Erlotinib Hydrochloride With or Without Celecoxib in Treating Patients With Stage IIIB-IV Non-Small Cell Lung Cancer

This study has been completed.
Sponsor:
Collaborator:
OSI Pharmaceuticals
Information provided by (Responsible Party):
City of Hope Medical Center
ClinicalTrials.gov Identifier:
NCT00499655
First received: July 10, 2007
Last updated: October 25, 2013
Last verified: October 2013
  Purpose

RATIONALE: Erlotinib hydrochloride and celecoxib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Celecoxib may also stop the growth of lung cancer by blocking blood flow to the tumor. Giving erlotinib hydrochloride together with celecoxib may kill more tumor cells.

PURPOSE: This randomized phase II trial is studying how well giving erlotinib hydrochloride together with celecoxib works compared with erlotinib hydrochloride alone in treating patients with stage IIIB-IV non-small cell lung cancer.


Condition Intervention Phase
Recurrent Non-small Cell Lung Cancer
Stage IIIB Non-small Cell Lung Cancer
Stage IV Non-small Cell Lung Cancer
Drug: erlotinib hydrochloride
Drug: celecoxib
Other: placebo
Other: laboratory biomarker analysis
Other: immunohistochemistry staining method
Genetic: fluorescence in situ hybridization
Genetic: mutation analysis
Genetic: protein expression analysis
Genetic: gene expression analysis
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized, Placebo-Controlled Phase II Clinical Trial of Combination Erlotinib (Tarceva) and Celecoxib (Celebrex) Versus Erlotinib (Tarceva)/Placebo in Advanced Non-Small Cell Lung Cancer Patients

Resource links provided by NLM:


Further study details as provided by City of Hope Medical Center:

Primary Outcome Measures:
  • Progression-free survival [ Time Frame: 1 year post treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response rate as assessed by RECIST criteria [ Time Frame: 16 weeks post start of treatment ] [ Designated as safety issue: No ]
  • Urinary prostaglandin E-metabolite levels [ Time Frame: At 4 and 8 weeks ] [ Designated as safety issue: No ]
  • Measurement of EGFR, COX-2, and E-cadherin expression [ Time Frame: At 8 weeks ] [ Designated as safety issue: No ]
  • Other COX-2 and EGFR-dependent markers [ Time Frame: At 4 and 8 weeks ] [ Designated as safety issue: No ]
  • Mutation status [ Time Frame: 8 weeks post start of treatment ] [ Designated as safety issue: No ]

Enrollment: 98
Study Start Date: June 2007
Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Arm I
Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28.
Drug: erlotinib hydrochloride
Given orally
Other Names:
  • CP-358,774
  • erlotinib
  • OSI-774
  • Tarceva
Other: placebo
Given orally
Other Name: PLCB
Other: laboratory biomarker analysis
Correlative studies
Other: immunohistochemistry staining method
Correlative studies
Other Name: immunohistochemistry
Genetic: fluorescence in situ hybridization
Correlative studies
Other Name: fluorescence in situ hybridization (FISH)
Genetic: mutation analysis
Correlative studies
Genetic: protein expression analysis
Correlative studies
Genetic: gene expression analysis
Correlative studies
Experimental: Arm II
Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28.
Drug: erlotinib hydrochloride
Given orally
Other Names:
  • CP-358,774
  • erlotinib
  • OSI-774
  • Tarceva
Drug: celecoxib
Given orally
Other Names:
  • Celebrex
  • SC-58635
  • YM 177
Other: laboratory biomarker analysis
Correlative studies
Other: immunohistochemistry staining method
Correlative studies
Other Name: immunohistochemistry
Genetic: fluorescence in situ hybridization
Correlative studies
Other Name: fluorescence in situ hybridization (FISH)
Genetic: mutation analysis
Correlative studies
Genetic: protein expression analysis
Correlative studies
Genetic: gene expression analysis
Correlative studies

Detailed Description:

PRIMARY OBJECTIVES:

I. Comparison of progression-free survival (PFS) in patients receiving erlotinib + celecoxib vs. erlotinib + placebo for advanced NSCLC.

SECONDARY OBJECTIVES:

I. Objective tumor response rate as defined by RECIST Criteria for subjects receiving erlotinib/celecoxib treatment arms.

