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Abraxane and Alimta in Advanced Solid Tumors

This study has been terminated.
(Practice patterns with pemetrexed have evolved.)
Sponsor:
Collaborators:
Celgene
Eli Lilly and Company
Information provided by (Responsible Party):
University of California, Davis
ClinicalTrials.gov Identifier:
NCT00470548
First received: May 3, 2007
Last updated: May 16, 2017
Last verified: May 2017
  Purpose

RATIONALE: Drugs used in chemotherapy, such as paclitaxel albumin-stabilized nanoparticle formulation, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Pemetrexed may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving paclitaxel albumin-stabilized nanoparticle formulation together with pemetrexed may kill more tumor cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of paclitaxel albumin-stabilized nanoparticle formulation when given together with pemetrexed and to see how well they work in treating patients with advanced non-small cell lung cancer, breast cancer, or other solid tumors.


Condition Intervention Phase
Breast Cancer Lung Cancer Unspecified Adult Solid Tumor, Protocol Specific Drug: Abraxane Drug: Alimta Phase 1 Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I/II Trial of Abraxane® (ABI-007) and Alimta® (Pemetrexed) in Advanced Solid Tumors With Emphasis on Non-Small Cell Lung Cancer (NSCLC) and Breast Cancer

Resource links provided by NLM:


Further study details as provided by University of California, Davis:

Primary Outcome Measures:
  • Number of Participants With Dose Limiting Toxicities [ Time Frame: Up to21 days ]
    Dose limiting toxicity (DLT) was defined as any of the following occurring during the first cycle: Grade 4 thrombocytopenia, or grade 3 thrombocytopenia associated with bleeding, requirement for transfusion, febrile neutropenia, neutropenia with documented infection. Non-hematologic DLT included any other ≥ grade 3 non-hematologic toxicity that was clinically significant and considered by the investigator to be related to study drug. Alopecia and grade 3 allergic reaction/hypersensitivity with infusion were not considered DLTs.

  • Number of Patients With Toxicities [ Time Frame: Up to 1 year ]
    Toxicities was evaluated based on the standard NCI CTCAE Version 3.0 grading criteria. Attributable grade ≥ 3 hematologic and non-hematologic toxicities are presented here.


Secondary Outcome Measures:
  • Duration of Overall Survival [ Time Frame: Up to 2 years ]
    From time of enrollment to the first observation of disease progression or death.

  • Number of Participants With Complete Response [ Time Frame: Up to 2 years ]
    Per RECIST criteria, complete response (CR) is defined as the disappearance of all target lesions.

  • Number of Participants With Stable Disease [ Time Frame: Up to 2 years ]
    Stable Disease is measured from the start of the treatment until the criteria for disease progression are met. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

  • Number of Participants With Partial Response [ Time Frame: Up to 2 years ]
    At least a 30% decrease in the sum of the longest diameter of target lesions

  • Number of Participants With Disease Control [ Time Frame: Up to 2 years ]
    Disease control is complete response plus partial response plus stable disease from the start of treatment to death or disease progression.


Enrollment: 49
Study Start Date: April 2007
Study Completion Date: October 2014
Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Phase I: Abraxane and Alimta
Three dose levels were tested. Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 180, 220, and 260 mg/m2 every 21 days.
Drug: Abraxane
ABI-007 IV administration following pemetrexed on Day 1 of each cycle (infused over 30 minutes)
Other Names:
  • paclitaxel albumin-stabilized nanoparticle formulation
  • ABI-007
Drug: Alimta
Pemetrexed IV administration on Day 1 of each cycle (infused over 10 minutes)
Other Name: pemetrexed disodium
Experimental: Phase II: Abraxane and Alimta
Pemetrexed 500mg/m2 day 1 and nab-paclitaxel day 1 at 260 mg/m2 every 21 days.
Drug: Abraxane
ABI-007 IV administration following pemetrexed on Day 1 of each cycle (infused over 30 minutes)
Other Names:
  • paclitaxel albumin-stabilized nanoparticle formulation
  • ABI-007
Drug: Alimta
Pemetrexed IV administration on Day 1 of each cycle (infused over 10 minutes)
Other Name: pemetrexed disodium

Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety of paclitaxel albumin-stabilized nanoparticle formulation when administered with pemetrexed disodium in patients with advanced non-small cell lung cancer, breast cancer, or other solid tumors. (Phase I)
  • Determine the efficacy of this regimen, as measured by objective tumor response rate (RECIST criteria), in these patients. (Phase II)

Secondary

  • Determine the preliminary efficacy of paclitaxel albumin-stabilized nanoparticle formulation and pemetrexed disodium in these patients. (Phase I)
  • Determine the overall survival of patients treated with this regimen. (Phase II)
  • Evaluate the frequency and severity of toxicities associated with this regimen. (Phase II)

OUTLINE: This is a phase I, dose-escalation study of paclitaxel albumin-stabilized nanoparticle formulation followed by an open-label, phase II study.

