Advanced Non-Small Cell Lung Cancer MedDRA version: 14.1 Level: LLT Classification code 10025054 Term: Lung cancer non-small cell stage IIIB System Organ Class: 100000004864 MedDRA version: 14.1 Level: LLT Classification code 10025055 Term: Lung cancer non-small cell stage IV System Organ Class: 100000004864
Conditions
Interventions
Product Name: Tamibarotene
Pharmaceutical Form: Tablet
INN or Proposed INN: Tamibarotene
CAS Number: 94497-51-5
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 2-
P
Sponsors
CytRx Corporation
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Subjects must be at least 18 years of age. 2. Subjects must have pathological findings consistent with primary non-small cell lung cancer of any histology. 3. Subjects must have either stage IIIB with pleural effusion or IV NSCLC with radiographically measurable disease (RECIST 1.1 criteria). Women non-smokers with stage IV NSCLC should be screened for EGFR mutations and if positive be excluded from the study and placed on an EGFR kinase inhibitor. 4. Subjects must have an ECOG Performance Status =2. 5. If corticosteroids are required for controlling cerebral edema, subjects must be on a stable dose for at least 1 week. 6. Subjects must have recovered from any toxicity of prior therapies. 7. Subjects must be at least 4 weeks removed from surgery or radiation therapy. 8. Subjects must have a life expectancy of at least 12 weeks. 9. Subjects must have adequate bone marrow function (defined as an absolute neutrophil count of =1500 cells/mm3 and platelet count =100,000 cells/mm3), liver function with total bilirubin =2.0 mg/dL, and serum creatinine =1.5 x institutional ULN. 10. Subjects must be able to understand and be willing to sign a written informed consent document. 11. Tamibarotene, as with all retinoids, is teratogenic. Therefore, female subjects of childbearing potential must agree to use 2 effective methods of contraception (hormonal, barrier method of birth control, or abstinence) and sexually-active male subjects must agree to use an effective method of contraception (hormonal or barrier method of birth control or abstinence) while participating in this study and for six months afterwards. Women of childbearing potential must have a negative pregnancy test =1 week prior to registration. 12. Subjects must be able to swallow tablets. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 80 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 60
Exclusion criteria
Exclusion criteria: 1. Subjects who have received or are currently receiving chemotherapy or antibody therapy, or are enrolled in another treatment clinical trial. 2. Subjects with a coagulopathy or bleeding disorder that is not adequately treated. 3. Clinically evident congestive heart failure >class II of the New York Heart Association (NYHA) guidelines. 4. Serious, clinically significant cardiac arrhythmias, defined as the existence of an absolute arrhythmia or ventricular arrhythmias classified as Lown III, IV, or V. 5. History or signs of active coronary artery disease with or without angina pectoris (i.e. myocardial infarction within 6 months prior to enrollment, uncontrolled angina, electrocardiographic evidence of acute ischemia). 6. Subjects who have a serious medical or psychiatric illness that could, in the investigator’s opinion, potentially interfere with the completion of treatment according to this protocol or may not be able to comply with the safety monitoring requirements of the study. 7. HIV-positive subjects; however, subjects will not be routinely screened for HIV. 8. Subjects who are allergic to any of the intended chemotherapies. 9. Female subjects who are pregnant or breast-feeding. 10. Active, clinically significant serious infection requiring treatment with antibiotics, anti-virals, or anti-fungals. 11. Subjects with peripheral neuropathy =grade 2. 12. Prior systemic treatment for locally advanced or metastatic disease (exception below). a. Prior adjuvant chemotherapy for Stage I-III or combined modality chemotherapy-radiation for locally advanced disease allowed if completed >12 months prior to randomization. 13. Subjects with brain metastases are only eligible if treated and neurologically stable with no ongoing requirement for corticosteroids, e.g., dexamethasone, for at least 2 weeks. 14. Subjects with hypertriglyceridemia (>1000 mg/dL). 15. Subjects with elevated liver function tests if AST is =2.5x the institutional or central laboratory’s upper limit of normal for subjects without liver metastases, or >5x the institutional or central laboratory’s upper limit of normal for subjects with liver metastases. 16. Subjects with HbA1c =8.0. 17. Subjects taking vitamin A either as a supplement or as part of a multivitamin unless there has been at least a 2 week washout. 18. Subjects using concomitant medications that are known inducers or inhibitors of cytochrome CYP3A4 up to 14 days before Cycle 1 Day 1 (pimozide, diltiazem, erythromycin, clarithromycin, and quinidine, and amiodarone) should be excluded from the study. 19. Subjects whose tumors cannot be adequately measured per RECIST 1.1.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: The primary objective of this study is to determine the progression-free survival and objective response rate (complete + partial responses) of subjects with stage IIIB with pleural effusion or IV non-small cell lung cancer treated with paclitaxel and carboplatin plus either tamibarotene or matching placebo.;Secondary Objective: • The secondary objectives of this study are: (1) to assess subject quality of life using EORTC QLQ-C30 version 3; (2) to evaluate the safety of tamibarotene in this population assessed by the frequency and severity of adverse events (AEs), abnormal findings on physical examination, laboratory tests, and vital signs; (3) to assess overall survival in this population, (4) to examine the pharmacokinetics of tamibarotene in this population; and (5) to evaluate the expression of retinoic acid receptors by immunohistochemistry in tumor specimens.;Primary end point(s): (1) Progression-free survival;Timepoint(s) of evaluation of this end point: Progression-free survival (PFS) is defined as the time from enrollment (i.e., assignment of subject ID number) to first documentation of objective tumor progression or to death due to any cause in the absence of previous documentation of objective tumor progression. PFS will be censored at the last date the subject was known to be progression-free in subjects who do not have objective tumor progression and who are: 1) still on study at the time of an analysis; 2) are given antitumor treatment other than the study treatment; or 3) are removed from study follow-up prior to documentation of objective tumor progression. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): (1)Objective response rate (complete + partial responses). (2) Overall survival. (3) Assessment of quality of life using EORTC QLQ-C30 version 3. (4) Safety of tamibarotene in this population assessed by the frequency and severity of adverse events (AEs), abnormal findings on physical examination, laboratory tests, and vital signs. (5) Pharmacokinetics of tamibarotene in selected subjects. (6) Pharmacodynamics of retinoic acid receptor expression in NSCLC tumor specimens. ;Timepoint(s) of evaluation of this end point: Subjects will be evaluated for tumor response prior to Cycles 3 and 5 of chemotherapy, 21 days after final chemoterapy treatment, and then every other month until tumor progression or until clinical signs are suggestive of progressive disease, or unacceptable toxicity occurs. | — |
Countries
Bulgaria, India, Mexico, Russian Federation, Ukraine, United States
Contacts
Public ContactRegulatory Department
PSI Pharma Support EOOD
Outcome results
None listed