II. Categorize the change in e-cadherin expression from baseline to week 8 in a subset of subjects.

III. Evaluation of overall survival (OS). IV. Measurement of COX-2, EGFR by immunohistochemistry and EGFR amplification by FISH, and EGFR mutation status to correlate with clinical response.

V. Measurement of change in urinary PGE-M and correlation with response.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28.

ARM II: Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28.

In both arms, treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically.

  Eligibility

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

Inclusion

  • Pathologically proven NSCLC, stage IIIB (defined as: with pleural effusion or recurrence after mediastinal radiation and chemotherapy) or IV
  • Available tumor tissue for mutation screening
  • Measurable stage IIIb or IV disease by RECIST guidelines
  • ECOG performance status of 0 or 1
  • Progressive disease despite >= 1 prior chemotherapy regimens as standard of care or subject's refusal or inability to receive standard chemotherapy
  • Normal renal function (defined as serum creatinine =< 2mg/dl)
  • Normal liver function (defined as serum total bilirubin =< 1.5, and serum transaminases =< 2.5X the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
  • No evidence of coagulopathy (defined as PT and/or PTT =< 1.5X ULN or platelets >= 100,000)
  • No evidence of leukopenia (defined as absolute neutrophil count >= 1,500 mm^3)
  • Negative pregnancy test prior to initiation of treatment and adequate contraception throughout treatment

Exclusion

  • Cytotoxic chemotherapy agents within 4 weeks of initiating treatment; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
  • Evidence of NYHA class III or greater cardiac disease, history of myocardial infarction, cerebral vascular accident, symptomatic ventricular arrhythmia, or symptomatic conduction abnormality
  • Non-cytoxic therapy within 2 weeks of initiating treatment ; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation
  • Prior radiotherapy to target lesions is not permitted unless completed more than 4 weeks prior to treatment within the study and that there has been documented progression at these sites (Radiotherapy to non-target lesions is permitted within 2 weeks of study entry provided all acute effects of the radiotherapy have resolved at least grade 1)
  • Comorbid disease or a medical condition that would impair the ability of the subject to receive or comply with the study protocol
  • Prior malignancy within the last 3 years with the exception of non-melanoma skin cancer or cervical cancer in situ
  • Hypersensitivity of erlotinib or celecoxib or to any of the excipients of these products
  • Hypersensitivity to sulfonamides, aspirin or other NSAIDS
  • Prior history of EGFR inhibitor for the treatment of cancer
  • Previous history of gastrointestinal ulceration, bleeding or perforation
  • Concurrent use of COX-2 inhibitors or other NSAIDS (For subjects on NSAIDS prior to study initiation, cessation of the drug for 72 hours prior to study entry is required)
  • Chronic or concurrent use of steroids (topical steroids are acceptable if medically indicated)
  • Subjects who require treatment with fluconazole or lithium
  • Any evidence of clinically active interstitial lung disease (patients with chronic stable radiographic changes who are asymptomatic need not be excluded)
  • Renal insufficiency (defined as serum creatinine > 2 mg/dl)
  • Liver insufficiency (defined as serum total bilirubin > 1.5, or serum transaminases > 2.5C the upper limits of normal [ULN]); if liver metastases are present, serum transaminases > 5X the ULN
  • Coagulopathy (defined as PT and/or PTT > 1.5X ULN or platelets < 100,000)
  • Leukopenia (defined as absolute neutrophil count < 1,500/mm^3)
  • Pregnancy or inadequate contraception
  • Lactating females
  • Active CNS metastasis (stable, treated CNS metastasis acceptable)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00499655

Locations
United States, California
City of Hope Medical Center
Duarte, California, United States, 91010
South Pasadena Cancer Center
South Pasadena, California, United States, 91030
Sponsors and Collaborators
City of Hope Medical Center
OSI Pharmaceuticals
Investigators
Principal Investigator: Karen Reckamp Beckman Research Institute
  More Information

No publications provided

Responsible Party: City of Hope Medical Center
ClinicalTrials.gov Identifier: NCT00499655     History of Changes
Other Study ID Numbers: 06254, NCI-2010-00353, CDR0000549751
Study First Received: July 10, 2007
Last Updated: October 25, 2013
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Carcinoma, Bronchogenic
Bronchial Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Celecoxib
Erlotinib
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Therapeutic Uses
Central Nervous System Agents
Antirheumatic Agents
Protein Kinase Inhibitors

ClinicalTrials.gov processed this record on April 15, 2014