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| ID | Type | Description | Link |
|---|---|---|---|
| 2007-003646-15 | EudraCT Number |
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| Name | Class |
|---|---|
| Merck Sharp & Dohme LLC | INDUSTRY |
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This is an open label, non-randomized, sequential, phase I/II trial in patients with stage IIIB or IV non-small cell lung cancer (NSCLC) with EGFR mutations after progression to Erlotinib. The study will have two parts. The first part (phase I) will be a dose finding (MTD) study to be implemented at three hospitals. The second part of the study (phase II) will asses the safety and efficacy of the combination. In this second part (phase II) patients will be treated with oral Erlotinib 150 mg P.O daily plus oral Vorinostat administered according to the results of the phase I. The study endpoints to be evaluated will include safety and response rate (RR) as primary endpoints and clinical benefit rate (CBR), time to progression, time to response, response duration and progression free survival as secondary endpoints. All the patients (phase I and II) will be treated until progression disease, unacceptable toxicity or withdrawal of the consent, and will be treated at the discretion of the principal investigator.
SAMPLE:
Patients must have histologically-confirmed diagnosis of stage IIIB or IV NSCLC, with prior treatment with Erlotinib. In the phase I study the upper expected number of patients will be eighteen. In the phase II thirty two eligible patients will be included in the study. The enrollment period will be approximately 1.5 years. All patients will be treated with Erlotinib and Vorinostat regimen. Participating hospitals will be those of the Spanish Lung Cancer Group (SLCG).
For the phase I portion, there will be 3 sites: Dr. Noemi Reguart and Dr. Rafael Rosell, Institut Catala d'Oncologia, Hospital Germans Trias i Pujol, Badalona (Barcelona, Spain), Dr. Felip Cardenal, Institut Catalan d'Oncologia. Centre Sanitari i Universitari de Bellvitge (CSUB), Hospitalet de Llobregat (Barcelona, Spain) and Dr. Lola Isla, Hospital Clinico Lozano Blesa, (Zaragoza, Spain) For the phase II portion, 10 hospitals (adding 7 to the first 3) from the Spanish Lung Cancer Group (SLCG) will be involved. Hospitals will be included during phase I study.
OBJECTIVES AND HYPOTHESES Primary Phase I
(1) To determine the MTD of oral vorinostat in combination with erlotinib and to ensure that this treatment is sufficiently safe and tolerable to permit further study.
Phase II (1) To determine the percentage of patients free of progression at 12 weeks. Hypothesis: We considered that treatment was effective if we obtained a percentage of patients free of progression at 12 weeks higher than 60%.
Secondary
(1) To determine the CBR (clinical benefit rate), response rate, time to progression, time to response, response duration, and progression free survival in patients treated with vorinostat and erlotinib in combination.
Hypothesis: CBR should be of at least 25% and it will include stable disease for at least 3 months and objective RECIST response for at least 4 weeks.
Exploratory endpoints
Molecular analysis:
Main Objective: analysis of EGFR mutations (in exons 19, 20 and 21) in serum samples at baseline (before treatment), at three months of treatment and at the end of the treatment.
