Phase II Study Alimta and Gemzar + Avastin as First Line Chemotherapy for Elderly Patients With Stage IIIB/IV NSCLC

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: NCT00517595
Recruitment Status : Completed
First Posted : August 17, 2007
Results First Posted : March 8, 2012
Last Update Posted : March 12, 2012
Eli Lilly and Company
Genentech, Inc.
Information provided by (Responsible Party):
Accelerated Community Oncology Research Network

Brief Summary:

The primary objective is to determine the progression free survival with pemetrexed, and gemcitabine plus bevacizumab as first-line chemotherapy in elderly patients with Stage IIIB/IV non-small cell lung cancer (NSCLC).

The secondary objectives are to determine the overall response rate; overall survival; chemotherapy induced toxicity profile of this combination; time to progression; and patient reported symptom burden.

Condition or disease Intervention/treatment Phase
Non-Small Cell Lung Cancer Drug: Pemetrexed and Gemcitabine plus Bevacizumab Phase 2

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 48 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Pemetrexed and Gemcitabine Plus Bevacizumab as First Line Chemotherapy for Elderly Patients With Stage IIIB/IV Non-Small Cell Lung Cancer
Study Start Date : August 2007
Actual Primary Completion Date : April 2011
Actual Study Completion Date : April 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lung Cancer

Intervention Details:
  • Drug: Pemetrexed and Gemcitabine plus Bevacizumab
    Bevacizumab 10 mg/kg will be given intravenously according to weight. Pemetrexed 500 mg/m^2 and gemcitabine 1500 mg/m^2 will be given intravenously according to weight and height. All agents are administered every 2 weeks.
    Other Names:
    • Pemetrexed/Alimta
    • Gemcitabine/Gemzar
    • Bevacizumab/Avastin

Primary Outcome Measures :
  1. Progression Free Survival (PFS) [ Time Frame: PFS was measured from day 1 of treatment until time of progression (assessed every 8 weeks) or death, whichever came first, assessed up to 15 months. ]
    PFS is defined as the duration of time from start of treatment to time of progression or death, whichever comes first. Progression is defined per RECIST criteria v1.0 as a measurable increase in the smallest diameter of any target lesion, progression of existing non-target lesions, or the appearance of 1 or more new lesions. The median progression free survival is the parameter used to describe PFS.

Secondary Outcome Measures :
  1. Time to Progression (TTP) [ Time Frame: TTP was measured from day 1 of treatment until time of progression (assessed every 8 weeks), assessed up to 15 months. ]
    Time to progression is defined as the time from treatment start until objective tumor progression. Progression is defined per RECIST criteria v1.0 as a measurable increase in the smallest diameter of any target lesion, progression of existing non-target lesions, or the appearance of 1 or more new lesions. The median time to progression is the parameter used to describe TTP.

  2. Overall Survival (OS) [ Time Frame: OS was measured from day 1 of treatment until time of death, assessed up to 20 months. ]
    Overall survival is defined as the time from treatment start until death from any cause. The median overall survival time is used to measure OS.

  3. Overall Response [ Time Frame: Response to treatment was assessed after every 8 weeks of treatment, up to 50 weeks. ]
    Response was evaluated via changes from baseline in radiological tumor measurements performed after every 4th treatment cycle and at the end of treatment or time of progression. Response was evaluated using RECIST version 1.0 guidelines, where complete response (CR) is the disappearance of all target lesions; partial response (PR) is >=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD) is neither sufficient shrinkage in sum of LD of target lesions to be PR nor increase of >=20%; Progressive Disease (PD) is the increase in existing lesions or new lesions.

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Ages Eligible for Study:   65 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient provides voluntary written informed consent before performance of any study-related procedure not part of normal medical care.
  • Patient ≥ 65 years of age with ECOG of 0 to 1
  • Patient must have histologically/cytologically confirmed Stage IIIB/IV NSCLC.
  • Patient has measurable disease defined as at least 1 lesion that can be accurately measured in at least 1 dimension (by CT or MRI) & used to assess response as defined by RECIST criteria. Tumors within a previously irradiated field will be designated nontarget lesions.
  • Patient has not received radiotherapy within 2 weeks(4 weeks required for brain metastases radiotherapy)of initial chemotherapy dosing for this study, and all acute toxicities due to prior radiotherapy have resolved prior to initial chemotherapy dosing.
  • Patient has a negative serum pregnancy test or has undergone hysterectomy at time of enrollment.
  • Greater than 12 weeks life expectancy.
  • Patient has recovered from any recent surgery for at least 30 days & is free of active infection requiring antibiotics.
  • Patient must be willing/able to discontinue use of NSAIDS prior to study drug dosing.
  • Patient must be able to take folic acid, Vitamin B12, & dexamethasone per protocol.
  • Patient must exhibit no greater than Grade 1 peripheral neuropathy.

