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Erlotinib Hydrochloride With or Without Celecoxib in Treating Patients With Stage IIIB-IV Non-Small Cell Lung Cancer

A Randomized, Placebo-Controlled Phase II Clinical Trial of Combination Erlotinib (Tarceva) and Celecoxib (Celebrex) Versus Erlotinib (Tarceva)/Placebo in Advanced Non-Small Cell Lung Cancer Patients

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00499655
Enrollment
107
Registered
2007-07-11
Start date
2007-11-30
Completion date
2016-12-31
Last updated
2017-03-29

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

Conditions

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

Brief summary

RATIONALE: Erlotinib hydrochloride and celecoxib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Celecoxib may also stop the growth of lung cancer by blocking blood flow to the tumor. Giving erlotinib hydrochloride together with celecoxib may kill more tumor cells. PURPOSE: This randomized phase II trial is studying how well giving erlotinib hydrochloride together with celecoxib works compared with erlotinib hydrochloride alone in treating patients with stage IIIB-IV non-small cell lung cancer.

Detailed description

PRIMARY OBJECTIVES: I. Comparison of progression-free survival (PFS) in patients receiving erlotinib + celecoxib vs. erlotinib + placebo for advanced NSCLC. SECONDARY OBJECTIVES: I. Objective tumor response rate as defined by RECIST Criteria for subjects receiving erlotinib/celecoxib treatment arms. II. Categorize the change in e-cadherin expression from baseline to week 8 in a subset of subjects. III. Evaluation of overall survival (OS). IV. Measurement of COX-2, EGFR by immunohistochemistry and EGFR amplification by FISH, and EGFR mutation status to correlate with clinical response. V. Measurement of change in urinary PGE-M and correlation with response. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28. ARM II: Patients receive oral erlotinib hydrochloride once daily and oral celecoxib twice daily on days 1-28. In both arms, treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically.

Interventions

DRUGerlotinib hydrochloride

Given orally

DRUGcelecoxib

Given orally

OTHERplacebo

Given orally

OTHERlaboratory biomarker analysis

Correlative studies

OTHERimmunohistochemistry staining method

Correlative studies

GENETICfluorescence in situ hybridization

Correlative studies

GENETICmutation analysis

Correlative studies

GENETICprotein expression analysis

Correlative studies

GENETICgene expression analysis

Correlative studies

Sponsors

OSI Pharmaceuticals
CollaboratorINDUSTRY
City of Hope Medical Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

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

Inclusion criteria

Inclusion * Pathologically proven NSCLC, stage IIIB (defined as: with pleural effusion or recurrence after mediastinal radiation and chemotherapy) or IV * Available tumor tissue for mutation screening * Measurable stage IIIb or IV disease by RECIST guidelines * ECOG performance status of 0 or 1 * Progressive disease despite \>= 1 prior chemotherapy regimens as standard of care or subject's refusal or inability to receive standard chemotherapy * Normal renal function (defined as serum creatinine =\< 2mg/dl) * Normal liver function (defined as serum total bilirubin =\< 1.5, and serum transaminases =\< 2.5X the upper limits of normal \[ULN\]); if liver metastases are present, serum transaminases \> 5X the ULN * No evidence of coagulopathy (defined as PT and/or PTT =\< 1.5X ULN or platelets \>= 100,000) * No evidence of leukopenia (defined as absolute neutrophil count \>= 1,500 mm\^3) * Negative pregnancy test prior to initiation of treatment and adequate contraception throughout treatment Exclusion * Cytotoxic chemotherapy agents within 4 weeks of initiating treatment; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation * Evidence of NYHA class III or greater cardiac disease, history of myocardial infarction, cerebral vascular accident, symptomatic ventricular arrhythmia, or symptomatic conduction abnormality * Non-cytoxic therapy within 2 weeks of initiating treatment ; all toxicities must be recovered to baseline or NCI CTCAE v3.0 Grade 1 from all acute effects of prior cancer treatment, except alopecia or any clinically insignificant effect, prior to study initiation * Prior radiotherapy to target lesions is not permitted unless completed more than 4 weeks prior to treatment within the study and that there has been documented progression at these sites (Radiotherapy to non-target lesions is permitted within 2 weeks of study entry provided all acute effects of the radiotherapy have resolved at least grade 1) * Comorbid disease or a medical condition that would impair the ability of the subject to receive or comply with the study protocol * Prior malignancy within the last 3 years with the exception of non-melanoma skin cancer or cervical cancer in situ * Hypersensitivity of erlotinib or celecoxib or to any of the excipients of these products * Hypersensitivity to sulfonamides, aspirin or other NSAIDS * Prior history of EGFR inhibitor for the treatment of cancer * Previous history of gastrointestinal ulceration, bleeding or perforation * Concurrent use of COX-2 inhibitors or other NSAIDS (For subjects on NSAIDS prior to study initiation, cessation of the drug for 72 hours prior to study entry is required) * Chronic or concurrent use of steroids (topical steroids are acceptable if medically indicated) * Subjects who require treatment with fluconazole or lithium * Any evidence of clinically active interstitial lung disease (patients with chronic stable radiographic changes who are asymptomatic need not be excluded) * Renal insufficiency (defined as serum creatinine \> 2 mg/dl) * Liver insufficiency (defined as serum total bilirubin \> 1.5, or serum transaminases \> 2.5C the upper limits of normal \[ULN\]); if liver metastases are present, serum transaminases \> 5X the ULN * Coagulopathy (defined as PT and/or PTT \> 1.5X ULN or platelets \< 100,000) * Leukopenia (defined as absolute neutrophil count \< 1,500/mm\^3) * Pregnancy or inadequate contraception * Lactating females * Active CNS metastasis (stable, treated CNS metastasis acceptable)

