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Phase 2 N=37 Treatment

BAY 43-9006 (Sorafenib) to Treat Relapsed Non-Small Cell Lung Cancer

Non-Small-Cell Lung Carcinoma

Enrolled (actual)
37
Serious AEs
29.7%
Results posted
May 2012
Primary outcome: Primary: Response Rate — 6 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
BAY 43-9006 (Sorafenib) (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
National Cancer Institute (NCI)
Primary completion
Nov 2009

Outcome Measures

OutcomeResultp-value
PRIMARY
Response Rate
6
PRIMARY
Progression Free Survival
3.4
PRIMARY
The Number of Participants With Adverse Events
37
SECONDARY
Overall Survival
11.6
SECONDARY
Percent of Participants With Genotyping of CYP3A4/5 and 5 Polymorphisms
SECONDARY
Overall Survival Reported Separately for Participants With a Change in PLGF Below 11 pg/ml and Above 12 pg/ml
6.6; 15.6 0.0027 sig
SECONDARY
Cytokine Levels
101; 115; 19; 6
SECONDARY
Correlation of Response to Treatment With KRAS Mutational Status
60; 71; 40; 69 0.33
SECONDARY
Overall Survival Associated With Basic Fibroblast Growth Factor (bFGF)
15.4; 5.5 0.042 sig
SECONDARY
Progression Free Survival Associated With Basic Fibroblast Growth Factor (bFGF)
4.4; 1.8 0.028 sig
SECONDARY
Percentage of Participants With an Increase or Decrease in the Reverse Contrast Transfer Rate (Kep), Forward Contrast Transfer Rate (Ktrans), and Extravascular Fraction (Ve) With the Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI)
19; 81; 0
SECONDARY
Percent of Participants Who Had Immunohistochemical Analysis Performed for Raf, MEK, ERK, ERK-1 and p90RSK,ERK, E Twenty-six (ETS)-Like Transcription Factor 1 (ELK-1) and p90Ribosomal S6 Kinase (p90RSK).
SECONDARY
Percent of Participants Who Had Cytokine Profiling for IL-6 and IL-8
SECONDARY
Percentage of Participants With BRAF Mutations
SECONDARY
Percent of Pts With Primary Pharmacoproteomic Modulation Targets
SECONDARY
Secondary Pharmacoproteomic Modulation Targets

Summary

This study will investigate the effects and side effects of BAY 43-9006 in patients with advanced, recurrent, or refractory non-small cell lung cancer (NSCLC). BAY 43-9006 is one of a new class of anticancer agents known as bi-aryl ureas. Patients 18 years of age and older with NSCLC that has recurred or progressed after one regimen of chemotherapy may be eligible for this study. Candidates are screened with a medical history and physical examination; blood tests; tumor biopsy (see below); chest x-ray; electrocardiogram; and imaging studies, including positron emission tomography-computed tomography (PET-CT, see below) and dynamic, contrast-enhanced MRI (DCE-MRI, see below). Participants take BAY 43-9006 by mouth twice a day, morning and evening. On the first and 15th days of treatment, patients are admitted to the hospital for pharmacokinetic studies; that is, a test of how the body handles the drug. For the test, blood is collected at intervals (at 15 minutes, 30 minutes, and 1, 2, 4, 6, 8, 12 and 24 hours after ingestion) to determine the drug's level in the bloodstream. Treatment with BAY 43-9006 continues until the study doctor determines that the medication is not beneficial or the patient wishes to withdraw from the study. In addition to drug therapy, patients undergo the following tests and procedures: * Physical examination every 4 weeks * Blood pressure checks once a week during the first 4 weeks * Blood tests every week * CT scans or other imaging tests, such as ultrasound or MRI, every 8 weeks to evaluate the tumor's response to treatment. CT is an x-ray test that provides detailed pictures of the inside of the body. It can be done from different angles, providing a 3-dimensional picture of the part of the body being studied and allowing the doctor to see the location, nature, and extent of disease. MRI uses a powerful magnet and radio waves instead of x-rays to produce accurate, detailed pictures of organs and tissues. * PET-CT approximately every 8 weeks to look at how different parts of the body take up and use glucose (a sugar nutrient). Because rapidly growing cells, such as tumors, use more sugar than normal cells do, this test can be used to detect cancer. For the test, the patient is given an injection of a sugar solution in which a radioactive tracer has been attached to the sugar molecule. A special camera detects the radiation emitted by the solution, and the resulting images show how much sugar is being used in various parts of the body. PET-CT uses the PET scan in combination with standard CT in a machine that does both tests. * DCE-MRI after 2 weeks of treatment. This test uses MRI with a special non-radioactive dye to examine blood flow in a certain part of the body. * Tumor biopsy (optional) after 2 weeks of treatment. A biopsy is the surgical removal of a small piece of tissue. The tumor biopsy is done either using a small bore needle under CT guidance or by direct visualization using a laparoscope/thoracoscope. For the needle biopsy, a needle is inserted through the skin and guided by CT into the tumor mass. For the laparoscopy/thoracoscopy, the patient is sedated or asleep and small lighted tubes are inserted into small holes made in the skin. The tumor is located and tissue withdrawn.

