Carboplatin and Gemcitabine Combined With Celecoxib and/or Zileuton in Treating Patients With Advanced Non-Small Cell Lung Cancer

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Alliance for Clinical Trials in Oncology
ClinicalTrials.gov Identifier:
NCT00070486
First received: October 3, 2003
Last updated: September 28, 2013
Last verified: September 2013
  Purpose

RATIONALE: Drugs used in chemotherapy, such as carboplatin and gemcitabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Celecoxib and zileuton may stop the growth of tumor cells by stopping blood flow to the tumor and may block the enzymes necessary for tumor cell growth. Combining chemotherapy with celecoxib and/or zileuton may kill more tumor cells.

PURPOSE: Randomized phase II trial to study the effectiveness of combining celecoxib and/or zileuton with carboplatin and gemcitabine in treating patients who have advanced non-small cell lung cancer.


Condition Intervention Phase
Lung Cancer
Drug: carboplatin
Drug: celecoxib
Drug: gemcitabine hydrochloride
Drug: zileuton
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Randomized Phase II Study of Eicosanoid Pathway Modulators and Cytotoxic Chemotherapy in Advanced Non-Small Cell Lung Cancer

Resource links provided by NLM:


Further study details as provided by Alliance for Clinical Trials in Oncology:

Primary Outcome Measures:
  • Disease free survival [ Time Frame: 9 months ] [ Designated as safety issue: No ]

Enrollment: 140
Study Start Date: December 2003
Study Completion Date: May 2011
Primary Completion Date: December 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Gem + Carboplatin + Zileuton Drug: carboplatin
given IV
Drug: gemcitabine hydrochloride
given IV
Drug: zileuton
given PO
Experimental: Gem + Carboplatin + celecoxib Drug: carboplatin
given IV
Drug: celecoxib
given PO
Drug: gemcitabine hydrochloride
given IV
Experimental: Gem + carboplatin + zilueton + celecoxib Drug: carboplatin
given IV
Drug: celecoxib
given PO
Drug: gemcitabine hydrochloride
given IV
Drug: zileuton
given PO

Detailed Description:

OBJECTIVES:

Primary

  • Compare the efficacy of carboplatin and gemcitabine with celecoxib and/or zileuton, in terms of 7-month progression-free survival, in patients with advanced non-small cell lung cancer.

Secondary

  • Compare the response rate, distribution of survival, and failure-free survival time of patients treated with these regimens.
  • Correlate CYFRA and serum vascular endothelial growth factor levels with response and survival of patients treated with these regimens.
  • Correlate cyclo-oxygenase-2 and 5-lipoxygenase expression with survival of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive gemcitabine IV over 30 minutes on days 1 and 8, carboplatin IV over 30 minutes on day 1, and oral zileuton 4 times daily on days 1-21.
  • Arm II: Patients receive gemcitabine and carboplatin as in arm I and oral celecoxib twice daily on days 1-21.
  • Arm III: Patients receive gemcitabine and carboplatin as in arm I, oral celecoxib as in arm II, and oral zileuton as in arm I.

In all arms, treatment repeats every 21 days for 6 courses. Patients with responding or stable disease continue courses of zileuton and/or celecoxib in the absence of disease progression or unacceptable toxicity.

Patients are followed monthly for 1 year, every 2 months for 2 years, and then every 4 months for 3 years or until disease progression.

PROJECTED ACCRUAL: A total of 117 patients (39 per treatment arm) will be accrued for this study within 11-12 months.

