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Docetaxel and Bortezomib in Treating Patients With Progressive or Recurrent Non-Small Cell Lung Cancer

Randomized Phase II Trial of Sequential Versus Concurrent Docetaxel and PS-341 (NSC 681239) in Previously Treated Non-Small Cell Lung Cancer (NSCLC)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00362882
Enrollment
81
Registered
2006-08-15
Start date
2006-07-31
Completion date
2010-07-31
Last updated
2017-12-05

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, Recurrent Non-small Cell Lung Cancer, Stage IV Non-small Cell Lung Cancer

Brief summary

This trial is studying two different schedules of docetaxel and bortezomib to compare how well they work in treating patients with progressive or recurrent non-small cell lung cancer. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving docetaxel together with bortezomib may kill more tumor cells

Detailed description

PRIMARY OBJECTIVE: I. To compare the efficacy and tolerability of sequential vs concurrent docetaxel and bortezomib in patients with previously treated, progressive or recurrent, advanced non-small cell lung cancer (NSCLC). SECOND OBJECTIVES: I. To compare time to progression in patients with previously treated NSCLC treated with these regimens. II. To compare 1-year and overall survival of patients treated with these regimens. III. To compare the toxicity of these regimens in these patients. IV. To determine the pharmacokinetics of docetaxel in the context of this study. TERTIARY OBJECTIVE: I. To determine levels of expression of molecular markers regulated by docetaxel and bortezomib and correlate with clinical response and overall survival of these patients. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG performance status (0 vs 1) and number of prior chemotherapy treatments (1 vs \>1). Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive docetaxel IV over 60 minutes on day 1 and bortezomib IV over 3-5 seconds on days 1 and 8. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive docetaxel as in arm I and bortezomib IV over 3-5 seconds on days 2 and 8. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. After completion of study therapy, patients are followed periodically.

Interventions

DRUGdocetaxel

Given IV

DRUGbortezomib

Given IV

OTHERlaboratory biomarker analysis

correlative study

OTHERimmunoenzyme technique

correlative study

OTHERimmunohistochemistry staining method

correlative study

OTHERpharmacological study

correlative study

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No

Inclusion criteria

Criteria: * No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage I or II cancer for which the patient is currently in complete remission, or any other cancer for which the patient has been disease-free for 5 years. * Histologically or cytologically confirmed non-small cell lung cancer (NSCLC). * Progressive or recurrent NSCLC after treatment with 1 prior platinum-based chemotherapy regimen for metastatic disease. Prior neoadjuvant/adjuvant chemotherapy and/or concurrent chemoradiation for early-stage disease allowed. * At least 4 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas) and recovered. * No prior docetaxel or bortezomib * Prior epidermal growth factor receptor inhibitor therapy allowed. * Prior paclitaxel allowed * At least 4 weeks since prior major surgery and recovered. * At least 2 weeks since prior and no concurrent enzyme-inducing anticonvulsants. * No concurrent hormonal therapy, biologic therapy, or radiotherapy to measurable lesions. Concurrent palliative radiotherapy to small-field nonindicator lesions (e.g., painful bony metastases) allowed. * Measurable disease\* with \>= 1 unidimensionally objectively measurable lesion, including any of the following: * Lung mass (measurable on chest x-ray, tomograms, or CT scan) * Enlarged lymph nodes * Liver metastasis (measurable as a discrete focal lesion on radionuclide or CT scan, or ultrasound) * Metastatic abdominal mass (measurable on CT scan with \>= 1 perpendicular diameter ≥ the distance between cuts) * Measurable disease must be outside the previous radiation field or a new lesion must be present. * Life expectancy \>= 12 weeks * Progressive disease within a previously radiated field allowed. * \[Note: \*Measurable disease DOES NOT include bone metastases or non-focal liver metastases\]. * No symptomatic or untreated brain metastasis requiring steroids. Asymptomatic, previously treated (surgical resection or radiotherapy) brain metastasis allowed provided they are neurologically stable and \>= 4 weeks since prior steroids. * Creatinine clearance \>= 50 mL/min * Creatinine =\< 1.6 mg/dL * Bilirubin normal * AST =\< 2 times upper limit of normal * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No peripheral neuropathy \>= grade 2 * Absolute granulocyte count \>= 1,500/mm³ * Platelet count \>= 100,000/mm³ * Cutaneous nodule * ECOG performance status 0-1 * At least 4 weeks since prior radiotherapy and recovered.

