Celecoxib and Gefitinib in Treating Former Smokers With Stage IIIB or Stage IV Non-Small Cell Lung Cancer
This study is currently recruiting patients.
Sponsored by: |
Duke Comprehensive Cancer Center
|
Information provided by: |
National Cancer Institute (NCI) |
Purpose
RATIONALE: Celecoxib and gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.
PURPOSE: Phase I trial to study the effectiveness of combining celecoxib with gefitinib in treating former smokers who have
stage IIIB, stage IV, recurrent, or progressive non-small cell lung cancer
Condition
|
Treatment or Intervention |
Phase |
recurrent non-small cell lung cancer stage IIIB non-small cell lung cancer stage IV non-small cell lung cancer
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Drug: celecoxib Drug: gefitinib Procedure: biological response modifier therapy Procedure: enzyme inhibitor therapy Procedure: prostaglandin inhibition Procedure: protein tyrosine kinase inhibitor therapy
|
Phase I
|
MedlinePlus related topics: Cancer; Cancer Alternative Therapy; Lung Cancer; Respiratory Diseases
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Study of Celecoxib and Gefitinib in Former Smokers With Stage IIIB or IV Non-Small Cell Lung Cancer
Further Study Details:
OBJECTIVES: Primary
- Determine the clinical toxicity and tolerability of celecoxib and gefitinib in former smokers with stage IIIB or IV or recurrent
or progressive non-small cell lung cancer.
Secondary
- Determine the tumor response rate in patients treated with this regimen.
- Determine the dose of celecoxib that results in maximal induction of apoptosis, maximal inhibition of prostaglandin E_2 (PGE_2)
in bronchoalveolar fluid, and maximal inhibition of bronchial cell proliferation in patients treated with this regimen.
OUTLINE: This is an open-label, dose-escalation study of celecoxib.
Patients receive oral gefitinib once daily and oral celecoxib twice daily. Treatment continues in the absence of disease progression
or unacceptable toxicity.
Cohorts of 6 patients receive escalating doses of celecoxib until the maximum tolerated dose (MTD) is determined. The MTD
is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined,
up to 6 additional patients are treated at the MTD.
Patients are followed at 4 weeks.
PROJECTED ACCRUAL: A total of 6-45 patients will be accrued for this study.
Eligibility
Ages Eligible for Study:
18 Years and above,
Genders Eligible for Study:
Both
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed non-small cell lung cancer (NSCLC) meeting 1 of the following stage criteria:
- Stage IIIB with pleural effusion
- Stage IV disease
- Recurrent or progressive disease after prior surgery, radiotherapy, and/or chemotherapy
- Meets 1 of the following criteria:
- Untreated disease with epidermal growth factor receptor (EGFR) mutation
- Advanced NSCLC with at least stable disease after ≥ 4 courses of platinum-containing chemotherapy
- Relapsed or refractory disease after treatment with ≥ 1 prior platinum-containing chemotherapy program, including adjuvant
or neoadjuvant therapy for NSCLC
- If the sole prior treatment was in the adjuvant or neoadjuvant setting, tumor progression or recurrence must have occurred
within 6 months after completion of prior treatment
- Former smoker, as indicated by the following:
- At least a 30 pack-year smoking history
- Smoking duration at least 10 years
- At least 12 months of self-reported smoking cessation
- Negative urine cotinine
- No untreated brain metastases
PATIENT CHARACTERISTICS: Age
Performance status
Life expectancy
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- Hemoglobin ≥ 10 g/dL
- Hemostasis normal
Hepatic
- Bilirubin ≤ 2.0 mg/dL
- PT/PTT within 0.5 seconds of normal
Renal
Cardiovascular
- No significant cardiovascular disease
- No New York Heart Association class III or IV cardiac disease
- No uncontrolled dysrhythmia
- No unstable angina
- No myocardial infarction within the past 6 months
Pulmonary
- FEV_1 ≥ 1.0 liter OR 40% of predicted within the past 3 months
- Oxygen saturation ≥ 90% on room air
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 6 months after study treatment
- Willing to undergo bronchoscopy
- No allergy to sulfonamides or hypersensitivity reaction to celecoxib
- No other medical or psychological condition (e.g., acute psychosis) that would preclude study participation
PRIOR CONCURRENT THERAPY: Biologic therapy
Chemotherapy
- See Disease Characteristics
- At least 4 weeks since prior chemotherapy (6 weeks for mitomycin)
Endocrine therapy
Radiotherapy
- See Disease Characteristics
- At least 4 weeks since prior radiotherapy
Surgery
- See Disease Characteristics
- Prior complete resection allowed provided there is histologic and cytologic documentation of disease recurrence
Other
- More than 3 months since prior chemopreventative agents (e.g., oltipraz, retinoids, or N-acetylcysteine [NAC])
- No prior geftinib
- No other prior EGFR antagonists
- No concurrent medication known to interact with gefitinib or celecoxib, including the following:
- Fluconazole
- Lithium
- Furosemide
- Angiotensin-converting enzyme inhibitors
- Phenytoin
- Carbamazepine
- Rifampin
- Barbiturates
- Hypericum perforatum (St. John's wort)
- No concurrent non-steroidal anti-inflammatory drugs
- Concurrent aspirin of up to an average dose of 325 mg/day allowed
- No aspirin treatment for 7 days prior to any bronchoscopic or skin biopsy
- No other concurrent EGFR inhibitors or cyclo-oxygenase-2 (COX-2) inhibitors
Location
and Contact
Information
North Carolina Duke Comprehensive Cancer Center, Durham,
North Carolina,
27705,
United States; Recruiting
Michael J. Kelley, MD
919-286-0411 ext. 7326
Veterans Affairs Medical Center - Durham, Durham,
North Carolina,
27705,
United States; Recruiting
Michael J. Kelley, MD
919-286-0411 ext. 7326
Study chairs or principal investigators
Michael J. Kelley, MD, Principal Investigator, Duke Comprehensive Cancer Center
More Information
Clinical trial summary from the National Cancer Institute's PDQ® database
Study ID Numbers:
CDR0000377689; DUMC-4939-04-6R1; DUMC-4939-03-6R0; VAMC-DURHAM-00813
Record last reviewed:
September 2004
Record first received:
August 4, 2004
ClinicalTrials.gov Identifier:
NCT00088959Health Authority: Unspecified
ClinicalTrials.gov processed this record on 2004-11-08