Therapy

Resource links provided by NLM:


Further study details as provided by AstraZeneca:

Primary Outcome Measures:
  • Progression-free survival [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall Survival [ Designated as safety issue: No ]
  • Response rates [ Designated as safety issue: No ]
  • Toxicity and safety [ Designated as safety issue: Yes ]
  • Pharmacokinetics [ Designated as safety issue: No ]
  • Quality of life (QOL) as measured by EORTC QLQ-C30 and QLQ-LC13 [ Designated as safety issue: No ]

Study Start Date: May 2003
Study Completion Date: December 2006
Primary Completion Date: December 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Compare the progression-free survival of patients with previously treated small cell lung cancer (SCLC) treated with ZD6474 vs placebo.
  • Compare the response rate of patients treated with these regimens (only patients who had measurable disease outside a prior radiation field at study entry).
  • Compare the toxicity and tolerability of these regimens in these patients.
  • Compare the pharmacokinetics of these regimens in these patients.
  • Correlate outcome and response with vascular endothelial growth factor expression and microvessel density in patients treated with these regimens.
  • Compare the quality of life of patients treated with these regimens.
  • Provide a comprehensive tumor, plasma, and urine bank linked to a clinical database for further study of molecular markers in SCLC.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to participating center, timing of prior radiotherapy (early [before day 1, course 4 of chemotherapy] vs late vs no prior radiotherapy), stage of disease at diagnosis (limited vs extensive), and response at study entry (complete vs partial). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral ZD6474 daily.
  • Arm II: Patients receive oral placebo daily. In both arms, courses repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, every 4 weeks while on therapy, and then every 8 weeks until disease progression.

Patients are followed every 8 weeks until disease progression and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 100 patients (50 per treatment arm) will be accrued for this study.

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed small cell carcinoma of the lung

    • Small cell and variant histology allowed
    • No mixed tumors (small and large cell)
    • No neuroendocrine tumors of the lung
  • Must have received at least 4 courses of first-line combination chemotherapy as part of an induction regimen

    • No prior change in regimen due to disease progression
  • Must have achieved a radiologically confirmed (i.e., CT scan, chest x-ray, or bone scan) complete response (CR) or partial response (PR) after prior chemotherapy with or without radiotherapy AND meets 1 of the following criteria:

    • No more than 28 days since prior chemotherapy
    • At least 7 and no more than 14 days since prior radiotherapy if administered after completion of prior chemotherapy*
  • No CNS metastases

    • Asymptomatic patients with CNS metastases who received prior therapeutic cranial irradiation and are on stable, decreasing, or no steroids are eligible
    • No symptomatic lesions or evidence of necrosis or bleeding NOTE: *Randomization may take place up to 21 days after prior radiotherapy in the instance of severe esophagitis that precludes administration of oral medications

PATIENT CHARACTERISTICS:

Age

  • Over 16

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks

Hematopoietic

  • Absolute granulocyte count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • No history of bleeding diathesis

Hepatic

  • Bilirubin less than 1.5 times upper limit of normal (ULN)
  • ALT less than 2.5 times ULN

Renal

  • Creatinine less than 1.5 times ULN
  • Calcium normal

Cardiovascular

  • No prior ventricular arrhythmia that was symptomatic or required treatment (CTC grade 3), including any of the following:

    • Multifocal premature ventricular contractions
    • Bigeminy
    • Trigeminy
    • Ventricular tachycardia
  • No prior QT prolongation with any medication
  • No congenital long QT syndrome
  • No QT and QTc (with Bazett's correction) that is unmeasurable or is 460 msec or higher on screening ECG
  • No significant cardiac event, including symptomatic heart failure or angina, within the past 3 months or any cardiac disease that increases the risk for ventricular arrhythmia
  • No ongoing chronic atrial fibrillation
  • LVEF at least 45% by MUGA for patients with significant cardiac history (myocardial infarction, severe hypertension, or arrhythmia) OR who received prior doxorubicin greater than 450 mg/m^2

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Potassium normal
  • Magnesium normal
  • No serious active infection
  • No recent major bleeding
  • No other concurrent serious underlying medical condition that would preclude study participation
  • Willing and able to complete quality of life questionnaires in English or French

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior signal transduction inhibitors
  • No prior angiogenesis inhibitors
  • No concurrent anticancer biologic therapy or immunotherapy

Chemotherapy

  • See Disease Characteristics
  • Recovered from prior chemotherapy

Endocrine therapy

  • Not specified

Radiotherapy

  • See Disease Characteristics
  • Recovered from prior radiotherapy
  • No concurrent anticancer radiotherapy

    • Concurrent low-dose, nonmyelosuppressive palliative radiotherapy allowed

Surgery

  • More than 2 weeks since prior major surgery

Other

  • More than 4 weeks since prior investigational drugs
  • No prior epidermal growth factor receptor inhibitors
  • No prior vascular endothelial growth factor receptor inhibitors
  • No concurrent CYP3A4 inhibitors or inducers, including any of the following:

    • Verapamil
    • Rifampin
    • Phenytoin
    • Carbamazepine
    • Barbiturates
    • Hypericum perforatum (St. John's wort)
  • No concurrent medication that affects QT/QTc and/or induces torsades de pointes
  • No other concurrent anticancer cytotoxic therapy
  • No other concurrent investigational drugs during and for 30 days after study participation
  • No concurrent oral bisphosphonates (e.g., clodronate)

    • Concurrent IV bisphosphonates allowed
  • No concurrent 5HT_3 antagonists
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00066313

Locations
Canada, Alberta
Tom Baker Cancer Centre - Calgary
Calgary, Alberta, Canada, T2N 4N2
Cross Cancer Institute at University of Alberta
Edmonton, Alberta, Canada, T6G 1Z2
Canada, British Columbia
British Columbia Cancer Agency - Centre for the Southern Interior
Kelowna, British Columbia, Canada, V1Y 5L3
Fraser/Valley Cancer Centre at British Columbia Cancer Agency
Surrey, British Columbia, Canada, V3V 1Z2
British Columbia Cancer Agency - Vancouver Cancer Centre
Vancouver, British Columbia, Canada, V5Z 4E6
Canada, New Brunswick
Moncton Hospital
Moncton, New Brunswick, Canada, E1C 6ZB
Saint John Regional Hospital
Saint John, New Brunswick, Canada, E2L 4L2
Canada, Ontario
Margaret and Charles Juravinski Cancer Centre
Hamilton, Ontario, Canada, L8V 5C2
Cancer Centre of Southeastern Ontario at Kingston General Hospital
Kingston, Ontario, Canada, K7L 5P9
Ottawa Hospital Regional Cancer Centre - General Campus
Ottawa, Ontario, Canada, K1H 8L6
St. Catharines General Hospital at Niagara Health System
St. Catharines, Ontario, Canada, L2R 5K3
Northwestern Ontario Regional Cancer Care at Thunder Bay Regional Health Sciences Centre
Thunder Bay, Ontario, Canada, P7B 6V4
Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
Mount Sinai Hospital - Toronto
Toronto, Ontario, Canada, M5G 1X5
Toronto East General Hospital
Toronto, Ontario, Canada, M4C 3E7
Toronto Sunnybrook Regional Cancer Centre at Sunnybrook and Women's College Health Sciences Centre
Toronto, Ontario, Canada, M4N 3M5
Windsor Regional Cancer Centre at Windsor Regional Hospital
Windsor, Ontario, Canada, N8W 2X3
Canada, Quebec
Hopital Notre- Dame du CHUM
Montreal, Quebec, Canada, H2L 4M1
McGill Cancer Centre at McGill University
Montreal, Quebec, Canada, H2W 1S6
L'Hopital Laval
Ste-Foy, Quebec, Canada, G1V 4G5
Canada, Saskatchewan
Saskatoon Cancer Centre at the University of Saskatchewan
Saskatoon, Saskatchewan, Canada, S7N 4H4
Sponsors and Collaborators
AstraZeneca
Investigators
Study Chair: Andrew M. Arnold, MD Margaret and Charles Juravinski Cancer Centre
  More Information

Additional Information:
Publications:
Responsible Party: AstraZeneca
ClinicalTrials.gov Identifier: NCT00066313     History of Changes
Other Study ID Numbers: D4200C00005, CAN-NCIC-BR20, ZENECA-6474IL/0005, CDR0000315518
Study First Received: August 6, 2003
Last Updated: April 7, 2011
Health Authority: United States: Food and Drug Administration
United States: Federal Government

Keywords provided by AstraZeneca:
extensive stage small cell lung cancer
limited stage small cell lung cancer

Additional relevant MeSH terms:
Lung Neoplasms
Small Cell Lung Carcinoma
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms

ClinicalTrials.gov processed this record on September 14, 2014