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Study of Pralatrexate vs. Erlotinib for Non-Small Cell Lung Cancer After at Least 1 Prior Platinum-based Treatment

Phase 2
Completed
Conditions
Non-small Cell Lung Cancer
Interventions
Dietary Supplement: Vitamin B12
Dietary Supplement: Folic Acid
Registration Number
NCT00606502
Lead Sponsor
Spectrum Pharmaceuticals, Inc
Brief Summary

The purpose of this clinical study is to determine the effectiveness (ability to provide beneficial treatment of the disease) and safety of pralatrexate compared to erlotinib when given to non-small cell lung cancer (NSCLC) patients who are current or former cigarette smokers and who have received at least 1 prior treatment with a platinum drug (cisplatin or carboplatin)

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
201
Inclusion Criteria
  • Confirmed Stage IIIB/ IV non-small cell lung cancer (NSCLC).
  • Relapsed after treatment with 1 or 2 prior chemotherapy regimens, including at least 1 platinum-based treatment. Patients may have received pemetrexed as 1 of the prior therapies. Patients may not have received investigational therapy as their only prior therapy.
  • Recovered from the toxic effects of prior therapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Smoked ≥ 100 cigarettes in their lifetime, whether a former or current cigarette smoker.
  • Adequate blood, liver and kidney function as defined by laboratory values.
  • Received 1-1.25 mg daily oral folic acid for at least 7 days prior to randomization and 1 mg intramuscular injection of vitamin B12 within 10 weeks prior to randomization.
  • Women of childbearing potential must use medically acceptable birth control and have a negative serum pregnancy test within 14 days prior to randomization. Patients who are postmenopausal for at least 1 year (> 12 months since last menses) or are surgically sterilized do not require this test.
  • Men who are not surgically sterile must use medically safe and effective birth control from the time of study randomization, and agree to continue practicing until at least 90 days after the last administration of study treatment.
  • Accessible for repeat dosing and follow-up.
  • Give written informed consent.
Exclusion Criteria
  • Active concurrent primary malignancy (except non-melanoma skin cancer or in situ carcinoma of the cervix). If there is a history of prior malignancy, the patient must be disease-free for ≥ 5 years. Patients with other prior malignancies less than 5 years before study entry may still be enrolled if they have received treatment resulting in complete resolution of the cancer and currently have no evidence of active or recurrent disease.
  • Use of investigational drugs, biologics, or devices within 4 weeks prior to randomization.
  • Previous exposure to pralatrexate or erlotinib.
  • Women who are pregnant or breastfeeding.
  • Congestive Heart Failure Class III/IV according to New York Heart Association (NYHA) Functional Classification.
  • Uncontrolled hypertension.
  • Human immunodeficiency virus (HIV)-positive diagnosis with a CD4 count of <100 mm3 or detectable viral load within the past 3 months, and is receiving combination anti-retroviral therapy.
  • Symptomatic central nervous system metastases or lesions for which treatment is required.
  • Major surgery within 2 weeks of study randomization.
  • Receipt of any conventional systemic chemotherapy within 4 weeks (6 weeks for nitrosoureas, mitomycin C), or radiation therapy (RT) within 2 weeks, prior to randomization.
  • Active infection or any serious underlying medical condition, which would impair the ability of the patient to receive protocol treatment.
  • Dementia or significantly altered mental status that would prohibit the understanding and giving of informed consent or limit study compliance.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PralatrexateFolic AcidIntravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride).
ErlotinibVitamin B12150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.
PralatrexateVitamin B12Intravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride).
ErlotinibFolic Acid150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.
PralatrexatePralatrexateIntravenous (IV) push administration over 3-5 minutes into a patent IV line containing normal saline (0.9% sodium chloride).
ErlotinibErlotinib150 mg orally in tablet form Administered daily 1 hour before or 2 hours after ingestion of food until criteria for discontinuation per the protocol are met.
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS) of Patients Receiving Pralatrexate vs. ErlotinibAssessed from date of randomization no less frequently than every 16 weeks for up to 2 years after randomization.

OS was defined as the length of time from randomization until death due to any cause. Patients who were alive at the time of the data cut-off date were censored at the last contact date.

Secondary Outcome Measures
NameTimeMethod
Response Rate (RR) to Treatment of Patients Receiving Pralatrexate vs. ErlotinibAssessed every 8 weeks for the first 24 weeks, then every 16 weeks for up to 2 years or until PD or start of subsequent treatment.

Number of patients whose tumors responded to Pralatrexate or Erlotinib, using the Response Criteria in Solid Tumors (RECIST).

Progression-free Survival (PFS) of Patients Receiving Pralatrexate vs. ErlotinibAssessed every 8 weeks for the first 24 weeks, then every 16 weeks for up to 2 years or until PD or start of subsequent treatment.