  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) of 1 of the following cellular types:

    • Adenocarcinoma
    • Large cell
    • Squamous cell
    • Mixed
  • Meets 1 of the following staging criteria:

    • Stage IIIB disease with malignant pleural effusion, supraclavicular node involvement, or contralateral hilar nodes

      • Stage IIIB patients eligible for Cancer and Leukemia Group B protocols of combined chemotherapy and chest irradiation are not allowed
    • Stage IV disease
  • Measurable or nonmeasurable disease

    • Unidimensionally measurable lesions at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
    • The following are considered nonmeasurable disease:

      • Bone lesions
      • Ascites
      • Pleural/pericardial effusion
      • Lymphangitis cutis/pulmonis
      • Abdominal masses that are not confirmed and followed by imaging techniques
      • Cystic lesions
      • Small lesions
  • No leptomeningeal disease
  • Symptomatic CNS metastases must be treated (e.g., surgery, radiotherapy, or gamma knife), neurologically stable, and off steroids

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • Granulocyte count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3

Hepatic

  • Bilirubin no greater than 1.5 mg/dL
  • AST no greater than 2.0 times upper limit of normal

Renal

  • Creatinine no greater than 1.5 mg/dL

Cardiovascular

  • None of the following within the past 6 months:

    • Myocardial infarction
    • Unstable angina
    • Symptomatic congestive heart failure
    • Serious uncontrolled cardiac arrhythmia
    • Cerebrovascular accident
    • Transient ischemic attack
    • Symptomatic carotid artery or peripheral vascular disease
    • Deep vein thrombosis
    • Significant thromboembolic event

Pulmonary

  • No pulmonary embolism within the past 6 months

Gastrointestinal

  • No history of gastrointestinal (GI) bleeding
  • No history of peptic ulcer disease
  • No active GI bleeding

Other

  • Not pregnant or nursing
  • No known hypersensitivity to aspirin, NSAIDs, or sulfonamides
  • No currently active second malignancy other than nonmelanoma skin cancer

    • Patients are not considered to have a currently active malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior immunotherapy for NSCLC

Chemotherapy

  • No prior chemotherapy for NSCLC
  • No other concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics
  • No concurrent chronic oral steroids

    • Concurrent episodic steroids for antiemetic purposes allowed
  • No concurrent hormonal therapy
  • Concurrent inhaled steroids allowed when medically indicated
  • Concurrent megestrol for appetite stimulation is allowed

Radiotherapy

  • See Disease Characteristics
  • At least 2 weeks since prior radiotherapy and recovered

Surgery

  • See Disease Characteristics
  • At least 2 weeks since prior surgery and recovered

Other

  • No prior systemic treatments for NSCLC
  • No other concurrent investigational therapy
  • At least 1 week since prior nonsteroidal anti-inflammatory drugs (NSAIDs), including any of the following:

    • Rofecoxib
    • Choline magnesium trisalicylate
    • Ibuprofen
    • Naproxen
    • Etodolac
    • Oxaprozin
    • Diflunisal
    • Nabumetone
    • Tolmetin
    • Valdecoxib
  • No concurrent NSAIDs
  • No concurrent chronic aspirin

    • Concurrent aspirin no greater than 325 mg/day is allowed
  • No concurrent fluconazole
  • No concurrent leukotriene antagonists (e.g., zafirlukast, montelukast, or pranlukast)
  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: NCT00070486

  Show 75 Study Locations
Sponsors and Collaborators
Alliance for Clinical Trials in Oncology
Investigators
Study Chair: Martin J. Edelman, MD University of Maryland Greenebaum Cancer Center
  More Information

Additional Information:
Publications:
Responsible Party: Alliance for Clinical Trials in Oncology
ClinicalTrials.gov Identifier: NCT00070486     History of Changes
Other Study ID Numbers: CDR0000334573, U10CA031946, CALGB-30203
Study First Received: October 3, 2003
Last Updated: September 28, 2013
Health Authority: United States: Federal Government

Keywords provided by Alliance for Clinical Trials in Oncology:
stage IV non-small cell lung cancer
adenocarcinoma of the lung
squamous cell lung cancer
large cell lung cancer
stage IIIB non-small cell lung cancer

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Carcinoma, Bronchogenic
Bronchial Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Gemcitabine
Zileuton
Celecoxib
Carboplatin
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Radiation-Sensitizing Agents
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics

ClinicalTrials.gov processed this record on August 28, 2014