Imetelstat as Maintenance Therapy After Initial Induction Chemotherapy in Non-small Cell Lung Cancer (NSCLC)

NCT ID: NCT01137968

Last Updated: 2016-01-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 116 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-05-31
• Study Completion Date: 2013-09-30

Brief Summary

The purpose of this is to evaluate the efficacy and safety of imetelstat (GRN163L) as maintenance therapy for patients with advanced stage NSCLC who have not progressed after 4 cycles of platinum based therapy.

Participants will be randomized in a 2:1 ratio to imetelstat + standard of care versus standard of care alone. Participants who received bevacizumab with their induction chemotherapy will continue to receive bevacizumab on this study.

Conditions

Non-small Cell Lung Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

imetelstat plus standard of care

imetelstat plus standard of care (bevacizumab or observation)

Group Type: EXPERIMENTAL

imetelstat

Intervention Type: DRUG

9.4 mg/kg over a 2 hour IV infusion on Day 1 and Day 8 of each 21 day cycle until disease progression.

Bevacizumab

Intervention Type: DRUG

Dosage and duration will be according to the FDA-approved bevacizumab package insert. Bevacizumab will be administered on Day 1 of each 21-day cycle.

Standard of care

Bevacizumab or observation

Group Type: OTHER

Bevacizumab

Intervention Type: DRUG

Dosage and duration will be according to the FDA-approved bevacizumab package insert. Bevacizumab will be administered on Day 1 of each 21-day cycle.

Interventions

imetelstat

9.4 mg/kg over a 2 hour IV infusion on Day 1 and Day 8 of each 21 day cycle until disease progression.

Intervention Type: DRUG

Bevacizumab

Dosage and duration will be according to the FDA-approved bevacizumab package insert. Bevacizumab will be administered on Day 1 of each 21-day cycle.

Intervention Type: DRUG

Other Intervention Names

GRN163L; Avastin

Eligibility Criteria

Inclusion Criteria

• Signed informed consent.
• Ability and willingness to comply with requirements of the study protocol.
• Male or female, age 18 or over.
• Histologically or cytologically confirmed diagnosis of NSCLC
• Stage IV (using the 7th edition of AJCC, or wet IIIb / IV using the 6th edition), or recurrent locally advanced disease not amenable to radiation or surgery with curative intent and not amenable to concurrent chemoradiation.
• Patients have completed four to six cycles of platinum-based chemotherapy doublet for first line, advanced NSCLC, with no evidence of disease progression according to RECIST version 1.1. Adjuvant chemotherapy greater than one year prior to progression is allowed.
• Patients are willing and able to continue treatment with bevacizumab, if they received it with their platinum based chemotherapy.
• ECOG performance status 0-1
• Adequate bone marrow reserve as measured by ANC ≥ 1500/mm3, hemoglobin

≥ 9 g/dL, platelet count ≥ 75,000 μL. Must be measured ≥ 1 week after last transfusion of blood products and/or last dose of hematopoietic growth factor.

• Prothrombin time (PT) or INR or aPTT ≤ 1.5 x ULN.
• Serum creatinine < 1.5 mg/dL or creatinine clearance > 45 mL/min.
• Urinalysis with < 2+ protein or urinary excretion of < 2 g of protein/day (for patients to receive bevacizumab).
• AST (SGOT) and ALT (SGPT) < 2.5 x the ULN, (AST (SGOT) and ALT (SGPT) < 5 x the ULN if documented liver metastases).
• Serum bilirubin < 2.0 mg/dL (patients with Gilbert's syndrome: serum bilirubin < 3 x ULN).
• Alkaline phosphatase < 2.5 x ULN (patients with documented liver or bone metastases, alkaline phosphatase ≤ 5 x ULN).
• No other obvious related major organ toxicities which would compromise the patient's ability to participate in a clinical trial of a novel agent.
• Patients may have received prior radiation therapy for local or locally advanced disease providing that any clinically significant adverse effects associated with prior therapy have recovered to Grade 1 or less.
• Women of childbearing potential must have a negative serum pregnancy test and agree to use effective birth control during and for 12 weeks after the last treatment with imetelstat.
• Males must agree to use effective birth control for themselves or their partner during and for 12 weeks after the last treatment with imetelstat.