Exclusion Criteria:

  • Prior systemic or other concurrent chemo for metastatic NSCLC(Prior Tarceva is not allowed).Prior adjuvant chemo acceptable as long as > 12 months since completion and no prior pemetrexed, gemcitabine or bevacizumab.
  • Lung carcinoma of squamous cell histology(mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible; sputum cytology alone is acceptable.Patients with extrathoracic-only squamous cell NSCLC are eligible.Patients with only peripheral lung lesions (of any NSCLC histology) will also be eligible(a peripheral lesion is defined as a lesion in which the epicenter of the tumor is ≤ 2 cm from the costal or diaphragmatic pleura in a three-dimensional orientation based on each lobe of the lung and is > 2 cm from the trachea, main, and lobar bronchi).
  • Hemoptysis within 1 month prior to study enrollment
  • Ongoing treatment with full-dose warfarin or its equivalent i.e., unfractionated and/or low molecular weight heparin.(Low dose warfarin 1 mg given for prophylaxis is allowed).
  • Hypersensitivity to any component of Alimta, gemcitabine &/or bevacizumab, &/or cannot tolerate folic acid, corticosteroids or Vitamin B12 supplements.
  • Currently/have recently taken long-acting NSAID (Ibuprofen ≤ 400 mg QID acceptable) or aspirin (>325mg/day) within 5 days of initial pemetrexed administration.
  • Clinically significant pericardial/pleural effusion or ascites unless able to be drained before study entry.
  • Presence of third space fluid which cannot be controlled by drainage.
  • Core biopsy/other minor surgical procedure(excluding placement of a vascular access device)within 7 days prior to study enrollment.
  • Active infection or fever ≥ 38.5°C within 3 days of first scheduled day of protocol treatment.
  • Serious, non-healing wound, ulcer, or untreated bone fracture.
  • NYHA Grade II or greater CHF
  • Inadequately controlled hypertension (defined as systolic blood pressure > 150 &/or diastolic blood pressure > 100mmHg on antihypertensive meds)
  • Any prior history of hypertensive crisis or hypertensive encephalopathy.
  • History of MI, CVA, TIA, or unstable angina within 6 months of study enrollment.
  • Significant vascular disease (aortic aneurysm, aortic dissection or recent peripheral arterial thrombosis.)
  • Symptomatic peripheral vascular disease
  • Known bleeding diathesis or coagulopathy
  • Presence of CNS(central nervous system) except for treated brain metastases. Treated brain metastases are defined as having no evidence of progression or hemorrhage after treatment and no ongoing requirement for dexamethasone, as ascertained by clinical examination and brain imaging(MRI or CT)during the screening period.Anticonvulsants(stable dose)are allowed.Treatment for brain metastases may include whole brain radiotherapy(WBRT),radiosurgery(RS;Gamma Knife,LINAC,or equivalent)or a combination as deemed appropriate by the treating physician.Radiotherapy must be completed at least 4 weeks prior to study enrollment and all acute radiotherapy toxicities resolved.Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded.
  • A major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 or anticipation of need for major surgical procedure during the course of the study.
  • Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to enrollment.
  • History of prior malignancy within the past 5 years except for curatively treated basal cell carcinoma of the skin, cervical intra-epithelial neoplasia, or localized prostate cancer with a current prostate specific antigen of < 1.0 mg/dL on 2 successive evaluations, at least 3 months apart, with the most recent evaluation no more than 4 weeks prior to entry.
  • Have received radiotherapy to more than 25% of their bone marrow.
  • Receiving concurrent investigational therapy or has received investigational therapy within 30 days of the first scheduled day of protocol treatment
  • Pregnant/lactating.
  • Any other medical condition deemed by the Investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate/participate in the study, or interfere with interpretation of the results.
  • History of allogeneic transplant.
  • Known HIV infection or Hepatitis B or C.

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): NCT00517595

United States, Connecticut
Medical Oncology & Hematology
Waterbury, Connecticut, United States, 06708
United States, Georgia
Augusta Oncology Associates
Augusta, Georgia, United States, 30901
Central Georgia Cancer Care
Macon, Georgia, United States, 31201
Northwest Georgia Oncology Center
Marietta, Georgia, United States, 30060
United States, Montana
Hematology Oncology Centers of the Northern Rockies
Billings, Montana, United States, 59101
United States, Ohio
Tri-County Oncology Hematology Associates
Canton, Ohio, United States, 44718
United States, Oregon
Pacific Oncology, PC
Portland, Oregon, United States, 97225
United States, Pennsylvania
Pennsylvania Oncology Hematology Associates
Philadelphia, Pennsylvania, United States, 19106
United States, Tennessee
The West Clinic
Memphis, Tennessee, United States, 38120
United States, Virginia
Cancer Specialists of Tidewater
Chesapeake, Virginia, United States, 23320
Sponsors and Collaborators
Accelerated Community Oncology Research Network
Eli Lilly and Company
Genentech, Inc.
Principal Investigator: Johnetta L Blakely, MD Accelerated Community Oncology Research Network

Responsible Party: Accelerated Community Oncology Research Network Identifier: NCT00517595     History of Changes
Other Study ID Numbers: ALJBNSCLC0602
First Posted: August 17, 2007    Key Record Dates
Results First Posted: March 8, 2012
Last Update Posted: March 12, 2012
Last Verified: March 2012

Keywords provided by Accelerated Community Oncology Research Network:
Non-Small Cell Lung Cancer

Additional relevant MeSH terms:
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors