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Celecoxib and Erlotinib in Treating Former Smokers With Stage IIIB or Stage IV Non-Small Cell Lung Cancer
This study has been completed.
First Received: August 4, 2004   Last Updated: August 14, 2009   History of Changes
Sponsor: Duke University
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00088959
  Purpose

RATIONALE: Celecoxib and erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.

PURPOSE: This phase I trial is studying the side effects and best dose of celecoxib when given together with erlotinib in treating former smokers with stage IIIB, stage IV, recurrent, or progressive non-small cell lung cancer


Condition Intervention Phase
Lung Cancer
Drug: celecoxib
Drug: erlotinib hydrochloride
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I Study of Erlotinib and Celecoxib in Former Smokers With Advanced Non-Small Cell Lung Cancer

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Clinical toxicity and tolerability as measured by NCI CTCAE v3.0 and protocol-specific definition of dose-limiting toxicity at 4 weeks after initiation of study treatment [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Tumor response rate as measured by RECIST at 4 weeks after initiation of study treatment and periodically thereafter [ Designated as safety issue: No ]
  • Effect of study drugs on biomarkers at 4 weeks after initiation of study treatment [ Designated as safety issue: No ]

Estimated Enrollment: 45
Study Start Date: September 2004
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the clinical toxicity and tolerability of celecoxib and erlotinib hydrochloride in former smokers with stage IIIB or IV or recurrent or progressive non-small cell lung cancer.

Secondary

  • Determine the tumor response rate in patients treated with this regimen.
  • Determine the dose of celecoxib that results in maximal induction of apoptosis, maximal inhibition of prostaglandin E_2 (PGE_2) in bronchoalveolar fluid, and maximal inhibition of bronchial cell proliferation in patients treated with this regimen.

OUTLINE: This is an open-label, dose-escalation study of celecoxib.

Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily. Treatment continues in the absence of disease progression or unacceptable toxicity.

Cohorts of 6 patients receive escalating doses of celecoxib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, up to 6 additional patients are treated at the MTD.

Patients are followed at 4 weeks.

PROJECTED ACCRUAL: A total of 6-45 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC) meeting 1 of the following stage criteria:

    • Stage IIIB with pleural effusion
    • Stage IV disease
    • Recurrent or progressive disease after prior surgery, radiotherapy, and/or chemotherapy
  • Meets 1 of the following criteria:

    • Advanced NSCLC with at least stable disease after ≥ 4 courses of platinum-containing chemotherapy
    • Relapsed or refractory disease after treatment with ≥ 1 prior platinum-containing chemotherapy program, including adjuvant or neoadjuvant therapy for NSCLC

      • If the sole prior treatment was in the adjuvant or neoadjuvant setting, tumor progression or recurrence must have occurred within 6 months after completion of prior treatment
  • Former smoker, as indicated by the following:

    • At least a 30 pack-year smoking history
    • Smoking duration at least 10 years
    • At least 12 months of self-reported smoking cessation
    • Negative urine cotinine
  • No untreated brain metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL
  • Hemostasis normal

Hepatic

  • Bilirubin ≤ 2.0 mg/dL
  • PT/PTT within 0.5 seconds of normal

Renal

  • Creatinine ≤ 2.0 mg/dL

Cardiovascular

  • No significant cardiovascular disease
  • No New York Heart Association class III or IV cardiac disease
  • No uncontrolled dysrhythmia
  • No unstable angina
  • No myocardial infarction within the past 6 months

Pulmonary

  • FEV_1 ≥ 1.0 liter OR 40% of predicted within the past 3 months
  • Oxygen saturation ≥ 90% on room air

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after study treatment
  • Willing to undergo bronchoscopy
  • No allergy to sulfonamides or hypersensitivity reaction to celecoxib
  • No other medical or psychological condition (e.g., acute psychosis) that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • See Disease Characteristics
  • At least 4 weeks since prior chemotherapy (6 weeks for mitomycin)

Endocrine therapy

  • Not specified

Radiotherapy

  • See Disease Characteristics
  • At least 4 weeks since prior radiotherapy

Surgery

  • See Disease Characteristics
  • Prior complete resection allowed provided there is histologic and cytologic documentation of disease recurrence

Other

  • More than 3 months since prior chemopreventative agents (e.g., oltipraz, retinoids, or N-acetylcysteine [NAC])
  • No prior erlotinib hydrochloride
  • No other prior EGFR antagonists
  • No concurrent medication known to interact with erlotinib hydrochloride or celecoxib, including the following:

    • Fluconazole
    • Lithium
    • Furosemide
    • Angiotensin-converting enzyme inhibitors
    • Phenytoin
    • Carbamazepine
    • Rifampin
    • Barbiturates
    • Hypericum perforatum (St. John's wort)
  • No concurrent non-steroidal anti-inflammatory drugs

    • Concurrent aspirin of up to an average dose of 325 mg/day allowed

      • No aspirin treatment for 7 days prior to any bronchoscopic or skin biopsy
  • No other concurrent EGFR inhibitors or cyclo-oxygenase-2 (COX-2) inhibitors
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00088959

Locations
United States, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27710
Veterans Affairs Medical Center - Durham
Durham, North Carolina, United States, 27705
Sponsors and Collaborators
Duke University
Investigators
Principal Investigator: Michael J. Kelley, MD Duke University
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000377689, DUMC-4939-04-6R2, DUMC-4939-03-6R0, VAMC-DURHAM-00813, DUMC-GCRC-911
Study First Received: August 4, 2004
Last Updated: August 14, 2009
ClinicalTrials.gov Identifier: NCT00088959     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
recurrent non-small cell lung cancer
stage IIIB non-small cell lung cancer
stage IV non-small cell lung cancer

Additional relevant MeSH terms:
Thoracic Neoplasms
Anti-Inflammatory Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Protein Kinase Inhibitors
Neoplasms by Site
Respiratory Tract Diseases
Lung Neoplasms
Sensory System Agents
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Erlotinib
Respiratory Tract Neoplasms
Celecoxib
Neoplasms by Histologic Type
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Pharmacologic Actions
Carcinoma
Neoplasms
Analgesics, Non-Narcotic
Lung Diseases
Peripheral Nervous System Agents
Antirheumatic Agents
Central Nervous System Agents
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on November 27, 2009