Lung Cancer
Conditions
Keywords
recurrent non-small cell lung cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer
Brief summary
RATIONALE: Celecoxib may slow the growth of cancer by stopping blood flow to the tumor. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with celecoxib may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining celecoxib and docetaxel in treating patients who have advanced non-small cell lung cancer that has been previously treated with platinum-based chemotherapy.
Detailed description
OBJECTIVES: * Determine the efficacy and feasibility of celecoxib combined with docetaxel in patients with advanced non-small cell lung cancer previously treated with platinum-based chemotherapy. * Determine the response rate of patients treated with this regimen. * Determine the toxicity of this regimen in these patients. OUTLINE: This is a multicenter study. Patients receive oral celecoxib twice daily (beginning on day -7 of the first course) and docetaxel IV over 1 hour on day 1. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses after CR. Patients who achieve stable disease (SD) or a partial response (PR) receive a minimum of 2 additional courses after SD or PR. At the discretion of the treating physician, patients then receive maintenance therapy comprising celecoxib only. Patients who discontinue therapy for disease progression or unacceptable toxicity are followed for at least 6 months. PROJECTED ACCRUAL: A total of 21-39 patients will be accrued for this study within 13-28 months.
Interventions
DRUGCelecoxib
400mg by mouth, twice a day, each dose given with meals, to start -7 days prior to first cycle of treatment.
DRUGDocetaxel
On day 1, 75mg/m2 IV over 60 minutes, repeated every 21 days
Sponsors
National Cancer Institute (NCI)
Barbara Ann Karmanos Cancer Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Diagnosis of stage IIIA, IIIB, or IV non-small cell lung cancer * Disease progression during or after 1 or more platinum-based chemotherapy regimens * Measurable or evaluable disease * No symptomatic or untreated brain or leptomeningeal metastases * Previously treated patients must be neurologically stable for 4 weeks after completion of appropriate therapy PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * SWOG 0-2 Life expectancy: * Not specified Hematopoietic: * Absolute neutrophil count at least 1,500/mm\^3 * Platelet count at least 100,000/mm\^3 * Hemoglobin at least 8 g/dL Hepatic: * Bilirubin no greater than upper limit of normal (ULN) * AST/ALT no greater than ULN (or no greater than 2.5 times ULN if alkaline phosphatase no greater than ULN) * Alkaline phosphatase no greater than ULN (or no greater than 5 times ULN if AST/ALT no greater than ULN) * No history of chronic hepatitis of any duration Renal: * Creatinine no greater than ULN Cardiovascular: * No uncontrolled congestive heart failure * No uncontrolled angina * No myocardial infarction and/or stroke within the past 6 months * No active thromboembolic event within the past 4 weeks Gastrointestinal: * No gastrointestinal bleeding within the past 6 months * No history of peptic ulcer disease Other: * No prior hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80 * No prior allergy to any non-steroidal anti-inflammatory drug * No other prior or concurrent malignancy within the past 3 years except adequately treated squamous cell or basal cell skin cancer or carcinoma in situ of the cervix * No grade 2 or greater peripheral neuropathy * No active infection * No other serious concurrent medical illness * No history of dementia, active psychiatric disorder, or other condition that would interfere with ability to take oral medication or preclude compliance with study * HIV negative * Must weigh at least 50 kg (110 pounds) * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective barrier contraception PRIOR CONCURRENT THERAPY: Biologic therapy: * Not specified Chemotherapy: * See Disease Characteristics * At least 4 weeks since prior chemotherapy * Prior paclitaxel allowed * No prior docetaxel Endocrine therapy: * At least 3 days since prior steroids Radiotherapy: * At least 4 weeks since prior radiotherapy * No prior radiotherapy to target lesion Surgery: * At least 4 weeks since prior major surgery Other: * Prior intermittent use of non-steroidal anti-inflammatory drugs (NSAIDs), including rofecoxib or celecoxib, allowed * At least 1 week since prior fluconazole * No recent prior NSAIDs, including rofecoxib or celecoxib, for a duration of more than 30 consecutive days * No concurrent fluconazole or lithium * No other concurrent NSAIDs except aspirin administered at a dose of no more than 325 mg/day for cardiovascular conditions * No other concurrent cyclo-oxygenase-2 inhibitors * No other concurrent investigational agents
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of combining Celecoxib with Docetaxel | Weeks 1 , 2 and 3 | Blood levels of VEGF & PGE2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Response rate of Celecoxib and Docetaxel | Every 2 cycles (or every 42 days); After therapy is completed or if the patient is only on Celecoxib, will be assessed for progression every month by clinical exam and every 3 months by radiological evaluation. | CT Chest/Abdomen |
| Toxicity of Celecoxib and Docetaxel | Every week | Routine bloodwork |
| Expression of cyclooxygenase-2 (COX-2) in tumors | Pre-study | Tissue sample from initial diagnosis, parrafin embedded tissue block |
| Changes in plasma levels of prostaglandin E2 (PGE2) & vascular endthelial growth factor (VEGF) | Pre-study; Weeks 1 , 2 and 3 | Collecting blood plasma |
| Vascular changes induced in the tumor by celecoxib | Weeks 1, 3 & 6 | Using DCE-MRI and PET scans to evaluate. |
Countries
United States
Outcome results
None listed