Trial Outcomes & Findings for Pemetrexed Plus Cisplatin Bi-Weekly, in Patients With Urothelial Cancer (Metastatic, Locally Advanced or Non-Resectable) (NCT NCT00374868)

NCT ID: NCT00374868

Last Updated: 2010-11-04

Results Overview

Best response recorded from the start of treatment until disease progression/recurrence using Response Evaluation Criteria In Solid Tumors (RECIST) criteria that defines when participants improve ("respond"), stay the same ("stable"), or worsen ("progression") during treatment. Complete response (CR) = disappearance of all target lesions. Partial response (PR) = 30% decrease in the sum of the longest diameter of target lesions. Progressive disease (PD) = 20% increase in the sum of the longest diameter of target lesions. Stable disease (SD) = small changes that do not meet above criteria.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

59 participants

Primary outcome timeframe

baseline to measured progressive disease (up to 620 days)

Results posted on

2010-11-04

Participant Flow

A total of 59 participants entered the trial (21 in Phase 1 and 38 in Phase 2). Phase 1 determined the dose for Phase 2 to be 400 mg/m\^2. Phase 2 results are reported.

Participant milestones

Participant milestones
Measure
Pemetrexed + Cisplatin
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Overall Study
STARTED
38
Overall Study
COMPLETED
2
Overall Study
NOT COMPLETED
36

Reasons for withdrawal

Reasons for withdrawal
Measure
Pemetrexed + Cisplatin
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Overall Study
Adverse Event
12
Overall Study
Progressive Disease
7
Overall Study
Physician Decision
13
Overall Study
Lost to Follow-up
1
Overall Study
Death
2
Overall Study
Other - Not Specified
1

Baseline Characteristics

Pemetrexed Plus Cisplatin Bi-Weekly, in Patients With Urothelial Cancer (Metastatic, Locally Advanced or Non-Resectable)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Age Continuous
67.1 years
STANDARD_DEVIATION 8.7 • n=5 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
Sex: Female, Male
Male
31 Participants
n=5 Participants
Region of Enrollment
Spain
38 participants
n=5 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
0 - Fully Active
21 participants
n=5 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
1 - Ambulatory, Restricted Strenuous Activity
15 participants
n=5 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
2 - Ambulatory, No Work Activities
2 participants
n=5 Participants
Location of Primary Tumor
Bladder
32 participants
n=5 Participants
Location of Primary Tumor
Ureter
1 participants
n=5 Participants
Location of Primary Tumor
Urethra
1 participants
n=5 Participants
Location of Primary Tumor
Renal Pelvis
4 participants
n=5 Participants
Height
166 centimeters
STANDARD_DEVIATION 7.5 • n=5 Participants
Weight
77.4 kilograms
STANDARD_DEVIATION 13.2 • n=5 Participants

PRIMARY outcome

Timeframe: baseline to measured progressive disease (up to 620 days)

Best response recorded from the start of treatment until disease progression/recurrence using Response Evaluation Criteria In Solid Tumors (RECIST) criteria that defines when participants improve ("respond"), stay the same ("stable"), or worsen ("progression") during treatment. Complete response (CR) = disappearance of all target lesions. Partial response (PR) = 30% decrease in the sum of the longest diameter of target lesions. Progressive disease (PD) = 20% increase in the sum of the longest diameter of target lesions. Stable disease (SD) = small changes that do not meet above criteria.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Best Overall Tumor Response
Complete Response
2 participants
Best Overall Tumor Response
Partial Response
13 participants
Best Overall Tumor Response
Stable Disease
13 participants
Best Overall Tumor Response
Progressive Disease
1 participants
Best Overall Tumor Response
Not Evaluated
3 participants
Best Overall Tumor Response
Not Performed
3 participants
Best Overall Tumor Response
Missing
3 participants

SECONDARY outcome

Timeframe: baseline to response (up to 620 days)

Population: 16 patients were censored.

Defined as time from study enrollment to the first Complete Response or Partial Response (using RECIST criteria). Complete response (CR) = disappearance of all target lesions. Partial response (PR) = 30% decrease in the sum of the longest diameter of target lesions.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Time to Response
111.816 days
Standard Error 6.480

SECONDARY outcome

Timeframe: time of response to progressive disease (up to 620 days)

Population: 10 patients were censored.

The duration of a complete response (CR) or partial response (PR) was defined as the time from first objective status assessment of CR or PR to the first time of progression or death as a result of any cause. Complete response (CR) = disappearance of all target lesions. Partial response (PR) = 30% decrease in the sum of the longest diameter of target lesions.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Duration of Response
184.100 days
Standard Error 19.595

SECONDARY outcome

Timeframe: time of no response or progression (up to 620 days)

Population: 1 patient was censored.