Design outcomes

Primary

MeasureTime frameDescription
Overall Response RateUp to 4 yearsPer Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT, MRI or X-ray: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Secondary

MeasureTime frameDescription
Overall SurvivalFrom first day of treatment to time of death due to any cause, up to 4 yearsWill be estimated using the product-limit method of Kaplan and Meier.
Disease Control RateUp to 4 yearsDisease control rate was defined as the rate of partial response (PR) plus stable disease (SD; for at least 2 cycles).
Progression-free Survival @ 6 Months6 monthsEstimated using the product-limit method of Kaplan and Meier. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), 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.

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm 1
Patients receive docetaxel IV at 75 mg/m2 on day 1 and bortezomib IV at 1.6 mg/m2 seconds on days 1 and 8. docetaxel: Given IV bortezomib: Given IV laboratory biomarker analysis: correlative study immunoenzyme technique: correlative study immunohistochemistry staining method: correlative study pharmacological study: correlative study
40
Arm 2
Patients receive docetaxel IV at 75 mg/m2 on day 1 and bortezomib IV at 1.6 mg/m2 seconds on days 2 and 8. docetaxel: Given IV bortezomib: Given IV laboratory biomarker analysis: correlative study immunoenzyme technique: correlative study immunohistochemistry staining method: correlative study pharmacological study: correlative study
41
Total81

Baseline characteristics

CharacteristicArm 1Arm 2Total
Age, Continuous61 years61 years61 years
Race/Ethnicity, Customized
African Americian
5 participants1 participants6 participants
Race/Ethnicity, Customized
Asian
3 participants6 participants9 participants
Race/Ethnicity, Customized
Caucasion
32 participants33 participants65 participants
Race/Ethnicity, Customized
Other
0 participants1 participants1 participants
Region of Enrollment
United States
40 participants41 participants81 participants
Sex: Female, Male
Female
17 Participants21 Participants38 Participants
Sex: Female, Male
Male
23 Participants20 Participants43 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
40 / 4041 / 41
serious
Total, serious adverse events
15 / 4021 / 41

Outcome results

Primary

Overall Response Rate

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT, MRI or X-ray: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Time frame: Up to 4 years

ArmMeasureValue (NUMBER)
Arm 1Overall Response Rate10 percentage of participants
Arm 2Overall Response Rate10 percentage of participants
Secondary

Disease Control Rate

Disease control rate was defined as the rate of partial response (PR) plus stable disease (SD; for at least 2 cycles).

Time frame: Up to 4 years

ArmMeasureValue (NUMBER)
Arm 1Disease Control Rate50 percentage of participants
Arm 2Disease Control Rate49 percentage of participants
Secondary

Overall Survival

Will be estimated using the product-limit method of Kaplan and Meier.

Time frame: From first day of treatment to time of death due to any cause, up to 4 years

ArmMeasureValue (MEDIAN)
Arm 1Overall Survival13.3 Months
Arm 2Overall Survival7.8 Months
Secondary

Progression-free Survival @ 6 Months

Estimated using the product-limit method of Kaplan and Meier. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST), 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.

Time frame: 6 months

ArmMeasureValue (NUMBER)
Arm 1Progression-free Survival @ 6 Months30 percent of participants
Arm 2Progression-free Survival @ 6 Months17 percent of participants
p-value: 0.17Log Rank

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