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Pemetrexed Plus Cetuximab in Patients With Recurrent Non Small Cell Lung Cancer

A Phase I-IIa Dose-Ranging Study of Pemetrexed (Alimta) Plus Cetuximab (Erbitux) in Patients With Recurrent Non-Small Cell Lung Cancer (NSCLC): Hoosier Oncology Group LUN04-79

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00216203
Enrollment
36
Registered
2005-09-22
Start date
2005-05-31
Completion date
2008-12-31
Last updated
2016-09-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Non-Small Cell Lung Cancer

Keywords

Non-Small Cell Lung Cancer

Brief summary

Both pemetrexed and cetuximab have single agent activity in NSCLC and non-overlapping toxicity profiles. While 2-drug combination therapy has proven superior to single agent therapy in the first-line setting of NSCLC, no such phase III trials have been reported in the second-line setting. Therefore, the purpose of this study is to determine the feasibility of combining these drugs, assessing the toxicity profile, determining the MTD and evaluating the activity of the combination in an expanded phase II setting. If the combination appears to have promising activity, further evaluation of this regimen may be warranted comparing it to single agent pemetrexed or cetuximab alone.

Detailed description

OUTLINE: This is a multi-center study. Week 1 (day 1): * Cetuximab 400mg/m2 Week 2 (Cycle 1, Day 1): * Cetuximab 250mg/m2 plus premetrexed at the assigned dose level. Patients will be treated with cetuximab on day 1, 8, 15 of each 21 day cycle. Patients will be treated with pemetrexed on day 1 of each 21 day cycle for a maximum of 6 cycles. Acceptable toxicity and SD, PR or CR: treat up to 6 cycles then continue cetuximab weekly until PD or excess toxicity Performance status: ECOG 0-2 Life expectancy: At least 12 weeks Hematopoietic: * ANC \> 1,500/mm3 * Platelets \> 100,000/mm3 Hepatic: * Bilirubin less than or equal to the upper limit of normal (ULN) * Aspartate aminotransferase (AST) \< 1.5 X ULN. AST may be \< 5 X ULN for patients with liver metastases * Alkaline phosphatase \< 5 X ULN Renal: * Calculated creatinine clearance \> 45 mL/min (by Cockcroft-Gault) Cardiovascular: * No significant history of uncontrolled cardiac disease (i.e., uncontrolled hypertension, unstable angina, and congestive heart failure) Pulmonary: * Not specified

Interventions

DRUGPemetrexed

Pemetrexed at the assigned dose, day 1 of each 21 day cycle for a maximum of 6 cycles

DRUGCetuximab

Cetuximab 400 mg/m2, week 1, day 1 Cetuximab 250 mg/m2, day 1, 8, 15 of each 21 day cycle

Sponsors

Eli Lilly and Company
CollaboratorINDUSTRY
Bristol-Myers Squibb
CollaboratorINDUSTRY
Walther Cancer Institute
CollaboratorOTHER
Nasser Hanna, M.D.
Lead SponsorOTHER

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

* Histologic or cytologic diagnosis of NSCLC * Recurrent or metastatic disease that is not amenable to curative therapyMeasurable disease according to RECIST * At least one prior platinum containing regimen for either locally advanced or metastatic disease * Prior chemotherapy must be completed at least 21 days prior to being registered for protocol therapy and the subject must have recovered from the acute toxicity effects of the regimen * Ability and willingness to interrupt aspirin or other nonsteroidal anti-inflammatory agents for a 5-day period * Prior radiation therapy allowed to \< 25% of the bone marrow * Negative pregnancy test

Exclusion criteria

* No active infection that in the opinion of the investigator would compromise the subject's ability to tolerate therapy. * No serious concomitant systemic disorders that would compromise the safety of the subject or compromise the subject's ability to complete the study, at the discretion of the investigator. * No prior malignancy is allowed except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the subject has been disease-free for at least 2 years. * No major thoracic or abdominal surgery within 30 days prior to being registered for protocol therapy. * No current breastfeeding

Design outcomes

Primary

MeasureTime frameDescription
Maximum Tolerated Dose (MTD) of Pemetrexed in Combination With Cetuximab12 monthsThe primary objective of the phase I portion of this study is to define the maximum tolerated dose (MTD) of the combination of pemetrexed and cetuximab
Time To Progression (TTP)24 MonthsThe primary objective of the phase II portion is to estimate the time to progression of this combination, evaluated per RECIST criteria where PD= at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions

Secondary

MeasureTime frameDescription
Median Survival Time24 Months
Toxicity and Safety Profile12 months
Clinical Benefit Rate12 monthsClinical Benefit Rate (CR + PR + SD lasting more than 90 days)

Countries

United States

Participant flow

Participants by arm

ArmCount
Pemetrexed + Cetuximab
Pemetrexed + cetuximab for patients with recurrent non-small cell lung cancer. Pemetrexed: Pemetrexed at the assigned dose, day 1 of each 21 day cycle for a maximum of 6 cycles Cetuximab: Cetuximab 400 mg/m2, week 1, day 1 Cetuximab 250 mg/m2, day 1, 8, 15 of each 21 day cycle
33
Total33