Defined as time from study enrollment to the first progression of disease, complete response, partial response, or death from any cause. Complete response (CR) = disappearance of all target lesions. Partial response (PR) = 30% decrease in the sum of the longest diameter of target lesions. Progressive disease (PD) = 20% increase in the sum of the longest diameter of target lesions. Stable disease (SD) = small changes that do not meet above criteria.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Duration of Stable Disease
80 days
Interval 71.0 to 103.0

SECONDARY outcome

Timeframe: baseline to measured progressive disease (up to 620 days)

Population: 19 patients were censored

Defined as the time from study enrollment to the first date of disease progression. Time to disease progression was censored at the date of death if death was due to other cause. Progressive disease (PD) = 20% increase in the sum of the longest diameter of target lesions.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Time to Progressive Disease
260.182 days
Standard Error 22.954

SECONDARY outcome

Timeframe: baseline to stopping treatment (up to 620 days)

Population: 1 patient was censored

Time from study enrollment to first observation of disease progression, death from any cause, or early discontinuation of treatment (including toxicity or if patient had stable disease after 4 cycles). TTF was censored at date of last follow-up visit for patients who did not discontinue early, who were still alive, and who had not progressed.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Time to Treatment Failure (TTF)
133.5 days
Interval 99.0 to 151.0

SECONDARY outcome

Timeframe: baseline to measured progressive disease (up to 620 days)

Population: 11 patients were censored

Defined as the time from study enrollment until disease progression or death from any cause.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Progression-Free Survival
203 days
Interval 137.0 to 285.0

SECONDARY outcome

Timeframe: baseline to date of death from any cause (up to 620 days)

Population: 20 patients were censored.

Overall survival is the duration from enrollment to death. For patients who are alive, overall survival is censored at the last contact.

Outcome measures

Outcome measures
Measure
Pemetrexed + Cisplatin
n=38 Participants
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Overall Survival
264.190 days
Standard Error 15.130

Adverse Events

Pemetrexed + Cisplatin

Serious events: 16 serious events
Other events: 38 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Pemetrexed + Cisplatin
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Blood and lymphatic system disorders
Anaemia
2.6%
1/38 • Number of events 3
Blood and lymphatic system disorders
Febrile neutropenia
2.6%
1/38 • Number of events 1
Blood and lymphatic system disorders
Leukopenia
7.9%
3/38 • Number of events 4
Blood and lymphatic system disorders
Neutropenia
10.5%
4/38 • Number of events 5
Blood and lymphatic system disorders
Thrombocytopenia
2.6%
1/38 • Number of events 1
Cardiac disorders
Cardio-respiratory arrest
2.6%
1/38 • Number of events 1
Gastrointestinal disorders
Abdominal pain
2.6%
1/38 • Number of events 1
Gastrointestinal disorders
Diarrhoea
7.9%
3/38 • Number of events 3
Gastrointestinal disorders
Dyspepsia
2.6%
1/38 • Number of events 1
Gastrointestinal disorders
Nausea
5.3%
2/38 • Number of events 2
Gastrointestinal disorders
Vomiting
7.9%
3/38 • Number of events 3
General disorders
Asthenia
2.6%
1/38 • Number of events 1
General disorders
Pyrexia
7.9%
3/38 • Number of events 3
Infections and infestations
Pseudomonal sepsis
2.6%
1/38 • Number of events 1
Infections and infestations
Urinary tract infection
7.9%
3/38 • Number of events 3
Investigations
Blood electrolytes abnormal
2.6%
1/38 • Number of events 1
Metabolism and nutrition disorders
Anorexia
2.6%
1/38 • Number of events 1
Musculoskeletal and connective tissue disorders
Bone pain
2.6%
1/38 • Number of events 1
Renal and urinary disorders
Renal failure
5.3%
2/38 • Number of events 2
Renal and urinary disorders
Renal impairment
2.6%
1/38 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnoea
2.6%
1/38 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
5.3%
2/38 • Number of events 2
Vascular disorders
Deep vein thrombosis
10.5%
4/38 • Number of events 4

