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Bendamustine as Second-Line Therapy in Treating Patients With Relapsed or Refractory Small Cell Lung Cancer

Phase II Study of Second-Line Bendamustine in Relapsed or Refractory Small Cell Lung Cancer (SCLC).

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00984542
Enrollment
50
Registered
2009-09-25
Start date
2009-09-30
Completion date
2012-09-30
Last updated
2014-03-12

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

Conditions

Lung Cancer

Keywords

recurrent small cell lung cancer

Brief summary

RATIONALE: Drugs used in chemotherapy, such as bendamustine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. PURPOSE: This phase II trial is studying how well bendamustine works as second- or third-line therapy in treating patients with relapsed or refractory small cell lung cancer.

Detailed description

OBJECTIVES: Primary * To determine the time to progression in patients with relapsed or refractory small cell lung cancer treated with second- or third-line bendamustine. Secondary * To determine the toxicity of this drug in these patients. * To determine the response rate, progression-free survival, and overall survival of patients treated with this drug. OUTLINE: This is a multicenter study. Patients receive bendamustine IV over 1 hour on days 1 and 2. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6-8 weeks.

Interventions

DRUGbendamustine hydrochloride

Bendamustine 120 mg/m2 IV on days 1 and 2 of a 21-day treatment cycle

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Vanderbilt-Ingram Cancer Center
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

DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed small cell lung cancer * Relapsed or refractory disease after 1-2 prior chemotherapy regimens * Measurable disease * ECOG - Eastern Cooperative Oncology Group performance status 0-2 * ANC ≥ 1,500/mm³: ANC = Absolute neutrophil count * Platelet count ≥ 100,000/mm³ * Hemoglobin ≥ 9 g/dL * Bilirubin normal * AST/ALT ≤ 2 times upper limit of normal (ULN) (≤ 5 times ULN in patients with hepatic metastases; AST/ALT = alanine transaminase (ALT) and aspartate aminotransferase (AST) * Creatinine clearance \> 40 mL/min * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception before, during, and for ≥ 3 months after completion of study therapy * No known hypersensitivity to bendamustine * No other malignancy for which the patient has been treated within the past year except for nonmelanoma skin cancer or carcinoma in situ of the cervix * No cardiac disease, including any of the following: * Unstable angina pectoris * Life-threatening cardiac arrhythmia * Symptomatic congestive heart failure * No uncontrolled infection * No other concurrent chemotherapy, immunotherapy, or anti-tumor hormonal therapy

Design outcomes

Primary

MeasureTime frameDescription
Time to ProgressionOn-study to date of progression, measured following cycle 2, 4, and 6 of a 21-day cycle for 6 cycles, (during 126 days)Estimated probable duration from on-study date to date of disease progression, using the Kaplan-Meier method with censoring (see analysis population description for additional details). Disease progression is defined under RECIST v1.1 as \>=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.

Secondary

MeasureTime frameDescription
Number of Patients With Each Worst-grade ToxicityDay 1 of each 21-day cycle for 6 cycles and at 30 days after end of treatment, at 156 daysNumber of patients with worst-grade toxicity at each of five grades following NCI Common Toxicity Criteria with grade 1 = mild, grade 2 = moderate, grade 3 = severe, grade 4 = life-threatening/disabling, 5 = death.
Best ResponseOn-treatment date to date of disease progression, following cycle 2, 4, and 6 of a 21-day cycle for 6 cycles, (assessed up to 126 days)Number of patients in each response category, per RECIST v1.1, summarized as follows for target lesion criteria (see RECIST v1.1 for additional details): complete response (CR),disappearance of target lesions; partial response (PR), \>=30% decrease in sum of longest diameter of target lesions; progressive disease (PD), \>=20% increase in sum of LD of target lesions or appearance of new lesions; stable disease (SD), insufficient change in target lesions or new lesions to qualify as either PD or SD. Patients are categorized according to the best response achieved prior to occurrence of progressive disease, where best response hierarchy is CR\>PR\>SD\>PD.
Progression-free SurvivalOn-study date to lesser of date of progression or date of death from any cause ,measured following cycle 2, 4, 6 of a 21-day cycle for 6 cycles, (assessed up to 126 days)Estimated probable duration of life without disease progression, from on-study date to earlier of progression date or date of death from any cause, using the Kaplan-Meier method with censoring (see analysis population description for additional details). Disease progression is defined under RECIST v1.1 as \>=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.
Overall SurvivalOn study to date of death from any cause or last date known alive, measured every 6-8 weeks from the end of treatment, up to 31 monthsEstimated probable duration of life from on-study date to date of death from any cause, using the Kaplan-Meier method with censoring (see analysis population description for additional details)

Countries

United States

Participant flow

Recruitment details

This study opened to accrual in September 2009 and closed to accrual in February 2012

Pre-assignment details

59 patients consented, 9 were determined to be ineligible to participate

Participants by arm

ArmCount
Bendamustine
Bendamustine 120 mg/m2 of body surface area intravenously on days 1 and 2 of a 21-day treatment cycle for a maximum of six cycles
50
Total50