Eligibility Criteria

  • INCLUSION CRITERIA:

Histologically documented Non-small cell lung cancer and confirmed by the Laboratory of Pathology at the Clinical Center/National Institutes of Health (NIH) or the Laboratory of Pathology at National Naval Medical Center (NNMC).

Recurrent or progressed Non-Small Cell Lung Cancer (NSCLC).

Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as greater than 20 mm with conventional techniques or as greater than 10 mm with spiral Computed tomography (CT) scan.

Patients must have recovered from toxicity related to prior therapy to at least to grade 1 (defined by Common Terminology Criteria for Adverse Events (CTCAE) 3.0) and must not have had prior chemotherapy within 4 weeks. Patients must be at least 28 days since any prior radiation or major surgery.

Age greater than 18 years (males or non-pregnant females). Because no dosing or adverse event data are currently available on the use of BAY 43-9006 in patients less than 18 years of age, children are excluded from this study but will be eligible for future pediatric single-agent trials, if applicable.

Life expectancy of greater than 3 months.

Eastern Cooperative Oncology Group (ECOG) performance status less than 2 (Karnofsky > 60%).

Patients must have adequate organ and marrow function (as defined below). Patients must have returned to base line or grade one from any acute toxicity related to prior therapy.

Leukocytes greater than 3,000/micro l;

Absolute neutrophil count greater than 1,200/micro l;

Platelets greater than 100,000/micro l;

International normalized ratio (INR) less than or equal to 1.2

Partial thromboplastin time (PTT) less than or equal to 36 seconds or abnormality can be explained by the presences of lupus anticoagulant

Total bilirubin less than or equal to 1.5 times the institutional upper limits of normal;

Aspartate aminotransferase, oxaloacetic transaminase (AST,SGOT) and alanine transaminase, serum glutamic pyruvic transaminase (ALT,SGPT) less than 2.5 times the institutional upper limits of normal;

Creatinine or creatinine clearance less than or equal to 1.5 times the institutional upper limits of normal or greater than 45 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal.

The effects of BAY 43-9006 on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because kinase inhibitors are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and continue for at least 2 months after completion. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with BAY 43-9006, breastfeeding should be discontinued if the mother is treated with BAY 43-9006.

Ability to comply with daily oral self administration schedule, and the ability to understand and the willingness to sign a written informed consent document.

EXCLUSION CRITERIA

Patients with symptomatic brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. However, patients who have had treatment for their brain metastases and whose brain metastatic disease status has remained stable for at least 3 months without steroids may be enrolled at the discretion of the principal investigator.

Uncontrolled medical illness including, but not limited to, ongoing or uncontrolled, symptomatic congestive heart failure (American Heart Association (AHA) Class I

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00098254). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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