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyWithdrawal by Subject2

Baseline characteristics

CharacteristicPemetrexed + Cetuximab
Age, Continuous64 years
Disease Stage
Disease Stage III
2 participants
Disease Stage
Disease Stage IV
31 participants
Eastern Cooperative Oncology Group (ECOG) performance status
ECOG PS 0
19 participants
Eastern Cooperative Oncology Group (ECOG) performance status
ECOG PS 1
14 participants
Previous Treatment
1 Chemotherapy
26 participants
Previous Treatment
>2 Chemotherapy
2 participants
Previous Treatment
2 Chemotherapy
5 participants
Previous Treatment
Previous radiotherapy
14 participants
Previous Treatment
Previous Targeted Therapy
6 participants
Region of Enrollment
United States
33 participants
Sex: Female, Male
Female
13 Participants
Sex: Female, Male
Male
20 Participants
Smoking History
Current Smoker
6 participants
Smoking History
Former Smoker
24 participants
Smoking History
Never a Smoker
3 participants
Tumor Histology
Adenocarcinoma
18 participants
Tumor Histology
Large cell carcinoma
2 participants
Tumor Histology
Non-small cell carcinoma (NOS)
5 participants
Tumor Histology
Squamous cell carcinoma
8 participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
32 / 36
serious
Total, serious adverse events
11 / 36

Outcome results

Primary

Maximum Tolerated Dose (MTD) of Pemetrexed in Combination With Cetuximab

The primary objective of the phase I portion of this study is to define the maximum tolerated dose (MTD) of the combination of pemetrexed and cetuximab

Time frame: 12 months

Population: 12 participants participated in the phase I portion of the trial.

ArmMeasureValue (NUMBER)
Investigational TreatmentMaximum Tolerated Dose (MTD) of Pemetrexed in Combination With Cetuximab750 mg/m^2 every 21 days
Primary

Time To Progression (TTP)

The primary objective of the phase II portion is to estimate the time to progression of this combination, evaluated per RECIST criteria where PD= at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions

Time frame: 24 Months

Population: 27 participants had enough data to complete TTP analysis

ArmMeasureValue (MEDIAN)
Investigational TreatmentTime To Progression (TTP)14.6 Weeks
Secondary

Clinical Benefit Rate

Clinical Benefit Rate (CR + PR + SD lasting more than 90 days)

Time frame: 12 months

Population: Data was not collected or analyzed for this secondary objective.

Secondary

Median Survival Time

Time frame: 24 Months

Population: 27 participants had data sufficient to complete Median Survival Time analysis

ArmMeasureValue (MEDIAN)
Investigational TreatmentMedian Survival Time42.0 weeks
Secondary

Toxicity and Safety Profile

Time frame: 12 months

ArmMeasureGroupValue (NUMBER)
Investigational TreatmentToxicity and Safety ProfileALT elevation: Phase I - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileALT elevation: Phase I - Grade 3/416.7 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileALT elevation: Phase II - Any Grade0 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileALT elevation: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileMucositis: Phase II - Any Grade38 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileMucositis: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAcne-like rash: Phase I - Any Grade58.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAcne-like rash: Phase I - Grade 3/416.7 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAcne-like rash: Phase II - Any Grade57 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAcne-like rash: Phase II - Grade 3/423.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnorexia: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnemia: Phase I - Any Grade0 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnemia: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnemia: Phase II - Any Grade14.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnemia: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileThrombocytopenia: Phase I - Any Grade8.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileThrombocytopenia: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileThrombocytopenia: Phase II - Any Grade14.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileThrombocytopenia: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNeutropenia: Phase I - Any Grade8.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNeutropenia: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNeutropenia: Phase II - Any Grade4.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNeutropenia: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFebrile Neutropenia: Phase I - Any Grade8.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFebrile Neutropenia: Phase I - Grade 3/48.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFebrile Neutropenia: Phase II - Any Grade0 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFebrile Neutropenia: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDizziness: Phase I - Any Grade8.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDizziness: Phase I - Grade 3/48.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDizziness: Phase II - Any Grade19 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDizziness: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDyspnea: Phase I - Any Grade25 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDyspnea: Phase I - Grade 3/48.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDyspnea: Phase II - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDyspnea: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileCough: Phase I - Any Grade25 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileCough: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileCough: Phase II - Any Grade28.6 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileCough: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFatigue: Phase I - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFatigue: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFatigue: Phase II - Any Grade76 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFatigue: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnorexia: Phase I - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnorexia: Phase II - Any Grade19 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileAnorexia: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileMucositis: Phase I - Any Grade41.7 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileMucositis: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNausea: Phase I - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNausea: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNausea: Phase II - Any Grade28.6 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileNausea: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDiarrhea: Phase I - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDiarrhea: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDiarrhea: Phase II - Any Grade33.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileDiarrhea: Phase II - Grade 3/49.5 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileConstipation: Phase I - Any Grade16.7 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileConstipation: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileConstipation: Phase II - Any Grade23.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileConstipation: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFever(no neutropenia): Phase I - Any Grade8.3 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFever(no neutropenia): Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFever(no neutropenia): Phase II - Any Grade19 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileFever(no neutropenia): Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHeadache: Phase I - Any Grade50 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHeadache: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHeadache: Phase II - Any Grade23.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHeadache: Phase II - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHypomagnesmia: Phase I - Any Grade0 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHypomagnesmia: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHypomagnesmia: Phase II - Any Grade19 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileHypomagnesmia: Phase II - Grade 3/44.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileVomiting: Phase I - Any Grade16.7 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileVomiting: Phase I - Grade 3/40 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileVomiting: Phase II - Any Grade23.8 percentage of particpants
Investigational TreatmentToxicity and Safety ProfileVomiting: Phase II - Grade 3/44.8 percentage of particpants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026