Exclusion Criteria

Patients who meet any of the following criteria will be excluded from screening and study entry:

• Patients who are not eligible for induction therapy with a platinum based chemotherapy doublet.
• Patients who have received, or are scheduled to receive pemetrexed or erlotinib as maintenance therapy.
• Patients receiving bevacizumab must not have a recent history of hemoptysis ≥ ½ teaspoon of red blood or history of ≥ 2 g/24 hr urine protein while receiving prior bevacizumab, or squamous cell histology.

Patients will be excluded from being randomized if any of the following criteria apply:

• Last dose of induction chemotherapy < 21 days prior to randomization or > 42 days prior to randomization
• History of pulmonary hemorrhage (> 1 teaspoon) within the 4 weeks prior to randomization.
• Anti-platelet therapy within 2 weeks prior to randomization, other than low dose aspirin prophylaxis therapy.
• Therapeutic anticoagulation therapy except for low dose warfarin (e.g., 1 mg by mouth per day).
• Radiation therapy within 3 weeks prior to randomization (palliative radiation therapy is allowed, provided that sites of bone marrow production, i.e. iliac crests are not in the radiation field)
• Major surgery within 4 weeks prior to first study drug administration (central line placement is allowed)
• Active central nervous system (CNS) metastatic disease. Patients with stable CNS disease following completion of radiation therapy and/or surgery are eligible.
• Any other active malignancy
• Active or chronically recurrent bleeding (e.g., active peptic ulcer disease)
• Clinically significant infection
• Active autoimmune disease requiring immunosuppressive therapy
• Clinically significant cardiovascular disease or condition including:
• Congestive heart failure (CHF) requiring therapy
• Need for anti-arrhythmic therapy for a ventricular arrhythmia
• Severe conduction disturbance
• Angina pectoris requiring therapy
• Medically uncontrolled hypertension per the Investigator's discretion
• Myocardial infarction within 6 months prior to first study drug administration
• New York Heart Association Class II, III, or IV cardiovascular disease
• Any other severe, acute, or chronic medical or psychiatric condition, laboratory abnormality, or difficulty complying with protocol requirements that may increase the risk associated with study participation or study drug administration or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the patient inappropriate for the study.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Geron Corporation

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Joan Schiller, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas

Locations

Achieve Clinical Research, Llc

Birmingham, Alabama, United States

Clearview Cancer Institute

Huntsville, Alabama, United States

Pacific Cancer Medical Center, Inc.

Anaheim, California, United States

Cancer Care Associates of Fresno Medical Group Inc

Fresno, California, United States

St. Joseph's Hospital

Orange, California, United States

Kaiser Permanente Medical Center

Vallejo, California, United States

University of Colorado Denver School of Medicine

Aurora, Colorado, United States

Florida Cancer Specialists

Fort Myers, Florida, United States

Integrated Community Oncology Network

Jacksonville, Florida, United States

H. Moffitt Lee Cancer Center

Tampa, Florida, United States

Ingalls Memorial Hospital

Harvey, Illinois, United States

Cancer Center of Kansas

Wichita, Kansas, United States

Montgomery Cancer Center

Mount Sterling, Kentucky, United States

Auerbach Hematology Oncology

Baltimore, Maryland, United States

Karmanos Cancer Institute

Detroit, Michigan, United States

Hematology Oncology Centers

Billings, Montana, United States

Blumenthal Cancer Center

Charlotte, North Carolina, United States

Kaiser Northwest

Portland, Oregon, United States

South Carolina Oncology Associates

Columbia, South Carolina, United States

The Jones Clinic

Germantown, Tennessee, United States

Sarah Cannon Research Institute

Nashville, Tennessee, United States

UT Southwestern Medical Center

Dallas, Texas, United States

Scott and White Memorial Hospital (Texas A & M)

Temple, Texas, United States

Swedish Cancer Institute

Seattle, Washington, United States

Northwest Medical Specialties

Tacoma, Washington, United States

University of Wisconsin

Madison, Wisconsin, United States

Hôpital Charles Lemoyne

Greenfield Park, Quebec, Canada

Hospital Notre-Dame

Montreal, Quebec, Canada

Krankenhaus Grosshansdorf

Grosshansdorf, City state of Hamburg, Germany

Krankenhaus Nordwest

Frankfurt, Frankfurt, Germany

Universitaetsklinikum Mainz

Mainz, Mainz, Germany

Asklepios Klinik Gauting GmbH

Gauting, Munich, Germany

Klinikum rechts der Isar der TU München

München, Munich, Germany

Countries

United States; Canada; Germany

Other Identifiers

CP14B012

Identifier Type: -

Identifier Source: org_study_id