PFS was calculated as the number of days from randomization to the date of radiological evidence of PD or death due to any cause.

Adverse Events of Patients Receiving Pralatrexate vs. ErlotinibAssessed every 2 weeks while on treatment through safety follow-up visit (35 +/-5 days post-last dose) or early termination visit (at time of withdrawal).

Trial Locations

Locations (47)

Donald Berdeaux

🇺🇸

Great Falls, Montana, United States

Instituto Medico Especializado Alexander Fleming

🇦🇷

Buenos Aires, Cuidad De Buenos Aires, Argentina

Policlinica Privada - Instituto de Medicina Nuclear

🇦🇷

Bahia Blanca, Provincia De Buenos Aires, Argentina

Centro Oncologico Rosario

🇦🇷

Rosario, Argentina

ISIS Clinica Especializada

🇦🇷

Santa Fe, Argentina

Zala County Hospital

🇭🇺

Zalaegerszeg, Zala, Hungary

Regional Cancer Center

🇮🇳

Trivandrum, Kerala, India

Komarom-Esztergom Megyei Onkorm. Szent Borbala Korhaza

🇭🇺

Tatabánya, Hungary

Jehangir Clinical Development Centre Pvt Ltd

🇮🇳

Pune, Mahara, India

MNJ Radium Hospital and Radium Institute of Oncology and Regional Cancer Centre

🇮🇳

Hyderabaad, Andhra Pradesh, India

Kidwai Memorial Institute of Oncology

🇮🇳

Bangalore, Karnataka, India

Dharmashila Cancer Hospital & Research Centre

🇮🇳

New Delhi, India

Hematology Oncology Associates of the Treasure Coast

🇺🇸

Port Saint Lucie, Florida, United States

Comprehensive Blood and Cancer Center

🇺🇸

Bakersfield, California, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

New Bern Cancer Care

🇺🇸

New Bern, North Carolina, United States

Hematology and Oncology Associates South Jersey

🇺🇸

Mount Holly, New Jersey, United States

Hospital de Clínicas de Porto Alegre

🇧🇷

Porto Alegre, RS, Brazil

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

Signal Point Clinical Research Center

🇺🇸

Middletown, Ohio, United States

Masarykuv onkologicky ustav

🇨🇿

Brno, Czechia

Instituto do Cancer - Arnaldo Vieira de Carvalho

🇧🇷

Sao Paulo, Brazil

B.P. Poddar Cancer Institute

🇮🇳

Kolkata, West Bengal, India

Tata Memorial Hospital

🇮🇳

Mumbai, Maharashtra, India

Fakultni nemocnice na Bulovce

🇨🇿

Praha 8, Czechia

Fundação Pio XII - Hospital do Câncer de Barretos

🇧🇷

Barretos, SP, Brazil

Vitkovicka nemocnice, a. s.

🇨🇿

Ostrava, Czechia

Hospital Britanico

🇦🇷

Capital Federal, Argentina

Providence Everett Medical Center

🇺🇸

Everett, Washington, United States

Associação Hospital de Caridade de Ijuí

🇧🇷

Ijui, RS, Brazil

National Koranyi TBC and Pulmonology Institute

🇭🇺

Budapest, Pest, Hungary

Matrai Allami Gyogyintezet

🇭🇺

Matrahaza, Hungary

Biocancer S.A.

🇧🇷

Belo Horizonte, Brazil

New York Oncology Hematology-Oncology Associates, P.C.

🇺🇸

Latham, New York, United States

Palacký University Medical School and Teaching Hospital

🇨🇿

Olomouc, Czechia

Clinionco - Clínica de Oncologia de Porto Alegre

🇧🇷

Porto Alegre, RS, Brazil

Cancer Therapy and Research Center

🇺🇸

San Antonio, Texas, United States

Baptist Regional Cancer Center

🇺🇸

Knoxville, Tennessee, United States

Summit Medical Group

🇺🇸

Berkeley Heights, New Jersey, United States

CAIPO (Centero Para la Atencion Integral del Paciente Oncologico)

🇦🇷

Tucuman, Argentina

Vas County Markusovszky Hospital

🇭🇺

Szombathely, Vas, Hungary

Nemocnice Na Homolce

🇨🇿

Praha, Czechia

Jósa András Teaching Hospital

🇭🇺

Nyiregyhaza, Szabolcs-Szatmár-Bereg, Hungary

Indo American Cancer Institute and Research Center

🇮🇳

Hyderabad, Andhra Pradesh, India

Fakultni nemocnice v Motole

🇨🇿

Praha, Czechia

Northwestern University Feinberg School of Medicine

🇺🇸

Chicago, Illinois, United States

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