Capecitabine and Celecoxib in Patients With Solid Cancers That Have Been Previously Treated With Standard Therapies

• ClinicalTrials.gov Identifier: NCT01705106
• Recruitment Status: Terminated
• First Posted: October 12, 2012
• Results First Posted: May 30, 2018
• Last Update Posted: May 30, 2018
• Sponsor: University of Chicago
• Collaborator: National Cancer Institute (NCI)
• Information provided by (Responsible Party): University of Chicago

Study Description

Brief Summary:

This clinical trial studies capecitabine and celecoxib in treating patients with solid malignancies that are metastatic or cannot be removed by surgery. Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Celecoxib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving capecitabine and celecoxib together may be an effective treatment for solid malignancies.

Condition or disease	Intervention/treatment	Phase
Unspecified Adult Solid Tumor, Protocol Specific	Drug: capecitabine; Drug: celecoxib; Other: pharmacological study; Other: laboratory biomarker analysis; Other: pharmacogenomic studies	Phase 1

Detailed Description:

PRIMARY OBJECTIVES:

I. To compare steady state pharmacokinetics (PK) (primarily minimum concentration [Cmin], maximum concentration [Cmax], and area under the curve [AUC]) of celecoxib on day 7 of monotherapy versus on day 14 of concomitant administration with capecitabine.

SECONDARY OBJECTIVES:

I. To develop a celecoxib PK drug interaction model using longitudinal data and determine whether the results are concordant with results from the primary objective.

II. To assess the impact of known cytochrome P450 2C9 (CYP2C9) pharmacogenetic variants with reduced enzyme activity (CYP2C9*2 and *3) on the between subject variability in celecoxib PK.

III. To assess tumor response by the Response Evaluation Criteria In Solid Tumors (RECIST, version 1.1) and explore whether there is any correlation between celecoxib PK and response.

IV. To assess toxicity by the Common Terminology Criteria for Adverse Events (CTCAE, version 4.0) and explore whether there is any correlation between celecoxib PK and toxicities related to either celecoxib or capecitabine.

OUTLINE:

Patients receive celecoxib orally (PO) twice daily (BID) for 7 days (course 0) and then on days 1-21 of course 1 and all subsequent courses. Patients also receive capecitabine PO BID on days 1-14 beginning in course 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 21 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Drug-drug Interaction Study of Capecitabine and Celecoxib in Patients With Advanced Solid Malignancies
• Actual Study Start Date: August 29, 2012
• Actual Primary Completion Date: February 10, 2016
• Actual Study Completion Date: February 10, 2016

Arms and Interventions

Arm	Intervention/treatment
Experimental: Treatment (capecitabine, celecoxib); Patients receive celecoxib PO BID for 7 days (course 0) and then on days 1-21 of course 1 and all subsequent courses. Patients also receive capecitabine PO BID on days 1-14 beginning in course 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.	Drug: capecitabine; Given PO; Other Names: CAPE; Ro 09-1978/000; Xeloda; Drug: celecoxib; Given PO; Other Names: Celebrex; SC-58635; Other: pharmacological study; Correlative studies; Other Name: pharmacological studies; Other: laboratory biomarker analysis; Correlative studies; Other: pharmacogenomic studies; Correlative studies; Other Name: Pharmacogenomic Study

Outcome Measures

Primary Outcome Measures :

1. AUC of Celecoxib on Combination Therapy (Day 14) and AUC of Celecoxib on Celecoxib Monotherapy(Day 7) [ Time Frame: Day 7 and 14 post treatment ]
   These parameters will be estimated for each subject under each treatment condition. The mean ratios (combination therapy/celecoxib monotherapy) will then be estimated together with 90% confidence intervals (CI).

Secondary Outcome Measures :

1. CYP2C9 Genotype [ Time Frame: one week ]
   Polymorphisms *2 and *3 will be genotyped and analyzed for their impact on celecoxib AUC using analysis of variance (ANOVA), controlling for gender, age, and other covariates.
2. Response Rate [ Time Frame: Up to 2 years ]
   Logistic regression analysis will be performed to describe the relationship (if any) between celecoxib AUC and response rate.
3. Drug-related Toxicities [ Time Frame: Up to six months ]
   Ordinal logistic regression modeling will be used to explore the relationship between celecoxib AUC and toxicity.
4. PK Drug Interaction Model [ Time Frame: 4 weeks ]
   NONMEM software will be used to develop a model describing the drug interaction between capecitabine and celecoxib using PK data collected during the first four weeks of the study.

