Phase II Trial of Sunitinib (Sutent, SU11248) Maintenance Therapy After Induction Platinum-Based Chemotherapy in Patients With Extensive-Stage Small Cell Lung Cancer
Overview
- Phase
- Phase 2
- Intervention
- sunitinib
- Conditions
- Extensive-Stage Small Cell Lung Cancer
- Sponsor
- University of Michigan Rogel Cancer Center
- Enrollment
- 16
- Locations
- 1
- Primary Endpoint
- Progression Free Survival Rate
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
The goal of this study is to determine the progression-free survival rate in patients with extensive-stage small cell lung cancer who had achieved complete response, partial response, or stable disease with their previous platinum chemotherapy regimen, such as cisplatin or carboplatin in combination with etoposide or irinotecan. In addition, the safety and effectiveness of sunitinib will also be evaluated.
Detailed Description
Despite a high initial response rate, all patients with extensive-stage small cell lung cancer treated with standard chemotherapy will develop disease progression, usually within one year of initial treatment. Therefore, prolonging progression-free survival in this disease is meaningful for clinical trials exploring agents such as sunitinib. Sunitinib is a drug that inhibits the biological pathway responsible for the growth and spread of cancer cells. For this reason, we believe that sunitinib maintenance therapy will delay or prevent recurrence and prolong survival. The goal of this study is to determine the progression-free survival rate in patients with extensive-stage small cell lung cancer who had achieved complete response, partial response, or stable disease with their previous platinum chemotherapy regimen, such as cisplatin or carboplatin in combination with etoposide or irinotecan. In addition, the safety and effectiveness of sunitinib will also be evaluated.
Investigators
Gregory Kalemkerian. M.D.
Professor of Internal Medicine
University of Michigan Rogel Cancer Center
Eligibility Criteria
Inclusion Criteria
- •Histologically or cytologically confirmed extensive-stage SCLC. Extensive-stage is defined as disease that extends beyond one hemithorax and regional lymph nodes (ipsilateral or contralateral hilar, mediastinal, or supraclavicular lymph nodes), or with cytologically positive pleural effusion.
- •Patients who have completed platinum-based chemotherapy and demonstrated a complete response, partial response, or stable disease can be registered on the trial. A maximum of 4 cycles of induction chemotherapy is allowed. Patients must begin therapy within 28-42 days after day 1 of the 4th cycle of induction therapy and within 28 days of scans demonstrating stable disease or better. Prior palliative radiation therapy will be allowed as long as radiation was completed at least 1 week before starting protocol therapy.
- •Resolution of all acute toxic effects of prior chemotherapy or radiotherapy or surgical procedures to NCI CTCAE Version 3.0 grade
- •Age \* 18 years with Southwest Oncology Group (SWOG) performance status of 0,1 or 2 (Appendix 2).
- •Adequate organ function as evidenced by the laboratory values listed in the protocol
Exclusion Criteria
- •Symptomatic or untreated brain or leptomeningeal metastases. Treated patients should be neurologically stable for at least 2 weeks after completion of appropriate therapy without the use of steroids. Patients currently on steroids are ineligible.
- •More than 4 cycles of induction chemotherapy. Patients will be eligible for if they have completed at least 2 cycles of platinum-based induction chemotherapy and they have exhibited a complete or partial response to therapy. Patients who have received less than 4 cycles of induction chemotherapy and have less than a partial response will not be eligible.
- •NCI CTCAE grade 3 hemorrhage within 4 weeks of starting the study treatment.
- •History of gross hemoptysis due to lung cancer.
- •Previous or concurrent malignancies, with the exception of adequately treated squamous cell or basal cell carcinoma of the skin, in situ carcinoma of the cervix, or any other malignancy treated and in clinical remission for more than 3 years.
- •Major surgery or within 4 weeks of starting study treatment.
- •Any history of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (CHF), cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
- •Ongoing cardiac dysrhythmias
- •Hypertension that cannot be controlled by medications
- •Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication.
Arms & Interventions
Maintenance Sunitinib
Main interventional arm of study. Subjects who received maintenance sunitinib experimentally on this study were from a population of (consenting) patients with histologically or cytologically documented Extensive-State Small Cell Lung Cancer (ES-SCLC) who did not progress (were classified as Complete Response or "CR", Partial Response or "PR", or Stable Disease or "SD") after an induction chemotherapy (Cisplatin and etoposide)
Intervention: sunitinib
Outcomes
Primary Outcomes
Progression Free Survival Rate
Time Frame: 4 Months Post Treatment
The proportion of patients who are progression-free at 4 months after starting sunitinib.
Secondary Outcomes
- Median Overall Survival(up to 4 months post treatment)
- Percent of Patients With an Objective Response(12 weeks (2 cycles))
- Number of Patients That Discontinue Drug Due to Toxicity(20 weeks)