Lung Cancer
Conditions
Keywords
adenocarcinoma of the lung, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent non-small cell lung cancer
Brief summary
RATIONALE: Dasatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying how well dasatinib works in treating patients with advanced lung cancer that is no longer responding to erlotinib or gefitinib.
Detailed description
OBJECTIVES: Primary * To determine the overall response rate (complete response and partial response) in patients with acquired erlotinib hydrochloride- or gefitinib-resistant advanced adenocarcinoma of the lung treated with dasatinib. Secondary * To determine the progression-free survival and overall survival of patients treated with this drug. * To determine the overall response rate in patients with EGFR T790M lung adenocarcinomas treated with this drug. * To determine the progression-free survival and overall survival of patients with EGFR T790M lung adenocarcinomas treated with this drug. * To determine the toxicity profile of dasatinib in these patients. OUTLINE: Beginning 1 week after completion of erlotinib hydrochloride or gefitinib therapy, patients receive oral dasatinib twice daily. Treatment continues in the absence of disease progression or unacceptable toxicity. Response is assessed by CT scan at 4 weeks, 8 weeks, and then every 8 weeks thereafter.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Pathologically confirmed adenocarcinoma of the lung * Advanced disease * Previously treated with erlotinib hydrochloride or gefitinib for 6 months (at any time) and meets 1 of the following criteria: * Previously received treatment with erlotinib hydrochloride or gefitinib\* and had a radiographic partial or complete response to treatment with erlotinib hydrochloride or gefitinib as defined by RECIST or WHO criteria * Documented mutation in EGFR from tumor DNA NOTE: \*Patients may have received other treatments subsequently including radiation or chemotherapy * Must have developed acquired resistance to erlotinib hydrochloride or gefitinib * Radiographic evidence of disease progression during treatment with erlotinib hydrochloride or gefitinib * Have previously undergone a biopsy of a site of progressive disease on protocol MSKCC 04-103\* NOTE: \*Results of this biopsy are not required to be enrolled on this trial * Measurable indicator lesions have not been previously irradiated * No CNS lesion that is symptomatic and/or requiring escalating doses of corticosteroids PATIENT CHARACTERISTICS: * Karnofsky performance status 70-100% * WBC ≥ 3,000/mm³ * Hemoglobin ≥ 9.0 g/dL * Platelet count ≥ 100,000/mm³ * Total bilirubin ≤ 2.0 mg/dL * AST and ALT ≤ 2.5 times upper limit of normal * Creatinine ≤ 2 mg/dL or creatinine clearance ≥ 55 mL/min * QTc \< 450 msec * Able to take oral medications * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for at least 4 weeks after study drug is stopped * No significant medical history or unstable medical condition, including any of the following: * History of diagnosed congenital long QT syndrome * Ventricular arrhythmia * Congestive heart failure * Recent myocardial infarction * Unstable angina * Active infection * Uncontrolled hypertension PRIOR CONCURRENT THERAPY: * See Disease Characteristics * At least 3 weeks since prior cytotoxic chemotherapy * At least 3 weeks since prior radiation therapy to a major bone-marrow containing area * At least 7 days since prior quinidine, procainamide, disopyramide, amiodarone, sotalol, ibutilide, dofetilide, erythromycin, clarithromycin, chlorpromazine, haloperidol, mesoridazine, thioridazine, pimozide, cisapride, bepridil, droperidol, methadone, arsenic, chloroquine, domperidone, halofantrine, levomethadyl, pentamidine, sparfloxacin, or lidoflazine
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine the Overall Objective Response | 2 years | To determine the overall response rate in patients with acquired erlotinib hydrochloride- or gefitinibresistant advanced adenocarcinoma of the lung treated with dasatinib using the RECIST criteria. Response and progression will be evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee.22 Changes in only the largest diameter (uni-dimensional measurement) of the tumor lesions are used in the RECIST. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Dasatinib Dasatinib in Patients with Lung Adenocarcinoma Receiving Erlotinib with Acquired Resistance to EGFR Tyrosine Kinase Inhibitors (TKIs) | 21 |
| Total | 21 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 2 |
Baseline characteristics
| Characteristic | Dasatinib |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 8 Participants |
| Age, Categorical Between 18 and 65 years | 13 Participants |
| Sex: Female, Male Female | 13 Participants |
| Sex: Female, Male Male | 8 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 15 / 21 |
| serious Total, serious adverse events | 12 / 21 |
Outcome results
Determine the Overall Objective Response
To determine the overall response rate in patients with acquired erlotinib hydrochloride- or gefitinibresistant advanced adenocarcinoma of the lung treated with dasatinib using the RECIST criteria. Response and progression will be evaluated in this study using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) Committee.22 Changes in only the largest diameter (uni-dimensional measurement) of the tumor lesions are used in the RECIST.
Time frame: 2 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Dasatinib | Determine the Overall Objective Response | Stable Disease (SD) | 6 participants |
| Dasatinib | Determine the Overall Objective Response | Progression of Disease (POD) | 13 participants |