Panobinostat, Etoposide, and Cisplatin as First-Line Therapy in Treating Patients With Extensive-Stage Small Cell Lung Cancer
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Purpose
RATIONALE: Panobinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as etoposide and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving panobinostat together with etoposide and cisplatin may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of panobinostat when given together with etoposide and cisplatin as first-line therapy in treating patients with extensive-stage small cell lung cancer.
| Condition | Intervention | Phase |
|---|---|---|
| Lung Cancer | Drug: cisplatin Drug: etoposide phosphate Drug: panobinostat Other: laboratory biomarker analysis Other: pharmacological study | Phase 1 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment |
| Official Title: | A Phase I Dose Finding Study of the Pan-DAC Inhibitor Panobinostat (LBH589) in Combination With Etoposide and Cisplatin in the First Line Treatment of Extensive-Stage Small Cell Lung Cancer - An ICORG In-House Study |
- Maximum-tolerated dose (MTD) and recommended dose (RD)
- Response rates and toxicity at MTD and RD
- Objective response rate according to RECIST criteria
- Time to progression according to RECIST criteria
- Duration of response or disease stabilization according to RECIST criteria
- Overall survival according to RECIST criteria
- Effect of the combination regimen on drug pharmacokinetics
- Adverse events
- Quality of life evaluated by EQ-5D (Euro QoL)
| Enrollment: | 0 |
| Study Start Date: | November 2009 |
| Primary Completion Date: | October 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Cisplatin, Etoposide & Panobinostat | Drug: cisplatin Drug: etoposide phosphate Drug: panobinostat Other: laboratory biomarker analysis Other: pharmacological study |
Detailed Description:
OBJECTIVES:
Primary
- To determine the maximum-tolerated dose, the recommended dose, and the activity of panobinostat when given in combination with etoposide and cisplatin to patients with extensive-stage small cell lung cancer.
Secondary
- To estimate the time-to-progression, the duration of response, and disease stabilization in these patients.
- To estimate the overall survival of these patients.
- To determine the pharmacokinetic profile of panobinostat in combination with etoposide and cisplatin.
- To assess the overall safety profile of panobinostat in these patients.
- To determine the adverse events in these patients treated with this regimen.
- To assess the quality of life of these patients.
OUTLINE: This is a multicenter, dose-escalation study of panobinostat.
Patients receive chemotherapy comprising cisplatin IV on day 1, etoposide IV on days 1-3, and panobinostat IV over 30 minutes on days 1 and 8. Treatment repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed at baseline and then periodically during study treatment and follow up, using questionnaire EQ-5D (Euro QoL).
Blood samples may be collected at baseline and periodically during and after study treatment for pharmacokinetic assessment and biomarker translational studies.
After completion of study treatment, patients are followed up at 4 weeks and then every 3 months.
Eligibility
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| Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
-
Histologically or cytologically confirmed small cell lung cancer
- Extensive-stage disease
- Measurable disease according to RECIST criteria
- No symptomatic brain metastasis or meningeal tumors
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
- Life expectancy ≥ 6 months
- Absolute neutrophil count > 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 10.0 g/dL
- Serum creatinine ≤ 1.5 x upper limit of normal (ULN) OR 24-hour creatinine clearance ≥ to 60 mL/min
- Magnesium, potassium, and phosphorus ≥ the lower limit of normal OR correctable with supplements prior to study treatment
- AST/ALT ≤ 2.5 x ULN (≤ 5.0 x ULN if hepatic metastases are present)
- Serum bilirubin ≤ 1.5 x ULN
- Alkaline phosphatase ≤ 2.5 x ULN OR liver fraction ≤ 2.5 x ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective double contraception (at least 1 barrier method) during and for at least 30 days after completion of study treatment
-
No impaired cardiac function, including any one of the following:
- LVEF < 45% as determined by ECHO
- Complete left bundle branch block, obligate use of a cardiac pacemaker, congenital long QT syndrome, history or presence of atrial or ventricular tachyarrhythmias, clinically significant resting bradycardia (< 50 beats per minute), QTcF > 480 msec on screening ECG, or right bundle branch block and left anterior hemiblock (bifascicular block)
- Uncontrolled angina pectoris or acute myocardial infarction within the past 3 months
- Other clinically significant heart disease (e.g., congestive heart failure, uncontrolled hypertension, history of labile hypertension, or history of poor compliance with an antihypertensive regimen)
- No history of HIV or AIDS-related illness
- No acute or chronic liver or renal disease
-
No other concurrent severe and/or uncontrolled medical conditions that could cause unacceptable safety risks or compromise compliance with the protocol, including any of the following:
- Uncontrolled diabetes
- Chronic obstructive or chronic restrictive pulmonary disease
- Active or uncontrolled infection
- No known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to panobinostat, cisplatin, or etoposide
- No hearing impairment that would be a contraindication to the use of cisplatin
PRIOR CONCURRENT THERAPY:
- No prior chemotherapy
- No investigational drug or experimental medications or treatments within the past 30 days or 5 half-lives, whichever is longer
Contacts and Locations
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 ClinicalTrials.gov identifier (NCT number): NCT01160731
| Principal Investigator: | Paul Donnellan | Galway University Hospital |
More Information
| Responsible Party: | Cancer Trials Ireland |
| ClinicalTrials.gov Identifier: | NCT01160731 History of Changes |
| Other Study ID Numbers: |
07-09 ICORG ICORG-07-09 EUDRACT-2008-003634-21 EU-21047 |
| First Submitted: | July 9, 2010 |
| First Posted: | July 12, 2010 |
| Last Update Posted: | December 31, 2014 |
| Last Verified: | October 2012 |
Keywords provided by Cancer Trials Ireland:
|
extensive stage small cell lung cancer |
Additional relevant MeSH terms:
|
Lung Neoplasms Small Cell Lung Carcinoma Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Neoplasms Lung Diseases Respiratory Tract Diseases Carcinoma, Bronchogenic Bronchial Neoplasms Etoposide phosphate |
Panobinostat Cisplatin Etoposide Antineoplastic Agents Antineoplastic Agents, Phytogenic Topoisomerase II Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Histone Deacetylase Inhibitors |