Celecoxib, Paclitaxel, and Carboplatin in Treating Patients With Cancer of the Esophagus

This study has been completed.
Sponsor:
Collaborator:
Pfizer
Information provided by:
Weill Medical College of Cornell University
ClinicalTrials.gov Identifier:
NCT00066716
First received: August 6, 2003
Last updated: December 7, 2009
Last verified: December 2009
  Purpose

RATIONALE: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop tumor cells from dividing so they stop growing or die. Celecoxib may increase the effectiveness of a chemotherapy drug by making tumor cells more sensitive to the drug. Celecoxib may also stop the growth of tumor cells by stopping blood flow to the tumor and/or may block the enzymes necessary for their growth. Combining celecoxib with paclitaxel and carboplatin before surgery may shrink the tumor so that it can be removed during surgery. Giving celecoxib alone after surgery may kill any remaining tumor cells.

PURPOSE: This phase II trial is studying how well giving celecoxib together with paclitaxel and carboplatin works in treating patients who are undergoing surgery for esophageal cancer.


Condition Intervention Phase
Esophageal Cancer
Drug: carboplatin
Drug: celecoxib
Drug: paclitaxel
Procedure: adjuvant therapy
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study Of Preoperative Celecoxib/Paclitaxel/Carboplatin For Squamous Cell And Adenocarcinoma Of The Esophagus

Resource links provided by NLM:


Further study details as provided by Weill Medical College of Cornell University:

Primary Outcome Measures:
  • Pathological response rate at time of surgical resection [ Time Frame: At completion of pathology report. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Clinical response rate [ Time Frame: At the time of tumor assessment obtained prior to definitive surgery approximately 1-2 weeks prior to surgical resection. ] [ Designated as safety issue: No ]
  • Disease-free survival [ Time Frame: From start of treatment to time of recurrent disease measured postoperatively every 6 months for 18 months. ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: 18 months after surgery ] [ Designated as safety issue: No ]
  • Toxicities and safety [ Time Frame: 30 days after completion of study treatment. ] [ Designated as safety issue: Yes ]

Enrollment: 39
Study Start Date: June 2003
Primary Completion Date: May 2007 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: carboplatin
    Dosed to an AUC of 6 by the Calvert formula, intravenously over 1 hour after paclitaxel on days 1, 22, and 43.
    Drug: celecoxib
    400 mg orally BID begins 3-7 days before the first dose of chemotherapy to the morning of surgery. Celecoxib 400 mg orally BID will resume post-operatively 4-8 weeks if there is adequate wound healing and will be continued for 1 year total, that is, 1 year from the date of surgery + 2 weeks unless tumor recurrence is documented.
    Other Name: Celebrex
    Drug: paclitaxel
    200 mg/m2 as a 3-hour intravenous infusion on days 1, 22, and 43.
    Other Name: Taxol
    Procedure: adjuvant therapy
    1. Surgery will be performed 3-4 weeks after the third dose of paclitaxel and carboplatin.
    2. Operation will be performed within 6-12 hours from the last dose of celecoxib.
    3. Surgery will include an esophagectomy as well as a complete mediastinal and abdominal lymph node dissection.
    4. Celecoxib 400 mg orally BID will resume post-operatively 4-8 weeks if there is adequate wound healing and will be continued for 1 year.
    Procedure: conventional surgery
    1. Surgery will be performed 3-4 weeks after the third dose of paclitaxel and carboplatin.
    2. Operation will be performed within 6-12 hours from the last dose of celecoxib.
    3. Surgery will include an esophagectomy as well as a complete mediastinal and abdominal lymph node dissection.
    Procedure: neoadjuvant therapy
    1. Surgery will be performed 3-4 weeks after the third dose of paclitaxel and carboplatin.
    2. Operation will be performed within 6-12 hours from the last dose of celecoxib.
    3. Surgery will include an esophagectomy as well as a complete mediastinal and abdominal lymph node dissection.
Detailed Description:

OBJECTIVES:

Primary

  • Determine the rate of complete pathological response and/or minimal residual microscopic disease in patients with squamous cell or adenocarcinoma of the esophagus treated with preoperative celecoxib, paclitaxel, and carboplatin.

Secondary

  • Determine the clinical response rate of patients treated with this regimen.
  • Determine the chemotherapy-related toxicity of this regimen in these patients.
  • Determine the time to progression, disease-free survival, and overall survival of patients treated with this regimen.

