Pemetrexed Disodium and Bevacizumab in Treating Patients With Stage III or Stage IV Non-Small Cell Lung Cancer

This study has been completed.
Southwest Oncology Group
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: December 20, 2005
Last updated: June 17, 2012
Last verified: January 2007

RATIONALE: 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. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving pemetrexed disodium together with bevacizumab may be an effective treatment for non-small cell lung cancer.

PURPOSE: This phase II trial is studying how well giving pemetrexed disodium together with bevacizumab works in treating patients with stage III or stage IV non-small cell lung cancer.

Condition Intervention Phase
Lung Cancer
Biological: bevacizumab
Drug: pemetrexed disodium
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Pemetrexed Disodium (ALIMTA®) Plus Bevacizumab in Patients With Stage IIIB Pleural Effusion or Stage IV Non-Small Cell Lung Cancer (Second-Line Treatment)

Resource links provided by NLM:

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

Primary Outcome Measures:
  • Proportion of progression-free patients at 3 months [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response (complete and partial) as assessed by RECIST criteria [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Time to treatment failure [ Designated as safety issue: No ]

Estimated Enrollment: 46
Study Start Date: May 2006
Primary Completion Date: May 2007 (Final data collection date for primary outcome measure)
Detailed Description:



  • Assess the 3 month progression-free survival rate of the combination of pemetrexed disodium with bevacizumab in a patient population with stage IIIB (due to pleural effusion) or IV non-small cell lung cancer.


  • Determine the tumor response rate in these patients.
  • Determine the effect of pemetrexed disodium in combination with bevacizumab on overall survival and duration of response in these patients.
  • Determine the toxicity profile of this drug regimen in these patients.

OUTLINE: This is an open-label, multicenter study.

Patients receive pemetrexed disodium IV over 10 minutes and bevacizumab IV over 30-90 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically for 5 years.

PROJECTED ACCRUAL: A total of 46 patients will be accrued for this study.


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


  • Histologically or cytologically diagnosed stage IIIB or IV non-small cell lung cancer

    • Stage IIIB patients must have pleural effusion

      • No symptomatic serosal effusion (grade 2 dyspnea) that is not amenable to drainage
    • Mixed histology allowed if all components consistent with non-small cell lung cancer
    • Tumors with squamous cell histology feature are allowed
  • Must have measurable disease with at least one lesion with a longest diameter accurately measured as ≥ 2.0 cm with conventional techniques or as ≥ 1.0 cm with spiral CT

    • Large ( > 4 cm) centrally located lesions or large lesions in close proximity to major blood vessels should receive palliative radiation

      • The irradiated lesion should not be a target lesion
  • Previously treated with one chemotherapy regimen in the neoadjuvant, adjuvant, or advanced disease setting
  • No symptomatic, untreated, or uncontrolled CNS metastases

    • CNS metastases treated with prior whole brain radiotherapy allowed


  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/ mm^3
  • Hemoglobin ≥ 9 g/dL
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN) or direct bilirubin normal
  • AST and ALT ≤ 3 times ULN (5 times ULN if liver has tumor involvement)
  • Creatinine clearance ≥ 45 mL/min
  • Urine protein:creatinine ratio < 1.0
  • Pregnant or nursing women are ineligible
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after study participation
  • No seizure disorder
  • No clinically significant infection
  • No other second primary malignancy within the past 5 years except carcinoma in situ of the cervix, non-melanomatous skin cancer, or low-grade (Gleason score ≤ 6) localized prostate cancer
  • No hypertension or labile hypertension
  • No history of poor compliance with antihypertensive medications
  • No angina pectoris
  • No congestive heart failure within the past 3 months unless ejection fraction > 40%
  • No myocardial infarction within the past 6 months
  • No cardiac arrhythmia
  • No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung
  • No active or recent history of hemoptysis

    • Hemoptysis resolved > 2 weeks ago with measures such as palliative radiation therapy (i.e., 3,000 cGy over 10 fractions), arteriographic embolization, or endobronchial interventions (e.g., photodynamic therapy or brachytherapy) is acceptable
  • No diabetes
  • No prior serious, non-healing wounds, ulcers, or bone fractures
  • No history of stroke within the past 6 months
  • No history of abdominal fistula or gastrointestinal perforation
  • No intra-abdominal abscess within the past 6 months
  • Not at greater than average risk of bleeding
  • No significant traumatic injury within the past 4 weeks


  • No aspirin at doses ≥ 1.3 grams per day within 10 days prior to or 10 days after pemetrexed disodium treatment
  • No chemotherapy within the past 3 weeks (6 weeks for mitomycin C or nitrosoureas)
  • No immunotherapy or biologic therapy within the past 2 weeks
  • No full field radiation therapy within the past 4 weeks or limited field radiation therapy within the past 2 weeks

    • The site of previous radiotherapy should have evidence of progressive disease if it is the only site of disease
  • No prior post pelvic radiation
  • No prior use of pemetrexed disodium
  • No prior radiation to > 25% of the marrow cavity
  • No major surgery (i.e., laparotomy) or open biopsy within the past 4 weeks
  • No minor surgery within the past 2 weeks except insertion of a vascular access device
  • No concurrent major surgery
  • No other chemotherapy, immunotherapy, hormonal therapy, radiotherapy, or any ancillary therapy considered investigational within the past 4 weeks
  • No concurrent use of Hypericum perforatum (St. John's wort)
  • No concurrent anticoagulant use

    • Low-dose warfarin or heparin for deep venous thrombosis prophylaxis allowed
  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 identifier: NCT00268489

  Show 248 Study Locations
Sponsors and Collaborators
North Central Cancer Treatment Group
Southwest Oncology Group
Study Chair: Alex A. Adjei, MD, PhD Roswell Park Cancer Institute
Investigator: Donald B. Wender, MD, PhD St. Luke's Regional Medical Center
Study Chair: Ralph G. Zinner, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
Adjei AA, Mandrekar SJ, Dy GK, et al.: A phase II second-line study of pemetrexed (pem) in combination with bevacizumab (bev) in patients with advanced non-small cell lung cancer (NSCLC): An NCCTG and SWOG study. [Abstract] J Clin Oncol 26 (Suppl 15): A-8080, 2008. Identifier: NCT00268489     History of Changes
Other Study ID Numbers: CDR0000456427, NCCTG-N0426, SWOG-N0426
Study First Received: December 20, 2005
Last Updated: June 17, 2012
Health Authority: United States: Federal Government

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

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Bronchial Neoplasms
Carcinoma, Bronchogenic
Lung Diseases
Neoplasms by Site
Respiratory Tract Diseases
Respiratory Tract Neoplasms
Thoracic Neoplasms
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Antimetabolites, Antineoplastic
Antineoplastic Agents
Enzyme Inhibitors
Folic Acid Antagonists
Growth Inhibitors
Growth Substances
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses processed this record on July 07, 2015