Secondary Objectives: retrospective analysis of molecular markers potentially related to drug sensitivity such as E-catherin protein expression, thioredoxin serum levels; Hsp70; methylation of 14-3-3r and CHFR.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vorinostat plus erlotinib | Experimental | Vorinostat plus erlotinib |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vorinostat plus Erlotinib | Drug | Phase I: Dose level 1: 300 mg V d1-7 every 21 days plus 100 mg E daily Dose level 2: 400 mg V d1-7 every 21 days plus 100 mg E daily Dose level 2b: 300 mg V d1-7 and 15-21 every 28 days plus 100 mg E daily Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily Phase II: Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily |
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival Rate at 12 Weeks | Progression Free Survival was defined as time from first treatment until progression or death from any cause. | From date of first day of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 weeks |
| Maximum Tolerated Dose (MTD) of Oral Vorinostat Phase I | In the phase I, a classic 3 + 3 dose escalation method with 3 patients treated initially at each dose level was used. MTD was determined by testing on dose escalation cohorts: continuous full dose of erlotinib 150 mg orally (p.o.) in a daily administration(QD) and escalating doses of vorinostat p.o. at three dose levels:300 mg QD 7 days every 21 days, 400 mg QD 7 days every 21 days,and 400 mg QD, 7 days every other week. MTD reflects the highest dose of drug that did not cause a Dose-Limiting Toxicity (DLT) in less than or equal to 1 in 6 patients. DLTs were defined as any Vorinostat-related Common Terminology Criteria for Adverse Events Version 3.0 (CTCAE 3.0) Grade 3 or 4 adverse events. | Up to 24 weeks for each dosing cohort |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival | Overall survival was defined as time from study inclusion until death | From the date of study inclusion until end of follow up, up to 36 months. |
| Time to Progression | The time to progression has been defined as the time that elapses, in months, since the patient begins study treatment until the patient progresses or dies from the disease, the first thing that occurs. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions |
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Inclusion Criteria:
16.Patient is able to read, understand, and complete the study questionnaires.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Teresa Moran, MD | Medical Oncology Service. Institut Catala d'Oncologia- ICO. Hospital Germans Trias i Pujol. Badalona - Barcelona (Spain) | Principal Investigator |
| Dolores Isla, MD | Medical Oncology Service. Hospital Clinico Lozano Blesa. Zaragoza. Spain | Study Chair |
| Felip Cardenal, MD | Institut Catala d'Oncologia. Centre Sanitari i Universitari de Bellvitge (CSUB). Hospitalet de Llobregat (Barcelona). Spain | Study Chair |
| Bertomeu Massutti, MD | Medical Oncology Service. General Hospital. Alicante. Spain | Study Chair |
| Rafael Rosell, MD | Medical Oncology Service. Institut Catala d'Oncologia- ICO. Hospital Germans Trias i Pujol. Badalona - Barcelona (Spain) | Study Chair |
| Noemi Reguart, MD | Medical Oncology Service. Hospital Clinic - Barcelona (Spain) | Study Chair |
| Amelia Insa, MD | Medical Oncology Service. Hospital ClÃnico Universitario - Valencia (Spain) | Principal Investigator |
| Cinta Pallarés, MD | Medical Oncology Service. Hospital de la Santa Creu i Sant Pau - Barcelona (Spain) |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital de la Santa Creu i Sant Pau | Barcelona | 08025 | Spain | |||
| Instituto Universitario Dexeus |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24636848 | Result | Reguart N, Rosell R, Cardenal F, Cardona AF, Isla D, Palmero R, Moran T, Rolfo C, Pallares MC, Insa A, Carcereny E, Majem M, De Castro J, Queralt C, Molina MA, Taron M. Phase I/II trial of vorinostat (SAHA) and erlotinib for non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations after erlotinib progression. Lung Cancer. 2014 May;84(2):161-7. doi: 10.1016/j.lungcan.2014.02.011. Epub 2014 Mar 2. |
| Label | URL |
|---|---|
| Web page of the sponsor where users can find more information about Fundación GECP studies | View source |
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Screening details:
Histologically confirmed NSCLC Diagnosis of advanced stage IIIB with pleural effusion or IV NSCLC Previous disease progression after >= 3 months treatment with Erlotinib. Must tolerate erlotinib dose of 150 mg daily during the prior month. Have demonstrated mutations at epidermal growth factor receptor (EGFR) at Exon 19 or Exon 21
Between December 2007 and November 2010 the patients were enrolled in the phase I-II trial.