Eligibility Criteria

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

Criteria

Inclusion Criteria:

• Histologically or cytologically confirmed solid tumor that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are no longer effective

OR

Histologically or cytologically confirmed solid tumor for which single agent capecitabine is an appropriate treatment option.

• Eastern Cooperative Oncology Group (ECOG) performance status =< 1
• Life expectancy > 3 months
• Absolute neutrophil count (ANC) >= l500/ul
• Hemoglobin >= 9g/dL
• Platelets >= 100,000/ul
• Creatinine within institutional normal limits or glomerular filtration rate >= 50 mL/min/1.73 m^2 by Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation
• Total bilirubin < 1.5 x upper limit of normal
• Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvate transaminase (SGPT) < 2.5 x upper limit of normal for patients without liver metastases OR SGOT and SGPT < 5 x upper limit of normal for patients with liver metastases
• Measurable or non-measurable disease will be allowed
• Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation, up until 30 days after final study treatment; should a woman become pregnant or suspect that she is pregnant while participating in this study, she should inform her treating physician immediately
• Patients taking substrates of CYP2C9 should be encouraged to switch to alternative drugs whenever possible, given the potential for drug-drug interactions with the study drugs
• Signed informed consent

Exclusion Criteria:

• Prior treatment with capecitabine and/or celecoxib is allowed; however, patients with a documented history (at the time of enrollment) of >= grade 3 toxicities with capecitabine or celecoxib are excluded
• Patients taking any of the following drugs are excluded: inducers or inhibitors of CYP2C9, warfarin, aspirin, corticosteroids, or non-steroidal anti-inflammatory drugs (NSAIDs)
• History of myocardial infarction or stroke within the last 6 months, or history of uncontrolled cardiovascular or cerebrovascular disease; a 12-lead electrocardiogram (ECG) will be performed during the screening period
• History of perforation or bleeding related to peptic ulcer disease
• History of hypersensitivity or allergy to study drugs, aspirin, sulfonamides, or NSAIDs
• Known poor metabolizers of CYP2C9 substrates
• Known deficiency of dihydropyrimidine dehydrogenase (DPD)
• Patients who have had chemotherapy, immunotherapy, or investigational anti-cancer therapy within 4 weeks of starting study drug, or radiotherapy within 14 days of starting study drug, or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• Patients may not be receiving any other investigational agents or any concomitant antineoplastic therapy, with the exception of androgen ablating agents (for patients with prior prostate cancer)
• Serious underlying medical or psychiatric illnesses that would, in the opinion of the treating physician, substantially increase the risk for complications related to treatment; similarly, any unstable medical condition that in the opinion of the treating physician or study investigators, would interfere with determination of the study objectives
• Pregnancy or breastfeeding
• Major surgery within 4 weeks

Contacts and Locations

Locations

United States, Illinois

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, United States, 60637-1470

Sponsors and Collaborators

University of Chicago

National Cancer Institute (NCI)

Investigators

• Principal Investigator: Manish R. Sharma, M.D.; University of Chicago Comprehensive Cancer Center

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Wood K, Byron E, Janisch L, Salgia R, Sharma MR. Capecitabine and Celecoxib as a Promising Therapy for Thymic Neoplasms. Am J Clin Oncol. 2018 Oct;41(10):963-966. doi: 10.1097/COC.0000000000000400.

• Responsible Party: University of Chicago
• ClinicalTrials.gov Identifier: NCT01705106
• Other Study ID Numbers: 12-1318; NCI-2012-01704 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
• First Posted: October 12, 2012
• Results First Posted: May 30, 2018
• Last Update Posted: May 30, 2018
• Last Verified: April 2018

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Product Manufactured in and Exported from the U.S.: No

Additional relevant MeSH terms:

Celecoxib; Capecitabine; Antimetabolites, Antineoplastic; Antimetabolites; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic; Analgesics; Sensory System Agents; Peripheral Nervous System Agents; Physiological Effects of Drugs; Anti-Inflammatory Agents; Antirheumatic Agents; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Enzyme Inhibitors