A Phase II Study of Pemetrexed and Carboplatin in the Treatment of Esophageal Cancer

Phase 2

Terminated

Conditions: Esophageal Neoplasms

Interventions: Drug: Pemetrexed
Drug: Carboplatin

Registration Number: NCT00383266

Lead Sponsor: Washington University School of Medicine

Brief Summary: This is a study of an investigational agent, pemetrexed, in combination with a standard chemotherapy drug, carboplatin, for treatment of patients with metastatic esophageal cancer.

Detailed Description: Not available

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 9

Inclusion Criteria

Patients must have a histologically or cytologically proven metastatic or recurrent esophageal cancer. Both adenocarcinoma and squamous carcinoma are eligible for the study. Patients with small cell carcinoma or sarcoma of the esophagus are not eligible for the study.
Patients may have had no prior chemotherapy treatment for metastatic esophageal cancer. Patients may have had chemotherapy with 5-FU combined with definitive radiotherapy for curative intent in the adjuvant, neoadjuvant, or definite setting for locally advanced esophageal cancer, if no less than one year prior to trial enrollment. Patients may not have received pemetrexed in the past.
Patients who have had radiotherapy for esophageal cancer must have completed radiotherapy at least four weeks prior to entry in the study.
Patients need to have measurable disease.
Lesions that are not considered measurable include the following:
- Bone lesions
- Brain metastases or leptomeningeal disease
- Ascites
- Pleural/pericardial effusion
- Abdominal masses that are not confirmed and followed by imaging techniques
- Cystic lesions
- Tumor lesions situated in a previously irradiated area
ECOG) performance status of 0-2.
Life expectancy of >=12 weeks.
Patients must have adequate bone marrow function defined as: white blood cells (WBC) >= 3000/mm^3, absolute neutrophil count (ANC) >= 1,500/mm^3, hemoglobin >= 9.0 g/dL, and platelet count >= 100,000/mm^3.
Patients must have adequate liver function defined as: Bilirubin <= 1.5 x institutional normal and ALT/AST < 3 x institutional normal.
Patients must have adequate renal function defined as: serum creatinine <= 3.0 mg/dL and creatinine clearance >= 45 mL/min.
Radiation therapy for brain metastases should be completed at least four weeks prior to enrollment to this protocol.
Patients must have recovered from uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or uncontrolled symptomatic cardiac arrhythmia.
Patients must be able to be compliant with premedications of dexamethasone, folic acid, and vitamin B12.
For all sexually active women of child-bearing age, the use of adequate contraception (hormonal or barrier method of birth control) will be required prior to study entry and for the duration of study participation.
Age >= 18 years.
- Written consent.
- Ibuprofen (400 mg qid) can be administered with Alimta in patients with normal renal function (creatinine clearance > 80 mL/min

Exclusion Criteria

Patients with third-space fluid (pleural effusions, ascites, etc.) uncontrolled by drainage.
Pregnant or nursing females
Patients who have had pre-existing neuropathy greater than or equal to grade 2.
Patients with known active CNS metastases.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Pemetrexed + Carboplatin	Pemetrexed	* Pemetrexed 500 mg/m\^2 IV over 10 minutes * Carboplatin AUC 5 IV over 30 minutes on day 1 of each cycle * Each cycle will last 21 days.
Pemetrexed + Carboplatin	Carboplatin	* Pemetrexed 500 mg/m\^2 IV over 10 minutes * Carboplatin AUC 5 IV over 30 minutes on day 1 of each cycle * Each cycle will last 21 days.

Primary Outcome Measures

Name	Time	Method
Overall Response Rate (ORR)	Until patient progresses or dies (median follow-up 293 days -- range (63-632 days)	* Overall response rate = complete response (CR) + partial response (PR) using RECIST. * CR=disappearance of all target lesions and disappearance of all non-target lesions and normalization of tumor marker level * PR=at least a 30% decrease in the sum of the longest diameter (LD) of the target lesions taking as reference the baseline sum LD

Secondary Outcome Measures

Name	Time	Method
Time to Disease Progression	Until patient progresses (median follow-up 293 days -- range (63-632 days)	-Progressive disease=at least a 20% increase in the sum of the LD of the target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions
Overall Survival Rate	2 years
Toxicities	30 days following completion of treatment (maximum number of cycles = 6)
Overall Survival (OS)	Until patient's death (median follow-up 293 days -- range (63-632 days))	OS is defined as the time from initiation of treatment to the date of any reason death while those living subjects will be censored at the last assessment date.