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| ID | Title | Description |
|---|---|---|
| FG000 | Vorinostat Plus Erlotinib Phase II | Vorinostat plus Erlotinib Phase II: 400 mg Vorinostat d1-7 and 15-21 every 28 days plus 150 mg Erlotinib daily per cycle |
| FG001 | Vorinostat Plus Erlotinib Phase I Level 1 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
|
| From the date of randomization until end of follow up, up to 36 months. |
| Barcelona |
| 08028 |
| Spain |
| Hospital Clinic | Barcelona | 08036 | Spain |
| Institut Catalá d'Oncologia, Centre Sanitari i Universitari de Bellvitge (CSUB) | Barcelona | 08907 | Spain |
| Institut Catalá d'OncologÃa, Hospital Germans Trias i Pujol | Barcelona | 08916 | Spain |
| Hospital La Paz | Madrid | 28046 | Spain |
| Hospital ClÃnico Universitario de Valencia | Valencia | 46010 | Spain |
| Hospital ClÃnico Lozano Blesa | Zaragoza | 50009 | Spain |
Phase I:
Dose level 1: 300 mg V d1-7 every 21 days plus 100 mg E daily If none of the patient experienced dose limiting toxicity, the next dose level was started.
| FG002 | Vorinostat Plus Erlotinib Phase I Level 2 | Dose level 2: 400 mg V d1-7 every 21 days plus 100 mg E daily Dose level 2b: 300 mg V d1-7 and 15-21 every 28 days plus 100 mg E daily If none of the patient experienced dose limiting toxicity, the next dose level was started. |
| FG003 | Vorinostat Plus Erlotinib Phase I Level 3 | Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily |
| COMPLETED |
|
| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Vorinostat Plus Erlotinib Phase II | Vorinostat plus erlotinib Phase II: Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily |
| BG001 | Vorinostat Plus Erlotinib Phase I | Drug: Vorinostat plus Erlotinib Phase I: Dose level 1: 300 mg V d1-7 every 21 days plus 100 mg E daily |
| BG002 | Vorinostat Plus Erlotinib Phase I Level 2 | Drug: Vorinostat plus Erlotinib Phase I: Dose level 2: 400 mg V d1-7 every 21 days plus 100 mg E daily Dose level 2b: 300 mg V d1-7 and 15-21 every 28 days plus 100 mg E daily |
| BG003 | Vorinostat Plus Erlotinib Phase I Level 3 | Drug: Vorinostat plus Erlotinib Phase I: Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||
| ECOG | ECOG Performance Status Scale: It describes a patient's level of functioning in terms of their ability to care for themself, daily activity, and physical ability GRADES: ECOG 0: Fully active. ECOG 1: Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature ECOG 2: Ambulatory and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours ECOG 3: Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours ECOG 4: Completely disabled ECOG 5: Dead | Number | participants |
| |||||||||||||||
| Smoking habits | Number | participants |
| ||||||||||||||||
| Stage | Staging is a classification where cancer is located, if or where it has spread and whether it's affecting other parts of the body. There are 5 stages for NSCLC: Stage 0:tumor hasn't grown into nearby normal lung tissues Stage I:small tumor that hasn't spread to any lymph nodes Stage II: medium tumor that hasn't spread to the nearby lymph nodes or N1 Stage III: cancer spread to the lymph nodes but haven't spread to other distant parts of the body Stage IV: cancer has spread to more than 1 area in the other lung, the fluid surrounding the lung or the heart, or distant parts of the body | Number | participants |
| |||||||||||||||
| Histology | Number | participants |
| ||||||||||||||||
| Metastatic sites | Number | participants |
| ||||||||||||||||
| EGFR tumor mutations | Number | participants |
| ||||||||||||||||
| EGFR mutations blood | Number | participants |
| ||||||||||||||||
| T790M blood | Number | participants |
| ||||||||||||||||
| Median prior treatments | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Progression Free Survival Rate at 12 Weeks | Progression Free Survival was defined as time from first treatment until progression or death from any cause. | Efficacy analysis PFSR12w population: all patients who have received at least one dose of study medication have been included. | Posted | Number | 95% Confidence Interval | percentage of participants | From date of first day of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 weeks |
|
|
| |||||||||||||||||||||||||
| Primary | Maximum Tolerated Dose (MTD) of Oral Vorinostat Phase I | In the phase I, a classic 3 + 3 dose escalation method with 3 patients treated initially at each dose level was used. MTD was determined by testing on dose escalation cohorts: continuous full dose of erlotinib 150 mg orally (p.o.) in a daily administration(QD) and escalating doses of vorinostat p.o. at three dose levels:300 mg QD 7 days every 21 days, 400 mg QD 7 days every 21 days,and 400 mg QD, 7 days every other week. MTD reflects the highest dose of drug that did not cause a Dose-Limiting Toxicity (DLT) in less than or equal to 1 in 6 patients. DLTs were defined as any Vorinostat-related Common Terminology Criteria for Adverse Events Version 3.0 (CTCAE 3.0) Grade 3 or 4 adverse events. | Fourteen patients were treated with escalation doses of vorinostat. | Posted | Number | mg | Up to 24 weeks for each dosing cohort |