Withdrawals & dropouts

PeriodReasonFG000
Overall Studyclinical deterioration2
Overall Studycomplicating disease3
Overall StudyDeath7
Overall Studydisease progression19
Overall Studytoxicity7
Overall StudyWithdrawal by Subject3

Baseline characteristics

CharacteristicBendamustine
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
16 Participants
Age, Categorical
Between 18 and 65 years
34 Participants
Age, Continuous62 years
STANDARD_DEVIATION 8
Region of Enrollment
United States
50 participants
Sex: Female, Male
Female
22 Participants
Sex: Female, Male
Male
28 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
50 / 50
serious
Total, serious adverse events
27 / 50

Outcome results

Primary

Time to Progression

Estimated probable duration from on-study date to date of disease progression, using the Kaplan-Meier method with censoring (see analysis population description for additional details). Disease progression is defined under RECIST v1.1 as \>=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.

Time frame: On-study to date of progression, measured following cycle 2, 4, and 6 of a 21-day cycle for 6 cycles, (during 126 days)

Population: All patients are included in the analysis on intention-to treat basis. Analysis is by Kaplan-Meier method, where progression is an event, with censoring for non-progressed patients at greater of off-study date, last known alive date, or date of death not attributable to disease progression.

ArmMeasureValue (MEDIAN)
BendamustineTime to Progression123 days
Secondary

Best Response

Number of patients in each response category, per RECIST v1.1, summarized as follows for target lesion criteria (see RECIST v1.1 for additional details): complete response (CR),disappearance of target lesions; partial response (PR), \>=30% decrease in sum of longest diameter of target lesions; progressive disease (PD), \>=20% increase in sum of LD of target lesions or appearance of new lesions; stable disease (SD), insufficient change in target lesions or new lesions to qualify as either PD or SD. Patients are categorized according to the best response achieved prior to occurrence of progressive disease, where best response hierarchy is CR\>PR\>SD\>PD.

Time frame: On-treatment date to date of disease progression, following cycle 2, 4, and 6 of a 21-day cycle for 6 cycles, (assessed up to 126 days)

Population: All patients with best overall response data; patients are excluded if best overall response data is missing or if the patient is non-evaluable for best overall response. 8 patients were not evaluable.

ArmMeasureGroupValue (NUMBER)
BendamustineBest ResponseComplete Response1 participants
BendamustineBest ResponsePartial Response10 participants
BendamustineBest ResponseProgressive Disease14 participants
BendamustineBest ResponseStable Disease17 participants
Secondary

Number of Patients With Each Worst-grade Toxicity

Number of patients with worst-grade toxicity at each of five grades following NCI Common Toxicity Criteria with grade 1 = mild, grade 2 = moderate, grade 3 = severe, grade 4 = life-threatening/disabling, 5 = death.

Time frame: Day 1 of each 21-day cycle for 6 cycles and at 30 days after end of treatment, at 156 days

Population: Total number of patients reported with any toxicity

ArmMeasureGroupValue (NUMBER)
BendamustineNumber of Patients With Each Worst-grade ToxicityNumber of patients with worst-grade toxicity of 11 participants
BendamustineNumber of Patients With Each Worst-grade ToxicityNumber of patients with worst-grade toxicity of 214 participants
BendamustineNumber of Patients With Each Worst-grade ToxicityNumber of patients with worst-grade toxicity of 321 participants
BendamustineNumber of Patients With Each Worst-grade ToxicityNumber of patients with worst-grade toxicity of 45 participants
BendamustineNumber of Patients With Each Worst-grade ToxicityNumber of patients with worst-grade toxicity of 59 participants
Secondary

Overall Survival

Estimated probable duration of life from on-study date to date of death from any cause, using the Kaplan-Meier method with censoring (see analysis population description for additional details)

Time frame: On study to date of death from any cause or last date known alive, measured every 6-8 weeks from the end of treatment, up to 31 months

Population: All patients are included in the analysis on intention-to-treat basis. Analysis is by Kaplan-Meier method, where death is an event, with censoring for non-expired patients at greater of off-study date or last known alive date.

ArmMeasureValue (MEDIAN)
BendamustineOverall Survival144 days
Secondary

Progression-free Survival

Estimated probable duration of life without disease progression, from on-study date to earlier of progression date or date of death from any cause, using the Kaplan-Meier method with censoring (see analysis population description for additional details). Disease progression is defined under RECIST v1.1 as \>=20% increase in sum of longest diameters of target lesions, unequivocal progression of non-target lesions, or appearance of new lesions.

Time frame: On-study date to lesser of date of progression or date of death from any cause ,measured following cycle 2, 4, 6 of a 21-day cycle for 6 cycles, (assessed up to 126 days)

Population: All patients are included in the analysis on intention-to-treat basis. Analysis is by Kaplan-Meier method, where either death or progression is an event, with censoring for non-progressed, non-expired patients at greater of off-study date or last known alive date.

ArmMeasureValue (MEDIAN)
BendamustineProgression-free Survival98 days

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