Design outcomes

Primary

MeasureTime frameDescription
Progression-free SurvivalUntil disease progression, up to 5 years.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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Secondary

MeasureTime frameDescription
Number of Participants With Overall Response16 weeks post start of treatmentPer Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by MRI: 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
Progression-free Survival - Elevated PGEMUntil disease progression, up to 5 years.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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Progression-free Survival - EGRFUntil disease progression, up to 5 years.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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Progression-free Survival - Low PGEMUntil disease progression, up to 5 years.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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Countries

United States

Participant flow

Participants by arm

ArmCount
Erlotinib\Placebo
Patients receive 150 mg of oral erlotinib hydrochloride once daily and oral placebo twice daily on days 1-28. erlotinib hydrochloride: Given orally placebo: Given orally laboratory biomarker analysis: Correlative studies immunohistochemistry staining method: Correlative studies fluorescence in situ hybridization: Correlative studies mutation analysis: Correlative studies protein expression analysis: Correlative studies gene expression analysis: Correlative studies
53
Erlotinib\Celecoxib
Patients receive 150 mg of oral erlotinib hydrochloride once daily and 600 mg of oral celecoxib twice daily on days 1-28. erlotinib hydrochloride: Given orally celecoxib: Given orally laboratory biomarker analysis: Correlative studies immunohistochemistry staining method: Correlative studies fluorescence in situ hybridization: Correlative studies mutation analysis: Correlative studies protein expression analysis: Correlative studies gene expression analysis: Correlative studies
54
Total107

Baseline characteristics

CharacteristicErlotinib\PlaceboErlotinib\CelecoxibTotal
Age, Continuous65 years63.5 years64 years
Region of Enrollment
United States
53 Participants54 Participants107 Participants
Sex: Female, Male
Female
29 Participants28 Participants57 Participants
Sex: Female, Male
Male
24 Participants26 Participants50 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
53 / 5354 / 54
serious
Total, serious adverse events
1 / 532 / 54

Outcome results

Primary

Progression-free Survival

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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Time frame: Until disease progression, up to 5 years.

Population: All patients receiving treatment.

ArmMeasureValue (MEDIAN)
Erlotinib\PlaceboProgression-free Survival3.5 Months
Erlotinib\CelecoxibProgression-free Survival5.4 Months
Secondary

Number of Participants With Overall Response

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by MRI: 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: 16 weeks post start of treatment

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Erlotinib\PlaceboNumber of Participants With Overall Response17 Participants
Erlotinib\CelecoxibNumber of Participants With Overall Response12 Participants
Secondary

Progression-free Survival - EGRF

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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Time frame: Until disease progression, up to 5 years.

Population: Analysis on a subset of patients with wild-type epidermal growth factor receptor (EGFR),

ArmMeasureValue (MEDIAN)
Erlotinib\PlaceboProgression-free Survival - EGRF1.8 Months
Erlotinib\CelecoxibProgression-free Survival - EGRF3.2 Months
Secondary

Progression-free Survival - Elevated PGEM

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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Time frame: Until disease progression, up to 5 years.

Population: Analysis on a subset of patients with elevated baseline urinary prostaglandin E metabolite (PGEM).

ArmMeasureValue (MEDIAN)
Erlotinib\PlaceboProgression-free Survival - Elevated PGEM2.2 Months
Erlotinib\CelecoxibProgression-free Survival - Elevated PGEM5.4 Months
Secondary

Progression-free Survival - Low PGEM

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, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.

Time frame: Until disease progression, up to 5 years.

Population: Analysis on a subset of patients with low baseline urinary prostaglandin E metabolite (PGEM).

ArmMeasureValue (MEDIAN)
Erlotinib\PlaceboProgression-free Survival - Low PGEM5.4 Months
Erlotinib\CelecoxibProgression-free Survival - Low PGEM6.8 Months

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