|
| |||||||||||||||||||||||||||
| Secondary | Overall Survival | Overall survival was defined as time from study inclusion until death | Efficacy analysis: all patients who have received at least one dose of study medication have been included. | Posted | Median | 95% Confidence Interval | Month | From the date of study inclusion until end of follow up, up to 36 months. |
|
| ||||||||||||||||||||||||||
| Secondary | Time to Progression | The time to progression has been defined as the time that elapses, in months, since the patient begins study treatment until the patient progresses or dies from the disease, the first thing that occurs. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions | Efficacy analysis: all patients who have received at least one dose of study medication have been included. | Posted | Median | 95% Confidence Interval | Month | From the date of randomization until end of follow up, up to 36 months. |
|
|
37 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Vorinostat Plus Erlotinib Phase II | Vorinostat plus erlotinib Phase II: Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily | 1 | 25 | 16 | 25 | 22 | 25 |
| EG001 | Vorinostat Plus Erlotinib Phase I Dose Level 1 | Dose level 1: 300 mg V d1-7 every 21 days plus 100 mg E daily If none of the patient experienced dose limiting toxicity, the next dose level was started. | 0 | 3 | 0 | 3 | 3 | 3 |
| EG002 | Vorinostat Plus Erlotinib Phase I Dose Level 2 | Dose level 2: 400 mg V d1-7 every 21 days plus 100 mg E daily Dose level 2b: 300 mg V d1-7 and 15-21 every 28 days plus 100 mg E daily. If none of the patient experienced dose limiting toxicity, the next dose level was started. | 0 | 3 | 1 | 3 | 3 | 3 |
| EG003 | Vorinostat Plus Erlotinib Phase I Dose Level 3 | Dose level 3: 400 mg V d1-7 and 15-21 every 28 days plus 150 mg E daily | 0 | 2 | 2 | 2 | 2 | 2 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Fever | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Diarrhea | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Anorexia | Metabolism and nutrition disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Pneumopathy | Respiratory, thoracic and mediastinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Mucositis | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Anemia | Blood and lymphatic system disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Leukopenia | Blood and lymphatic system disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Lymphopenia | Blood and lymphatic system disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Neutropenia | Blood and lymphatic system disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Ocular toxicity | Eye disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Fatigue | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Asthenia | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Anorexy | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Fever | General disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Diarrhea | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Epigastralgia | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Xerostomia | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Mucositis | Gastrointestinal disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Creatinine elevation | Renal and urinary disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Hyperbilirubinemia | Hepatobiliary disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Non-systematic Assessment |
| |
| Xeroderma | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Non-systematic Assessment |
|
The study was stopped prematurely because it did not meet the goal required for study continuation.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Eva Pereira | Fundación GECP | +34 934302006 | secretaria@gecp.org |
| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D000077337 | Vorinostat |
| D000069347 | Erlotinib Hydrochloride |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| Male |
|
| ECOG 1 |
|
| ECOG 2 |
|
| Former > 5 years |
|
| Former 1-5 years |
|
| Former < 1 year |
|
| Never |
|
| Not recorded |
|
| IV |
|
| Squamous |
|
| Large cell |
|
| Two |
|
| Three or more |
|
| Not recorded |
|
| L858R |
|
| L858R |
|
| Wild type |
|
| NE |
|
| Wild type |
|
| NE |
|
| Two |
|
| Three |
|
| Four or more |
|
| Not recorded |
|
|
| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
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|