A Phase I Study of Concurrent CPT-11/Cisplatin and Celecoxib With Radiation Therapy for Patients With Unresectable Non-Small Cell Lung Cancer (NSCLC)
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Maximum Tolerated Dose (MTD) of Celebrex (celecoxib)
研究概览
简要总结
Primary Objectives:
- To determine the feasibility, activity, and toxicity of a novel regimen using a concurrent irinotecan (CPT-11)/cisplatin and celecoxib combination for patients with unresectable NSCLC.
- To determine the maximal tolerance dose of celecoxib in patients with unresectable NSCLC treated with irinotecan/cisplatin and concurrent thoracic radiation therapy.
- To correlate the COX-2 expression and other biomarkers with response to the treatment in the tumor from a pretreatment biopsy specimen.
详细描述
Celecoxib is a non-steroidal-anti-inflammatory drug (NSAIDS), similar to aspirin or ibuprofen. Recent studies have shown that celecoxib has antitumor activity when used alone. It may also increase the tumor sensitivity to radiation, making tumors more responsive to radiation therapy.
Before treatment starts, you will have a complete physical exam, including blood (about 2 teaspoons) and urine tests. You will have a chest x-ray, CT/MRI scans, and/or a PET scan. You may have a bone scan (x-rays of your bones) if your doctor feels it is necessary. You may also have blood tests, x-rays, biopsy of the tumor, and any other tests which your physician feels are necessary for your standard of care.
In this study, you will take celecoxib by mouth for 5 days before beginning radiation therapy. You will continue to receive celecoxib 7 days per week throughout radiation treatment (about 7 weeks). The amount of drug that you take will depend on what dose level you are assigned to. The dose levels are 200mg, 400mg, and 800 mg per day. Ten patients will be treated on each dose level starting at the lower level. You will be required to fill out a medication diary, documenting the dose of celecoxib you are taking and the time that you take it.
You will receive cisplatin and CPT-11 by vein on Day 1 of Weeks 2 through 8. Chemotherapy will be given on an outpatient basis. CPT-11 will be infused by vein over 90 minutes followed by cisplatin which will be infused for 60 minutes. Because cisplatin can cause kidney damage, fluids may need to be injected to "flush" the kidneys. Diuretics are given by vein just before and after receiving cisplatin. So that the physician may better evaluate kidney function during this time, you may be asked to save urine specimens and to keep a record of all fluids taken by mouth during the first 24-48 hours after receiving cisplatin.
Radiation therapy will begin on Day 1 of Week 2 and be given at the same time as chemotherapy. The radiation therapy treatments will be given once a day for 5 days a week, Monday-Friday. The total treatment time for individual patients will be decided by the physician, based on the your general condition and stage of disease. The length of the radiation treatment should be about 7 weeks (35 radiation treatments).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •No history of active gastric ulcer, active GI bleeding, or renal failure.
- •Patient must have histological or cytological evidence of NSCLC.
- •Nonresectable Stage II or III NSCLC. Inoperable based on patient's physical status is acceptable.
- •KPS is greater than or equal to
- •Age is greater than or equal to 18 or less than or equal to
- •Patient not receiving irradiation therapy or combined modality therapy to treat another malignancy.
- •No evidence of distant metastatic disease.
- •ANC count (segs & bands) is greater than or equal to 2000/mm3 and platelet count is greater than or equal to 100,000/mm
- •Serum creatinine less than or equal to 1.5 mg/dL.
- •Total bilirubin is less than or equal to 1.5 times the institutional upper limits of normal value, SGOT less than or equal to 1.5 times the the institutional upper limit of normal.
- •Patients may not be entered on investigational therapeutic trials.
- •Patients or guardian must be informed of and understand the investigational nature of this study and give written informed consent prior to any study procedures.
- •Patient may have prior chemotherapy. Chemotherapy must have been completed 4 weeks prior to study entry.
- •Patients taking cardio-protective dose of aspirin 81 mg are allowed.
排除标准
- •History of poorly controlled hypertension (systolic >150 mm Hg), angina, or other cardiac abnormalities or history of MI or CHF in the last 6 months.
- •General medical or psychological conditions which would not permit the patient to complete the study or sign the informed consent.
- •Pregnancy or women of child bearing potential who do not use an effective (for them) method of birth control throughout their participation in this study.
- •Patients who are currently receiving or have received amifostine for radioprotection within the prior six months are excluded.
- •Patient with history of malignancy other than skin cancer or Carcinoma in-situ within 2 years.
- •Patients who are allergic to Sulfonamides, NSAIDS or Celebrex will be excluded from this protocol.
- •Patients who use routine NSAIDS such as high dose daily use of Aspirin higher than 2 Gm per day will be excluded. Patients will be allowed to take low dose aspirin (less than 200 mg per day).
- •History of cardiovascular diseases that might include one of the following: myocardial infraction, angina, coronary angioplasty, congestive heart failure, stroke, or coronary bypass surgery in the last 6 months.
- •Family history of premature coronary disease (i.e. - onset < 55 years of age).
- •Uncontrolled hypercholesteremia [low-density lipoprotein cholesterol (LDL-C) > 200] more than twice in the repeated tests. Hypercholesteremia needs to be controlled following the updated National Cholesterol Education Program Adult Treatment Panel III Guidelines for at least 3 months prior to enrollment on the study. Hypercholesteremia treatment should continue during the entire period of Celecoxib treatment on the protocol
- •History of deep venous thrombosis, pulmonary embolism, systemic lupus erythematous, family history of protein S or C deficiencies, prior heparin-induced thrombocytopenia, Factor V Leiden deficiencies or high homocysteine levels.
研究组 & 干预措施
CPT-11 + Celecoxib/Cisplatin with RT
CPT-11 + Celecoxib + Cisplatin + Radiation Therapy (RT)
干预措施: Celecoxib (Drug)
CPT-11 + Celecoxib/Cisplatin with RT
CPT-11 + Celecoxib + Cisplatin + Radiation Therapy (RT)
干预措施: Cisplatin (Drug)
CPT-11 + Celecoxib/Cisplatin with RT
CPT-11 + Celecoxib + Cisplatin + Radiation Therapy (RT)
干预措施: CPT-11 (Drug)
CPT-11 + Celecoxib/Cisplatin with RT
CPT-11 + Celecoxib + Cisplatin + Radiation Therapy (RT)
干预措施: Concurrent Thoracic Radiation Therapy (Radiation)
结局指标
主要结局
Maximum Tolerated Dose (MTD) of Celebrex (celecoxib)
时间窗: 12 week treatment; Continuous assessment and determination of dose-limiting toxicities.
次要结局
未报告次要终点