OUTLINE: Patients receive paclitaxel IV over 3 hours and carboplatin IV over 1 hour on days 1, 22, and 43. Patients also receive oral celecoxib twice daily beginning 3-7 days before the first dose of chemotherapy and continuing until the morning of planned surgical resection (between days 64 and 71). Approximately 28-56 days after resection, patients may resume oral celecoxib twice daily and continue for 1 year in the absence of disease progression or unacceptable toxicity.

Patients are followed periodically for 18 months after surgery.

PROJECTED ACCRUAL: A total of 39 patients will be accrued for this study within 18 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed esophageal cancer of 1 of the following cellular types:

    • Squamous cell
    • Adenocarcinoma
  • Potentially resectable disease
  • No distant metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 80-100%

Life expectancy

  • Not specified

Hematopoietic

  • WBC at least 3,000/mm^3
  • Platelet count at least 100,000/mm^3
  • No bleeding disorder

Hepatic

  • Bilirubin normal
  • AST and ALT less than 2.5 times upper limit of normal (ULN)
  • Alkaline phosphatase no greater than 2.5 times ULN

Renal

  • Creatinine no greater than 2.0 mg/dL

Cardiovascular

  • No significant history of unstable cardiovascular disease
  • No inadequately controlled hypertension
  • No angina
  • No myocardial infarction within the past 6 months
  • No ventricular cardiac arrhythmias requiring medication
  • No congestive heart failure that would preclude study therapy

Pulmonary

  • Pulmonary function acceptable for surgery
  • No interstitial pneumonia
  • No interstitial fibrosis

Gastrointestinal

  • No history of peptic ulcer disease
  • No irritable bowel syndrome
  • No inflammatory bowel disease
  • No chronic diarrhea
  • No bowel obstruction within the past 5 years

Other

  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No known hypersensitivity or allergic reactions to COX-2 inhibitors, sulfonamides, NSAIDs, or salicylates
  • No hypersensitivity to paclitaxel or carboplatin
  • No other serious underlying medical condition that would preclude study therapy
  • No significant psychiatric illness that would preclude study compliance
  • No uncontrolled diabetes mellitus
  • No uncontrolled infection
  • HIV negative

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • Not specified

Endocrine therapy

  • No concurrent chronic steroid use except inhaled mometasone or fluticasone

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • More than 3 weeks since other prior clinical trial therapy
  • At least 72 hours since prior nonsteroidal anti-inflammatory drugs (NSAIDs)
  • No concurrent chronic NSAID use (7 or more days of continuous therapy per month OR 3 or more days of therapy per week)
  • No other concurrent investigational agents
  • No concurrent enzyme-inducing anticonvulsants (e.g., phenytoin or phenobarbital)
  • No other concurrent cyclo-oxygenase (COX)-2 inhibitors
  • No concurrent lithium or fluconazole
  • Concurrent low-dose aspirin (325 mg/day or less) allowed for cardiovascular prophylaxis
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00066716

Locations
United States, New York
New York Weill Cornell Cancer Center at Cornell University
New York, New York, United States, 10021
Sponsors and Collaborators
Weill Medical College of Cornell University
Pfizer
Investigators
Study Chair: Nasser K. Altorki, MD Weill Medical College of Cornell University
  More Information

Additional Information:
No publications provided

Responsible Party: Nasser Altorki, MD, Weill Cornell Medical College
ClinicalTrials.gov Identifier: NCT00066716     History of Changes
Other Study ID Numbers: CDR0000316464, NYWCCC-0902-463
Study First Received: August 6, 2003
Last Updated: December 7, 2009
Health Authority: United States: Institutional Review Board

Keywords provided by Weill Medical College of Cornell University:
adenocarcinoma of the esophagus
squamous cell carcinoma of the esophagus
stage I esophageal cancer
stage II esophageal cancer
stage III esophageal cancer
stage IV esophageal cancer (lymph node metastasis only)

Additional relevant MeSH terms:
Esophageal Neoplasms
Adenocarcinoma
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Head and Neck Neoplasms
Digestive System Diseases
Esophageal Diseases
Gastrointestinal Diseases
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Paclitaxel
Carboplatin
Celecoxib
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics

ClinicalTrials.gov processed this record on October 16, 2014