  • Phase I: Patients receive pemetrexed disodium IV over 10 minutes and paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of paclitaxel albumin-stabilized nanoparticle formulation until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

  • Phase II: Patients receive pemetrexed disodium and paclitaxel albumin-stabilized nanoparticle formulation at the MTD as in phase I.

After completion of study treatment, patients are followed periodically.

  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  1. For the phase II portion patients must have cytologically or histologically proven selected stage IIIB (pleural effusion) or IV NSCLC.
  2. For the phase II portion patients must have NSCLC that has progressed or recurred after treatment with platinum-based therapy.
  3. No prior pemetrexed. Prior Taxol is allowed. Prior ABI 007 is not allowed.
  4. Patients must have measurable disease by RECIST criteria for the phase II portion.
  5. Patients must be 18 years of age or older.
  6. Patients must have a performance status of 0 -2
  7. Patients must have an estimated survival of at least 3 months.
  8. Any prior chemotherapy must have been completed at least 4 weeks prior to start of treatment.
  9. Patients must have adequate renal function as documented by a calculated creatinine clearance of > 45 ml/min
  10. Patients must have adequate liver functions: AST and ALT < 2.5 X upper limit of normal, and bilirubin < upper limit of normal.
  11. Patients must have adequate bone marrow function: Platelets >100,000 cells/mm3 and ANC > 1,500 cells/mm3.
  12. For patients who have baseline clinically significant pleural or peritoneal effusions (on the basis of symptoms or clinical examination) before initiation of pemetrexed therapy, consideration should be given to draining the effusion prior to dosing.
  13. Patients with asymptomatic treated brain metastasis (surgical resection or radiotherapy) may be included if they are neurologically stable and have been off steroids and anticonvulsants for at least 4 weeks.
  14. Patients must be able to take and retain oral medication.
  15. Ability to take folic acid, vitamin B12 and dexamethasone according to protocol.
  16. Ability to interrupt NSAIDS 2 days before, the day of, and 2 days following administration of pemetrexed.
  17. Patients of reproductive potential must agree to use effective contraceptive method while on treatment and for 3 months afterwards as the effects of these drugs on the unborn fetus are unknown.
  18. No other current active malignancy.
  19. Patient or his/her legally authorized representative or guardian signed the Informed Consent form prior to participation in any study-related activities.

Exclusion Criteria

  1. Pregnant or breastfeeding women.
  2. Patient with pre-existing peripheral neuropathy of NCI CTCAE Version 3.0 of grade 2.
  3. Patient has a clinically significant concurrent illness.
  4. Patient is currently enrolled in a different clinical study in which investigational procedures are performed or investigational therapies are administered.
  5. Patient has a history of allergy or hypersensitivity to the study drugs or a taxane.
  6. Patient has serious medical risk factors involving any of the major organ systems such that the investigator considers it unsafe for the patient to receive an experimental research drug.
  7. Prior therapy with pemetrexed, or ABI-007.
  8. Patient is receiving treatment with any excluded concomitant medication.
  9. Presence of third space fluid which cannot be controlled by drainage.
  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: NCT00470548

Locations
United States, California
University of California Davis Cancer Center
Sacramento, California, United States, 95817
Sponsors and Collaborators
University of California, Davis
Celgene
Eli Lilly and Company
Investigators
Study Chair: David R. Gandara, MD University of California, Davis
  More Information

Publications:
Responsible Party: University of California, Davis
ClinicalTrials.gov Identifier: NCT00470548     History of Changes
Other Study ID Numbers: UCDCC#185
H3E-US-I017 ( Other Grant/Funding Number: Eli Lilly )
ABX027 ( Other Grant/Funding Number: Celgene )
Study First Received: May 3, 2007
Results First Received: January 17, 2017
Last Updated: May 16, 2017

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by University of California, Davis:
male breast cancer
recurrent breast cancer
stage IIIA breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage IV breast cancer
stage IIIA non-small cell lung cancer
stage IIIB non-small cell lung cancer
stage IV non-small cell lung cancer
recurrent non-small cell lung cancer
unspecified adult solid tumor, protocol specific

Additional relevant MeSH terms:
Breast Neoplasms
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Respiratory Tract Neoplasms
Thoracic Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Paclitaxel
Albumin-Bound Paclitaxel
Pemetrexed
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors

ClinicalTrials.gov processed this record on September 21, 2017