R-(-)-Gossypol Acetic Acid in Treating Patients With Recurrent Extensive-Stage Small Cell Lung Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00773955
Recruitment Status : Completed
First Posted : October 16, 2008
Results First Posted : March 21, 2013
Last Update Posted : May 12, 2014
Information provided by (Responsible Party):
National Cancer Institute (NCI)

Brief Summary:
This phase II trial is studying how well R-(-)-gossypol acetic acid works in treating patients with recurrent extensive-stage small cell lung cancer. Drugs used in chemotherapy, such as R-(-)-gossypol acetic acid, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.

Condition or disease Intervention/treatment Phase
Extensive Stage Small Cell Lung Cancer Recurrent Small Cell Lung Cancer Drug: R-(-)-gossypol acetic acid Other: pharmacological study Other: laboratory biomarker analysis Phase 2

Detailed Description:


I. To determine the objective response rate of R-(-)-gossypol in patients with recurrent chemotherapy-sensitive extensive stage small cell lung cancer.

II. To determine the time to disease progression. III. To determine the overall survival. IV. To assess the toxicities associated with this drug. V. To explore whether intratumoral Bcl-2 family member expression correlates with sensitivity to targeting by R-(-)-gossypol.

VI. To explore whether the administration of R-(-)-gossypol causes specific induction of the intrinsic apoptotic pathway.

OUTLINE: This is a multicenter study.

Patients receive oral R-(-)-gossypol once daily on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Blood is collected periodically during treatment for pharmacodynamic analysis. Peripheral blood mononuclear cells are analyzed via protein isolation and western blotting for Bcl-2, cytoplasmic release of cytochrome c, and caspase activation. Available tumor tissue blocks are assessed by immunohistochemistry.

After completion of study therapy, patients are followed periodically for up to 5 years.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 15 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of AT-101 in Recurrent Extensive Stage Small Cell Lung Cancer
Study Start Date : November 2008
Actual Primary Completion Date : October 2009
Actual Study Completion Date : August 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lung Cancer

Arm Intervention/treatment
Experimental: Treatment (R-(-)-gossypol)
Patients receive oral R-(-)-gossypol once daily on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: R-(-)-gossypol acetic acid
Given orally
Other Name: AT-101

Other: pharmacological study
Correlative studies
Other Name: pharmacological studies

Other: laboratory biomarker analysis
Correlative studies

Primary Outcome Measures :
  1. Number of Participants With Confirmed Tumor Response Defined to be Either a Complete Response (CR) or Partial Response (PR) [ Time Frame: During the first 6 courses of treatment ]

    The number of successes will be estimated by counting the number of participants with confirmed responses. A confirmed tumor response is defined to be either a CR or PR noted as the objective status on 2 consecutive evaluations at least 4 weeks apart.

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions:

    A Complete Response (CR) requires the disappearance of all target lesions

    A Partial Response (PR) requires a >=30% decrease in the sum of the longest diameter of target lesions from baseline measurements.

Secondary Outcome Measures :
  1. Survival Time [ Time Frame: From registration to death due to any cause, assessed up to 5 years ]
    Estimated using the method of Kaplan-Meier.

  2. Time to Disease Progression [ Time Frame: From registration to the earliest date documentation of disease progression, assessed up to 5 years ]

    Time to disease progression is defined as the time from registration to the earliest date documentation of disease progression. Estimated using the method of Kaplan-Meier.

    Per the RECIST criteria, progression is defined as at least a 20% increase in the sum of Longest Dimension (LD) of target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.

  3. Duration of Response [ Time Frame: From the date at which the patient's earliest best objective status is first noted to be either a CR or PR to the earliest date progression is documented, assessed up to 5 years ]

Information from the National Library of Medicine

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

Inclusion Criteria:

  • Histologically or cytologically confirmed small cell lung cancer

    • Extensive stage disease
    • Recurrent disease
  • Measurable disease
  • Chemotherapy-sensitive disease, defined as:

    • No progression during first-line chemotherapy
    • No disease recurrence < 2 months after completion of first-line chemotherapy
  • Must have received prior platinum-based chemotherapy
  • No symptomatic or progressive brain metastases

    • Patients with previously treated brain metastases who are clinically and radiographically stable or improved and have been off steroids ≥ 14 days are eligible
  • ECOG performance status 0-2
  • Life expectancy > 12 weeks
  • Leukocytes ≥ 3,000/μL
  • ANC ≥ 1,500/μL
  • Platelet count ≥ 100,000/μL
  • Total bilirubin < 1.5 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Serum creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
  • Hemoglobin > 8 g/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception before, during, and for 30 days after completion of study therapy
  • Able to take oral medications on a regular basis
  • Willing to provide blood samples for mandatory correlative studies
  • No condition that impairs the ability to swallow and retain R-(-)-gossypol tablets, including the following:

    • Gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation
    • Active peptic ulcer disease
  • No malabsorption syndrome or disease significantly affecting gastrointestinal function
  • No ulcerative colitis, inflammatory bowel disease, or a partial or complete small bowel obstruction
  • No uncontrolled concurrent illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would limit compliance with study requirements
  • No symptomatic hypercalcemia > grade 2
  • No requirement for routine use of hematopoietic growth factors (including G-CSF, GM-CSF, or IL-11) or platelet transfusions to maintain ANC or platelet counts
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to R-(-)-gossypol
  • No HIV positivity
  • Recovered from all prior therapy, including prior surgical procedures
  • No prior surgical procedures affecting absorption
  • No prior resection of the stomach or small bowel
  • No more than one prior chemotherapy regimen
  • No prior racemic gossypol or R-(-)-gossypol
  • At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C)
  • At least 4 weeks since prior radiotherapy, hormonal agents, or biologic response modifiers
  • At least 4 weeks since prior and no concurrent investigational agents or devices
  • No concurrent prophylactic hematopoietic growth factors (including filgrastim [G-CSF], sargramostim [GM-CSF], or interleukin-11 [IL-11]) during course one
  • No concurrent combination antiretroviral therapy for HIV-positive patients

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00773955

United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
National Cancer Institute (NCI)
Principal Investigator: Maria Baggstrom Mayo Clinic

Responsible Party: National Cancer Institute (NCI) Identifier: NCT00773955     History of Changes
Obsolete Identifiers: NCT01647113
Other Study ID Numbers: NCI-2009-01058
NCI-2009-01058 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
MC0721 ( Other Identifier: Mayo Clinic )
8027 ( Other Identifier: CTEP )
N01CM62205 ( U.S. NIH Grant/Contract )
P30CA015083 ( U.S. NIH Grant/Contract )
N01CM62209 ( U.S. NIH Grant/Contract )
First Posted: October 16, 2008    Key Record Dates
Results First Posted: March 21, 2013
Last Update Posted: May 12, 2014
Last Verified: October 2011

Additional relevant MeSH terms:
Lung Neoplasms
Small Cell Lung Carcinoma
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Retinol acetate
Gossypol acetic acid
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Anticarcinogenic Agents
Protective Agents
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Contraceptive Agents, Female
Contraceptive Agents
Reproductive Control Agents
Spermatocidal Agents
Antispermatogenic Agents
Contraceptive Agents, Male