Other adverse events

Other adverse events
Measure
Pemetrexed + Cisplatin
Pemetrexed: phase 1 determined dose=400 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy Cisplatin: 50 mg/m2, intravenous (IV), days 1 and 15 every 28 days until disease progression, unacceptable toxicity or patient decision to discontinue or 6 cycles of therapy
Blood and lymphatic system disorders
Anaemia
21.1%
8/38 • Number of events 12
Blood and lymphatic system disorders
Neutropenia
5.3%
2/38 • Number of events 3
Blood and lymphatic system disorders
Thrombocytopenia
7.9%
3/38 • Number of events 7
Ear and labyrinth disorders
Tinnitus
5.3%
2/38 • Number of events 2
Eye disorders
Conjunctivitis
10.5%
4/38 • Number of events 4
Gastrointestinal disorders
Abdominal discomfort
5.3%
2/38 • Number of events 3
Gastrointestinal disorders
Abdominal pain
26.3%
10/38 • Number of events 10
Gastrointestinal disorders
Abdominal pain lower
5.3%
2/38 • Number of events 2
Gastrointestinal disorders
Abdominal pain upper
13.2%
5/38 • Number of events 5
Gastrointestinal disorders
Constipation
26.3%
10/38 • Number of events 18
Gastrointestinal disorders
Diarrhoea
47.4%
18/38 • Number of events 32
Gastrointestinal disorders
Dry mouth
5.3%
2/38 • Number of events 2
Gastrointestinal disorders
Dyspepsia
10.5%
4/38 • Number of events 4
Gastrointestinal disorders
Nausea
52.6%
20/38 • Number of events 48
Gastrointestinal disorders
Stomatitis
5.3%
2/38 • Number of events 4
Gastrointestinal disorders
Tongue ulceration
5.3%
2/38 • Number of events 2
Gastrointestinal disorders
Vomiting
52.6%
20/38 • Number of events 30
General disorders
Asthenia
76.3%
29/38 • Number of events 82
General disorders
Chest pain
5.3%
2/38 • Number of events 2
General disorders
Gait disturbance
7.9%
3/38 • Number of events 3
General disorders
Mucosal inflammation
36.8%
14/38 • Number of events 33
General disorders
Oedema
10.5%
4/38 • Number of events 6
General disorders
Oedema peripheral
15.8%
6/38 • Number of events 10
General disorders
Pyrexia
7.9%
3/38 • Number of events 6
Infections and infestations
Influenza
5.3%
2/38 • Number of events 2
Infections and infestations
Nasopharyngitis
5.3%
2/38 • Number of events 2
Infections and infestations
Urinary tract infection
5.3%
2/38 • Number of events 2
Investigations
Alanine aminotransferase increased
5.3%
2/38 • Number of events 2
Investigations
Aspartate aminotransferase increased
5.3%
2/38 • Number of events 2
Investigations
Gamma-glutamyltransferase increased
5.3%
2/38 • Number of events 2
Investigations
Weight decreased
5.3%
2/38 • Number of events 2
Metabolism and nutrition disorders
Anorexia
50.0%
19/38 • Number of events 26
Metabolism and nutrition disorders
Decreased appetite
10.5%
4/38 • Number of events 4
Metabolism and nutrition disorders
Diabetes mellitus
5.3%
2/38 • Number of events 2
Metabolism and nutrition disorders
Dyslipidaemia
5.3%
2/38 • Number of events 2
Musculoskeletal and connective tissue disorders
Back pain
18.4%
7/38 • Number of events 8
Musculoskeletal and connective tissue disorders
Limb discomfort
5.3%
2/38 • Number of events 2
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
5.3%
2/38 • Number of events 2
Musculoskeletal and connective tissue disorders
Pain in extremity
5.3%
2/38 • Number of events 2
Nervous system disorders
Dizziness
7.9%
3/38 • Number of events 3
Nervous system disorders
Dysgeusia
18.4%
7/38 • Number of events 12
Nervous system disorders
Headache
7.9%
3/38 • Number of events 3
Nervous system disorders
Neuropathy
5.3%
2/38 • Number of events 2
Nervous system disorders
Paraesthesia
13.2%
5/38 • Number of events 10
Nervous system disorders
Tremor
5.3%
2/38 • Number of events 2
Psychiatric disorders
Depression
5.3%
2/38 • Number of events 2
Psychiatric disorders
Insomnia
7.9%
3/38 • Number of events 3
Renal and urinary disorders
Dysuria
7.9%
3/38 • Number of events 3
Renal and urinary disorders
Haematuria
5.3%
2/38 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Cough
5.3%
2/38 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Dyspnoea
13.2%
5/38 • Number of events 6
Respiratory, thoracic and mediastinal disorders
Epistaxis
5.3%
2/38 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Hiccups
5.3%
2/38 • Number of events 2
Skin and subcutaneous tissue disorders
Erythema
7.9%
3/38 • Number of events 4
Skin and subcutaneous tissue disorders
Pruritus
5.3%
2/38 • Number of events 2
Skin and subcutaneous tissue disorders
Rash
10.5%
4/38 • Number of events 4
Vascular disorders
Deep vein thrombosis
5.3%
2/38 • Number of events 2
Vascular disorders
Hypertension
13.2%
5/38 • Number of events 5

Additional Information

Chief Medical Officer

Eli Lilly and Company

Phone: 800-545-5979

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60