Cilengitide and Whole-Brain Radiation Therapy in Treating Patients With Brain Metastases From Lung Cancer (CIRAB)

Universitätsmedizin Mannheim

Status and phase

Completed

Phase 1

Conditions

Brain and Central Nervous System Tumors

Lung Cancer

Treatments

Drug: cilengitide

Radiation: radiation therapy

Other: pharmacological study

Study type

Interventional

Funder types

Other

Identifiers

NCT00884598

EUDRACT-2008-004573-17

HUMCM-CIRAB

CDR0000636508

Details and patient eligibility

About

RATIONALE: Cilengitide may stop the growth of brain metastases by blocking blood flow to the tumor. Radiation therapy uses high energy X-rays to kill tumor cells. Giving cilengitide together with radiation therapy may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of cilengitide when given together with whole-brain radiation therapy in treating patients with brain metastases from lung cancer.

Full description

OBJECTIVES:

Primary
- To assess the safety and tolerability of daily cilengitide by determining its dose-limiting toxicity and maximum-tolerated dose when combined with concomitant fractionated whole-brain radiation therapy in patients with brain metastases from lung cancer.
Secondary
- To collect evidence of the best overall response rate, overall survival, brain-specific progression-free survival, and tumor-specific progression-free survival of these patients.
- To collect evidence of changes in functional MRI imaging studies at 6 and 12 weeks after initiation of therapy.
- To collect evidence of early response by functional MRI (ASL technique) on days 1, 4, and 12, immediately before and after the administration of cilengitide.
- To collect evidence of changes in neurological and neurocognitive function tests at 6 and 12 weeks after initiation of therapy.
- To further evaluate the safety and toxicity of the combination of cilengitide and whole-brain radiation therapy.
- To further evaluate the pharmacokinetics of cilengitide administered daily.

OUTLINE:

Patients receive oral cilengitide once daily and undergo whole-brain radiotherapy on the same days. Treatment continues for 2 weeks in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection on days 1, 4, 5, and 12 for pharmacokinetic studies.

After completion of study treatment, patients are followed for 10 weeks.

Enrollment

19 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

DISEASE CHARACTERISTICS:

Histologically confirmed lung cancer (small cell or non-small cell lung cancer)
Patient must be eligible for whole-brain radiotherapy
Presence of brain metastasis (single or multiple, synchronous or metachronous) from lung cancer not amenable to surgery or radiosurgery (presence of metastases at any other site is allowed)
No leptomeningeal metastasis or known subarachnoid spread of tumor

PATIENT CHARACTERISTICS:

ECOG performance status (PS) 0-1 (ECOG PS 2 allowed if due to the presence of cerebral metastases and not due to a high peripheral-tumor load or other reasons)
Life expectancy ≥ 3 months
Adequate hematologic function
Total bilirubin < 1.5 times upper limit of normal (ULN)
AST, ALT, and alkaline phosphatase < 2.5 times ULN
Creatinine clearance > 60 mL/min
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 6 months after completion of study treatment
No history of acute or chronic renal disease
No other malignancies treated within the past 5 years, except adequately treated carcinoma in situ of the cervix or basal cell carcinoma of the skin
No uncontrolled hypertension
No history of coagulation disorder associated with bleeding or recurrent thrombotic events
No peptic ulcer disease within the past 6 months
No congestive heart failure, high risk for uncontrolled arrhythmia, or history of clinically significant coronary heart disease
No known alcohol or drug abuse
No other significant or acute concomitant disease
No dementia or altered mental status

PRIOR CONCURRENT THERAPY:

See Disease Characteristics
Concurrent corticosteroids allowed if the dosing regimen has ben stable ≥ 5 days
Concurrent anticonvulsants allowed if the dosing regimen has been stable for the past week
More than 30 days since prior participation in another clinical trial
No concurrent anticoagulation with vitamin K antagonists, therapeutic-dose anticoagulation with heparin resulting in prolonged PTT, or therapeutic-dose anticoagulation with low molecular weight heparin (low-dose [i.e. prophylactic], low molecular weight heparins allowed)
No prior whole-brain radiation or radiosurgery
No prior antiangiogenic therapy
No other concurrent anticancer therapy