Trial Outcomes & Findings for Hydroxychloroquine With or Without Erlotinib in Advanced Non-small Cell Lung Cancer (NSCLC) (NCT NCT01026844)

NCT ID: NCT01026844

Last Updated: 2017-01-30

Results Overview

HCQ doses tested included 400mg, 600mg, 800mg, and 1000mg. Dose-limiting toxicities (DLTs) were defined as CTC of grade 2 or higher retinopathy or keratitis, or CTC of grade 3 or higher hematologic, skin, CNS, neuropathic, cardiac, respiratory, gastrointestinal, or renal AEs in the first cycle considered at least possibly related to HCQ. If a DLT was observed, an additional three patients were enrolled at that dose level. The maximum tolerated dose for HCQ in each arm would be defined as one dose level below that at which two or more of 6 patients experienced a DLT, or if no DLTs were observed, the highest tested dose.

Recruitment status

TERMINATED

Study phase

PHASE1

Target enrollment

27 participants

Primary outcome timeframe

2 years

Results posted on

2017-01-30

Participant Flow

Twenty-seven patients were enrolled between August 2007 and May 2010. They were all patients at Mass General Hospital Cancer Center

Participant milestones

Participant milestones
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Overall Study
STARTED
19
8
Overall Study
COMPLETED
19
8
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Hydroxychloroquine With or Without Erlotinib in Advanced Non-small Cell Lung Cancer (NSCLC)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=19 Participants
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 Participants
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Total
n=27 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
Age, Categorical
>=65 years
10 Participants
n=5 Participants
2 Participants
n=7 Participants
12 Participants
n=5 Participants
Age, Continuous
65 years
n=5 Participants
61 years
n=7 Participants
64 years
n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
5 Participants
n=7 Participants
15 Participants
n=5 Participants
Sex: Female, Male
Male
9 Participants
n=5 Participants
3 Participants
n=7 Participants
12 Participants
n=5 Participants
Region of Enrollment
United States
19 participants
n=5 Participants
8 participants
n=7 Participants
27 participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 years

Population: In October 2008, after enrollment of 18 patients (8 on arm A and 10 on arm B), the study was amended to limit enrollment to arm B only (HCQ plus erlotinib) given the increasing preclinical evidence supporting a role for combination therapy (but not HCQ monotherapy) and to help increase overall patient accrual.

HCQ doses tested included 400mg, 600mg, 800mg, and 1000mg. Dose-limiting toxicities (DLTs) were defined as CTC of grade 2 or higher retinopathy or keratitis, or CTC of grade 3 or higher hematologic, skin, CNS, neuropathic, cardiac, respiratory, gastrointestinal, or renal AEs in the first cycle considered at least possibly related to HCQ. If a DLT was observed, an additional three patients were enrolled at that dose level. The maximum tolerated dose for HCQ in each arm would be defined as one dose level below that at which two or more of 6 patients experienced a DLT, or if no DLTs were observed, the highest tested dose.

Outcome measures

Outcome measures
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=19 Participants
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 Participants
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Describe the Number and Type of Observed Dose Limiting Toxcities
0 participants
0 participants

SECONDARY outcome

Timeframe: 2 years

Population: The patients participating in the randomized portion of the study were analyzed for PK parameters. When the HCQ alone arm of the study was closed, PK measurements were no longer performed

PK parameter tested was dose normalized minimum steady state concentration (Cmin SS) of HCQ in micromolar per gram. Note this outcome was only analyzed for the first 21 patients enrolled, 13 on erlotinib/HCQ and 8 on HCQ arm.

Outcome measures

Outcome measures
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=13 Participants
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 Participants
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Determine the Pharmacokinetic (PK) Parameters of Hydroxychloroquine (HCQ) Plus Erlotinib.
5.93 micromolar per gram
Standard Deviation 2.51
9.40 micromolar per gram
Standard Deviation 5.85

SECONDARY outcome

Timeframe: 2 years

Number of Response Evaluation Criteria in Solid Tumors (RECIST) responses divided by number of patients treated. Per RECIST version 1.0 complete response (CR) is defined as disappearance of all target lesions; Partial Response (PR) is defined as \>=30% decrease in the sum of the longest diameter of target lesions. The objective tumor response rate is the CR + PR divided by the total number of patients

Outcome measures

Outcome measures
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=19 Participants
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 Participants
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Objective Tumor Response Rate
5 percentage of patients
Interval 1.0 to 25.0
0 percentage of patients
Interval 0.0 to 34.0

SECONDARY outcome

Timeframe: 2 years

Population: Because so few responses were observed, this exploratory outcome was not analyzed

Outcome measures

Outcome data not reported

Adverse Events

Erlotinib Plus HCQ (Hydroxychloroquine)

Serious events: 6 serious events
Other events: 15 other events
Deaths: 0 deaths

HCQ (Hydroxychloroquine)

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=19 participants at risk
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 participants at risk
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Skin and subcutaneous tissue disorders
rash
5.3%
1/19 • Number of events 1
0.00%
0/8
Gastrointestinal disorders
nausea
5.3%
1/19 • Number of events 1
0.00%
0/8
Gastrointestinal disorders
dehydration
5.3%
1/19 • Number of events 1
0.00%
0/8
Skin and subcutaneous tissue disorders
nail changes
5.3%
1/19 • Number of events 1
0.00%
0/8
Blood and lymphatic system disorders
anemia
5.3%
1/19 • Number of events 1
0.00%
0/8
Respiratory, thoracic and mediastinal disorders
pneumonitis
5.3%
1/19 • Number of events 1
0.00%
0/8

Other adverse events

Other adverse events
Measure
Erlotinib Plus HCQ (Hydroxychloroquine)
n=19 participants at risk
Erlotinib at 150mg QD and HCQ at escalating doses (400mg, 600mg, 800mg and 1000mg QD)
HCQ (Hydroxychloroquine)
n=8 participants at risk
HCQ at escalating doses (400mg, 600mg, 800mg, and 1000mg QD)
Skin and subcutaneous tissue disorders
rash
52.6%
10/19 • Number of events 10
0.00%
0/8
Gastrointestinal disorders
diarrhea
47.4%
9/19 • Number of events 9
0.00%
0/8
Gastrointestinal disorders
nausea
47.4%
9/19 • Number of events 9
37.5%
3/8 • Number of events 3
General disorders
fatigue
36.8%
7/19 • Number of events 7
12.5%
1/8 • Number of events 1

Additional Information

Lecia Sequist, MD

Massachusetts General Hospital

Phone: 617-724-4000

Results disclosure agreements

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