Dasatinib in Treating Patients With Relapsed Small Cell Lung Cancer

A Phase II Study of Dasatinib (NSC #732517) in Patients With Chemo-Sensitive Relapsed Small Cell Lung Cancer

This phase II trial is studying how well dasatinib works in treating patients with relapse small cell lung cancer. Dasatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PRIMARY OBJECTIVE I. Determine the efficacy of dasatinib in patients with relapsed small cell lung cancer.

SECONDARY OBJECTIVE II. Determine the objective response rate (complete and partial response) in patients treated with this drug.

III. Determine the overall survival of patients treated with this drug. IV. Determine the toxicity of this drug in these patients.

OUTLINE:

Patients receive oral dasatinib twice daily on days 1-21. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at least every 3 months for 1 year and then every 6 months for 3 years.

Inclusion Criteria:

• Histologically or cytologically confirmed small cell lung cancer (SCLC) (limited or extensive stage disease)

• Progressive or recurrent disease after an initial response to first-line treatment with a platinum-based chemotherapy with or without concurrent definitive radiotherapy to the chest (chemotherapy must have been completed at least 90 days prior to documentation of relapse)

• Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm by conventional techniques OR >= 10 mm by spiral CT scan

• Lesions that are not considered measurable include the following:

  • Bone lesions
  • Leptomeningeal disease
  • Ascites
  • Pleural or pericardial effusion
  • Abdominal masses that are not confirmed and followed by imaging techniques
  • Cystic lesions
  • Tumor lesions situated in a previously irradiated area, unless progression after radiotherapy is documented in these lesions

• No known brain metastases (previously treated brain metastases allowed provided they are neurologically stable for >= 4 weeks)

• ECOG performance status 0-1

• Platelet count >= 100,000/mm^3

• Bilirubin =< 1.5 times upper limit of normal (ULN)

• Creatinine =< 1.5 times ULN OR creatinine clearance >= 60 mL/min

• AST =< 2.5 times ULN

• Not pregnant or nursing

• Negative pregnancy test

• No significant cardiac disease, including any of the following:

  • New York Heart Association class III-IV heart disease
  • Myocardial infarction or ventricular tachyarrhythmia within the past 6 months
  • Prolonged QTc > 480 msec (Fridericia correction)
  • Major conduction abnormality (unless a cardiac pacemaker is present)

• No more than 1 prior chemotherapy regimen

• No prior dasatinib or compounds of similar chemical composition or similar biologic therapeutic activity including, but not limited to, any inhibitors of SRC, BCR-ABL, c-KIT, EPHA2, or PDGFRB kinases

• At least 2 weeks since prior definitive or palliative radiotherapy (prior radiotherapy allowed in the context of combined modality treatment with curative intent for limited stage disease; prophylactic cranial radiotherapy; or palliative radiotherapy initially or at relapse)

• At least 2 weeks since prior surgery and recovered

• At least 1 week since prior and no concurrent agents with proarrhythmic potential

• At least 1 week since prior and no concurrent CYP3A4 inhibitors or inducers

• At least 1 week since prior and no concurrent grapefruit concentrate

• No concurrent palliative radiotherapy

• No concurrent hormones or other chemotherapeutic agents, except steroids for adrenal failure, hormones for noncancer-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic

• No concurrent combination antiretroviral therapy for HIV-positive patients

• No other concurrent chemotherapeutic or investigational agents

• Fertile patients must use effective contraception during and for >= 6 weeks after completion of study therapy