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Lenalidomide and Paclitaxel in Advanced Solid Tumors

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.
 
ClinicalTrials.gov Identifier: NCT01155505
Recruitment Status : Unknown
Verified September 2011 by Southern Europe New Drug Organization.
Recruitment status was:  Active, not recruiting
First Posted : July 1, 2010
Last Update Posted : September 13, 2011
Sponsor:
Collaborator:
Celgene Corporation
Information provided by (Responsible Party):
Southern Europe New Drug Organization

Tracking Information
First Submitted Date  ICMJE June 30, 2010
First Posted Date  ICMJE July 1, 2010
Last Update Posted Date September 13, 2011
Study Start Date  ICMJE November 2009
Estimated Primary Completion Date December 2011   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 30, 2010)
Define the MTD of the combination of CC-5013 and paclitaxel in patients with advanced solid tumors [ Time Frame: 4 weeks after the first drug administration ]
Number of Dose-Limiting Toxicities (DLTs)
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 30, 2010)
  • Safety profile of the drug combination [ Time Frame: from the first administration to 30 days after the trial end ]
    Physical examination, laboratory and instrumental assessments and AE type and frequency
  • Pharmacokinetics of CC-5013 and paclitaxel given in combination [ Time Frame: untill 4 weeks after the first drug administration ]
    CC-5013 and paclitaxel plasma concentration
  • the pharmacodynamic effects of CC-5013 and paclitaxel given in combination [ Time Frame: from the first drug administration to 30 days after trial end ]
    Increase (%) in selected serum cytokines (IL2, IL6, IL10, IL12, TNFα, γIF and TGFβ). T-cell phenotyping:
    • T-cell markers (CD4/CD45RA/CCR7/CD3,CD8/CD45RA/CCR7/CD3)
    • Treg markers: CD4/CD25/FoxP3
    • NKcells: CD16+/CD56+
  • Evidence of antitumor activity in selected tumor types [ Time Frame: From the first drug administration to 30 days after the trial end ]
    Response Rate according to RECIST criteria
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Lenalidomide and Paclitaxel in Advanced Solid Tumors
Official Title  ICMJE Phase Ib of CC-5013 and Paclitaxel in Patients With Advanced Solid Tumors
Brief Summary

This is a dose finding, open-label, uncontrolled, dose-escalation trial to determine the maximum Tolerated Dose (MTD) of the combination of CC-5013 (Lenalidomide)and paclitaxel in patients with advanced solid tumors.

Other purposes of the study are:

  1. Define the safety profile of the CC-5013 and paclitaxel given in combination
  2. Define the pharmacokinetics of CC-5013 and paclitaxel given in combination
  3. Define the pharmacodynamic effects of the combination by monitoring potential biomarkers of the different biological activities of each component of the regimen
  4. Define the optimal biological dose (OBD) and the dose recommended (RD) for phase II studies in selected tumor types (breast, ovary, prostate, NSCLC)
  5. Collect evidence of antitumor activity in selected tumor types
Detailed Description

The new immunomodulatory drugs (IMiD) derivatives of thalidomide (CC-5013 lenalidomide and CC4047 pomalidomide) are endowed of direct antitumor activity besides the indirect effects attributed to antiangiogenic, antiinflammatory and T-cell co-stimulatory properties.

Combination therapy with cytotoxic agents or other anticancer drugs could lead to additive or synergistic interactions and support their clinical development in tumor types in which the specific activities of IMiDs could be of potential value.

Combinations with weekly paclitaxel could be of interest because of its antiangiogenic activity, antitumor activity in prostate, NSCLC, ovary, breast cancer, tumor types in which IMiD could be of clinical value because of either enhancement of tumor specific immunity (ovary, prostate) or inhibition of Treg function (breast, NSCLC, ovary).

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Advanced Solid Tumors
Intervention  ICMJE Drug: Lenalidomide (CC-5013)
CC-5013 given PO daily on D1-D14 every 21 days and Paclitaxel administered IV over 1 hour on d1 and 8 every 21 days until tumor progression or unacceptable toxicity
Study Arms  ICMJE Experimental: CC-5013 in combination with Paclitaxel

Cohorts of 3 evaluable patients will initially be entered within each dose level, sequentially. In each dose level the second and third patient will enter 2 weeks after the first one. The second and third patient may be treated simultaneously, except if a DLT is reported in the first patient, in which case the second and third patient should be treated sequentially, at least one week apart.

Dose escalation will be done when all the patients included in each DL will finish the first treatment cycle. Three additional patients will be sequentially entered (separated by one week each other) if one DLT is observed in cycle 1 among the first 3 patients entered within a dose level. If a DLT is observed in a second patient at this dose level, no further dose escalation will be allowed and the dose level will be considered the MTD.

Once the RD (one level below the MTD) has been defined, additional patients (up to 12) will be treated in order to confirm the safety profile of the combination.

Intervention: Drug: Lenalidomide (CC-5013)
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Unknown status
Estimated Enrollment  ICMJE
 (submitted: June 30, 2010)
28
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE March 2012
Estimated Primary Completion Date December 2011   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Histological/cytological diagnosis of solid tumors for which a treatment with paclitaxel could be indicated (preferentially ovary, breast, prostate, NSCLC)
  • Documented progression of the tumor in the 3 months preceding the study
  • Expected survival ≥ 3 months
  • Age 18-75 years
  • ECOG PS 0-1
  • measurable/evaluable disease during escalation phase, according to modified RECIST criteria. For patients with ovarian and prostatic cancer, tumor markers (CA125 for ovarian and PSA for prostatic) are accepted as only evidence. Measurable/evaluable disease is mandatory during the RD expansion phase

    •≤ 2 prior lines of chemotherapy for metastatic disease. For ovarian patients reintroduction of a platinum at relapse, after an initial response lasting > 6 months is considered one chemotherapy regimen only

  • Adequate contraception for all fertile patients
  • Adequate hematological function as defined by: ANC ≥ 1.5 x 109/L, platelet count ≥100 x 109/L, hemoglobin ≥ 10 g/dL.
  • Normal PTand INR; fibrinogen > lower Normal Limit (LNL)
  • Adequate renal function, as defined by: creatinine ≤ 1.5 x UNL
  • Adequate hepatobiliary function, as defined by the following baseline liver function tests:

    • total serum bilirubin within upper normal limit (UNL)
    • alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤2.5xUNL or ≤ 5xUNL in case of liver metastases; alkaline phosphatase (AP) ≤ 2.5xUNL. If total alkaline phosphatase (AP) > 2.5xUNL, alkaline phosphatase liver fraction must be ≤ 2.5xUNL.
    • albumin ≥ 2.5 g/dL

Exclusion Criteria:

  • History of DVT or coagulation disturbances
  • Need of treatment with oral anticoagulants or LMW heparin
  • Clinical resistance to taxanes defined as progression during therapy or within 6 months from the end of adjuvant treatment
  • Known or prior hypersensitivity to taxanes or drugs containing chemophor, or to thalidomide (or analogues)
  • Preexisting peripheral neuropathy > grade 1
  • Concomitant treatment with non steroid anti-inflammatory agents (NSAIA), high dose steroids or immunosuppressants
  • Concomitant hormonal treatment (including those with antiandrogenic)
  • Radiotherapy involving > 30% of the active bone marrow
  • Radiotherapy ≤ 4 weeks prior to enrolment
  • Other chemotherapy treatment ≤ 4 weeks prior to enrolment, at least 6 weeks for nitrosoureas or mitomycin C, or investigational drugs
  • Symptomatic brain metastases
  • Active infection
  • Gastro-intestinal abnormalities, inability to take oral medication, any condition affecting absorption
  • Impaired cardiac function including any of the following:

History of cardiac disease, such as myocardial infarction, in the year prior to enrollment in the clinical trial, symptomatic/uncontrolled angina pectoris, congestive heart failure or uncontrolled cardiac ischemia, or arrhythmia, abnormal left ventricular ejection fraction, or uncontrolled arterial hypertension.

  • Major surgery in the two weeks prior to entering the clinical trial
  • Concurrent treatment with any other anti-cancer therapy
  • History of another neoplastic disease (except basal cell carcinoma of the skin or uterine cervix carcinoma in situ adequately treated), unless in remission for ≥ 5 years
  • Patient unable to comply with the study protocol owing to psychological, social or geographical reasons
  • Pregnant and lactating women
  • Men and women of childbearing potential who are not using an effective method of contraception
  • Participation in another clinical trial or treatment with any investigational product within 30 days prior to inclusion in this study
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 75 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Italy,   Switzerland
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT01155505
Other Study ID Numbers  ICMJE S095LEPT01
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Southern Europe New Drug Organization
Study Sponsor  ICMJE Southern Europe New Drug Organization
Collaborators  ICMJE Celgene Corporation
Investigators  ICMJE
Study Chair: Cristiana Sessa, MD Istituto Oncologico della Svizzera Italiana -6500 Bellinzona, Switzerland
PRS Account Southern Europe New Drug Organization
Verification Date September 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP